Last month, the American Psychiatric Association held their 168th annual meeting in Toronto. One of the symposia for the conference was Mineral-Vitamin Combinations as Primary Treatment of Psychiatric Symptoms, which included 4 Ph.D. and M.D. researchers presenting on various aspects regarding micronutrient treatment and mental health.
Dr. Bonnie Kaplan and Dr. Julia Rucklidge, two of the presenters, wrote an article last week indicating that the 3-hour symposia saw about 175 people attending, 95% of which were clinical psychiatrists, a far cry from a similar symposia held in 2003.
In addition to the 4 presenters in this specific symposia, other presenters spoke on related topics:
There were some other talks on issues related to diet, and also on issues related to the failures of medications. There was a talk on the best news stories of 2014, most of which seemed to be reversing former medical advice, such as that after all the advice to eat low fat and drink non-sugary drinks, the evidence now suggests that drinking beverages with aspartame is probably worse for our health. A session on the future of antidepressant drug discovery and development given by Dr. Florian Holsboer from the Max-Planck Institute for Psychiatry provided a convincing description of new ways to move forward that might target the stress system, new receptor sites and identifying those who might respond via genetic testing. He argued for personalized medicine as the way of the future, perhaps acknowledging that with our current approach, it is nearly impossible to identify who will respond to medications and who won’t.
Even with more exposure for this progressive stance on mental health treatment, “there was still a reluctance to accept the inadequacies of psychiatric medications.”
For example, a talk by Dr. Charles Nemeroff (Univ of Miami) focused on how to treat those who are treatment resistant. Despite acknowledging the sober reality of the STAR*D trial, in which regardless of how many drugs a patient was tried on, remission rates were still unacceptably low, the discussion focused largely on what other drugs to try, what doses, how to manage noncompliance, and how to manage side effects. As another example, Dr. Barbara Coffey (New York Univ) gave an overview of challenges in child and adolescent psychopharmacology, showing some sobering data on the poor outcomes of children on antipsychotics, the severe weight gain issues and metabolic problems. However, in her review of stimulants, she didn’t mention the results from Janet Currie’s study on Quebec children that has shown that community use of stimulants has resulted in no real benefits and that they actually carry some potential harm. Her review of the MTA trial focused on the growth restriction effects of stimulant medications, and did not discuss the lack of long-term efficacy of stimulants.
That being said, talks on diet as prescription and manipulating diet to improve mental health were packed to overflowing. Unfortunately, despite what seems to be an increase in interest toward diet-based solutions, such presentations made up less than 1% of the total talks at the conference.
The big question then is whether psychiatrists are finally opening their minds to the idea that nutrition can be a front line defence treatment in mental health.