EMPowerplus is a nutritional supplement that consists of 14 vitamins, 16 minerals, 3 amino acids, and 3 antioxidants. According to its makers, TrueHope Nutritional Support, EMPowerplus “works by giving the brain the right balance of vitamins and trace minerals on a regular basis.”
It backs up that statement with a link to 11 research studies which it says demonstrates the effectiveness of this supplement to help people with attention hyperactivity disorder (ADHD), bipolar disorder, and depression.
It’s been selling the supplement for over a decade now from Canada, to hundreds of thousands of people. Many people swear by it. Others have questioned whether it is really any better than placebo.
So does it work? Let’s find out…
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I’ve been watching this company for a few years and in my view their are engaged in quackery (some signs: calling itself a “miraculous treatment”, lack of rigorous research as you’ve described here, testimonial advertising – see http://psychcentral.com/blog/archives/2011/01/03/testimonials-arent-real-evidence/, and the product is only available through the company’s web site after providing lots of personal data and agreeing to stop taking medication and maintain ongoing contact with their sales rep.)
When you attempt to purchase the product you are forced to sign a terms of agreement that includes:
“Some of the medications I’m currently taking or have taken (if any) may require that I take extra care when starting the EMPowerplus nutrient program and I agree to follow the guidelines of the program as suggested by my Truehope Assistant.”
A Truehope Assistant is essentially a sales rep for the company. They are not mental health professionals. However, based on your checking a box when you order that states “I am taking or have recently taken medication for sleep or a mood disorder,” they advise you to discontinue taking all psych medications before taking Truehope. Why? If it were really a safe nutritional supplement, there wouldn’t be any interaction, and if it’s not, they don’t say what’s in their proprietary formula so we don’t know what’s in it that might pose a risk. Either way, advising people to discontinue medication – without a professional assessment or medical supervision – is a dangerous ploy. To me, this what’s most disturbing about Truehope, even more than their marketing techniques and lack of rigorous research.
From their FAQ:
“do medications interfere with EMPowerplus?
Yes, especially psychiatric medications. As your brain function improves, you can become increasingly over-medicated. Psychiatric medications should be gradually tapered off when using EMPowerplus.
“I’m tired of drugs. Can’t I just stop taking them now and switch to EMPowerplus?
No! Suddenly stopping psychiatric medication is very dangerous and can lead to hospitalization or worse. Withdrawal effects of medications can be severe. And EMPowerplus works gradually. That’s why the transition must be done under close supervision
“what is the Truehope Support Team?
The Truehope Support Team works with both individuals and doctors in managing the transition process. The Truehope Support Team members are not medical professionals but are highly knowledgeable about EMPowerplus and the past experiences of thousands of other EMPowerplus users. Please call [number] to register, order and access Truehope Support.”
http://www.truehope.com/truehope_bipolar_disorder_faq.aspx
A quick web search will turn up many sites that question the product and have monitored their court battles. I hope people will take time to consider all perspectives before purchasing this product and going off meds based on some slick marketing.
I agree that a person should never discontinue psychotropic meds without doctor supervision. If this product does not strongly address how important that is they should correct it immediately.
I also believe that for many this could be the answer. I have been reading of psychiatric conditions in respected forums (Pubmed, Medline, which doctors consult) that seem to have roots in deficiencies of vitamins, minerals and fatty acids. (or oxidation from bad fats)
I wonder at your interest in this product. Most disease can be corrected & what the product offers is correction. Sadly, doctors don’t address causes to these kinds of illness or correct them. Without a biological connection to mental health disorders there would be no magic pills. It is confusing for the lay person & hard, if not impossible to find medical professionals trained to treat. For many this is a solution because they understand the science.
Yes, caution should be exercised, questions asked and doctors should monitor titration of medications. You just can’t fault a person for looking for ways to wellness when mainstream medicine has failed. These are people looking outside the box and finding answers.
I am reading more and more about impaired antioxidant enzymes in mental illnesses, even in autism. It is only a matter of time before the pharmaceutical industry thinks of a name for this impairment and manufactures a drug to mask it’s symptoms. The person unlucky enough to be treated with this new drug will likely suffer side affects that could be avoided by a true correction.
“First they ignore you, then they laugh at you, then they attack you, then you win.” -GANDHI
My husband has been taking EMPowerplus for over 4 years. He’s back at work and living a vibrant life. The meds didn’t work. The hospitalizations didn’t work. There was alot of pain and disfunction that swirled into every aspect of our relationship and our childrens lives. It was horrible.
It took about 3 months for him to really notice a difference. I noticed within the first month that there were things that were better (less frequent rages and not so out-of -control episodes). It took alot of faith and time with the support staff at Truehope. We wanted to give up but we decided to commit to trying, struggled through the med withdrawals and continued with the EMPowerplus. Truehope are not medical proffessionals but they did answer many of our questions and help us through these bumps along the road. If it wasn’t for them, we wouldn’t be where we are today.
I have my husband back. There is no question in my mind that it works. If this is a placebo effect. I’ll take it.
I too had no luck with meds….I have bipolar II. I now take Lavendula Compound, which you can get from health food shops. I also take a multi vitamin, fish oil, which has been said to help with depression and bipolar, magnesium, also known to help with depression, vit D3 also known to help with depression and zinc
I have been in a better place than I have in years! No being drowsy all the time from meds and the lavendula helps wonders with my anxiety! If I’m having a more anxious day than usual I can take one and within 15mins am feeling much calmer 
you can take up to 3 a day 
I do even better when i stick to exercise too. where can I get some of this EMP in Australia?
Ilse, email support@truehope.com and they can tell you what options are available in Australia.
Haven’t read everything yet about Truhope & I have an old browser so I may not get the info I need specifically the ingredients(I’m gluten intolerant,taking 3mg melatonin on occasion worked better for insomnia better than chloral hydrate!!!but that was prior to being treated for ADHD/depression with Ritalin-when my retired psychiatrist told be I had to take melatonin daily I suffered intolerable adverse reactions,I tried fish oil for omega-3-fatty acids & also got intolerable adverse reactions.So I’d need to know what’s in Truhope before taking it;I’m prone to allergies-it’s in my family,too)but I will try to read more if this browser allows it,send info to my present psychiatrist if it looks promising just for the sake of interest because I actually couldn’t really afford $75(I’m on SSI & get all my medicines for free)but it’s still intriquing & I’m going to see if I can email the company with my questions-I’ll let you know if I find anything out but if it really did work I’d try to find the money & I’d find out about a refund policy & of course,consult with my doctor first.If I find anything more I’ll send it to Dr. Grohol/psych central. Sincerely, Morgana(I have Bipolar I with psychotic features(rare) & ADHD & panic/anxiety disorders & phobias complicated by Irritable Bowel Syndrome-the reason I feel disabled but I”m fairly sure the gov’t(US) determined by disability from the Bipolar Disorder although when I got SSI 30 years ago I wasn’t yet diagnosed;I was too phobic to go to the appeal court;at that time I was beginning to experience symptoms of severe Graves’ Disease,now treated-was diagnosed at 25 & I’m now 54 & take thyroid supplement.
I found out about Truehope from David Moyer’s book “Too Good to be True”.
Since then I’m getting their newsletter. I hoped to get some review of their product or any feedback from psychiatrists who used it on bipolar patients.
I see that it is not going to happen. The supplements are natural, so pharmaceutical companies will not pay for the research. The government is the one who should sponsor such studies, but they are more interested in restricting supplements in order to “protect the public” from unfounded claims. The researchers only work on studies that are funded. Doctors only prescribe what is approved by FDA.
The article gives credit to Mr. Hardy and Mr. Stephan for trying to help people in need with something they believe works to help alleviate mental illness. They need help from the mental health community to validate their results and follow-through with adequate research.
Thanks for an excellent article about such an important topic, John. There’s so much confusion out there about the causes of ADHD, and about appropriate treatment. Parents especially are so eager to give their kids the best treatment possible, it’s easy to buy into something that looks like a quick fix, and especially difficult for us lay people to discern what’s “science” and what’s spin based on, as you point out, anecdote and skewed “research.”
Much gratitude for this important piece!
Thank you.
Zoë
Psych Central Blogger, ADHD from A to Zoë
Interesting they’re Canadian as Hoffer was from there.. any affiliation?
Certainly, Hoffer and Pauling delineated many of the orthomolecular benefits and relationships between mental disorders and nutrient deficiencies.
thanks for the site.i am a 29 year old male kenyan. depression has shattered life physically,emotionally and has absolutely crippled me financially.i believe in your supplements but icannot afford.can you please connect me to a wellwisher who can help me access the supplements so that i can regain my former self?thanks.
It is sad to see an approach that is helping some people rubbished in this way. I work as a naturopath specialising in mental health and find that different combinations of nutrients and dietary modification together with psychotherapy or counselling work best both for my clients and myself. So please let us be a little more open minded and support independent research.
I am a 32 year old female on True Hope Since mid 2010. I have been on several medications for Depression and Bipolar, and the effects were very short lived. I wished they worked, I tried very hard for them to work, all the necessary lifestyle, etc. As a result I gained 50lbs, and became very ill.
True Hope came as a last hope. The recovery was almost immediate and felt within days (faster than any medication) and it was not placebo, as it lasted for over a year. There have been several times, where i decided I felt so good i went off the Program and the Symptoms returned. I tried cheaper Vitamin brands matching exactly the quantities on EMPOWER (wasn’t really that much cheaper after all the ingredients are acquired btw), and once again, realized I can’t function without True Hope’s Empower. For me this is the only available option out there that worked, and it is worth $250 a month for me, as I can stay gainfully employed on Empower, and it wasn’t the case on medication. I find Empower Especially effective for PMS Symptoms and wish someone would conduct a study.
Hi,
I wanted to weigh in here to say that while I agree that scientific evidence is important, I also feel it’s important to have an open mind about treatments that seem not to be doing harm and may be helping some people significantly — especially people who have been unable to get relief from the “proven” treatments, or who experience such terrible side effects from the usual approaches that they can’t really tolerate them.
My stepson, now 9, has been taking EMPower for almost 2 years. We worked with a respected child psychiatrist to transition him from 10 mg of Abilify to the EMPower. He is very bright but also on the autism spectrum and was having terrible tantrums that were destroying his ability to attend a regular school even with a full-time aide and a lot of special services. The Abilify had helped him calm down but also made him lethargic and hungry, and he was putting on a lot of weight. It was really hard to watch this slim, active, generally happy (if unpredictable), child balloon up and lose interest in almost everything he had cared about only 6 months before.
With the help of this psychiatrist, who is knowledgeable about alternative therapies, we tapered the Abilify down and ramped up the EMPower very carefully. We didn’t tell the school about the medication change until well after it was complete because we didn’t want to bias their recording of his behavior.
The change in him after the 2 1/2 months of shifting to EMPower was truly astounding — he came out of his stupor AND his difficult behaviors went down precipitously. They didn’t cease entirely, but disruptive behaviors that had been occurring daily became milder, weekly events instead, and resolved more quickly. He was able to stay in class almost all the time, and he renewed friendships that he had stopped caring about while on the Abilify. Our happy, funny boy is back!
I have always believed that nutrition matters, but even I would have scoffed at the idea of replacing 10 mg of an anti-psychotic with VITAMINS. I was so impressed that last summer I (I’m diagnosed with ADHD and some mood instability) transitioned from Lamictal to the EMPower myself (with the help of my psychiatrist). I take only 3-4 capsules a day (my stepson takes 11), so the expense is manageable. I expected only a mood stabilizing effect but have found I can also reduce my ADHD medication by 1/3 to 1/2.
I did try using regular vitamins in roughly the same proportions as the EMPower in order to save money — what I found was that the savings was relatively small and the combination (presumably because it was not chelated and packaged as odorless capsules) made me queasy. I wasn’t able to sustain the regimen except with the EMPower. It’s an unfortunate irony that EMPower, which overall is cheaper than pharmaceuticals, costs ME more than the psychotropic medications did because it’s not covered by insurance.
Previous posters are correct, it is very challenging to get useful research studies done about supplements. There is not much government money funding them and the pharmaceutical industry has a vested interest in keeping them from happening.
Finally, for those who don’t already know, doctors receive only the most cursory information about nutrition during medical school — basically, they are taught how to keep people alive on sugar water, and that’s about it. My suggestion is to look for a doctor who has made a significant effort to get educated about alternative/complementary medicine, or at least is open to these approaches and willing to work with you if you want to try things that may not be “proven,” but have reasonably strong anecdotal support and don’t appear harmful.
Best wishes to all.
While I appreciate the testimonial, it’s just not the same as scientific evidence.
There isn’t a whole lot of funding for research in the hundreds of different psychotherapy modalities available either. And yet, in the past 50 years, there are literally thousands of studies conducted on the effectiveness and safety of psychotherapy. All without a whole lot of government support, and with zero pharmaceutical funding.
So I don’t buy it when someone says that even simple, basic research is “too expensive.” If you’re selling a product you believe in, and believe that works, you make it a part of your business model to fund the research to support your claims. Especially if those claims are — like some people in this thread — made to support the treatment of a medical concern. (Because it’s illegal in the U.S. to advertise you treat a medical concern unless you have scientific data.)
Just my thoughts,
John
FWIW, randomized trials we had been approved for had been cancelled by Health Canada, which makes it difficult to conduct the research that validates our claims. That cancellation has since been reversed and we are in the middle of double-blind placebo-controlled studies. Hopefully, we can see the results published this year or next, but these things take times, as I’m sure you can appreciate.
Dear John,
At first when I read this, I felt disgusted by the way you talked about what has been for some people the greatest thing in their lives. So I thought it could’ve been personal thing between you and the truehope guys, but no, it’s just business for you. You’ve been working on this problem so hard and for so long that you’ve actually become obsessed with it & forgotten about the purpose of your work.
You could be using some of the passion you use in writing this article to actually do something useful.
The truehope medication has worked for some people(full stop)
Is life a complex organism, yes it is? and everyday we know a little bit more about its complexity. One doesn’t have to get a degree, or a PhD, or any piece of paper to appreciate, value or to consider that Truehope’s people are at least heading towards the “right direction”. Of course it’s not just about a few vitamins, minerals, etc. But even the most complex of things in this world, such as humans, rely on simplicity. In this case relying on the saying: healthy body, healthy mind.
Truehope, on its own, it’s not the solution(for everyone). There are other areas, like the one your an expert in, that need to work in conjuction to it. But it’s not until people start eating their pride and get ride of their stubbornness that we’re gonna start seeing some change.
PS: a fan of yours
Truehope empowerplus is not a medication. It is a “nutritional supplement.” If it were a medication, it would actually have to go through the same rigorous scientific process the FDA requires of all medications marketed and sold in the U.S.
Science is science. You’re welcomed to disagree with its purpose, but if you don’t agree science helps us with understanding data, that in turn helps us understand voodoo treatments versus legitimate treatments, this is definitely not the blog for you.
BTW, we talk about a lot of good, helpful alternative treatments on this blog too. The main difference is those treatments have bothered to do some research to back up their effectiveness, and don’t rely on individuals posting testimonials — the similar kind you see for every fake treatment pushed online.
Dr. Grohol,
Are there “scientific studies” relaying on rigorous data” regarding the effectiveness or side effects of patients taking a combination of psychiatric drugs? Are there any “scientific or rigorous studies” done regarding the effects of prescription meds on the developing brains of children? What happens with research studies that are never published because they fail to demonstrate drug effectiveness? What is the percentage of those unpublished studies? Is there any conflict of interest between pharmaceutical companies and the FDA? Do you know if FDA members have invested interests in promoting these drugs? I invite you to investigate, and you will be surprised of the findings.
If we are going to be talking about sound data and respectable studies or “good science” I think we need to be asking these questions.
The fact that Truehope has not been able to complete any double-blind experiments does not indicate that the product is not good. It simply means that the product is promising but it is still under investigation.
Professionals have the moral responsibility to discuss ALL treatment options with their patients, including the ones that are not FDA approved. Any parent can make an informed decision between trying an experimental approach with minimal side effects or an approach that has more research support but with more side effects.
Disregarding any other type of alternative or making it seen as non important is a lack of respect to many families that have found an answer in these supplements.
There is a more recent, more thorough research summary than I have seen cited above: Nutritional Management of Bipolar Disorder in Adults and Youth by Charles Popper http://bit.ly/KJwiuy at Harvard’s MacLean Hospital. He issues a great many cautions about the issues that may arise during the process of transitioning onto this formulation, but cites open-label studies involving nearly 650 pts with what I would have to consider a significant success rate (47% completely off psych meds). He offers recommendations for MDs interested in learning how to use this formulation. And he actually comes out and says “Don’t try this yourself at home!” Brains are still unique, complex and delicate, even when you treat them with nutrients instead of meds.
My pdoc made me buy them [through him], and 2 days in I’ve already had to call him due to a terrible reaction (woke up at 3am having terrible tremors, muscle pains, and anxiety; haven’t slept since). My only other med is a lorazepam (for panic attacks).
I couldn’t believe vitamins could have such a tremendous (terrible) effect on my central nervous system. Pdoc says it’s the amino acids kicking in.
I’m not even sure I have an amino acid deficiency, tbh. I do have panic attack issues, and have been on Ativan for 5 years (happily; you just wasn’t get to a point where you feel good and you’re not sure if you can come off the benzos). SSRIs and tricyclics were a nightmare (worse anxiety or [new for me] rage), and I won’t try antipsychotics since I’m happy and functional on my current med.
My comment is that the pdoc is SO into the Empower Plus. For everything: schizophrenia, bipolar, major depressive. I wondered if pDoc converted to Scientology; he’s a bit too enthusiastic about these vitamins.
For me, one more night like last night, I’m done with the Empower.
Also, I’m 100lbs, and will not take 8-15 vitamin pills per day, ever. I’d rather pop an Ativan; helluva lot cheaper, fewer side effects. However, if I titrate up to 4 pills a day (2X2/day), and it’s helping at all, I’ll buy another bottle.
(If it’s not working, I can tell you now I’ll have to find another pDoc — he wouldn’t HEAR of these vitamins not working.)
Shouldn’t there be a test to determine if there ARE deficiencies before Rxing these, though? Seems like such a waste if there aren’t nutritional problems present. And I’m a little worried about getting a toxic dose of vitamins. I get a lot naturally (whole milk addict; big fresh fish eater).
Only well people need clinical studies to prove anything. People with chronic conditions only need to know that it is not dangerous. We are at our wits end, and will try whatever is safe to get better.
No offense to the author, but I suspect there is no incidence of mental illness in his immediate family. If there were, he would not need studies, just options.
The benefits of the Ivory Tower is that it creates new thought. The drawbacks is that those in the Ivory Tower only have theory. And as any sea-going person knows, you want a Captain with many years of sea legs, not someone who has never sailed before but only watches and jeers from the land.
Hoping this goes through to counter all the misinformation in most of these comments…
Does the company who makes this product take any responsibility for the death of Donald Ramsay and beating of Wendy Ramsay?
The company apparently recommended taking their son Jordan off his Schizophrenia medication(s) while taking their product. Jordan then got up one day and decided his parents were aliens who needed to die, bludgeoning them in their bed with a wrench.
http://www.cbc.ca/news/canada/british-columbia/story/2012/07/04/bc-schizophrenic-homicide-trial.html
The products have worked wonders for our family. Our now 8 year daughter has an early onset BP. Numerous different drugs wouldn’t touch it. She was either drugged asleep or in a screaming rage. Now she is essentially neurotypical 1 year after starting Empower and changing the diet to eliminate grains, dairy, and chemical additives in our food. My wife has been on BP meds for 25+ years. A year ago, she was on 5 different meds at maximal doses (Lamictal, Geodon, Busbar, Ativan, Ambien), and had been on more different meds than I can count off the top of my head. She still lived most of her life in an agitated mania. She has spent the last year tapering off the meds, and is down to less than therapeutic levels of 2 meds, and she is doing great.
I read 100s of journal articles before we started this course of treatment. There is significant published literature to support using nutritional therapies in the mainstream, even if a lot of it is open label or otherwise does not all meet the double blind bar.
Aside form nutrition working, it meets “do no harm” and is essentially without side effect. Whereas, the psychiatric meds are highly addictive and with significant side effects. (Our daughter still has a heart rhythm disturbance). My question is: What would make more sense–to put a 5 year old child on addictive brain chemical altering drugs or to first try and resolve her illness through nutrition? I wish we had known about the latter at the time.
For our daughter, the drugs didn’t work at all and some intensified the rages. Not Lamictal, Geodon, Depakote, Lithium, Risperdal, Adderal, Klonapin, Intuniv, nor Trileptal. Maybe other combinations would have worked better? She had been hospitalized a few times. It had not helped, and a long term residential care facility was the next option. We started EMPower when she was in a crisis but we had to wait for another hospital bed to open up. Within 2 days, there was no need for that hospital bed. Not perfect, but much improved. We had a great month, then, we were arm twisted by the local docs and CPS to discontinue. 1 week later, she was in a rage so intense that I can’t really describe it in words. It took 5 adult men to hold her and strap her to the ambulance stretcher, and 7-8 injections to sedate her. Thankfully, her pediatrician reluctantly agreed to help us, and went back to EMPower (although he doubted it’s effectiveness). We had a few good months, then several months of pain with a 7 year old girl going through med withdrawals. Now today, it is a happy story. Aside from taking a boatload of supplements and a strange diet, she is essentially neurotypical.
Add us to the list of testamonials strongly supporting the product, and who hopes it does not ever get forced off the market.
Brian
Brian, if it’s simply nutrition a person lacks — and it “cures” a person of a serious mental disorder like bipolar disorder — I suspect the person wasn’t properly diagnosed in the first place.
Exercise and proper nutrition — the kind you get from just eating the right kinds of food in the right quantities — are the basic building blocks of good health for everyone. But such basics come in the form of green vegetables, fruits, and minimizing sugar intake — not from a bottle of pills.
I’m glad to hear your daughter is better no matter what the reason. But again, a testimonial isn’t the same as scientific evidence, and no one should confuse the two. There are millions of testimonials online, for every possible treatment under the sun, such as eating wheatgrass to cure cancer.
But it’s not science and it’s no better than bleeding or using leeches (both of which also still have testimonials for support for a wide range of diseases).
EMPower is not some miracle drug, and it has little science to support its use for anything, except maybe using an empty bottle of it to store buttons in.
I would respectfully submit that testimonials are indeed evidence. The more testimonials, the more credible the evidence.
I would also respectfully submit that there are indeed a number of peer reviewed published articles. Hence, I take issue with the statement “it has little science”. I as well would like to see a carefully controlled study, but that doesn’t mean that there isn’t science out and it is of little use.
Here are a few references:
http://online.liebertpub.com/doi/abs/10.1089/acm.2011.0270
http://www.biomedcentral.com/1471-244X/11/62
http://www.cnsspectrums.com/aspx/articledetail.aspx?articleid=2613
http://online.liebertpub.com/doi/pdf/10.1089/cap.2009.0011
http://www.sciencedirect.com/science/article/pii/S0887618509000577
http://online.liebertpub.com/doi/abs/10.1089/cap.2008.0157
http://online.liebertpub.com/doi/abs/10.1089/104454604773840553
http://online.liebertpub.com/doi/abs/10.1089/104454602760386897
Here is an article describing a possible mechanism of action: http://www.ajcn.org/content/75/4/616.full
Other possible mechanisms include poor absorption of vitamins&minerals from the GI tract and swamping the system with vitamins and minerals helps rectify the situation.
Are you saying my wife was misdiagnosed? She has had a BP-1 diagnosis for approx. 25 years, has had a number of psychiatric hospitalizations, and has seen several psychiatrists over her life. She has spent a lot of her adult life in somewhat of an agitated mania. Yet, now a year after starting EMPower she is almost completely off psych meds and doing great.
What about numerous other testimonials: Were they all misdiagnosed as well? I can not possibly believe that a placebo effect would have had any lasting effect on anybody with a severe mental illness, and certainly not either my wife or daughter. New medicines rarely worked for more that a few weeks.
In my opinion, the time is now to start introducing the True Hope products into mainstream medicine. A responsible “do no harm” approach to a new case of childhood mental illness would be to start with the mildest treatment possible, which would be EMPower combined with diet and other supplements. It could also be prudent to use the approach in mainstream medicine with established patients who are seeking fewer side effects or who have not been completely treated through conventional techniques. Again, there is A LOT of testimonial evidence, some PEER REVIEWED literature, and minimal NO SIDE EFFECTS.
Brian
I didn’t say there wasn’t any research on this pill. The whole blog entry reviews some of the studies to demonstrate they aren’t exactly without their problems. So “little science” simply means the data that’s out there, in my opinion, is mostly of the weak variety. Case studies, open-label designs (where the researchers know who gets what, leading to unconscious bias), mixed data on some results, and no RCTs for the type of mental disorders it’s being “prescribed” for.
Testimonials do not, and have never, equaled scientific data. There are dozens of reasons why a person might write something positive about a treatment they believe is helping them, including confirmation bias and a whole host of other reasons:
http://www.exercisebiology.com/index.php/site/articles/why_anecdotes_testimonials_are_unreliable/
I can’t speak to specific cases, since I don’t know you or your family, sorry.
Doctor, with all due respect, I disagree that “nutritional supplements cannot treat, let alone cure, an illness.” Study after study,based on the research of Dr. Linus Pauling and Dr. Abram Hoffer, have shown that Orthomolecular treatment works. Personally, I have been stabilized using an orthomolecular treatment since 1999. It works! It is not a placebo.
Dr. Grohol,
There are also a number of reasons why randomized controlled trials are misleading as well. For one, most trials start with a rapid taper down of existing psychiatric medication. The subjects are essentially in a state of acute drug withdrawals. Anything that activates the receptors would be expected to show benefit compared to placebo.
Many techniques in wide use in medicine do not have the RCT trials. For instance, how can you do a RCT on a heart-healthy diet, yet diet is clearly addressed for heart conditions. The psycho-therapies such as CBT and DBT are widely accepted, yet there are no double blind RCTs. Furthermore, a large number of common psychiatric medicines are used off-label. I think almost all of the bipolar medicines were originally used off-label before RCTs allowed marketing for bipolar disorder.
Additionally, both conventional or nutritionally based treatments are rarely monotherapies, like the trials. Conventional treatment generally includes both mood stabilizers and antipsychotics, often combined with anti-anxiety meds, sleep meds, and/or anti-depressants. There are not RCTs on the combinations, just a few consensus based guidelines and practitioner skill.
The same is that a successful nutrition based treatment includes a multi-pronged approach. No one aspect is a magic bullet by itself, not even EMPower. Other components can include addressing food allergies and sensitivities, intestinal flora, casomorphins and gladiomorphins, proper functioning of the methylation cycle, addressing sleep deficiencies, and the addition al supplements.
In our case, I read 100s of journal articles , several books, and communicated with other parents before starting our daughter on a nutritional treatment path. In addition to EMPower, we take additional True Hope products, AminoPower, inositol, and phosphatidyl choline. On top of that, we add extra vitamin C, NAC, and melatonin. Inositol does have a RCT behind which shows it is as effective as SSRIs in treating OCD. NAC has RCTs for a variety of mental illness, and is a component of EMPower. Choline derivatives has significant research articles related to reducing mania but at a possible cost of inducing depression. Amino acid mixtures (but I don’t think the True Hope mixture) have been shown by RCT to be effective at abruptly stopping an acute mania.
Part of the Hippocratic Oath that all US doctors take is to do no harm. To me that should include starting psychiatric treatment on young children using low-risk methods first, such as EMPower and diet. If the effect is not as desired, then move to the strong medications with significant side effects. There is certainly a plethora of research literature available for all kinds of nutritional interventions.
Regards,
Brian
Nutritional supplements, by definition, cannot treat — much less cure — any medical or mental disease. If they made that claim, they would be considered medications and be subjected to the usual FDA clinical trials requirements.
So since EMPower cannot make this claim and is unwilling to undergo FDA clinical trials, they will remain in the same category as taking any multi-vitamin or nutritional supplement.
Taking such vitamins, in general, are a placebo effect:
http://www.dailymail.co.uk/health/article-2078861/Taking-multi-vitamin-pills-does-health.html
Unless your doctor has determined specific vitamin deficits, taking vitamins or minerals — outside of what you normally ingest in a balanced, healthy diet — are unnecessary and actually may be harmful (in some minority of cases).
While it’s certainly a possibility that a complex and serious mental disorder like bipolar disorder could be caused by a simple lack of nutritional balance, in the vast majority of cases, that has not been shown to be a significant causal factor. If it were, we would be sending people to nutritionists — not psychiatrists and psychologists.
Hey, if a placebo works for you — more power to you. Seriously. I’m not going to convince someone who’s belief (like in a religion) is more powerful than actual scientific data.
Dr. Grohol,
You make a strong negative statement when you call it a placebo. I would encourage you to read more of the research that is out there. I understand being skeptical about quantity or quality of research, but that does not mean it is a placebo. I doubt any researcher would want to use EMPower as a placebo in a pharmaceutical study.
Here is a case-controlled study with Autistic Children. 44 children took micronutrients and were compared to 44 children taking pharmacauticals: http://online.liebertpub.com/doi/abs/10.1089/cap.2009.0011.
“Both groups also exhibited significant decreases in total Aberrant Behavior Checklist scores, but the micronutrient group’s improvement was significantly greater (p < 0.0001). SIB {Self Injourous Behaviour} Intensity was lower in the micronutrient group at the end of the study (p = 0.005), and improvement on the Clinical Global Impressions scale was greater for the micronutrient group (p = 0.0029). It is difficult to determine whether the observed changes were exerted through improvement in mood disorder or through an independent effect on autistic disorder. There were some advantages to treatment with micronutrients—lower activity level, less social withdrawal, less anger, better spontaneity with the examiner, less irritability, lower intensity SIB, markedly fewer adverse events, and less weight gain. Advantages of medication management were insurance coverage, fewer pills, and less frequent dosing."
Here is a large double-blind placebo controlled study showing the effect on stress. While not curing mental illness, it certainly shows a clear beneficial effect of micronutrients in reducing stress. http://www.ncbi.nlm.nih.gov/sites/entrez/11234653?dopt=Abstract&holding=f1000,f1000m,isrctn
"RESULTS: Thirty-three patients dropped out and were replaced, leaving 300 patients who completed the study–151 in group 1 (multivitamin-mineral combination), and 149 in group 2 (placebo).
There were no statistically significant differences between the two groups regarding demographics and baseline stress scores at study entry. Both groups improved between baseline and the end of treatment as assessed. The degree of improvement was statistically significant and greatest in group 1 for all psychometric instruments, with this beneficial effect increasing over the course of the day. Subgroup analyses for age (18-44 and 45-65 years), gender and ethnicity showed no general effect on the overall study outcome. CONCLUSIONS: The multivitamin-mineral combination tested is well tolerated and can be used as part of a treatment programme for stress-related symptoms at the recommended dose"
I hope that these 2 articles + the earlier ones I submitted are sufficient to warrent changing the tune from "placebo" to "interesting prospect", or even to "would consider trying it with medication resistant patients" or "would consider it with medication nieve children whose parents are concerned about side effects".
Brian
Thank you Brian for your articulate, well-thought out answer.
What is driving the skeptics crazy is the possibility that it could be that simple. That a particular composition of vitamins and minerals could help alleviate or even eliminate certain mental illness symptoms.
True hope does not claim it cures or treats anything any more than food cures hunger – we all have to continue eating for the rest of our lives. That does not mean it is hoax – it is a fact. We need vitamins and minerals everyday. Period.
The B vitamins, particularly Vitamin B12 is significantly connected to mental functioning. Look at the alcoholic who develops Korsakoffs syndrome and short term memory deteriorates – while little is known about this syndrome, they do know that it is because a chronic alcoholic loses their ability to digest and absorb vitamin B12.
I am still a skeptic but after one month on EMP, I have to admit the results are something else. After being diagnosed with depression for almost 30 years, on Prozac and Wellbutrin for a good portion of them, being told I would be on anti-depressants for the rest of my life, i sought a second opinion from a different psychatrist. I got my answer – I am actually bipolar, brain scans and appointments with two more leading psychiatrists (including one who is world-renowned and a leading expert on bipolar) confirmed this diagnosis.
With the Rx for bipolar looking less attractive than the anti-depressants, EMP was recommended to me by a registered psychologist. I am trying it. I am off ALL medications for the first time in my life. Nobody could have convinced me that was possible a few months ago. You can argue about my diagnosis/misdiagnosis all you want – all I know is that I needed those medications to prevent me from sinking into deeper depressions and having repeated suicidal attempts.
What it doesn’t do is numb you from all of the crap we all have to deal with – still, I can get out of bed in the morning without the dread and depression I have battled for many, many years.
Allison
I think that the author of this article makes some good points, but then regresses and makes a couple of very poor statements. To suggest that anyone can go down to the local store and buy any cheap supplement and have the same results shows very little knowledge about supplements. My naturopath said that water soluable vitamins are hard to mess up chemically, but that fat soluable ones and minerals can have the chemistry messed up more easily. There is also the absorption issue and the amount and type of fillers. This is the first time that I’ve taken a multivitamin and mineral (including vitamin B) where my urine was not bright yellow due from what was not being metabolized. And of course there is the exact ratio of things. One would need to mix quite a lot of different supplements to get that.