About Mind/Body Consultant Services & Protocols

Protocols: Inositol

Psychoactive

Description: Adopted member of B-Vitamin (B-3 Niacinamide) family and ubiquitous component of living cells. It's chemical structure is C6/H12/06. Myo-Inositol (the form is use for psychological disorders) is an ubiquitous carbohydrate present in large amount in brain tissue and a naturally occurring isomer of glucose. It is involved in neuronal signaling and osmoregulation.

Method of Action: Most conventional psychotropics in use today act at receptors on the cell membrane. Inositol, which acts at the second-messenger intracellular level, is a truly novel psychotropic agent. Chronic inositol administration has been found to induce a significant increase in striatal dopamine2 receptor density (Bmax), but not affinity, with a slight increase in 5HT2 receptor density, but not affinity. The changes observed in striatal D1-D2 balance will result in marked changes in activity in the cortical-striatal-thalamic circuit - and in the modultation of thalamic activation of the cortex and striatum. Inositol's effect on mGlu-1 receptors may modulate dopaminergic function indirectly and resent with biochemical and behavioral consequences of DA hyperactivity. (It is possible that Inositol and Serotonin Reuptake Inhibitors (SSRIs) converge to a common final, perhaps genetic, destination. It is also possible that Inositol actives a cascade of events (as do other antidepressants), but at a later point or a different cascade that eventually interacts of converges with the events related to other antidepressant drugs.) Inositol is a key intermediate of the phosphatidyl-inositol (PI) cycle - a second messenger system used by several noradrenergic alpha, several types of serotonergic and cholinergic nerve receptors and is a rate-limiting step in the synthesis of PI - considered a saturated system. No changes in mono-aminergic systems follow acute or chronic Inositol administration. Inositol is responsible for the production of second messengers Inositol triphospahte3 (IP3) and DAG and regulation of phospholipase C. Inositol functions as cell growth factor by stimulating fat used to construct myelinated nerve materials. In animal models, chronic dietary inositol significantly elevates cellular Inositol levels in the cortex (36%) and hippocampus (27%) but not in the striatum or cerebellum. Regional differences in inositol uptake by the brain may shed light on the mechanism of action of lithium in different brain regions. Cerebellar granule cells in culture, which do not accumulate high levels of inositol, are also less susceptible to inositol-induced reversal of the biochemical effects of lithium. (Introcerebroventricular replenishment of lithium-induced depletion of inositol reverses lithium's effects on behavior.) Inositol also reverses desensitization of serotonin receptors.

Indications and Usage: Epi-inositol appears to be more potent than myo-inositol, but all studies referenced in this document relate to the use of Myo-Inositol. Animal and human studies have shown Inositol to have efficacy in treating: Mild-Moderate Anxiety; Panic Attacks; Obsessive Compulsive Disorder (OCD); Agoraphobia; Simple Phobias; Social Phobia; Sensory Nerve Problems; Post-Traumatic Stress Disorder, Mild-Moderate Depression. Inositol is significantly effective for approximately 60-70% of patients depending on condition. Inositol has been found to be ineffective in treating Bipolar Disorder, Schizophrenia, Autism, Alzheimer patients, and to worsen Attention Deficit Disorder. Benefit from Inositol appears to increase with severity of disorder. Inositol also reverses desensitization of serotonin receptors so it may have some use in combination with serotonergic medications to prevent receptor desensitization with long-term use. Inositol Nicotinate (Hexopal) has been used to abolish the increased vascular spasm found in Raynaud's phenomenon.

Contraindications: Do not use this product if you are pregnant or lactating without first seeking advice from your physician. Diabetics may wish to consult their physician before use as Inositol is an isomer of glucose. Persons with a personal or family history bleeding problems, blood clotting disorders, high blood pressure or who ware taking a prescription, over the counter or herbal vasodilator should consult their physician before use. Persons with Alzheimer's Disease, other memory impairing diseases, Autism, or Schizophrenia will likely find no effect with Inositol use. Persons with Attention Deficit Disorder may experience a worsening of symptoms with chronic Inositol use.

Dosage and Administration: Inositol administered orally in high enough doses crosses the blood-brain barrier. Administration of 3 grams of inositol will triple blood levels of inositol and 12 grams will increase human cerebral spinal fluid (CSF) inositol levels by as much as 70%. Range - 6 to 18 grams taken in powdered form. Begin with 4 grams per day taken in two divided doses a.m. and p.m. dissolved in juice. The second week increase to 8 grams per day in three divided doses. The third week take 12g per day in divided doses. Maintain this level for milder depression and anxiety disorders. Continue to increase to 18 grams for OCD and more moderate depression and anxiety over the next two weeks. Can also supplement morning and evening powered doses with chewable tablets during the day whenever symptoms arise but amount taken must be written down to calculate daily target total.

Clinical Effect In: Results after two weeks are comparable to placebo. After 4 weeks significant results have been reported. In Obsessive Compulsive Disorder clinical effect may be delayed in similar fashion to serotonin reuptake inhibitor treatment.

Adverse Reactions: Inositol appears quite safe. It has been administered without untoward effects to adult diabetics in doses up to 12g/day and to newborns with acute respiratory distress syndrome in doses of 80 mg/Kg. (As Inositol is an isomer of glucose persons with diabetes should discuss the use of Inositol with their physicians.) Persons with Inositol Hexaphospate, Nicotinate and Trisphosphate have been found to act as a vasodilator - increasing arterial blood flow. The clinical significance of this for Inositol has not been determined, but it is recommend that persons with a personal or family history of vascular disease consult their physician before initiating Inositol use. Side Effects include: Early stimulation of anxiety and insomnia is common and clears within two weeks. Gastrointestinal upset such as loose stools, nausea and flatulence are sometimes seen and tend to disappear within two weeks. No changes have been found in studies of hematology, kidney, or liver function. If you suspect that an herb or other supplement is making you sick, call the FDA's MedWatch hotline at 800-332-1088 or contact the agency via its website at http://www.fda.gov/medwatch.

Known Interactive Effects: Inositol (18 grams/day) has been administered in combination with SSRI medications for periods up to 6 weeks. While small studies conducted to date found no augmentation effect or additional benefit from combining inositol with serotonergic drugs (probably because the site of action of the two drugs is different) the combination was well tolerated with no adverse effects.

Additional Considerations: Inositol is about 4 calories per gram. Attempt discontinue in 6 months but 50% of subjects in studies relapsed to pre-treatment condition after discontinuation of Inositol. NOW brand powered inositol appears to be subjected to the greatest quality control standards on the market and can be ordered in quantity from: Health Research Institute Pharmacy 800-505-2842.

Warnings: The information above is provided for educational purposes and may not be construed as a medical prescription or as a substitute for the advice of your physician. Do not use this product without first consulting your physician especially if you are pregnant or lactating. Be advised that some herbs and dietary supplements can cause severe allergic reactions in some individuals and may also have an adverse result in conjunction with other medications, or treatments. You should regularly consult your physician in matters regarding your health and particularly in respect to symptoms and conditions, which may require diagnosis or medical attention. Reevaluate use of this product after 6 months.

Back to Protocols >>