Wednesday, July 23, 2008

Mixing old and new to create something better


I've got friends on both sides of the medication issue reading this blog. Some are vehemently anti-medication, while others are suspicious of natural alternatives. My desire is to make this as balanced a blog as possible, and fair to both sides. Maybe that's the Libra in me...maybe it's just that I think there are positive and negative aspects of each approach, and there are safety issues with each approach. It's not so important WHAT treatment is used, as it is WHY and HOW.

I really like this study because it integrates both schools of treatment in a promising way.

Two of the medications I write a lot about, olanzapine (Zyprexa) and clozapine (Clozaril), are notorious for their effects on blood lipids, weight gain, and diabetes risk. I'm not a big fan of either, but I do know because I work with a very skilled psychiatrist in town who completely supports my nutritional and complementary suggestions, that there are simply some people who need the medication in order to be safe to self and others. And because of that, they are simply at risk of metabolic syndrome-related side effects. I am always looking for ways that high-risk-of-side-effects medications can be used in combination with therapies that minimize the actual dose that needs to be used.

Gingko biloba is primarily recognized for its use in preserving memory. However, it was also recently tested on 42 patients with refractory schizophrenia who were maintained on stable doses of clozapine. A dose of 120 mg per day helped to reduce the negative symptoms of schizophrenia. It did not, however, reduce psychopathology symptoms.

So what's the point of taking it if it didn't reduce the medication need? I have read study after study after study over the years and it is clear, people stop taking medications when they don't like the side effects. If you can help push the balance of effects of a medication over to the positive, you might just increase compliance. And compliance to a medication regime means, potentially, better quality of life.

Who would have thought that beautiful tree with the funny shaped leaves had such a great little secret in its biochemistry?

Doruk A, Uzun O, Oz┼čahin A. A placebo-controlled study of extract of ginkgo biloba added to clozapine in patients with treatment-resistant schizophrenia. Int Clin Psychopharmacol. 2008 Jul;23(4):223-7.

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