ChapterPDF Available

.Inositol in treatment of psychiatric disorders

Authors:
Robert H Belmaker at Ben-Gurion University of the Negev
Robert H Belmaker
Levine J
Levine J
Levine J
  • This person is not on ResearchGate, or hasn't claimed this research yet.
Download full-text PDF
Read full-text
Download citation
Content uploaded by Robert H Belmaker
Author content
All content in this area was uploaded by Robert H Belmaker on Mar 21, 2015
Content may be subject to copyright.
Belmaker RH, J Levine. (2008). Inositol in treatment of
psychiatric disorders In: Alternative Medications and the
Treatment of Psychiatric Disorders. (2nd edition).
Mischoulon D and Rosenbaum JF (eds). Lippincott
Williams & Wilkins, Baltimore, MD, 105-115.
... It can be obtained in the diet by eating beans, grains, nuts, and fruits (Moore et al. 1999). There are six small clinical trials of inositol, primarily as augmentation for antidepressants and mood stabilizers in unipolar and bipolar depression (Belmaker and Levine 2008). Inositol outperformed placebo in three controlled studies, and two studies on unipolar depression were negative. ...
... Inositol participates in the synthesis of membrane phospholipids and is a precursor in the phosphatidylinositol (PI) cycle, producing inositol triphosphate (IP3) and diacylglycerol (DAG), both second messengers that interact with neurotransmitter receptors (Baraban et al. 1989). Mechanistic similarities to lithium have been proposed to account for inositol's mood-enhancing effects (Belmaker and Levine 2008). ...
... Recommended doses range from 6 to 20 g/day, depending on the indication. For depression, doses are typically 12 g/day divided on a two to four times a day basis (Belmaker and Levine 2008;Iovieno et al. 2011). ...
Current Role of Herbal and Natural Preparations
Chapter
  • Aug 2018
  • Handbook Exp Pharmacol
Depression remains difficult to manage, despite the many registered treatments available. For many depressed individuals, particularly those who have not responded to and/or had adverse effects from standard therapies, herbal and natural medications represent a potentially valuable alternative. This chapter will review several natural remedies used in the treatment of depression. Specific remedies covered include St. John’s wort (SJW), S-adenosyl-L-methionine (SAMe), omega-3 fatty acids, rhodiola, and others. We will begin by providing some historical and social context about these remedies. Then we will review efficacy and safety data, as well as biological mechanisms of action of these therapies. Finally, we will discuss the limitations of the current state of knowledge and provide suggestions for a productive research agenda focused on natural remedies. While many questions about these treatments remain unanswered and much work needs to be done before we determine their place in the psychiatric armamentarium, we believe that this chapter will give psychiatrists a good perspective on the pros and cons of herbal and natural antidepressants as part of the pharmacological armamentarium and sensible guidelines on how and when they should be used.
View
... Furthermore, the mechanism of action of omega-3 FAs and inositol is complementary, with omega-3 FAs increasing membrane fluidity and inositol working as a critical second messenger in cell processes. 9,[12][13][14] Thus, their use in combination could have an additive effect in the treatments of youth with bipolar disorder, which is an area of significant clinical need. ...
... These findings are consistent with the hypothesized complementary mechanism of action of omega-3 FAs and inositol, with omega-3 FAs increasing membrane fluidity and inositol working as a critical second messenger in cell processes occurring in the cell membrane. 9,[12][13][14] Furthermore, the effects observed on symptoms of mania and depression with the combination of high EPA/DHA omega-3 FAs with inositol were robust, with large effect sizes (see Table 2). Some subjects were considered to be highly improved or in remission. ...
A Randomized Clinical Trial of High Eicosapentaenoic Acid Omega-3 Fatty Acids and Inositol as Monotherapy and in Combination in the Treatment of Pediatric Bipolar Spectrum Disorders
Article
Full-text available
  • Nov 2015
Objective: We conducted a 12-week, randomized, double-blind, controlled clinical trial to evaluate the effectiveness and tolerability of high eicosapentaenoic acid (EPA)/docosahexaenoic acid (DHA) omega-3 fatty acids and inositol as monotherapy and in combination in children with bipolar spectrum disorders. Method: Participants were children 5-12 years of age meeting DSM-IV diagnostic criteria for bipolar spectrum disorders (bipolar I or II disorder or bipolar disorder not otherwise specified [NOS]) and displaying mixed, manic, or hypomanic symptoms. Subjects with severe illness were excluded. Subjects were randomized to 1 of 3 treatment arms: inositol plus placebo, omega-3 fatty acids plus placebo, and the combined active treatment of omega-3 fatty acids plus inositol. Data were collected from February 2012 to November 2013. Results: Twenty-four subjects were exposed to treatment (≥ 1 week of study completed) (inositol [n = 7], omega-3 fatty acids [n = 7], and omega-3 fatty acids plus inositol [n =10]). Fifty-four percent of the subjects completed the study. Subjects randomized to the omega-3 fatty acids plus inositol arm had the largest score decrease comparing improvement from baseline to end point with respect to the Young Mania Rating Scale (P < .05). Similar results were found for the Children's Depression Rating Scale (P < .05) and the Brief Psychiatric Rating Scale (P <.05). Conclusion: Results of this pilot randomized, double-blind, controlled trial suggest that the combined treatment of omega-3 fatty acids plus inositol reduced symptoms of mania and depression in prepubertal children with mild to moderate bipolar spectrum disorders. Results should be interpreted in light of limitations, which include exclusion of severely ill subjects, 54% completion rate, and small sample size. Trial registration: ClinicalTrials.gov identifier: NCT01396486.
View
... Therefore, RH suggested inositol, a naturally occurring compound that is a member of the B-vitamin family. There is evidence for its effectiveness in anxiety-related disorders and depression (Belmaker & Levine, 2008). The effective dosage is 12-18 g (Settle, 2007). ...
Unraveling the temporal dynamics between symptom and treatment variables in a lifestyle-oriented approach to anxiety disorder. A time-series analysis
Article
Full-text available
  • Jan 2011
Background: Although there is increasing evidence for the positive effects of a healthy lifestyle on mental health, most studies only take into account a single lifestyle factor, ignore the possibility of bidirectional causality, and focus on average group results. Methods: In the present single-subject study we used time-series analysis to unravel the dynamic interplay between symptom and treatment variables in a multi-component treatment of anxiety disorder. Main treatment variables were two lifestyle factors (physical activity and relaxation). Results: The patient in this study recovered completely. Multivariate timeseries analysis revealed an intricate pattern of dynamic relationships between symptom and treatment variables. Relaxation was predictive of symptom reduction but physical activity surprisingly worsened the symptoms. Changes in energy predicted changes in anxiety. Evidence for bidirectional causality was present as well, with changes in relaxation predicting changes in energy and vice versa, indicating a positive feedback loop. Conclusions: This type of research is useful for gaining insight into the causal mechanisms underlying the effects of a healthy lifestyle on mental health.
View
... Examples are St. John's wort for depression, 18 valerian for insomnia, 19 relaxation for anxiety, 20 mindfulness-based stress reduction 21,22 and mindfulness-based cognitive therapy for depression, 23 massage for stress, anxiety, and depression, 24 exercise for depression, anxiety, and sleep disorders, 25 heart rate variability training for anxiety and stress-related and depressive symptoms, 26,27 single vitamins as a supplement to medication for depression (such as folic acid), 28 food supplements like such as S-adenosyl-l-methionine 1,4-butanedisulfonate for depression, 29 melatonin for sleep disorders, 30 inositol for depression, panic, and obsessivecompulsive disorder, 31 and dietary changes for depression. 32 These treatments, integrated with conventional psychiatry, have been offered for 3 years to psychiatric outpatients in the CIP. ...
The Dutch complementary and alternative medicine (CAM) protocol
Article
Full-text available
  • Dec 2009
Background: Complementary and alternative medicine (CAM) is subject to heated debates and prejudices. Studies show that CAM is widely used by psychiatric patients, usually without the guidance of a therapist and without the use of a solid working method, leading to potential health risks. Aim: The purpose of this study is to facilitate the judicious use of CAM alongside conventional psychiatry in an outpatient psychiatric clinic. Methods: A search was made through scientific and legal articles and discussion in focus groups. Results: In the Centre for Integrative Psychiatry (CIP) of Lentis in the Netherlands, some carefully selected CAM are offered under strict conditions, alongside conventional treatments. Because of the controversy and the potential health risks, Lentis designed a protocol that is presented. Conclusions: The CIP hopes, by using this protocol, to better serve and respect the individual needs and preferences of the diversity of psychiatric patients in our Dutch multicultural society, and better protect them from harm.
View
View
View
Supplements and Natural Remedies for Depression: New Treatment Insights and Options
Chapter
  • Jan 2019
Over the past two decades, natural remedies have been growing in popularity in the USA and worldwide. Given the limitations of current treatments for depression, natural medications as well as other complementary therapies represent for many a beneficial alternative to registered medications, particularly in cases of limited efficacy and/or side effects. This chapter will review several popular natural remedies often used in the treatment of depression. Specific remedies covered include St. John’s wort (SJW), S-adenosyl-L-methionine (SAMe), omega-3 fatty acids, rhodiola, and some less-known ones. We will provide some historical and socioeconomic perspectives on treatment with natural products, including present-day limitations to the systematic study of these remedies. We will examine the published research data from efficacy studies and discuss potential mechanisms of antidepressant action and specific safety considerations for each. Evidence for these remedies is varied in quantity and quality, and many questions remain unanswered with regard to their place in the psychopharmacological armamentarium. Clinicians who read this chapter will develop a good sense of how to apply these remedies in clinical practice safely.
View
References
Chapter
  • Apr 2011
View
Autonomic Insufficiency in Patients with Advanced Breast Cancer
Chapter
  • Jan 1987
Autonomic insufficiency is a clinical syndrome including cardiovascular manifestations (postural hypotension, syncope, fixed heart rate) and gastrointestinal symptoms (nausea, anorexia, constipation, or diarrhea [1–4]). This syndrome has been found most commonly in neurologic disorders, chronic renal disease, and diabetes mellitus [1]. Although isolated reports have suggested the presence of autonomic insufficiency in advanced cancer patients [5,6,7], no prospective studies have focused on the incidence of this syndrome in cancer patients.
View
Stereotypies in Captive Primates and the Use of Inositol: Lessons from Obsessive–Compulsive Disorder in Humans
Article
Full-text available
  • Aug 2012
Animal stereotypies have long been used in the study of obsessive–com-pulsive disorder (OCD) in humans. These studies have led to the understanding of some of the molecular pathways in the disorder and the use of selective serotonin reuptake inhibitors and myo-inositol in the treatment of these conditions. If animal models, especially nonhuman primate models, were used to study human disorders and if the resulting treatments were successful, then conversely one should be able to treat nonhuman primate stereotypies with similar methods. We here summarize animal models of OCD (including nonhuman primate models) and human OCD treatments, and using successful human treatment by myo-inositol as models, recommend the use of myo-inositol in good captive management practice and the treatment of nonhuman primate stereotypies. We believe that this would be particularly useful in the treatment of stereotypies in nonhuman primates because they are physiologically so similar to humans.
View