Welcome to another edition of Common Ground Online. Here's what's in this week's edition:
On August 24, 2009 a new case study was published in the
Journal of Child and Adolescent Psychopharmacology on the effect EMPowerplus had on a youth with bipolar disorder. The research was conducted at Ohio State University by researchers Elisabeth A. Frazier, B.S., Mary A. Fristad, Ph.D., ABPP, and L. Eugene Arnold, M.D., M.Ed. Below are some excerpts from the case presentation as outlined in the study:
 “This case presentation follows the treatment of a 12-yearold boy (‘‘John’’) diagnosed with BP-NOS, which later developed into BP-I with psychotic features, generalized anxiety disorder (GAD), and OCD. Enuresis also emerged while taking lithium. By age 6, John experienced severe mood cycling, sadness, irritability, self-harming behaviors, sleep disturbance, and severe tantrums. He also experienced elevated mood, poor peer relations, low frustration tolerance, flight of ideas, aggressive behavior, hyperactivity, and impulsive negative behaviors. By age 8, John developed impairing anxiety and worsening mood symptom intensity and cycling, increased destructive behavior, transient suicidal ideation, and increased global impairment. These symptoms continued as he grew older, and between ages 10 and 11, John began experiencing auditory hallucinations, developed obsessions and compulsions, and displayed increasingly disrespectful and aggressive behaviors. He reported hearing intrusive, commanding voices when he became anxious, telling him to act on his obsessions and do things he did not want to do, and threatening him. At one point, John reported hearing voices almost 100 times in one week telling him, ‘‘If you don’t do this you’ll surely die.’’ And ‘‘Don’t listen to them [referring to parents and other adults],’’ When he was 10 years old, John specifically noted the voices told him he would die on the day John Glenn dies. John’s symptoms became so impairing he was removed from his private school and transferred to homeschooling.
“John’s treatment team frequently altered his medications from the time he was 6 years old until he was 12 years old (2001–2007) in conjunction with individual/family psychoeducational psychotherapy (Fristad et al., in press ) provided by the second author. Medication changes were due to intolerable side effects and/or inadequate treatment response. During this time, he took various combinations of prescription and over-the-counter agents, including lithium citrate, risperidone, lithium carbonate, clonidine, flax seed, Desmopressin, omega-3 fatty acids, magnesium, trazodone, gabapentin, valproic acid, propranolol, quetiapine, aripiprazole, lorazepam, and lamotrigine. No medication, alone or in combination, maintained a desirable mood balance or consistent improvement in global functioning over an extended period of time.
“When John was 12 years old, his mother approached his therapist (the second author) asking about EMPowerplus. Coincidentally, the authors were intending to begin an open-label trial of EMPowerplus at their treatment center; however, there was a considerable delay in commencing the study due to impediments in receiving all research approvals needed. Thus, rather than wait, the family chose to work independently with the Truehope staff in starting EMPowerplus and received directions to taper psychotropic medication from his child and adolescent psychiatrist. The family continued to report John’s progress to his therapist over the subsequent 14 months... John took 5 capsules per day, then 10 per day, and then the recommended 15 capsules per day. After 7 days on EMPowerplus, he began to reduce his lithium carbonate and lamotrigine as recommended by the Truehope consultant and his psychiatrist. After 19 days on EMPowerplus, John was completely off all psychotropic medications.
“Throughout this tapering-and-titration process, John experienced transient episodes of irritability, headache, dizziness, and fatigue. However, his global functioning notably increased. As treatment continued, John began interacting more appropriately with peers, remained calm and playful throughout most of the day, slept throughout the night, remained focused and efficient while completing schoolwork, and experienced decreased compulsions. Hallucinations ceased. John continued to experience brief periods in the afternoon when he would become frustrated, irritable, or defiant with his parents. However, his parents reported these behaviors were consistently followed by a sincere apology, which they viewed as an improvement compared to previous behavior. The night terrors and previously mentioned side effects ceased, his bowel movements normalized, his skin appeared smooth without dry patches, and his symptoms remained stable. His anxiety decreased, functioning was no longer impaired at home, with schoolwork, or with peers, and his impulsivity and fidgeting decreased substantially. All diagnoses fully remitted.
“After 4 months of EMPowerplus, John’s mother increased his dose from 15 capsules a day to 18 capsules to manage emerging irritability, possible mood cycling, and ‘‘odd’’ behavior. She reported this increase relieved his symptoms. One month later, the dose was returned to 15 capsules of EMPowerplusowerplus daily. John has maintained health over the subsequent 9 months. He enrolled in regular public school for the first time, where he plays successfully on the school soccer and baseball teams and maintains friendships. His parents subjectively report that improvements in his functioning while taking EMPowerplus are greater than those he made in the past on other medications. His only additional interventions are drinking a half cup of whey protein mixed in milk in the morning during sports seasons while very active and using a lightbox during the winter. According to his mother, EMPowerplus helps keep him ‘‘clear, slowed down, peaceful, settled and happy.’’
To access the full study click on the citation below:
Elisabeth A. Frazier, Mary A. Fristad, L. Eugene Arnold. Journal of Child and Adolescent Psychopharmacology. August 2009, 19(4): 453-460. doi:10.1089/cap.2008.0157.
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Yours in health,
The Truehope Staff
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