Much of what we recommend in our How to Quit Action Plan in the How to Quit book you can do for yourself or with the guidance and support of a nutritional therapist. However, the process of weaning yourself off antidepressants is something you must do with the support and guidance of your doctor. Ask your doctor to wean you off gradually.
- A week before you begin reducing your antidepressant, start taking the Basic Supplements.
- Increase your intake of essential fats, both by eating oily fish three times a week and supplementing 1,000mg of omega-3 fish oil twice a day as recommended in the Mood Prescription (see p. 416). For some people, fish oil can be miraculous.
- Supplement tryptophan or 5-HTP, (included in the Mood Prescription(see p. 416). However, we recommend that 5-HTP not be taken in significant amounts, above 50mg, if you are on an antidepressant. 5-HTP helps the body make serotonin whereas SSRI antidepressants stop it being broken down. If your doctor is willing to wean you off antidepressants, it helps if you are weaned onto 5-HTP at the same time, gradually building the daily amount up to a maximum of 300mg, but no more than 100mg before you are completely off the antidepressant. In our experience, this minimises and shortens the withdrawal effects that many people experience when coming off antidepressants. Alternatively, don’t take any 5-HTP until you have stopped the antidepressant drug completely. Then take 200mg a day. Two of the hardest to come off are the SSRI, Seroxat, and the new SNRI drug, Efexor. The withdrawal symptoms are longer lasting and the drugs are best tapered off gradually over at least three months. Other antidepressants, such as Zoloft and Prozac, can be tapered off over a week or two.
- Supplement with B vitamins, including vitamin B6 50mg daily with meals. There are several medical conditions associated with depression where B6 plays a pivotal role. Supplement with folic acid 800mcg per day. Thirty-eight per cent of depressed patients have low blood levels of folate. These B vitamins are also included in the Mood Prescription(see p. 416).
- Make sure you are on a low-GL diet by following our How to Quit Diet strictly.
- The mineral chromium (included in the Mood Prescription(see p. 416), taken at a level of 400mcg a day (200mcg twice a day) helps relieve depression in those with carb cravings who are suffering with excessive sleepiness and grogginess at the same time.
- Faulty methylation (the process that makes the brain’s neurotransmitters from amino acids) is very strongly linked with depression. Do check your blood homocysteine level, which can be done using a home test kit and if it is raised above 9 units, supplement the recommended level of B vitamins, along with the amino acid TMG, in Chapter 9. Also, eat more greens, beans, nuts and seeds, as these are rich sources of folate.
- If you are also low in motivation and energy, additional tyrosine and/or L-phenylalanine can give you a boost. All of these nutrients are in the Mood Prescription(see p. 416).
- Exercise is a proven mood booster (see Chapter 16) and recent research suggests it can even stimulate the building of new brain cells. Sunlight and vitamin D, which is made from cholesterol in the skin in the sun, makes a big difference. So exercise outdoors regularly and make sure your multivitamin gives you at least 15mcg of vitamin D. If not, and if you are prone to depression in the winter, supplement up to 50mcg a day.
- Counselling also works, so make sure you have the support of a good counsellor as you come off antidepressants. Often depression is really about unexpressed anger and childhood trauma.
- Sometimes depression is a symptom of an unidentified food allergy, wheat gluten being one of the most common offending foods. You can test yourself with a home-test kit.
- Sometimes depression is a symptom of an underactive thyroid. Discuss with your doctor a trial period of a low level of thyroxine if you have the following symptoms: you are still exhausted all the time, have a problem with dry skin, constipation and sensitivity to cold, and also unable to lose weight, even if your blood test is apparently normal, although at the low end of the scale. Thyroxine, the thyroid hormone, is made from tyrosine, which is part of our Mood Prescription(see p. 416).
- Some herbs work well for some people. The most popular is standardised St John’s wort. When taken alone, it is safe and has few side effects. However, it should not be taken in conjunction with prescription antidepressants. Try 300mg of an extract of 0.3 per cent hypericin, starting with one or two 300mg capsules or tablets in the morning with breakfast. If there is no change after a week, add a third dose at lunchtime. You can also take it as doses of 450mg each, or take your entire daily dose in the morning, since the effect lasts for a long time.
- Some people report great results with the herb Rhodiola rosea. Try 200 to 300mg twice daily, one early in the morning and the other early in the afternoon, of a standardised extract of 3 per cent rosavins and 0.8–1 per cent salidroside with meals. Rhodiola rosea should be taken early in the day because it may interfere with sleep if taken late in the day. If you become overly active, jittery or agitated, then a smaller dose with very gradual increases might be needed. It shouldn’t be taken if you are restless, agitated or overly tense, nervous or excited.
The most important ......
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