Posts by Dr. Robert Hedaya

Do Antidepressants Really Work?

Antidepressants have a role in clinical practice but they are grossly over-utilized.  As a certified psychopharmacologist, practitioner of The Center for Whole Psychiatry + Brain Recovery (Functional Medicine and traditional psychiatry) and Clinical Professor of Psychiatry at Georgetown School of Medicine, I prescribe antidepressants, but  only after a thorough multi-faceted  evaluation of the patient. We rely on drugs as a solution rather than deal with root causes of illness, and the pills generally are not as effective as we would be led to believe by the pharmaceutical companies (publically acknowledged as distorted in peer reviewed journals such as New England Journal of
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Categories: Health Matters Blog.

Vitamin B12

Vitamin B12 deficiency and its detection have been in the news lately from the New York Times and The Dr. Oz Show. B12 Deficiency Effects Widespread The effects of vitamin B12 deficiency are widespread.  Vitamin B12 has a major influence on the function of neurons and also on the ability of the bone marrow to make red blood cells. B12 Causes Psychiatric Symptoms B12 deficiency can cause almost any psychiatric symptom—from anxiety, and panic to depression and hallucinations.  This is because B12 deficiencies trigger symptoms in the nervous system and red blood cells. Diagnosing B12 Deficiency While it is not
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Categories: Health Matters Blog.

Laughing Gas (Nitrous Oxide) is No Laughing Matter

I was wandering around the internet last night, looking for scholarly articles on something called ‘methylation pathways’, when I came across a very disturbing article on the potentially quite toxic interaction between nitrous oxide (NO2) and certain states of B12 deficiency. Before getting into the nitty gritty, bottom line, let me give you some background. Nitrous Oxide (NO2)-commonly referred to as ‘laughing gas’ was used for years in the practice of dentistry.  It is used currently as part of general anesthesia, and recently has been gaining popularity as a ‘recreational drug’.  An article in Popular Science in the late 1940’s
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Categories: Health Matters Blog.

Light Therapy & Health

Your Biologic Clock Your Biologic Clock keeps our body rhythms and sleep –wake cycles in synch with the light-day cycle of the earth. It is located in the suprachiasmatic nucleus (SCN) in the hormone control center of the brain, the hypothalamus.  When light enters the eye, it activates this part of the brain and reduces production of the sleep hormone (melatonin) produced in the pineal gland of the brain.  The light also acts to the release of a variety of other hormones and affects body temperature. Interestingly, we are programmed to cycle every 24.2 hours―but our exposure to light on
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Categories: Health Matters Blog.

Can a Brain Be on Fire?

Yes! Over the last 20 years, ample evidence has accumulated to prove that inflammation in the body causes changes in the brain that lead to depression, anxiety, sleep problems, and memory problems. Inflammation comes from the Latin  ‘inflammare’ — to set on fire.  Our brain is ‘on fire’ when it is inflamed, or when our body is inflamed. What sets your brain on fire? Your body experiences inflammation the way your skin reacts to a cut:  The area becomes swollen, warmer, and it may hurt.  (This happens because there is increased blood flow, increased immune activity, and a change in
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Categories: Health Matters Blog.

Highest Rates of Bipolar Disorder in the United States: Why?

According to a new study discussed on Health.com about 2.4% of people around the world have had a diagnosis of bipolar disorder at some point in their lifetime, according to the first comprehensive international figures on the topic. The United States has the highest lifetime rate of bipolar disorder at 4.4%, and India the lowest, with 0.1%”. Bipolar disorder has a strong genetic component. Depending on which studies you look at, the genetics account for anywhere from 40-60% of the vulnerability. While that seems like a high number it also means 40-60% of the risk of developing the disorder  despite having the same
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Categories: Health Matters Blog.

Nutrition and Depression: Nutrition, Neuronal Protection, Omega 3 Fatty Acids, Vitamin D and Depression, Part 3

Nutrition, Neuronal Protection and Depression Neuronal protection (protection against cognitive decline) requires glutathione peroxidase (a crucial enzyme which requires selenium, cysteine, carotenoids, zinc,  and vitamin E) is an important aspect of the treatment of mood disorders both because they tend to be recurrent over one’s life, and because they are associated with neuronal loss in specific parts of the brain, such as the hippocampus. R-lipoic acid, vitamin C and omega 3 fatty acids are also critical to neuronal protection. Omega 3 Fatty Acids, Vitamin D, and Depression There are numerous studies of the efficacy of omega 3 EFA’s in depression.  A recent large-scale
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Categories: Health Matters Blog.

Nutrition and Depression: Nutrition, Methylation, and Depression, Part 2

Nutrition, Methylation, and Depression Nutritional support for the methylation cycle is another area in which nutrition plays a critical role.  The methylation cycle is essential for mental and physical health.  It is critical to the metabolism of catecholamines in the synapse via an enzyme (COMT) as well as the synthesis of ‘depression-relevant’ compounds such as melatonin, myelin basic protein, carnitine, CoQ10, etc.  Methylation is required to inactivate histamine. Basic nutrients necessary for normal function of this cycle include B12, glycine, serine, activated B6, selenium, cysteine, methionine and folic acid. Several studies have shown the utility of folic acid as an adjunct to medication
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Categories: Health Matters Blog.

Nutrition and Depression: State of the Science and Treatment, Part 1

Efficacy and Use of Medications in the Treatment of Depression It is becoming widely recognized that the current treatment of mood disorders (such as depression), while offering better outcomes than several decades ago, leave much room for improvement. The remission rate at the end of the first phase of the well-publicized STAR-D study (1) was only 25%. In fact, a recent review of 4 meta analyses of the effectiveness of anti-depressants by PIGOTT(2) found that of the 4041 patients initially started on citalopram in the STAR=D study, (after 4 trials of medication combinations and psychotherapy), only 108 of those who
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Categories: Health Matters Blog.

“Are there Benefits to having Bipolar disorder?”

Let me start by acknowledging what is well known: Manic Depression or Bipolar disorder can be a devastating illness. Affecting at least 1% of the population, it can, untreated, result in suicide, ruined careers and devastated families. Bipolar disorder is often accompanied by alcohol and drug abuse and addiction, criminal and even violent behavior. I acknowledge this, because I do not want to make light of the burden this illness places on people’s lives, their families and communities. On the other hand, the history of the world has been influenced very significantly by people with manic depression – from actors and
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Categories: Health Matters Blog.