Suicide: A Symptom of Depression

"However, GSK researchers submitting data on Paxil to the US Food and Drug Administration in the late 1980s and early 1990s included suicides and suicide attempts from the washout period in the results for the placebo arms of trials, but not from the Paxil arms. Glenmullen alleges that these extra "placebo" suicides negated suicides attributed to Paxil in the trials, making the drug appear safer than it really was. He says that if the washout results had been excluded, the data would have showed that Paxil increased eightfold the risk of suicidal behaviour in adults."

Giles, Jim (Ref. 1)

Suicide can be a symptom of both depression and schizophrenia. It can also be a symptom of bipolar disorder. Ref. 5 discusses depression. This reference is available free full text at Pubmed Central. They blame the disease on stress. Treatments have been largely trail & error as with schizophrenia. The chemical imbalances are not understood by the drug companies, unfortunately.

Depression

There are genetic theories (6). There are also theories of abnormal tryptophan metabolism. There are nutritional treatments for depression (10).

Pellagra

This is a vitamin deficiency disease with psychiatric symptoms. It is discussed in Ref. 11.

Mania

Dietary tryptophan depletion has been proposed as a treatment for mania (12).

Irritable Bowel Syndrome with Psychiatric Symptoms

According to Ref. 13, tryptophan catabolism is high in IBS (Irritable Bowel Syndrome). This was measured in the kynurenine pathway, which is the main pathway of tryptophan degredation. This is an important study, in my opinion. Serotonin is an important neurotransmitter in the bowel (as well as in the brain).

"Those with severe IBS symptoms had increased Kyn:Trp (P < 0.005) compared to those with less severe symptoms and controls, and were over twice as likely to have depression or anxiety compared to those with less severe IBS (RR = 2.2, 95% CI 1.2-3.9)." Fitzgerald et al (13)

This reminds me of celiac disease, where both gastrointestinal symptoms and psychiatric symptoms are seen. However, in celiac disease the offending amino acid is glutamine. Celiac disease is treated by a diet very low in glutamine, which is found in wheat gluten and in dairy products. Milk has all the essential amino acids plus glutamine, which is not essential.

Perhaps a low tryptophan diet should be tried in IBS.

Foods High in Tryptophan

The following foods are high in tryptophan:

Baked potatoes with their skin

Bananas

Beans

Cheddar

Cheese

Cottage Cheese

Eggs

Fish

Gruyere (a type of Swiss cheese)

Hazelnuts

Heated milk

Hummus

Lentils

Kelp

Meat (including red meats)

Milk

Nuts

Peanuts

Rice

Roasted Pumpkin Seeds

Sesame Seeds

Shellfish

Soy Milk

Soybean Nuts

Sunflower Seeds

Swiss cheese

Tofu

Tuna

Turkey

Yogurt

Most of these items are animal products, which are high in protein as a rule. An exception is butter, which is an animal product that has almost no protein and therefore almost no tryptophan. Seeds and nuts are plant products that are high in protein. Legumes are also high in protein.

The banana is unusual because most fruits are low in tryptophan except for dates and bananas. I may do a slide show on Gather of foods high in tryptophan. I already have a photo album on this subject at Gather.

Schizophrenia

Schizophrenia has also been reported to be caused by an error in tryptophan metabolism (14-19). too much tryptophan is flooding the brain cells.

Conclusions

Many different forms of mental illness can have suicidality as a symptom. When tryptophan floods the brain cells, thinking is adversely affected. My recommendation for a treatment is a diet very low in tryptophan. Also sugar is a problem because it has the effect of pumping tryptophan into the brain by a complex mechanism involving insulin. Insulin causes the cells to eat. Therefore sugar should be avoided. Too much complex carbohydrates can also do this, but as a rule complex carbohydrates cause a slower rise in the blood sugar.

Fiber also slows the rise in blood sugar after a meal.

References

1. "Did drug trial data mask suicide risk?(This week)." New Scientist, Feb 9, 2008 v197 i2642 p12(1). Science Resource Center. Gale. 23 May 2009 http://galenet.galegroup.com/servlet/SciRC?ste=1&docNum=A175182553.

2. Lacasse JR, Leo J. Serotonin and depression: a disconnect between the advertisements and the scientific literature. PLoS Med. 2005;2:e392. doi: 10.1371/journal.pmed.0020392.

3. Effectiveness of antidepressants: an evidence myth constructed from a thousand randomized trials? John PA IoannidisPhilos Ethics Humanit Med. 2008; 3: 14. Published online 2008 May 27. doi: 10.1186/1747-5341-3-14. PMCID: PMC2412901.

4. The Latest Mania: Selling Bipolar Disorder David HealyPLoS Med. 2006 April; 3(4): e185. Published online 2006 April 11. doi: 10.1371/journal.pmed.0030185. PMCID: PMC1434505.

5. Stress and Depression: Preclinical Research and Clinical Implications Alessandro Bartolomucci and Rosario LeopardiPLoS ONE. 2009; 4(1): e4265. Published online 2009 January 30. doi: 10.1371/journal.pone.0004265. PMCID: PMC2629543.

6. Malhi GS, Moore J, McGuffin P. The genetics of major depressive disorder. Curr Psychiatry Rep. 2000;2:165-169.

7. Duman RS, Monteggia LM. A neurotrophic model for stress-related mood disorders. Biol Psychiatry. 2006;59:1116-1127.

8. Lesch KP. Gene-environment interaction and the genetics of depression. J Psychiatry Neurosci. 2004;29:174-184.

9. Nestler EJ, Gould E, Manji H, Buncan M, Duman RS, et al. Preclinical models: status of basic research in depression. Biol Psychiatry. 2002;52:503-528.

10. Major depressive disorder and nutritional medicine: a review of monotherapies and adjuvant treatments.

Sarris J, Schoendorfer N, Kavanagh DJ.

Nutr Rev. 2009 Mar;67(3):125-31. Review.

11. Rapid resolution of delusional parasitosis in pellagra with niacin augmentation therapy.

Prakash R, Gandotra S, Singh LK, Das B, Lakra A.

Gen Hosp Psychiatry. 2008 Nov-Dec;30(6):581-4. Epub 2008 Jul 23.

12. Dietary tryptophan depletion according to body weight - a new treatment option in acute mania?

Zepf FD, Wöckel L, Poustka F, Holtmann M.

Med Hypotheses. 2009 Jan;72(1):47-8. Epub 2008 Oct 11.

13. Tryptophan catabolism in females with irritable bowel syndrome: relationship to interferon-gamma, severity of symptoms and psychiatric co-morbidity.

Fitzgerald P, Cassidy Eugene M, Clarke G, Scully P, Barry S, Quigley Eamonn MM, Shanahan F, Cryan J, Dinan Timothy G.

Neurogastroenterol Motil. 2008 Dec;20(12):1291-7. Epub 2008 Sep 24.

14. http://www.associatedcontent.com/article/1485724/a_hypothesis_for_mental_disease.html

15. www.associatedcontent.com/article/1728112/mental_illness_and_homelessness.html
16. www.associatedcontent.com/article/1698919/advances_in_biological_psychiatric.html
17. www.associatedcontent.com/article/1680090/cuban_research_on_schizophrenia.html
18. www.associatedcontent.com/article/1680380/the_virus_theory_for_schizophrenia.html
19. www.associatedcontent.com/article/1676885/new_ideas_in_psychiatry.html