Jule Klotter
I recently came upon a Substack essay by Aruna K Tummala, MD, that examined the hazards of relying solely on psychiatric medications, which are standard-of-care, to treat mental illnesses.1 Dr. Tummala is a board-certified adult and geriatric psychiatrist with additional certification in integrative and holistic medicine (by Academy of Integrative Health & Medicine). She also has training in functional medicine, Ayurveda, and hyperbaric oxygen therapy.2
Early in 2022, she received an email from her professional liability company about a lawsuit against a psychiatrist whose 71-year-old patient had killed his wife, two of his children, and then committed suicide. The patient’s initial complaints included a six-month history of insomnia, low energy, depression, confusion, memory problems, headaches, and a 50-pound weight loss; he had stopped a 50-year practice of daily alcohol consumption one year before. The patient also had multiple physical problems, including arthritis, GERD, prostate cancer, diabetes, and hyperlipidemia, and was taking medications (e.g., Lipitor, Tricor, Protonix). The psychiatrist prescribed Wellbutrin XL 150 mg/day and Ativan as needed for severe insomnia, anxiety, or panic attacks. As the weeks passed, other medications were tried and the Wellbutrin dosage was increased to 450 mg/day.
After one year, the patient’s mood had improved, and he decided to self-taper off the Wellbutrin even though office staff warned he might have a relapse. In the ensuing weeks, the patient reported increased anxiety and insomnia, and the psychiatrist prescribed Remeron and Halcion. Still, his symptoms continued to increase. In Dr. Tummala’s opinion, the patient was experiencing severe antidepressant withdrawal syndrome and the additional side effect of akathisia (inner and outer subjective restlessness that increases the risk of suicide and homicide). After trying other medications, the psychiatrist decided to restart him on Wellbutrin as well. The patient shot and killed his wife, two of his children, and himself the next day.
Family members of the patient sued the psychiatrist, alleging negligent failure to diagnose and treat the condition that led to the shootings. A jury decided in favor of the psychiatrist. The liability publication pointed to the psychiatrist’s keeping excellent documentation and following standard of care protocols as key reasons for the jury’s decision.
Dr. Tummala responds:
…the problem here is not this one psychiatrist [who failed to recognize the withdrawal hazards]. The problem is the whole system—psychiatric and medical educational institutions that rely on unproven theories of chemical imbalance, Big Pharma pushing its products despite limited efficacy and serious signals of harms, ineffective governmental agencies like the FDA. Big insurance dictating how medicine is practiced…and the unholy alliance between all these entities.1
Pharma-driven psychiatry considers mental conditions—whether it is depression, ADHD, or schizophrenia—to be biochemical imbalances in the brain that need to be manipulated with pharma chemicals. Yet, it fails to consider the state of the body in which that brain resides. As Dr. Tummala points out, the patient’s long history of alcoholism (with resulting nutrient deficiencies) along with nutrient-depleting effects from the medications he was taking and the effects of insulin imbalance (diabetes) and systematic inflammation (arthritis) each contribute to the patient’s original complaint of insomnia and depression. But pharma psychiatry does not look for or address the root causes; it addresses mental symptoms only. And the drugs too often cause unintended physical and mental adverse effects.
Dr. Tummala explains in another Substack essay:
“Psych meds can lead to symptomatic improvements in the short term, but invariably they cause further deterioration in the root causes, which are never addressed. In addition, most psychiatric medications cause dependence that is very hard to overcome without holistic treatment. Long-term studies for things like depression, schizophrenia, or ADHD, which are typically not funded by industry, have consistently shown short-term gains but long-term harms, including more severe episodes and more risk for permanent disability.”3
In her view, three main root causes of mental illness are bad diet, trauma or stress in life, and toxins in the environment.
The connection between mental and physical health was noted by Linus Pauling, one of the pioneers of orthomolecular medicine. In a 1968 article, he wrote:
The proper functioning of the mind is known to require the presence in the brain of molecules of many different substances. For example, mental disease, usually associated with physical disease, results from a low concentration in the brain of any one of the following vitamins: thiamine (B1), nicotinic acid or nicotinamide (B3), pyridoxine (B6), cyanocobalamin (B12), biotin (H), and ascorbic acid ©, and folic acid.4
He refers to the work of Abram Hoffer, Humphry Osmond, and John Smythies, who used nicotinic acid or nicotinamide to treat schizophrenia in the 1950s. But orthomolecular psychiatry did not stop with this one vitamin.
In her excellent book Natural Healing for Schizophrenia and Other Common Mental Disorders (2nd edition), Eva Edelman said that orthomolecular psychiatrists had identified four biochemical conditions that underlie schizophrenic behavior: very high blood histamine levels (histadelia), very low blood histamine levels (histapenia), excess urinary kryptopyrrole (pyroluria), and cerebral allergies to foods, chemicals, or airborne substances. A third edition of this book and another book by Edelman, Natural Healing for Bipolar Disorder (2018), are available at Borage Books.
Other sources for information on biochemical individuality and nutrient therapy include Walsh Research Institute (https://www.walshinstitute.org/) and Pfieffer Medical Center (http://www.hriptc.org/hriptc/index.html).
Functional and integrative medicine, which seeks to treat underlying causes of mental and physical illness, has expanded beyond orthomolecular therapy to address body, mind, and spirit. Psychiatry Redefined, founded by James M. Greenblatt, MD, is a platform for practitioners who want to use more than symptom-suppressing drugs. Dr. Greenblatt wrote several informative articles for Townsend Letter, including “Functional Treatment of Obsessive-Compulsive Disorder,” “Treating Stress and Anxiety with Functional Medicine,” and “Irritability, Anger, and Rage: Lithium Deficiency Syndrome.”
The current medicine system does not support non-pharma treatments for mental conditions. As Dr. Tummala explained, insurance companies will usually not pay for lab tests that can uncover underlying factors that are contributing—even causing—the illness.1 And it takes time to elicit possible causes from a patient’s medical history—time that most practitioners do not have. But it is important for practitioners and patients to understand that there are many options before going on possibly addictive psychiatric drugs—beginning with nutrient therapy and stress reduction. Getting off these drugs can be difficult and requires supervision by a knowledgeable practitioner.
In This Issue
Being able to get a good night’s sleep is imperative for both physical and mental health. As Jacob Teitelbaum, MD, explains in his article “Optimizing Sleep – Naturally,” too little sleep contributes to fatigue, cognitive dysfunction, immune dysfunction, weight gain, premature aging, and chronic pain.
Dr. Teitelbaum has become widely known for his integrative approach for treating fibromyalgia and chronic fatigue syndrome. He is the author of best-selling books such as From Fatigued to Fantastic! and Pain Free, 1, 2, 3! Over the years, he has also written many articles for Townsend Letter.
In this issue’s article, Dr. Teitelbaum highlights some of the physical conditions that disrupt sleep, such as fibromyalgia, restless leg syndrome, and upper airway resistance syndrome. He also suggests herbal preparations that he has found effective for improving sleep. And as always, he offers practitioners links to more information that may help patients.
References
- Tummala AK. Whodunnit??? A story of a psychiatric murder/suicide. March 23, 2022. https://arunatummala.substack.com/p/whodunnit-a-story-of-a-psychiatric
- https://trinergyhealth.com/team/aruna-k-tummala/
- Tummala AK. Myths of mental illnesses—Let’s break them down. April 20, 2022. https://arunatummala.substack.com/p/myths-of-mental-illnesses-lets-break
- Pauling L. Orthomolecular Psychiatry. Science. April 19, 1968. https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=a9bcb3b073eab4ec4bf94c8503f39dedd55d48ad
Published November 4, 2023