Course Description:

This course offers practitioners a functional medicine model for the reduction and elimination of side-effects in patients taking psychotropic drugs.  Registrants will be provided with an overview of pharmaceutical use in mainstream psychiatry, and the unprecedented steps some patients are now taking in order to get themselves off medication.  A rationale for the implementation of a slow taper, secondary to an integrative assessment per THE ZEEEBRA approach, will be presented as a protocol for discontinuation and the elimination of withdrawal effects.  Thereafter, nutritional and herbal interventions for the amelioration of medication-induced weight gain and sexual dysfunction will be reviewed. Gene variants associated with medication-induced weight gain will be discussed, and the clinical utility of gene testing for minimizing weight-related side-effects will be elucidated.  Finally, tardive dyskinesia (TD) will be explored: biologic factors linked to its pathogenesis, mainstream treatment options, and the demonstrated superiority of integrative approaches for symptom resolution.  Nutritional interventions with a proven track record of success in eliminating TD will be introduced, along with Dr. Greenblatt’s recommendations for dosing and titration.  The course will conclude with an open-minded discussion about the role medications can and should play in today’s functional medicine practice, and a clarification of psychiatry’s most fundamental objectives in addressing mental illness safely, effectively, and ethically.

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1. Medication Withdrawal & Weight Gain

Module 1 will begin with an examination of current practices in traditional psychiatry for the use of psychotropic medications in the treatment of mental illness.   The flaws inherent in this system will be explored with a close focus on the ethics of informed consent, supported by studies which reveal disturbing trends in the administration of drugs known to cause side-effects in significant percentages of individuals.  Research demonstrating dissent in the field regarding best practices for side-effect management and medication discontinuation will shed additional light on a problem that has led some patients to take matters into their own hands.  An integrative protocol for preventing and eliminating medication side-effects will then be introduced, with specific guidelines to be implemented in accordance with THE ZEEBRA approach.  A program of core nutritional support for antidepressant withdrawal will be outlined, highlighting essential nutrients that Dr. Greenblatt has, in his own practice, found to be most strongly associated with withdrawal symptoms.  Finally, the issue of weight gain side-effects in patients taking psychotropic medication will be reviewed: genetic factors associated with increased susceptibility, the mechanisms through which gene variants contribute to appetite dysregulation, and how practitioners can implement genetic testing in their integrative approaches to minimize patients’ weight gain risk.

2. Suicide, Sexual Dysfunction, & Tardive Dyskinesia

Module 2 will explore more serious side-effects linked to psychotropic medication: suicidality, sexual dysfunction, and tardive dyskinesia.  The module will begin with a look at the association between antidepressants and suicide, an association that must be understood in order to be effectively prevented.  Research studies corroborating incidence, symptom progression timelines, and populations of increased susceptibility will be reviewed, and geared towards informing best practices in order to minimize risk.  Next, a frequently under-reported phenomenon that can significantly impact patient well-being will be appraised: antidepressant-induced sexual dysfunction.  Nutritional and herbal interventions for the elimination of sexual side-effects, including Wellbutrin, Maca root, and Pycnogenol, will be discussed, as will the importance of proactively maintaining open lines of communication between patients and prescribers.  The lecture will then turn to tardive dyskinesia (TD), a movement disorder associated with antipsychotic medication that can severely affect patient quality of life.  Factors contributing to TD pathogenesis will be examined, as will pharmaceutical treatments currently available to patients.  Dr. Greenblatt’s evidence-based, integrative approach, used successfully for the eradication of TD symptoms in his own clinical practice, will then be presented in detail, along with guidelines for the administration of specific nutritional interventions.


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1 Year Access

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Learning Objectives:

Upon completion of this course, registrants will be able to:

  • Identify physical, neurologic, and emotional symptoms associated with antidepressant withdrawal
  • Elucidate the rationale for enacting a slow taper secondary to an integrative assessment and nutrient repletion for the discontinuation of psychotropic medications
  • Enact, in their own practices, a program of core nutritional support for antidepressant withdrawal
  • Identify gene variants most strongly associated with weight gain and appetite dysregulation in patients taking psychotropic medication
  • Elucidate the clinical utility of genetic testing as part of an integrative protocol to prevent medication side-effects
  • Describe specific nutritional interventions for the mitigation of antipsychotic- and antidepressant-induced weight gain
  • Expound upon the link between antidepressants and suicidality, and identify patient populations most at-risk for developing suicidal ideation in response to antidepressant treatment
  • Explain why current statistics regarding the incidence of medication-induced sexual side-effects in patients are likely inaccurate
  • Identify specific augmentation and supplementation interventions that can combat medication-induced sexual side-effects
  • Describe neurochemical and genetic factors thought to play a role in the pathogenesis of tardive dyskinesia
  • Identify nutritional interventions demonstrated by scientific research to be effective in reducing or eliminating symptoms of tardive dyskinesia
  • Discuss the ethical shortcomings of traditional psychiatry’s model for the use of psychiatric medication, and what steps can be taken to rectify these shortcomings
  • Discuss the role that medications can and should play in an integrative, functional medicine practice
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