Calcium Imbalance

Proper Name: Calcium Common Name: Calcium Evidence of Efficacy: statement to the effect of Calcium deficiency or imbalance plays a role in the symptoms of mood disorders. Observational and experimental studies have shown an association between calcium and aggression1,2, anxiety3,4,5,6,7 and ADHD8,9, bipolar disorder10,11,12,13,14,15,16,17, depression18,19,20,21,22,23 and premenstrual syndrome24,25,26,27,28. References: 1. Walsh, William J., analytical chemist, Argonne National Laboratory; Sci News 124:122-2, 1983. 2. Schmidt K, Wier WR, Asch M. Clinical ecology treatment approach for juvenile offenders. J Behav Ecology: Bioscocial 2(1), 1981. 3. Carlson RJ. Longitudinal observations of two cases of organic anxiety syndrome. Psychsomatics 27(7):529-31, 1986. 4. Lawlor BA. Hypocalcemia, hypoparathyroidism, and organic anxiety syndrome. J Clin Psychiatry. 1988 Aug;49(8):317-8. 5. Crammer JL. Calcium metabolism and mental disorder. Psychol Med 7(4):557-60, 1977. 6. Houssain M. Neurological and psychiatric manifestations in idiopathic hypoparathyroidism: Response to treatment. J Neurol Neurosurg Psychiatry 33:153-6, 1970. 7. Joborn C etal. Psychiatric symptomatology in patients with primary hyperparathyroidism. Ups J Med Sci 91(1):77-87, 1986. 8. Kozielec T, Starobrat-Hermelin B, Kotkowiak L. Deficiency of certain trace elements in children with hyperactivity. Psychiatr Pol. 1994 May-Jun;28(3):345-53. 9. Walker S III. Drugging the American child: We’re too cavalier about hyperactivity. J Learn Disabil 8:354, 1975. 10. Bowden CL, Huang LG, Javors MA, Johnson JM, Seleshi E, McIntyre K, Contreras S, Maas JW. 11. Calcium function in affective disorders and healthy controls. Biol Psychiatry. 1988 Feb 15;23(4):367-76. 12. Groat RD, Mackenzie TB. The appearance of mania following intravenous calcium replacement. J Nerv Ment Dis 168:562-3, 1980. 13. Dubovsky SL, Christiano J, Daniell LC, Franks RD, Murphy J, Adler L, Baker N, Harris RA. Increased platelet intracellular calcium concentration in patients with bipolar affective disorders. Arch Gen Psychiatry. 1989 Jul;46(7):632-8. 14. Dubovsky SL, Murphy J, Thomas M, Rademacher J. Abnormal intracellular calcium ion concentration in platelets and lymphocytes of bipolar patients. Am J Psychiatry. 1992 Jan;149(1):118-20. 15. Dubovsky SL, Murphy J, Christiano J, Lee C. The calcium second messenger system in bipolar disorders: data supporting new research directions. J Neuropsychiatry Clin Neurosci. 1992 Winter;4(1):3-14. 16. Carman JS, Wyatt RJ. Calcium: pacesetting the periodic psychoses. Am J Psychiatry. 1979 Aug;136(8):1035-9. 17. Carman JS, Wyatt RJ. Calcium: bivalent cation in the bivalent psychoses. Biol Psychiatry. 1979 Apr;14(2):295-336. 18. Depression and hypercalcemia. Am J Med. 1996 Jul;101(1):111-7. 19. Joborn C etal. Psychiatric symptomatology in patients with primary hyperparathyroidism. Ups J Med Sci 91(1):77-87, 1986. 20. Alarcon RD, Franceschini JA. Hyperparathyroidism and paranoid psychosis. Br J Psychiatry. 1984 Nov;145:477-86. 21. Webb WL Jr, Gehi M. Electrolyte and fluid imbalance: neuropsychiatric manifestations. Psychosomatics. 1981 Mar;22(3):199-203. 22. Linder J, Brismar K, Beck-Friis J, Saaf J, Wetterberg L.Calcium and magnesium concentrations in affective disorder: difference between plasma and serum in relation to symptoms. Acta Psychiatr Scand. 1989 Dec;80(6):527-37. 23. Levine J, Stein D, Rapoport A, Kurtzman L. High serum and cerebrospinal fluid Ca/Mg ratio in recently hospitalized acutely depressed patients. Neuropsychobiology. 1999;39(2):63-70. 24. Thys-Jacobs S. Micronutrients and the premenstrual syndrome: the case for calcium. J Am Coll Nutr. 2000 Apr;19(2):220-7. 25. Goei GS, Abraham GE. Effect of a nutritional supplement, optivite, on symptoms of premenstrual tension. J Reprod Med. 1983 Aug;28(8):527-31. 26. Abraham GE. Nutritional factors in the etiology of the premenstrual tension syndromes. J Reprod Med. 1983 Jul;28(7):446-64. 27. Alvir JM, Thys-Jacobs S. Premenstrual and menstrual symptom clusters and response to calcium treatment. Psychopharmacol Bull. 1991;27(2):145-8. 28. Thys-Jacobs S, Ceccarelli S, Bierman A, Weisman H, Cohen MA, Alvir J. Calcium supplementation in premenstrual syndrome: a randomized crossover trial. J Gen Intern Med. 1989 May-Jun;4(3):183-9.

Potassium Imbalance

Proper Name: Potassium Common Name: Potassium Evidence of Efficacy: statement to the effect of Potassium deficiency or imbalance plays a role in the symptoms of mood disorders1. Observational and experimental studies have shown an association between potassium and aggression2,3,4, anxiety5 , bipolar disorder6,7,8,9, and depression10,11. References: 1. Webb WL, Gehi M. Electrolyte and fluid imbalance: Neuropsychiatric manifestations. Psychosomatics 22(3):199-203, 1981 2. William J. Walsh, analytical chemist, Argonne National Laboratory – reported in Sci News 124:122-5, 1983 3. Schmidt K, Wier WR, Asch M. Clinical ecology treatment approach for juvenile offenders. J Behav Ecology: Biosocial 2(1), 1981 4. Von Hilsheimer G, Philpott W, Buckley W, Klotz SC. Correcting the incorrigible. A report on 229 “incorrigible” adolescents. Am Lab 107:22-49, 1977 5. McCleane GJ, Watters CH. Pre-operative anxiety and serum potassium. Anaesthesia 45(7):583-5, 1990 6. Klemfuss H. Dietary potassium effects on lithium concentration and toxicity in humans. Biol Psychiatry 37:42-7, 1995 7. Jefferson JW. Potassium supplementation in lithium patients: a timely intervention or premature speculation? J Clin Psychiatry 53:10, 1992 8. Bkaskara Rao Tripuraneni, fellow in child psychiatry, Harbo-UCLA Medical Center, Torrance, California – reported in Clin Psychiatry News 18(10):3, October, 1990 and presented to the 143rd Annual Mtg of the Am Psychiatric Assoc, May 12-17, 1990, Abstracts NR 100 and NR 210 9. Cater RE. The use of sodium and potassium to reduce toxicity and toxic side effects from lithium. Med Hypotheses 20(4):359-83, 1986 10. Webb WL, Gehi M. Electrolyte and fluid imbalance: Neuropsychiatric manifestations. Psychosomatics 22(3):199-203, 1981 11. Cox JR et al. Changes in sodium, potassium and fluid spaces in depression and dementia. Gerontology Clin 13:232-45, 1971 Aggressive Behavior

Vitamin B6 Imbalance

Proper Name: Pyridoxine Hydrochloride Common Name: Vitamin B6 Evidence of Efficacy: statement to the effect of Vitamin B6 deficiency or imbalance plays a role in the symptoms of mood disorders. Observational and experimental studies have shown an association between vitamin B6 and aggression1, anxiety2,3,4, ADHD5,6,7,8,9,10,11,12, bipolar disorder13,14, depression15, 16 ,17 ,18 ,19 ,20 ,21 ,22 ,23 ,24 ,25 ,26, obsessive compulsive disorder27,28, premenstrual syndrome29, 30, 31, 32, 33,3 4,3 5,36 ,37, 38, ,39 ,40, 41, 42,43 ,44, 45, 46, 47, 48, 49, 50 ,5 1,52, 53,and schizophrenia54, 55, 56, 57, 58, 59,6 0,6 1,62 ,63 ,64 .65 References: 1. Noted in McLaren DS. Clinical manifestations of nutritional disorders, in ME Shils, VR Young, Eds. Modern Nutrition in Health and Disease, Seventh Edition. Philadelphia, Lea & Febiger, 1988. 2. Heseker H, Kubler W, Pudel V, Westenhoffer J. Psychological disorders as early symptoms of a mild-moderate vitamin deficiency. Ann N Y Acad Sci 669:352-7, 1992. 3. Hoes MJ et al. Hyperventilation syndrome, treatment with L-tryptophan and pyridoxine; Predictive value of xanthurenic acid excretion. J Orthomol Psychiatry 10(1):7-15, 1981. 4. Buist RA. Anxiety neurosis: The lactate connection. Int Clin Nutr Rev 5:1-4, 1985. 5. Coleman M et al. Serotonin in Down’s syndrome. Amsterdam, North Holland, 1973. 6. Kleijnen J, Knipschild P. Niacin and vitamin B6 in mental functioning: a review of controlled trials in humans. Biol Psychiatry 29(9):931-41, 1991. 7. Haslam RH, Dalby JT. Blood serotonin levels in the attention-deficit disorder. Letter. N Engl J Med 309(31):1328-9, 1983. 8. Brenner A. The effects of megadoses of selected B complex vitamins on children with hyperkinesis: Controlled studies with long-term follow-up. J Learn Disabil 15(5):258-64, 1982. 9. Klieger JA, Altshuler CH, Krakow L, Hollister L. Abnormal pyridoxine metabolism in toxemia of pregnancy. Ann N Y Acad Sci 166:288-96, 1969. 10. Coleman M et al. A preliminary study of the effect of pyridoxine administration in a subgroup of hyperkinetic children: A double-blind crossover comparison with methylphenidate. Biol Psychiatry 14(5):741-51, 1979. 11. Brenner A, Wapnir R. A pyridoxine-dependent behavioral disorder unmasked by Isoniazid. Am J Dis Child 132:773-6, 1978. 12. Bhagavan HN et al. The effect of pyridoxine hydrochloride on blood serotonin and pyridoxal phosphate contents in hyperactive children. Pediatrics 55:437-41, 1975. 13. Moller SE et al. Tryptophan availability in endogenous depression – relation to efficacy of L-tryptophan treatment. Adv Biol Psychiatry 10:30-46, 1983. 14. The pharmacokinetics of oral L-tryptophan: Effects of dose and concomitant pyridoxine, allopurinol or nicotinamide administration. Adv Biol Psychiatry 10:67-81, 1983. 15. Noted in McLaren DS. Clinical manifestations of nutritional disorders, in ME Shils, VR Young, Eds. Modern Nutrition in Health and Disease, Seventh Edition. Philadelphia, Lea & Febiger, 1988. 16. Bell I et al. Complex vitamin patterns in geriatric and young adult inpatients with major depression. J Am Geriatr Soc 39:252-7, 1991. 17. Stewart TW, Harrison W, Quitkin F, et al. Low B6 levels in depressed outpatients. Biol Psychiatry 19(4):613-16, 1984. 18. Russ CS et al. Vitamin B6 status of depressed and obsessive-compulsive patients. Nutr Rep Int 27(4):867-73, 1983. 19. Carney MW, Ravindran A, Rinsler MG, et al. Thiamine, riboflavin and pyridoxine deficiency in psychiatric inpatients. Br J Psychiatry 141:271-2, 1982. 20. Carney MW, Williams DG, Sheffield BF. Thiamin and pyridoxine lack in newly-admitted psychiatric patients. Br J Psychiatry 135:249-54, 1979. 21. Nobbs B. Pyridoxal phosphate status in clinical depression. Letter. Lancet i:405, 1974. 22. Bermond P. Therapy of side effects of oral contraceptive agents with vitamin B6. Acta Vitaminol Enzymol 4(1-2):45-54, 1982. 23. Adams PW, Wynn V, Rose DP, et al. Effect of pyridoxine hydrocholoride (vitamin B6) upon depression associated with oral contraception. Lancet ii:899-904, 1973. 24. Adams PW, Wynn V, Seed M, Folkard J. Vitamin B6, depression, and oral contraception. Letter. Lancet ii:516-17, 1974. 25. Benton D, Haller J, Fordy J. Vitamin supplementation for 1 year improves mood. Neuropsychobiology 32(2):98-105, 1995. 26. Hallert C, Astrom J, Walan A. Reversal of psychopathology in adult coeliac disease with the aid of pyridoxine (vitamin B6). Scand J Gastroenterol 18(2):299-304, 1983. 27. Yaryura-Tobias JA. Presentation to the Third World Congress of Biological Psychiatry, Stockholm – reported in Clinical Psychiatrty News. September, 1981. 28. Yaryura-Tobias JA, Bhagavan HN. L-tryptophan in obsessive-compulsive disorders. Am J Psychiatry 134(11):1298-9, 1977. 29. Mira M, Stewart PM, Abraham SF. Vitamin and trace element status in premenstrual syndrome. Am J Clin Nutr 47(4):636-41, 1988. 30. Gallant MP, Bowering J, Short SH, et al. Pyridoxine and magnesium status in women with premenstrual syndrome. Nutr Res 7:243-52, 1987. 31. Stewart A. Clinical and biochemical effects of nutritional supplementation on the premenstrual syndrome. J Reprod Med 32(6):435-41, 1987. 32. Richie CD, Singkamani R. Plasma pyridoxal-5’-phosphate in women with the premenstrual syndrome. Hum Nutr Clin Nutr 40C:75-80, 1986. 33. Parry GJ, Bredesen DE. Sensory neuropathy with low-dose pyridoxine. Neurology 35:1466-8, 1985; Waterston JA, Gilligan BS. Pyridoxine neuropathy. Med J Aust 146:640-2, 1987. 34. Guy Abraham – personal communication reported in Piesse JW. Nutrition factors in the premenstrual syndrome: A review. Int Clin Nutr Rev 4(2):54-81, 1984. 35. Abraham GE. Nutrition and the premenstrual tension syndromes. J Appl Nutr 36(2):103-17, 1985; Hargrove JT, Abraham GT. Effect of vitamin B6 on infertility in women with the premenstrual syndrome. Infertility 2:315: 1979. 36. Leklem JE. Vitamin B6: The pill, pregnancy and premenstrual syndrome. Abstract. J Am Coll Nutr. 11(5):624, 1992. 37. Kleijnen J, Ter Riet G, Knipschild P. Vitamin B6 in the treatment of premenstrual syndrome – a review. Br J Obstet Gynaecol 97(9):847-52, 1990. Berman MK et al. Vitamin B-6 in premenstrual syndrome. J Am Diet Assoc 90(6):859-61, 1990. 38. Doll H, Brown S, Thurston A, Vessey M. Pyridoxine (vitamin B6) and the premenstrual syndrome: A randomized crossover trial. J R Coll Gen Pract 39:364-8, 1989. 39. Brush MG, Bennett T, Hansen K. Pyridoxine in the treatment of premenstrual syndrome: A retrospective survey in 630 patients. Br J Clin Pract 42(11):448-52, 1988. 40. Kendall KE, Schnurr PP. The effects of vitamin B6 supplementation on premenstrual symptoms. Obstet Gynecol 70(2):145-9, 1987. 41. David R. Rubinow, biological psychiatry branch, National Institute of Mental Health (USA) – quoted by Clin Psychiatry News, December, 1987. 42. Hagen I et al. No effect of vitamin B-6 against premenstrual tension: A controlled clinical study. Acta Obstet Gynecol Scand 64:667, 1985. 43. Williams MJ, Harris RI, Dean BC. Controlled trial of pyridoxine in the premenstrual syndrome. J Int Med Res 13:174-9, 1985. 44. Barr W. Pyridoxine supplements in the premenstrual syndrome. Practitioner 228:425-7, 1984. 45. Mattes JA, Martin D. Pyridoxine in premenstrual depression. Hum Nutr Appl Nutr 36(2):131-3, 1982. 46. Abraham GE, Hargrove JT. Effect of vitamin B-6 on premenstrual symptomatology in women with premenstrual tension syndrome: A double-blind crossover study. Infertility 3:155-65, 1980. 47. Day JB. Clinical trials in the premenstrual syndrome. Curr Med Res Opin (Suppl 6) 5:40-5, 1979. 48. Kerr GD. The management of the premenstrual syndrome. Curr Med Res Opin (Suppl 4) 4:29-34, 1977. 49. Stokes J, Mendels J. Pyridoxine and premenstrual tension. Letter. Lancet i:1177-8, 1972. 50. Piesse JW. Nutrition factors in the premenstrual syndrome. Int Clin Nutr Rev 4(2):54-81, 1984. 51. Lee CM, Leklem JE. Blood magnesium constancy with vitamin B-6 supplementation in pre- and post-menopausal women. Ann Clin Lab Sci 14(2):151-4, 1984. 52. Abraham GE et al. Effect of vitamin B6 on plasma and red blood cell magnesium levels in premenopausal women. Ann Clin Lab Sci 11(4):333-6, 1981. 53. Holley J et al. Effect of vitamin B6 nutritional status on the uptake of [3H]-oestradiol into the uterus, liver and hypothalamus of the rat. J Steroid Biochem 18:161-6, 1983. 54. Pfeiffer CC, Audette L. Pyroluria – Zinc and B6 deficiencies. Int Clin Nutr Rev 8(3):107-10; 1988. 55. Pfeiffer CC. The schizophrenias ’76. Biol Psychiatry 2:773-5, 1976. 56. Pfeiffer CC, Bacchi D. Copper, zinc, manganese, niacin and pyridoxine in the schizophrenias. J Appl Nutr 27:9-39, 1975. 57. Pfeiffer CC. Observations on trace and toxic elements in hair and serum. J Orthomol Psychiatry 3(4):259-64, 1974. 58. Cruz R, Vogel WH. Pyroluria: A poor marker in chronic schizophrenia. Am J Psychiatry 135(10):1239-40, 1978. 59. Parry GJ. Sensory neuropathy with low-dose pyridoxine. Neurology 35:1466:8, 1985. 60. Kleijnen J, Knipschild P. Niacin and vitamin B6 in mental functioning: a review of controlled trials in humans. Biol Psychiatry 29(9):931-41, 1991. 61. Brooks SC et al. An unusual schizophrenic illness responsive to pyridoxine HCl (B6) subsequent to phenothiazine and butyrophenone toxicities. Biol Psychiatry 18(11):1321-8, 1983. 62. Yamauchi M. Effects of L-dopa and vitamin B6 on electroencephalograms of schizophrenic patients: A preliminary report. Folia Psychiatrica et Neurologica Japonica 30(2):121-51, 1976. 63. Sandyk R, Pardeshi R. Pyridoxine improves drug-induced parkinsonism and psychosis in a schizophrenic patients. J Neurosci 53(3-4):225-32, 1990. 64. Petrie WM, Ban TA, Anath JV. The use of nicotinic acid and pyridoxine in the treatment of schizophrenia. Int Pharmacopsychiatry 16(4):245-50, 1981. 65. Ananth JV, Ban TA, Lehmann HE. Potentiation of therapeutic effects of nicotinic acid by pyridoxine in chronic schizophrenics. Can Psychiatr Assoc J 18:377-83, 1973.

Magnesium Imbalance

Proper Name: Magnesium Common Name: Magnesium Evidence of Efficacy: Magnesium deficiency or imbalance plays a role in the symptoms of mood disorders. Observational and experimental studies have shown an association between magnesium and aggression 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, anxiety 11, 12, 13, 14, 15, ADHD 16, 17, 18, bipolar disorder 19, 20 ,21, depression 22,23,24,25,26,27,28,29,30,31,32,33,34,35, premenstrual syndrome 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, and schizophrenia 58, 59, 60, 61, 62, 63, 64, 65 ,66 ,67 ,68 ,69, 70. References: 1. Izenwasser SE et al. Stimulant-like effects of magnesium on aggression in mice. Pharmacol Biochem Behav 25(6):1195-9, 1986. 2. Henrotte JG. Type A behavior and magnesium metabolism. Magnesium 5:201-10, 1986. 3. Bennett CPW, McEwen LM, McEwen HC, Rose EL. The Shipley Project: treating food allergy to prevent criminal behaviour in community settings. J Nutr Environ Med 8:77-83, 1998. 4. Kirow GK, Birch NJ, Steadman P, Ramsey RG. Plasma magnesium levels in a population of psychiatric patients: correlation with symptoms. Neuropsychobiology 30(2-3):73-8, 1994. 5. Kantak KM. Magnesium deficiency alters aggressive behavior and catecholamine function. Behav Neurosci 102(2):304-11, 1988. 6. Izenwasser SE, Garcia-Valdez K, Kantak KM. Stimulant-like effects of magnesium on aggression in mice. Pharmacol Biochem Behav 25(6):1195-9, 1986. 7. Struempler RE et al. Hair mineral analysis and disruptive behavior in clinically normal young men. J Learn Disabil 18(10):609-12, 1985. 8. Banki CM, Vojnik M, Papp Z, et al. Cerebrospinal fluid magnesium and calcium related to amine metabolites, diagnosis, and suicide attempts. Biol Psychiatry 20(2):163-71, 1985. 9. Schmidt K, Wier WR, Asch M. Clinical ecology treatment approach for juvenile offenders. J Behav Ecology: Biosocial 2(1), 1981. 10. Von Hilsheimer G, Philpott W, Buckley W, Klotz SC. Correcting the incorrigible. A report on 229 "incorrigible" adolescents. Am Lab 107:22-49, 1977. 11. Buist RA. Anxiety neurosis: The lactate connection. Int Clin Nutr Rev 5:1-4, 1985. 12. Seelig MS, Berger AR, Spieholz N. Latent tetany and anxiety, marginal Mg deficit, and normocalcemia. Dis Nerv Syst 36:461-5, 1975. 13. Durlach J, Durlach V, Bac P, et al. Magnesium and therapeutics. Magnes Res 7(3/4):313-28, 1994. 14. Kirov GK, Tsachev KN. Magnesium, schizophrenia and manic-depressive disease. Neuropsychobiology 23(2):79-81, 1990. 15. Weston PG et al. Magnesium sulphate as a sedative. Am J Med Sci 165:431-3, 1923. 16. Durlach J. Clinical aspects of chronic magnesium deficiency, in MS Seelig, Ed. Magnesium in Health and Disease. New York, Spectrum Publications, 1980. 17. Kozielec T, Starobrat-Hermelin B. Assessment of magnesium levels in children with attention deficit hyperactivity disorder (ADHD). Magnes Res 10(2):143-8, 1997. 18. Starobrat-Hermelin B, Kozielec T. The effects of magnesium physiological supplementation on hyperactivity in children with attention deficit hyperactivity disorder (ADHD). Positive response to magnesium oral loading test. Magnes Res 10(2):149-56, 1997. 19. George MS, Rosenstein D, Rubinow DR, et al. CSF magnesium in affective disorder: lack of correlation with clinical course of treatment. Psychiatry Res 51(2):139-46, 1994. 20. Kirov GK, Birch NJ, Steadman P, Ramsey RG. Plasma magnesium levels in a population of psychiatric patients: correlations with symptoms. Neuropsychobiology 1994;30(2-3):73-8, 1994. 21. Chouinard G, Beauclair L, Geiser R, Etienne P. A pilot study of magnesium aspartate hydrochloride (Magnesiocard) as a mood stabilizer for rapid cycling bipolar affective disorder patients. Prog Neuropsychopharmacol Biol Psychiatry 14(2):171-180, 1990. 22. Kirow GK, Birch NJ, Steadman P, Ramsey RG. Plasma magnesium levels in a population of psychiatric patients: correlation with symptoms. Neuropsychobiology 30(2-3):73-8, 1994. 23. Linder J et al. Calcium and magnesium concentrations in affective disorder: Difference between plasma and serum in relation to symptoms. Acta Psychiatr Scand 80:527-37, 1989. 24. Frazer A et al. Plasma and erythrocyte electrolytes in affective disorders. J Affect Disord 5(2):103-13, 1983. 25. Bjorum N. Electrolytes in blood in endogenous depression. Acta Psychiatr Scand 48:59-68, 1972. 26. Cade JFJA. A significant elevation of plasma magnesium levels in schizophrenia and depressive states. Med J Aust 1:195-6, 1964. 27. Kirov GK, Tsachev KN. Magnesium, schizophrenia and manic-depressive disease. Neuropsychobiology 23(2):79-81, 1990. 28. Hall RCW, Joffe JR. Hypomagnesemia: Physical and psychiatric symptoms. JAMA 224:1749-51, 1973. 29. Frizel D, Coppen A, Marks V. Plasma magnesium and calcium in depression. Br J Psychiatry 115:1375-7, 1969. 30. Frizel D et al. Plasma calcium and magnesium in depression. Br J Psychiatry 115:1375-7, 1969. 31. Hasey GM, D'Alessandro E, Cooke RG, Warsh JJ. The interface between thyroid activity, magnesium, and depression: A pilot study. Biol Psychiatry 33:133-5, 1993. 32. Linder J et al. Calcium and magnesium concentrations in affective disorder: Difference between plasma and serum in relation to symptoms. Acta Psychiatr Scand 80:527-37, 1989. 33. Frazer A et al. Plasma and erythrocyte electrolytes in affective disorders. J Affect Disord 5(2):103-13, 1983]. 34. Banki CM et al. Aminergic studies and cerebrospinal fluid cations in suicide. Ann N Y Acad Sci 487:221-30, 1986. 35. Banki CM et al. Cerebrospinal fluid magnesium and calcium related to amine metabolites, diagnosis, and suicide attempts. Biol Psychiatry 20:163-71, 1985. 36. Posaci C, Erten O, Uren A, Acar B. Plasma copper, zinc and magnesium levels in patients with premenstrual tension syndrome. Acta Obstet Gynecol Scand 73(6):452-5, 1994. 37. Rosenstein DL et al. Magnesium measures across the menstrual cycle in premenstrual syndrome. Biol Psychiatry 35:557-61, 1994. 38. Chuong CJ, Dawson EB., Magnesium levels in premenstrual syndrome. Nutr Res 14(11):1623-34, 1994. 39. Mira M, Stewart PM, Abraham SF. Vitamin and trace element status in premenstrual syndrome. Am J Clin Nutr 47:636-41, 1988. 40. Sherwood RA, Rocks BF, Stewart A, Saxton RS. Magnesium and the premenstrual syndrome. Ann Clin Biochem 23(6):667;70, 1986. 41. Stebbing JB et al., Reactive hypoglycaemia and magnesium. Magnesium Bull 4(2):131-4, 1982. 42. Rosenstein DL et al. Magnesium measures across the menstrual cycle in premenstrual syndrome. Biol Psychiatry 35:557-61, 1994. 43. Stewart A., Clinical and biochemical effects of nutritional supplementation on the premenstrual syndrome. J Reprod Med 32:435-41, 1987. 44. Sherwood RA, Rocks BF, Stewart A, Saxton RS. Magnesium and the premenstrual syndrome. Ann Clin Biochem 23(6):667-70, 1986. 45. Stebbing JB et al., Reactive hypoglycaemia and magnesium. Magnesium Bull 4(2):131-4, 1982. 46. Abraham GE. Magnesium deficiency in premenstrual tension. Magnesium Bull 1:68-73, 1982. 47. Abraham GE, Lubran MM. Serum and red cell magnesium levels in patients with premenstrual tension. Am J Clin Nutr 34(11):2364-6, 1981. 48. Rosenstein DL et al. Magnesium measures across the menstrual cycle in premenstrual syndrome. Biol Psychiatry 35:557-61, 1994. 49. Stewart A., Clinical and biochemical effects of nutritional supplementation on the premenstrual syndrome. J Reprod Med 32:435-41, 1987. 50. Stebbing JB et al. Reactive hypoglycaemia and magnesium. Magnesium Bull 4(2):131-4, 1982. 51. Brown RC, Bidlack WR. Regulation of glucuronyl transferase by intracellular magnesium, in Proceedings of the International Symposium on Magnesium and its Relationship to Cardiovascular, Renal and Metabolic Disorders. Los Angeles, 1985:24. 52. Curry DL et al. Magnesium modulation of glucose-induced insulin secretion by the perfused rat pancreas. Endocrinology 101:203, 1977. 53. Abraham GE. Management of the premenstrual tension syndromes: Rationale for a nutritional approach, in J Bland, Ed. 1986: A Year in Nutritional Medicine. New Canaan, CT, Keats Publishing, 1986:125-66. 54. Brown RC, Bidlack WR. Regulation of glucuronyl transferase by intracellular magnesium, in Proceed Int Sympos Magnesium and its Relationship to Cardiovascular, Renal and Metabolic Disorders. Los Angeles, 1985:24. 55.Cunnane SC, Horrobin DF. Parnteral linoleic and gamma-linolenic acids ameliorate the gross effects of zinc deficiency. Proc Soc Exp Biol Med 164:583, 1980. 56. Facchinetti F, Bolrella P, Sances G, et al. Oral magnesium successfully relieves premenstrual mood changes. Obstet Gynecol 78(2):177-81, 1991. 57. Facchinetti F et al. Magnesium prophylaxis of menstrual migraine: effects of intracellular magnesium. Headache 31:298-304, 1991. 58. Levine J, Rapoport A, Mashiah M, Dolev E. Serum and cerebrospinal levels of calcium and magnesium in acute versus remitted schizophrenic patients. Neuropsychobiology 33(4):169-72, 1996. 59. Kirow GK, Birch NJ, Steadman P, Ramsey RG. Plasma magnesium levels in a population of psychiatric patients: correlation with symptoms. Neuropsychobiology 30(2-3):73-8, 1994. 60. Kanofsky JD et al. Is iatrogenic hypomagnesemia common in schizophrenia? Abstract. J Am Coll Nutr 10(5):537, 1991. 61. Kirov GK, Tsachev KN. Magnesium, schizophrenia and manic-depressive disease. Neuropsychobiology 23(2):79-81, 1990. 62. Chhatre SM et al. Serum magnesium levels in schizophrenia. Ind J Med Sci 39(11):259-61, 1985. 63. Paul EA et al. Serum calcium and magnesium in schizophrenia. Relationship to clinical phenomena and neuroleptic treatment. Br J Psych 133:143-9, 1978. 64. Daly RM, Gold G. Serum magnesium levels in nonacute schizophrenics. N Y State J Med 76:188-9, 1976. 65. Hakim AH et al. A comparative study of serum calcium and magnesium in cases of endogenous depression, reactive depression, schizophrenia and conversion reaction. J Assn Phys Ind 23:513-17, 1975. 66. Pandey SK et al. An estimation of magnesium and calcium in serum and CSF in schizophrenia. J Assn Phys Ind 21:203-5, 1973. 67. Chugh TD et al. Magnesium in schizophrenia. Ind J Med Res 61:998-1001, 1973. 68. Cade JFJ. A significant elevation of plasma magnesium level in schizophrenia and depressive states. Med J Aust 1:195-6, 1964. 69. Kornhuber J, Lange KW, Kruzik P, et al. Iron, copper, zinc, magnesium, and calcium in postmortem brain tissue from schizophrenic patients. Biol Psychiatry 36(1):31-4, 1994. 70. Levine J, Rapoport A, Mashiah M, Dolev E. Serum and cerebrospinal levels of calcium and magnesium in acute versus remitted schizophrenic patients. Neuropsychobiology 33(4):169-72, 1996.

Common Treatments: Choline

When medical researchers use the term "lecithin", they are referring to a purified substance called phosphatidylcholine (PC). Supplements labeled as "lecithin" usually contain 10-20% PC. Relatively pure PC supplements are generally labeled as "phosphatidylcholine". PC best duplicates supplements used in medical research. Most commercial lecithins contain various amounts of other phospholipids such as phosphatidylserine and phosphatidylethanolamine. Source Choline, a lipotropic molecule and the major constituent of phosphatydyl choline, is also available by itself (without the "phosphatidyl" group) in foods and supplements. It is found in soybeans, liver and other animal organs, bile, oatmeal, cabbage, and cauliflower. Egg yolks, meat, and some vegetables contain PC. Lecithin (containing 10-20% PC) is added to many processed foods in small amounts, for the purpose of maintaining texture consistency. Most commercial lecithin is derived from soybeans. Choline is added as an ingredient in some multivitamin products as well as those specifically designed for the liver or gastrointestinal conditions. Choline is also a precursor to the neurotransmitter acetylcholine, and is often added to products designed to improve memory or depression. Commercial lecithin supplies choline, inositol, phosphoric acid and fatty acids to the diet. Choline can also be found in stable salt forms such as choline bitartrate. Function; Reasons For Use PC acts as a supplier of choline. Choline is now considered an essential nutrient, needed for cell membrane integrity and to facilitate the movement of fats in and out of cells. It is also a component of the neurotransmitter acetylcholine and is needed for normal brain functioning, particularly in infants. For this reason, PC has been used in a number of preliminary studies for a wide variety of neurological and psychiatric disorders [Benjamin J, Levine J, Fux M, et al. Double-blind, placebo-controlled, crossover trial of inositol treatment for panic disorder. Am J Psychiatry 1995;152: pp.1084-6.], though not every study suggests that supplemental choline is capable of reaching the brain [Dechent P, Pouwels PJW, Frahm J. Neither short-term nor long-term administration of oral choline alters metabolite concentrations in human brain. Biol Psychiatry 1999;46: pp.406-11]. Choline participates in many functions involving cellular components called phospholipids. Choline is a vitamin that is lipotropic (has an affinity for lipids - fats). Lipotropics are fat metabolism assisting agents. As a lipotropic agent it is helpful in moving fat out of the liver into the bile. As a precursor to betaine, choline is also involved in methylation of homocysteine as well as DNA. Lecithin, with other phospholipids, is essential for every cellular and sub-cellular membrane in the body, especially the brain and central nervous system. Lecithin helps to regulate fat and cholesterol metabolism and is beneficial in atherosclerosis, hypertension and diabetes. Phosphatidyl choline has been used in connection with the following conditions:

• Gallbladder attacks, High homocysteine, Liver cirrhosis, Tardive dyskinesia;
• Alzheimer's disease, Bipolar disorder, Hepatitis, High cholesterol.

Side-Effects In high amounts, pure choline can make people smell like fish, so it's rarely used, except in the small amounts found in multivitamin supplements.