Dr Jay Seitz Dr Jay Seitz
Health & Wellness Products

Fish Oil May Enhance Cognition

Fish oil supplementation (FOS) may prevent cognitive decline and preserve brain volume with age.

Click here

Extending Longevity

Resveratrols in red wine may be a key to anti-aging and longevity.

Click here

Check out the research at the National Institute of Health and David Sinclair, Ph.D. at Harvard Medical School.

Click here and Click here

Elysium Health (founded by Dr Leonard Guarente at MIT) is theorizing that a NAD+ precursor (Nicotinamide riboside) combined with a resveratrol variant (Pterostilbene) may have synergistic effects in promoting longevity. NAD+ is crucial to DNA repair and energy production and declines with age.  Pterostilbene is found in almonds, lingonberries, grape leaves, and blueberries.

Click here

Ray Kurzweil & Terry Grossman, M.D.

Check out their website on maintaining mental and physical health throughout the lifespan.

Click here

Book an Appointment

Please call to schedule an appointment (no online scheduling at this time)

Schedule An Appointment

Not currently accepting new patients

Call: (917) 209-9623 Email Dr Jay Seitz

GoodTherapy

Search This Site
Hosted by Squarespace
Powered by Squarespace

 

Blog: Neuroscience & Brain Health - Dr Jay Seitz

Arranged alphabetically:

  1. Aging
  2. Antidepressant Diet, Exercise, and Supplement Use
  3. Anxiety Spectrum Disorders
  4. Assessment and Treatment of Addictive Disorders
  5. Autistic Spectrum Disorders
  6. Borderline Personality Disorder
  7. Career Guidance
  8. Clinical Neuropsychology & Neurocognitive Rehabilitation
  9. Cognitive-Behavioral Therapy
  10. Conversational Style & Communication
  11. Descending Scale of Harmful Drugs
  12. Developmental Test of Visuomotor Integration
  13. Drug Descriptions - Psychotropic Drugs
  14. Dynamic Testing
  15. Enhancing Everyday Cognition: Nootropic & Promnestic Drugs
  16. Enhancing Creativity
  17. Estrogen & Anxiety Spectrum Disorders
  18. Fitness and Health
  19. Forgoing Psychoanalysis: Problems with "Projection"
  20. How to Treat Insomnia
  21. Learning Disabilities
  22. Mind-Body Disorders
  23. Mystification of Attention: Parts I, II, III
  24. Obsessive-Compulsive Behavior & Treatment
  25. Positive Psychology
  26. Psychosomatic Illness
  27. Romantic Relationships
  28. Social & Cultural Aspects of Mental Illness
  29. Stress Reduction Techniques
  30. Stuttering: Theories and Treatment
Monday
Oct112010

Aging Gracefully: Aging, Dementia, Diet, & Nutrition

The overmineralization hypothesis argues that the buildup of minerals over time leads to the oxidation of bodily tissues and speeds up the aging process in the human body.  Women age less quickly because they lose iron with age as a result of their monthly menstrual cycles whereas men tend to build up minerals more quickly in the body leading to shorter lifespans.  Diet and nutrition appear to play a major role.  The aging process, however, declines significantly in the elderly.  On the one hand, men accumulate iron in their bodies up until middle age whereas females only begin to accumulate iron with cessation of menstruation or menopause.  In both women and men, there is some evidence that dietary iron up to 10 mg achieves iron adequacy without inducing anemia.  

  • Iron and copper play a destructive role in brain aging in such degenerative disorders as dementia, Parkinson’s disease, and Huntington’s disease.  Iron accumulates in the striatum and substantia nigra in the subcortex of the brain with age and impacts on cognitive and motor abilities.  Iron accumulation leads to problems in cellular metabolism due to oxidation of the mitochondria (key structures inside the cell that facilitate cell metabolism) and appears to produce degenerative brain conditions.  More than 90% of oxidation that occurs in the body is in the mitochondria and the major free radical in the mitochondria is the superoxide radical that releases iron from binding proteins.  Indeed, the accumulation of iron and calcium in the mitochondria are age-related.
  • Physical exercise is beneficial to health for many reasons but it also leeches iron, a mineral, from the brain and body.
  • Green tea extracts and quercetin remove or “chelate” iron from the body.
  • Polyphenols (bioflavenoids) including rinds of citrus fruits; the skin and seeds of grapes, berries and cherries; and the phytonutrients in wine chelate iron and copper from the body.
  • Resveratrols are a group of phytonutrients found in red wine that have a number of important benefits and are now being investigated by scientists.  Resveratrols chelate copper and reduce oxidation of cholesterol induced by unbound copper in the body.  They inhibit the shortening of cell telomeres, which are linked to aging and stress as well as the formation of the superoxide radical. Most importantly, they activate the Sirtuin 1 DNA repair gene that appears to be one of the central genes that impacts on the aging process.
  • Phytic acid IP-6 (“phytate IP6”) (derived from rice and wheat bran, whole grains, seeds, and soy protein) impacts on iron oxidation.  Soy protein chelates iron and calcium.  The health benefits of soy protein (which contains IP-6) is its iron control effect which produces the cardiovascular health benefits NOT the weak phytoestrogens in soy.
  • Phytic acid IP-6 inhibits the shorting of the end caps or telomeres of cells and telomeres shorten each time the cell divides.  Cell shortening is correlated with increasing age as well as the effects of psychosocial stress (work, family, friendships) on the body.  IP-6 is also critical for cellular (DNA) repair and cell longevity.  It regulates the influx of calcium into the mitochondria thus reducing oxidative damage.
  • Under normal conditions, iron and copper are bound to transport proteins (i.e., ferritin and ceruloplasmin) and do not cause tissue damage because the majority of iron is bound to red hemoglobin pigment in the bloodstream.  In the skin, brown melanin pigment binds to iron.  But when set free iron and copper can damage bodily tissues and DNA and raise cholesterol.  Thus, some observers believe that copper and iron chelation therapy may be helpful in diminishing the effects of Alzheimer’s disease, the most common form of dementia. About 50% of adults will show some symptoms of dementia over 80 years-of-age.
  • The cellular cleaning process or what is called “autophagy” can increase longevity.  That is, lysosomes continually cleanse cells of cellular debris.  Caloric restriction (eating about two-thirds or less of your normal caloric intake), iron chelation, and the use of resveratrols and IP-6 appear to facilitate autophagy.
Tuesday
Feb142017

Antidepressant Diet, Exercise, and Supplement Use

Antidepressant Diet, Exercise, and Supplement Use – Dr Jay Seitz
1. Omega-3 fatty acids
a. EPA (dicosapentaneoic acid): 1000-3000 mg
b. DHA (docosahexaneoic acid): 700-2000 mg
2. S-adenosylmethionine (SAMe): 200 mg BID (twice-a-day)
a. Supplement with folic acid (800 mcg) and Vitamin B12 (1000 mcg) per day (or take “B-50” of B vitamins)
b. Vitamin B-6 (100 mg)
c. Magnesium (Magnesium citrate): 400 mg
d. Zinc: 25 mg
3. St. John’s Wort (Hypericum perforatum): 350-1800 mg
4. Phosphatidylserine: 100 mg TID (three times-a-day)
5. Ginkgo biloba: 40-200 mg
6. Siberian ginseng (Eleutherococcus senticosus): 100-300 mg
7. Meditation – mornings and evenings (office handout)
8. Yoga & moderate exercise – 3-4 times-a-week
9. Light therapy
10. Massage therapy
11. Green tea extract (for weight loss): 300 mg BID
a. High protein low saturated fat diet
Monday
Feb152010

Anxiety, Depression, Post-Traumatic Stress and Panic Disorders, & their Treatment

About 20% of visits to health care providers involve difficulties with anxiety and depression and their various manifestations: Bipolar disorder as well as anxiety- and depression-spectrum disorders.  These include generalized anxiety disorder (GAD) and major depressive disorder (MDD).  Since anxiety and depression are related, you get mixed anxiety depression (MAD) and its lesser form, “anxious dysthymia,” since more milder forms of depression are called dysthymia.  In addition, you have panic disorder, which is related to anxiety–they often co-occur–and the resulting spectrum of disorders are called anxiety or depression spectrum disorders.

What are the putative biological origins of anxiety and depression?

Let’s count the number of ways that anxiety and depression have been theorized to arise.  Here are some of the major ones: The monoamine hypothesis, the neurotransmitter receptor hypothesis that posits the occurrence of abnormal receptors in the brain or aberrant signal transduction, insufficient genetic expression of relevant brain neurons, and the neurokinin hypothesis of emotional dysfunction.

The basis of the monamine hypothesis is that there is insufficient serotonin in the brain in individuals with anxiety and depression and females, on average, have about 1/3 less than males, leading to about a 2:1 ratio of female:male depressives or anxious individuals.  In the case of the neurotransmitter receptor hypothesis, the lack of serotonin affects the receptors on neighboring neurons or the ability to transduce signals to neighboring neurons leading to anxiety and depression.  The monoamine hypothesis of gene expression argues that the gene for brain-derived neurotrophic factor is repressed under stress undermining the viability of brain neurons, atrophy, apoptosis),

The neurokinin hypothesis of emotional dysfunction claims that the neurokinins in the brain, such as substance P, are causing anxiety and depression and by decreasing the availability of neurokinins, the regulation of emotions by individuals may be improved.

When the predominant symptoms are anxiety, it has been suggested that there is an overproduction of norepinephrine in the locus coeruleus deep within the subcortex of the brain and by blocking receptors on the surface of neurons that are sensitive to noreprinephrine, anxiety is reduced.

When the predominant symptoms are panic disorder, it has been posited that overproduction of norepinephrine in the locus coerleus is, rather, a result of abnormal discharge of norepinephrine neurons suggesting that panic attacks are similar to seizure-like activity in the areas of the brain that subserve emotions.

Post-traumatic stress disorder may also be due to overproduction of noreprinephrine in the locus coerleus but with accompanying arousal of the autonomic nervous system, an abnormal stress response, and an inflated startle response.

Cognitive-behavioral therapy (CBT) is effective for anxiety, depression, and panic disorder but in more moderate to severe cases, the addition of anxiolytic or anti-depressive medication may be more effective than CBT or medication alone.  In very severe cases of depression and bipolar disorder–the occurrence of both depression and mania–electroconvulsive shock therapy (ECT) is still widely practiced in the psychiatric profession.

What about medication for anxiety and depression?  The response rate for anti-depressant medication is only about 67% whereas the response rate for a placebo is around 33% suggesting that antidepressant medication is often not effective alone.  For instance, when individuals who responded positively to a placebo are given an antidepressant, there is a 50% relapse rate while the rate of relapse is only 10% without a placebo.  However, often many medications must be tried before the right one or more is found and then a “cocktail” of various psychoactive medications may be employed to get a favorable therapeutic dosage.

For instance, lithium is often prescribed for severe depression.  Anticonvulsants (e.g., carbamazepine, galapentin, lamotrigine, and topiramate, and valproic  acid), benzodiazipines such as diazepam and fluzazepam, which facilitate the production of gamma amino butyric acid or “GABA” that inhibits activity of the amygdala (one of the emotional centers of the brain), and atypical antipsychotics (i.e., clozapine, risperidone, olanzapine, quetiapine, and ziprasidone) are often used to stabilize mood and reduce manic symptoms.  The benzodiazipine, Alprazolam, is often used to treat panic disorder.  Estrogen supplements and stimulants such as dextroamphetamine are also sometimes used.  Beta adrenergic blockers or psychoactive drugs that block epinephrine, another important neurotransmitter, and Paxil, a selective serotonin reuptake inhibitor, are often used to treat social phobias such as fear of public speaking.

What are some of the other medications used to treat anxiety and depression spectrum disorders?

Remeron (mirtazapine) and Serzone (nefazodone) are often prescribed for GAD and Effexor (Venlafaxine XR) to stabilize mood.  Monoamine oxidase (MAO) inhibitors such as Aurorix, Marplan, Nardil, Parnate, and Selegiline are often effective in preventing the decay of another important neurotransmitter in the brain linked to depression, noreprinephrine.  By inhibiting MAO, more noreprinephrine is made available to brain systems.

Tricyclic antidepressants such as Anafranil, Asendin, Elavil, Ludiomil, Norpramin, Parmelor, Sinequan, Surmontil, Tofranil, and Vivactil impede the reuptake of noreprinephrine and serotonin in the nerve synapse increasing the availability of these two neurotransmitters to brain systems.

The most common antidepressants and anxiolytics are selective serotonin reuptake inhibitors such as Celexa, Luvox, Paxil, Prozac, and Zoloft.  They make more serotonin available to brain systems by preventing its “reuptake” in the nerve synapse.  They are the treatment of choice in treating post-traumatic stress disorder.

There are also selective noradrenergic reuptake inhibitors such as reboxetine, noreprinephrine and dopamine reuptake inhibitors such as bupropion, serotonin-norepinephrine reuptake inhibitors such as venlafaxine and Effexor, alpha 2 antagonists or noradrenergic and specific serotonergic antidepressants such as mirtazapine, which increases the availability of serotonin and norepinephrine to brain systems, and serotonin 2A antagonist/reuptake inhibitors such as nefazodone and trazodone.

“Buspar” (buspirone) is a partial (serotonin) agonist and is often used to treat anxiety.

Anxiety spectrum disorders (GAD) are also treated with sedating antihistamines; beta adrenergic blockers; alpha 2 agonists such as clonidine; non-benzodiazepine short-acting hypnotics such as zalepon, zolpidem, and zopiclone; sedating antidepressants such as mirtazapine, nefazodone, and trazodone; sedating antihistamines such as diphenhydramine, doxylamine, and hydroxyzine; sedating anticholinergics such as scopolamine; and sedative-hypnotics such as choral hydrate, melatonin, and valerian.  The latter two are available through your local health food store.

In all, quite a wide range of possible biological solutions.

Some suggested reading:

Beck, J. S. (1995).  Cognitive therapy: Basics and beyond. NY: Guilford.

Stahl, S. M. (2000).  Essential psychopharmacology: Neuroscientific basis and practical applications (2nd. ed.).  Cambridge: University of Cambridge Press.

Tuesday
Feb142017

Assessment and Treatment of Addictive Disorders

Addiction Model: Addiction as a set of behaviors

• Arousal (dopamine & norephinephrine): But also affected by use of stimulants (e.g, coffee, cigarettes, and sugar) and sedation including excessive food consumption, television, and oversleeping.

• Satiation (GABA)

• Fantasy (serotonin)

Elements of compulsivity, impulsivity, and OCD: Pharmacological treatment as primary treatment modality with cognitive-behavioral therapy

PTSD: trauma therapy

Addictions (general treatment modalities): Group therapy, mutual-help group therapy, AA and relapse prevention, and individual psychotherapy. GOAL  = abstinence.

Sexual addiction: Pathological relationship with mood-altering behavior

Sexual compulsivity is a comorbid marker for chemical dependency

• Preoccupation

• Ritualization

• Sexual acting out

• Despair, shame and guilt (shame is best addressed in a group)

SRIs (serotonin-reuptake inhibitors) suppress compulsive behaviors and sexual preoccupation.  They also inhibit orgasm (e.g., fluoxetine, setraline, paxetine, and fluoxamine).

Relief of sexual obsessions: imipramine and lithium.

Anti-androgenic progestational agents: Lower semen count, testosterone, and sexual arousal.

Triptorelin (long-acting agonist of gonadotropin-releasing hormone or GRH): Inhibits pituitary-gonadal function and decreases serum testosterone levels along with use of adjunctive supportive psychotherapy.  It also decreases deviant sexual fantasies and desire in men with pedophilia or paraphilia.

Leuprolide: Diminishes serum testosterone levels and decreases inappropriate sexual behavior.

Sex addicts: 87% sexually abused as children.  Thus, lack of healthy sexuality. Maintained by ritualization and reinfoircement.

Relapse prevention is the GOAL secured with a WRITTEN CONTRACT.

Monday
Oct042010

Autistic Spectrum Disorders: Pervasive Developmental Disorders

Autism, a rare but devastating disorder of childhood, was originally defined by the physician, Leo Kanner, in 1943, as a constitutional inability to make emotional contact with others.  More than a decade later, it was widely agreed that the two central deficits in autism were profound social impairment and insistence by the child on sameness in behavioral routines (i.e., behavioral stereotypies).  Currently, the received view designates a triad of symptoms as central to the autistic syndrome:  (1) social impairment, (2) deficits in verbal and nonverbal communication, and (3) behavioral stereotypies (e.g., hand-flapping, repetitive play behaviors).

The nature of the social deficits has increasingly taken front stage in studies of autism.  Moreover, newer theories of intellective processes indicate that social "intelligence" consists of two essential components.  Intrapersonal abilities include (a) one's affective range and intensity, (b) the ability to discriminate among the emotions, (c) the ability to label them appropriately, and (d) the ability to use them to guide one's behavior.  Interpersonal abilities include (a) the ability to decode feelings, intentions, and motivations in others, (b) recognize characteristics among people (e.g., age, gender, and ethnicity) and (c) influence others to behave in desired ways.  Autistic children's social impairment appears to involve deficits in both intrapersonal and interpersonal abilities.

Autistic spectrum disorders include autism, Asperger’s disorder, Rett’s syndrome, and childhood disintegrative disorder.  Asperger’s is a milder form of autism that does not include significant deficits in cognitive and language development.  Rett’s syndrome is typically found in very young females who despite a brief period of normal development in the first year or two of life begin to regress by avoiding social contact with others, refusing to speak, as well as evincing an inability to control their actions and behaviors.  On the other hand, childhood disintegrative disorder generally only affects males who demonstrate normal development in the first 2-3 years of life but then begin to deteriorate in social, language, and motor development in the ensuring years.

There are many treatment options for autistic spectrum disorders including intensive behavioral therapy, psychoactive medications, as well as some dietary and nutritional approaches.

The National Institute of Health has a extensive discussion of autistic spectrum disorders on their web pages at click here.