ROLE OF VITAMINES & MINERALS IN PSYCHOLOGICAL ILLNESS

ROLE OF NEUTRITIONAL THERAPY IN PSYCHIATRY
DIETARY REGULATIONS IN PSYCHOLOGICAL PROBLEMS
Psychiatric disorders like Schizophrenia, Depression, anxiety, Obsessive compulsive disorder are common in today’s stress-ful era. In resent research increasing evidence about the effect of trace elements, vitamins, on brain & behavior is appearing as well, for example- Schizophrenics were found to have very low serum iron levels.
Dr Deshmukh revived resent clinical research in world for use of these nutrients in psychiatric illnesses -
1} The role of dietary nutrients in Schizophrenia – newer studies have found that resistant cases of Schizophrenia respond well to high doses of minerals like Zinc, Copper, Magnesium ( Play role at NMDA receptors in brain), Iron ( Low level of serum Iron found in clinical research). Vitamin’s like - Niacinamide, Pyridoxine( B6), Riboflavin, B12, Folate. Study conducted in United Stats also suggests use of Omega-3 fatty acid, Free fatty acid/ Arachidonic acid can lead o significant improvement. These treatments are available in India also but routinely ignored by practicing psychiatrist. Dietary changes can help Schizophrenic patients in better outcome and should be advised.
2} The role of dietary nutrients in Depression – Folic acid ( B9 ), Pyridoxine( B6 100mg/day), Vita B12. Also Zinc, Copper, Magnesium and use of Omega-3 fatty acid can help in better outcome
3} The role of dietary nutrients in Anxiety / panic / phobic disorder:- Via B1, (250mg/ day), Vita B6 , Niacinamide (100mg/day)
4} The role of dietary nutrients in O.C.D. (obsessive compulsive disorder):- Vitamin B-6
5} The role of dietary nutrients in Autism :- Vita B6( pyridoxine 300mg/day), Magnesium (10/kg/day), Omega-3 fatty acid.
6) Mood swings and Irritability commonly seen with deficiencies of Zinc, Copper, Magnesium, Manganese, & Vitamin B12, B-6, Riboflavin, Nicotinic acid, Folate.
7} Conditions like Dementia ( Vita C & E), Tardive Dyskinesia ( Vita B6), Epillepsy/ Seizer ( Niacinamide)
It is essential that treating psychiatrist should know about these simple dietary requirements of patients with these illnesses and advise changes accordingly.

Dr. Deshmukh MBBS, MIPS, MD Psychiatrist

RECENT ADVANCES IN TREATMENT OF SCHIZOPHRENIA / MENTAL ILLNESS

TREATMENT OF SCHIZOPHRENIA / MENTAL ILLNESS IN PUNE :-
Schizophrenia / psychosis are illness due to brain pathology. Neuro- transmitter like Dopamine dis-regulation play major role in etiology. Genetic also plays important role in etiology. Neuro-structural changes can be seen on MRI studies. MRI brain should always be done as 1st line investigation to rule out brain pathology.

(1) Schizophrenia is long term illness that require medication for long duration may be life long. Patient should not hesitate continuing medication for long time as newer molecules are safer, prevent long term cognitive deterioration, prevent further episodes, and benefits of continuing medications are significantly more than risk or side effect of continuation of these medicines. (2) Newer drugs ( Olanzapine, Amisulpride, Quetiapine, Aripiprazol, Risperidone) are more effective in controlling negative symptoms as well as positive symptoms also. Patients should ask treating Psychiatrist about them as risk of tremors, Extrapyramidal symptoms, Tardive Dyskinesia, drowsiness is less common with these drugs. (3) Clozapin is more useful in resistant and poorly responding patients but white blood cell count required to be monitored considering risk of agranulocytosis. (4) More negative symptoms / cognitive problems are present in patient with long term illness. (5) Omega 3 fatty acids are useful in resistant cases but are costly. (6) Counseling & Depot injectable will help in better compliance (Once in month) which in term help patient in better response. (7) Mouth dissolving preparation of medicine are available which are color less/ odor less/ and test less so can be dissolved in food of un-cooperative patient or patient who is not ready to accept medication due to poor understanding about illness. (8) The role of dietary nutrients in Schizophrenia – newer studies have found that resistant cases of Schizophrenia respond well to high doses of minerals like Zinc, Copper, Magnesium ( Play role at NMDA receptors in brain), Iron ( Low level of serum Iron found in clinical research). Vitamin’s like - Niacinamide, Pyridoxine( B6), Riboflavin, B12, Folate. Study conducted in United Stats also suggest use of Omega-3 fatty acid, Free fatty acid/ Arachidonic acid can lead o significant improvement. These treatments are available in India also but routinely ignored by practicing psychiatrist. Dietary changes can help Schizophrenic patients in better outcome and should be advised. (9) Govt.of India has given disability benefits to these patients with Schizophrenia and can get pension/ Travel & Incom tax concession / also continuation of pension of there parents. Relative should ask treating Psychiatrist about Disability certificate. (10) Proper training & rehabilitation can help patient in regaining his lost cognitive , social, occupational, functioning and better treatment outcome on long run. ( 11)  rTMS, Transcranial Magnetic Stimulation is newer development in treatment of Schizophrenia ( approved by US FDA in 2008), now it is available in India in few centers like Pune. Cost of therapy is low and effects are seen in 10 days. rTMS is very safe and effective treatment for resistant cases, for patients not tolerating medications due to side effect. In schizophrenia rTMS is very useful in controlling Hallucinations and negative symptoms/ cognitive deterioration. Cost per rTMS is around 3450/- Rs ( around 73 US $ ) in Joshi Hospital Pune.

swapnilsdesh@gmail.com

OBSESSIVE COMPULSIVE DISORDER ( OCD) - ADVANCED CARE

OBSESSIVE COMPULSIVE DISORDER ( OCD) TREATMENT IN PUNE
Dr Deshmukh MBBS,MD (9923291312) Psychiatrist is well-known leading psychiatrist in Pune. Study conducted by him and his counselor on 63 patients of Obsessive Compulsive Disorder (OCD) with or without psychotic features at his Shreeyash Hospital ( psychiatric treatment & counseling center), Deccan, Pune revealed that (1) Drug management is very essential part of management of OCD. (2) Cognitive behavior therapy in combination with drug treatment is more effective than treating with medicine alone. (3) Clomipramine in combination with SSRI is more useful in poorly responsive or resistant cases of OCD. (4) Regular long term management is usually required. (5) Add on therapy with drugs like Lithium, low dose antipsychotics, Buspirone, BZDs also helps. (6) Exposure & response prevention is very useful treatment in compulsive symptoms. (7) Thought stopping techniques like wrist band / mind diversion can be easily taught to patient.(8) Activity scheduling, family support, counseling helps.(9) Medicine are essential in management treatment of OCD, patient needs to understand that they may have side effect but considering risk & benefit its always recommended that continuing medications for long time/ may be years together gives more benefits than side effect. Also drugs may take around 3 months to start showing its effects but slow escalation of dose use of minimum dose & medicine in combination with therapies helps patient to great extent. (10) The role of dietary nutrients -Vitamin B-6 improves OCD. (11) Newer studies have shown that N- Acetylcysteine – amino acid ( a protein) can be used in reducing compulsive behavior in OCD ( also in Trichotilomania). It’s a well tolerated drug without any side effect. (12) TMS, Transcranial Magnetic Stimulation is newer devlopment in treatment of poorly responding OCD, available in USA, but is very expensive, but safest method without side effects / non medicinal method.

CBT in OCD patients :-) there are three irrational beliefs of OCD. 1. One is worth while if he is thoroughly competent, adequate, & achieving in all the aspects of life. 2. Some things may be dangerous or fearsome,& one should be terribly concerned and keep on dwelling on the possibility of their occurrence. 3. There is a right and precise solution to human problemS, it is catastrophic if this perfect solution is not found.

For further details contact - Dr Swapnil S. Deshmukh (9923291312)