Research Update: Biomedical and Epigenetic Interventions for the Assessment and Treatment of Autism
Robert L. Hendren, DO
Autism Spectrum Disorder (ASD) is increasingly understood as a “whole body disorder” going from the genetic constitution of an individual (genotype), the way genes express themselves as influenced by the environment (epigenetic process or endophenotype) to an individual’s observable traits and characteristics (phenotype). To be most effective in understanding and treating ASD, this whole process should be taken into account along with the interacting parts of the body and the way these processes and body systems change during development.
This presentation will describe an integrated whole body approach to enhancing neurodevelopmental resilience throughout the life cycle in individuals with ASD and their caretakers. This includes the medical (genetic, neurologic, GI, other medical symptoms); ancillary (speech, OT); behavioral; treating associated symptoms (medical, pharmacologic interventions; biomedical (CAM, Integrative assessment and treatments) and most of all, building all-encompassing personal relationships and resilience with the greatest focus on biomedical treatments.
The Most Lethal, Yet Misunderstood, Disorder in Child & Adolescent Psychiatry
James Greenblatt, MD
Anorexia nervosa (AN) is a vastly complex mental illness marked by etiologic contributions of genetic, psychological, and metabolic origin. In this presentation, Dr. Greenblatt will introduce a comprehensive, evidence-based model for AN treatment and explore the concept of AN as the result of a complex and biologically-mediated interplay between environmental, psychosocial, and metabolic factors. He will review published research and clinical evidence supporting associations between discrete metabolic abnormalities, micronutrient imbalances, and systemic inflammation, with a special focus on essential fatty acid deficiency (dyslipidemia) and zinc deficiency. He will also illuminate critical treatment targets for today’s psychiatry practice and provide an empirically validated blueprint for personalized interventions.
The Emerging Role of B Vitamin & Micronutrient Coenzymes in Pediatric Depression and ADD/ADHD
Andrew Farah, MD
In this presentation, Dr. Farah will discuss the genetic underpinnings of depression, controversies and issues associated with standard antidepressant therapy, and ways to address pediatric depression with natural therapy. He will also review the role of nutraceuticals in ADD and ADHD, and clarify the confusing landscape of options for clinicians.
Transforming a Devastating Chronic Illness into a Treatable Disorder
Nancy H. O’Hara, MD, MPH, FAAP
Pediatric Autoimmune Neuropsychiatric Disorders associated with Streptococcal infections, or PANDAS, is a common autoimmune disorder with far-reaching movement, behavioral, and cognitive consequences. While OCD and tics are common with PANDAS/PANS, autoimmune encephalitis caused by these infections may create other issues like anxiety, bedtime fears, inability to control urination, aggression, and deficits in learning, attention, and social interaction. Heightened clinical suspicion and more appropriate and comprehensive treatment with antibiotics and immune-modulating therapy will transform PANDAS/PANS from a devastating chronic illness with episodic flares into a treatable disorder.
Finally Focused: A Functional Medicine Approach to ADHD
James Greenblatt, MD
Far from being a mere “discipline problem,” ADHD is a neurologic ailment in which genetic, nutritional, and environmental factors create imbalances in the brain, leading to disruptions in attentional processing, emergent hyperactivity, and impulsive behaviors. Unfortunately, ADHD treatment models have changed little over the last decades and focus almost exclusively on symptom suppression through pharmaceutical and/or behavioral interventions. These models do not target the underlying causes of ADHD. In this presentation, Dr. Greenblatt will introduce his groundbreaking and clinically-proven functional medicine approach to ADHD – the Plus/Minus Plan – and provide a comprehensive overview of the biochemistry behind the disorder. He will also review dietary interventions and augmentation strategies for the mitigation of specific deficiencies and excesses and provide evidence-based recommendations for going beyond biochemistry to enhance patient outcomes.
The Roles of Inflammation, Oxidative Stress, and the Gut-Brain Axis in Treatment-Refractory Depression in Youth-A Functional Medicine Approach
Deborah Simkin, MD
Teen depression and suicide rates have risen despite conventional treatments. Refractory youth depression may be linked to abnormalities in functional biological systems, with excessive inflammation, oxidative stress, and gut-brain issues. Addressing modern lifestyle changes which may be responsible for refractory depression is critical. In this presentation Dr. Simkin will review research that identifies reasons for dysbiosis in the gut, such as, diet, stress, medications, artificial sweeteners, sedentary lifestyle, decreased sleep, etc. She will also review research associated with inflammation in the gut and how it interplays with changes in the brain, oxidative stress, the role of the folate and methylation cycles, and the effect of mitochondria on refractory depression. She will review researched treatment options that may optimize treatment for refractory depression, including a case presentation, demonstrating how she approaches refractory depression from a Functional Medicine.
Broad Spectrum Micronutrients: Evidence & Applications for ADHD
Amelia Villagomez, MD
Over the past decades, research has been growing for the use of Broad Spectrum Micronutrients (BSMs) in children and adolescents. Two specific BSM products have been studied in multiple clinical trials and contain a blend of amino acids, antioxidants, and all vitamins and known minerals in amounts between the Recommended Dietary Allowance and Upper Tolerable Intake Level. Supplementation with single nutrients (eg magnesium, zinc, iron, omega 3s, vitamin D) has shown mixed and typically small benefit for the treatment of ADHD; however, two randomized clinical trials and open label trials have shown that BSMs have a significant and clinically meaningful improvement in symptoms of ADHD in children and adolescents – specifically in irritability, aggression, and anger. In this presentation, we will discuss the potential mechanism of action, research trials, and indications for the use of BSMs, as well as prescribing BSMs in clinical practice.
A Functional Medicine Perspective on Disruptive Behavior Disorder in Children and Adolescents
James Greenblatt, MD
Current psychiatric models offer today’s practitioner little guidance insofar as understanding and treating Disruptive Behavior Disorders – characterized by abnormally high levels of aggression and irritability – in child and adolescent patients. While acknowledged as symptoms of established diagnoses such as depression and bipolar disorder, aggression and irritability are frequently neglected as psychiatric phenomena in their own right. In this presentation, Dr. Greenblatt will introduce a well-studied biologic model of Disruptive Behavior Disorders from a functional medicine standpoint, and discuss mechanisms through which specific nutritional, metabolic, and biochemical factors can elicit behavioral pathology. He will review scientific research supporting associations between discrete biologic imbalances, nutritional deficiencies, and aggression / irritability, with a key focus on the established mood-stabilizing properties of lithium and powerful evidence of low-dose lithium’s clinical utility. Finally, he will present evidence-based recommendations for a functional medicine approach to the treatment of aggression and irritability.