MHM Magazine

28 | MENTAL HEALTH MATTERS | 2022 | Issue 6 MHM and natural products (such as herbs and dietary supplements). There is a vast array of products available on the shelves. Some of the most common of these products contain: • Bacopa monnieri (water hyssop), which has some evidence for improving cognition through reducing anxiety – presumably through effects on dopamine, serotonin and GABA. Side-effects include decreased motivation and spermatogenesis, gastrointestinal side-effects, and more serious problems such as asthma, bradycardia and hyperthyroidism. • Withania somnifera (Indian ginseng), with an anti-anxiety effect which aids in learning and memory. It can cause drowsiness, auto-immune aggravation, hyperthyroidism, ulcers and hypotension • Celastrus paniculatus (“the intellect tree”), which delays the reuptake of DA, 5HT and NA. Side effects include vivid and lucid dream states. • Ginkgo biloba, which claim to sharpen mental focus through improving brain glucose metabolism, increasing brain blood flow, vasodilatation, anti- oxidant effect, and blocking 5HT3 receptors. Side-effects include bleeding tendencies, serotonin syndrome, convulsions, and even cases of inducing coma (in combination with trazodone). • American and Asian ginseng (Panax ginseng), which claims benefits such as increased energy, lowered blood sugar and cholesterol levels, reduced stress, and the treatment of sexual dysfunction in men. However, the side-effect profile is disconcerting: Steven-Johnsons syndrome, mastalgia, vaginal bleeding, mania, diarrhoea, insomnia, headaches, tagicardia, blood pressure fluctuations, and vaginal bleeding. “Ginseng abuse syndrome” is also described and marked by hypertension, nervousness, insomnia, skin eruptions, morning diarrhoea, depersonalisation, confusion and depression • Siberian ginseng (Eleutherococcus senticosis) seems more promising. Benefits include improved working memory and concentration, processing speed, and reduced hyperactivity and impulsiveness – without the dangers associated with Panax ginseng. • Cordyceps sinensis (Caterpillar fungus) may have some value. It improves memory and mood through increasing 5HTP, BDNF and anti-oxidants. However, it can aggravate autoimmune disorders and cause bleeding tendencies. • Curcumin and Rhodiola rosea both are MOA-A inhibitors • Guarana, a stimulant, is used for weight loss, to enhance athletic performance, to reduce mental and physical fatigue, and to enhance libido. However, it can cause anxiety, bleeding disorders, irritable bowel syndrome, dysrhythmias, hypertension, glaucoma, and osteoporosis. It should not be used in combination with antidepressants and lithium. • Huperzine A may improve concentration, learning and memory, but may also worsen asthma, epilepsy, bradycardia and ulcers. • Other products with anxiolytic and/or antioxidant effects, and potential indirect benefits on cognition, includes lemon balm, valeriana, kava kava, passion flower, ginger and cinnamon. CONCLUSION Although many individuals, with and without ADHD, report benefits from ‘brainsmart food’, formal studies of the effectiveness of these agents are lacking and there is no consistent evidence from randomised control trials for the use of any food supplements. When deciding to use CAMs, you need to be cautious - even more so when giving it to children. Not everything is safe. More research is needed before doctors can confidently recommend the use of CAMs instead of the ADHD treatment registered in South Africa. References available on request.