In this issue I'm honored to interview my colleague and , Rosemarie Rose, MD. Dr. Rose is a board-certified family physician who has recently opened an Alexandria practice concentrating on neurotransmitter diseases. She practiced family medicine in Fairfax and Arlington for eight years, where she diagnosed and treated many of these conditions including AD/HD, migraine headache, fibromyalgia and depression. In search of methods of treatment apart from the traditional pharmaceutical approach, she completed additional training in the use of amino acids for these conditions. Her practice involves individualized programs of nutritional supplements including amino acids to improve neurotransmitter supply and function in the body and address the symptoms of disease. 

Rosemarie D. Rose, MD

3331 Duke Street

Alexandria, VA 22314

703-244-4889

drrose@rrosemd.com

www.rrosemd.com

1.   What are neurotransmitter disorders?

 Neurotransmitter disorders include many common conditions like AD/HD, depression, migraine headache, fibromyalgia and many others.  These conditions all involve either a relative lack of neurotransmitters, or an imbalance in them.  Serotonin and dopamine are two of the master neurotransmitters (along with epinephrine and norepinephrine) which together control many of our mental and physical processes.  When they are out of whack, we get symptoms. AD/HD involves problems with dopamine transporters, receptors, and decreased levels of dopamine and these problems affect areas of the brain that control attention and motivation.

 2.   How are neurotransmitter disorders usually treated, and why is there a need for another kind of treatment?

 The most important part of treatment for AD/HD is a correct diagnosis, followed by environmental and behavioral accommodations to address the effects of AD/HD at home, school and in the work place.

Given that, traditional pharmaceutical approaches usually involve trying to keep the neurotransmitters that are present out in the spaces between brain cells longer.  This can result in more efficient transmission of nerve impulses in the brain and improve function. The effect is achieved by what is called "re-uptake inhibition," blocking up transporters that allow the neurotransmitters to re-enter the nerve cells. Selective serotonin re-uptake inhibitors or "SSRIs" include Prozac and Zoloft.  Most of the stimulants used for treatment of AD/HD are similarly dopamine re-uptake inhibitors. Some people get good effect.  Others get either less than optimal effect, or they have side effects which limit their ability to take the drugs.  And some people notice decreased effectiveness after being on the medications for a time. These last two groups of people often seek out alternatives to stimulants and SSRIs, as well as people who prefer to avoid pharmaceuticals in general.

In my practice, I use amino acid supplements to provide the body with the building blocks of serotonin and dopamine and allow it to manufacture more of these neurotransmitters.  When people are adequately supplemented and the levels of these neurotransmitters are balanced, symptoms of AD/HD and other neurotransmitter diseases can improve.  This functional medicine approach allows the body's own molecular machinery to operate at its best, as opposed to trying to alter the molecular pathways from their normal state.

 3.   The research to date on dietary and supplement treatments for AD/HD in particular, are at best mixed. What makes your amino acid supplement approach to AD/HD treatment different?

 Many recommendations for nutritional supplements for AD/HD involve a "one-size-fits-all" approach. "Take 50 mg of supplement X, and see if it works." It may work for a few, but not for many people, all of  whom have differing levels of need for supplementation.  I follow both symptoms and urinary neurotransmitter levels to assess whether someone is on the most appropriate dose of supplements for them.  No one in my practice is on the same dose as anyone else.  Everyone is different.

 4.   How, and by whom, was the amino-acid supplement treatment for neurotransmitter disorders developed? How much data are there to back up the success of this approach?

 The techniques for supplementation and testing I use were developed over the last 15 years by a group of physicians in Duluth, Minnesota called NeuroResearch Clinics.  They have used amino acid supplements on a large patient population to treat neurotransmitter conditions and amassed a clinical database comprising over 1.5 million patient-days of treatment. This database has been "mined" by the University of Minnesota Medical School to write articles being published in the peer-reviewed medical literature.  One article has been published already, and two others are in the works. (These articles deal with the urinary excretion assay used to assess neurotransmitter balance, not AD/HD specifically.) The lead researcher, Marty Hinz, MD, has also used this clinical evidence to contribute a chapter on the use of amino acids for treatment of depression to a book edited by Ingrid Kohlstadt, MD of Johns Hopkins University.

 5.   Where did you get your training to conduct the treatment? What have been the results for your patients who have begun the supplement regimen?

 I have been studying the use of amino acids for over two years through reading of medical literature and through a continuing medical education course taught by Dr. Hinz, the lead researcher. Over 900 health care providers across the country have completed this training.

The results in my patients have been gratifying to see.  Specifically with regard to AD/HD, my patients have reported improved ability to concentrate and motivate themselves to do what they need to do.  Many decrease or discontinue their use of stimulants if they are already on them.  They appreciate the even effectiveness of the supplements without the "on-off" effects they experienced on stimulants. As with any approach, not everyone who tries the amino acid supplementation elects to stay with it, but all of my patients who have used the supplements for AD/HD have reported some level of improvement in symptoms.

 6.   Who would most likely benefit from this new kind of treatment?

 People who have been unable to achieve sufficient improvement in their AD/HD symptoms with behavioral accommodations and are considering pharmaceuticals or supplements should consider amino acid supplementation.  People who have not had good success or too many side effects with pharmaceuticals may find that amino acid supplementation can avoid the problems and still achieve the desired effect.

7.   Is there a website or other source of information where one can learn more about this treatment?

There is a more in-depth explanation on how amino acids work on my website at www.rrosemd.com.  The website contains links to other sites with information on neurotransmitter disease.

Kevin, thank you for this opportunity to contribute to your newsletter and hopefully provide your readers with some new information.