Ten years ago, I would have never believed discontinuing antidepressant medication was harder than kicking opiates and alcohol. The US has over 28,000 psychiatrists scripting 37 million patients with antidepressants.  Many of those patients want to stop taking antidepressants and they can’t!  Follow me down this rabbit hole and find out why we developed an antidepressant withdrawal program.  OK, ready?  Let’s dance.

The Dark Ages of Psychiatry

We have come a long way from the dark ages of psychiatry.  Think about this for a second.

In 1949, the Portuguese neurologist António Egas Moniz received the Nobel Prize in medicine for his development of the prefrontal lobotomy, a procedure in which the connection is cut to a part of the brain called the prefrontal cortex in mentally ill, depressed or learning-disabled people.  Winning a Nobel Prize for scrambling a patient’s brain?!  I know, right?  You’re probably thinking how in the hell could this happen…turning people into vegetables who sit in a chair and stare out the window of a mental institution?

About 50,000 people received lobotomies in the United States, most of them between 1949 and 1952. About 10,000 of these procedures were transorbital lobotomies—which involves injecting pure ethyl alcohol into the prefrontal cortex right underneath the upper orbital bone of the eye.  (Sorry for the visual.)  By the way, the Soviet Union banned lobotomies in 1950, arguing that it was “contrary to the principles of humanity.”

Electro convulsive therapy (ECT), shock therapy, became popular in the US in the 1940s.  Psychiatric hospitals were overrun with patients who doctors were desperate to treat and cure.  Whereas lobotomies would reduce a patient to a more manageable submissive state, ECT helped to improve mood in patients.

Psychiatry was almost run out of town in the 1960s as a pseudo-science by the American Medical Association.  There was no research to show their treatments worked.  Then, the DSM (Diagnostic and Statical Manual) was designed that contained medical labels (e.g., bipolar, social anxiety disorder and depression) to name a few.  The DMS now lists over 300 disorders.  These disorders are not grounded in studies or clinical trials; they are voted on by a committee.

The progressive psychiatrists of today say antidepressants are a chemical lobotomy that starts slowly, causing many neurological symptoms and damage to the prefrontal cortex. Over the last 10 years we have hundreds of patients call our facility to help them stop taking antidepressants. I believe antidepressants have addictive properties that are just now being discovered.  Many of the studies only test patients on the antidepressants for months; there are no long-term studies.

Using new research and developing advanced treatments is giving the finger to the medical establishment who can’t find their ass with both hands.  It also gives me satisfaction when I think about Joey D.  We were best friends and firefighters in the early 80s.  Joey put a .357 Magnum to his chest and pulled the trigger.  The day before that, we were hanging out laughing and cutting up.  I’ve often thought, “How the fuck did I miss his pain?”  Folks, trust me, now nothing gets by me.  My personal traumas and loss keep me moving forward. 

Understanding Addiction Through Brain Research

Maybe it’s the Jersey boy in me, but I never had a problem taking a beating over my new ideas.  There were three people who helped me research and validate my traumatic brain injury protocol.  This is where the planets aligned because basically, I’m a nobody in medicine, but passion, persistence and a fuck-you attitude allows me to help people anyhow.

Dr. George Stanley, owner of University Diagnostic Institute, helped me out in the early days.  Anytime I needed an FMRI George was there to offer his company and consultation.  I remember one time we were both being interviewed by a reporter and George said without hesitation, “Russ knows more about the metabolism then I ever will.”  I was shocked.  What physician would say that to a reporter?   George is still a good friend.

When I needed a better understanding of the substructure of the prefrontal cortex and the brain’s alarm center, the amygdala, I asked my physician friends for the best and most respected neurologists in the area.  They all told me to look up Dr. Ira Goodmen who heads up Compass Research and Dr. Arnaldo Isa.  They both made the trip to my small office located inside an imaging center.  I walked them through my brain rehabilitation PowerPoint, watching their facial expressions as each slide clicked by.  In the end, they were both extremely excited and impressed.  They said their practices were too conservative for this advanced research, but they would take calls for me.  “Great,” I said, a little let down but thinking what great guys to meet.  Ready?  Here comes crazy… 

Months later, I was making a pitch to a large medical practice about developing an advanced rehab program. Three physicians and their CEO were in attendance.  When they asked if I had any references to my research, I said, “Yes, Ira Goodman at Compass Research.”  The CEO said, “I know Ira well,” then got up and stepped out if the meeting room.  As I finished up my pitch, the CEO walked back in, looked at the three physicians and said, “Ira just gave this guy a stellar recommendation as an innovator.”  I looked around the room and said nothing.  No one else said a word.  We shook hands and I left the room thinking, “Holy shit, he did it! Ira did what he said he would do!”

Rolling Out the Personalized Addiction Aftercare Program

I took a consulting gig for three years as Director of Research at an addiction center called Professional Treatment Centers in Winter Park, Florida.  I’d been friends with the owner, Bob Nies, for 10 years.  Bob was in the addiction business for over twenty-five years.  At the end of the day, he cared about people; he didn’t charge $70k a month for some bullshit detox rehab program.  Bob himself was an alcoholic and used the Sinclair Method to rid himself of his addiction.

The Sinclair Method for alcoholism involves taking the FDA-approved prescription medication, Naltrexone, on an as-needed basis at least one hour prior to drinking alcohol.  The medication blocks endorphins from being experienced by the drinker, which prevents the alcoholic beverage from causing a buzz.  One good size drink is allowed per day.  This way of thinking seems to resonate better with people than total abstinence.

Bob knew I worked with nutritional and hormonal replacement for people in high-stress occupations. Many of my clients—be they war vets, surgeons, attorneys or professional athletes—were dealing with one addiction or another.  While helping them, I’d met with fifteen different addiction centers around the US and conducted a discovery of their treatments.  I knew we could do better.  When I finished the new program, pulled in new lab work and secured a pharmacy, Bob wanted to roll it out at his location first.  I loved this.  We both knew we were developing a new first-in-kind program and with the opiate epidemic we would save thousands of people.  That’s the hook for me.  We did this with a handshake.

Incidentally, the military vetted my program for its 26 chemical dependency centers on the East Coast.  Juan Gonzalez, national military liaison for the largest behavioral health company in the US, oversaw these centers and shot a video with me for the Russ Scala YouTube channel talking about this new personalized gender-specific treatment.  (See below.)

As Bob and I rolled out our aftercare program, I updated him on how we can look at addicts now on the cellular level, as well as test the gut or microbiome, now considered the second brain.  Bob was in his late 70s and his eyes filled with excitement.  No egos here, just two guys with a mission, drilling down on all the research the addiction gods of bureaucracy missed. 

We knew we were going to have a difficult time getting recovering addicts off antidepressants.  We had our physicians slowly remove a few milligrams of an 80mg Prozac tablet every two weeks.  The patients must shift their diet, do advanced nutritional and hormonal testing and then test the microbiome in the gut which must function properly with the beneficial bacteria in place.  The gut, as mentioned, is the second brain.  Today, not one addiction center is looking at this research; we are the first as far as I know.

My work with brain injuries also played into this treatment.  How to stimulate neurogenesis by testing and elevating BDNF (brain-derived neurotropic factor, what I call Miracle-Gro for the brain) was the next paradigm in neuroendocrinology and we were right there.  It was hard to sleep during this time, like a kid on the night before Christmas.  I could not wait to get up and kick it at the addiction center, seeing our new program working.

The Damage Done by Antidepressants

It doesn’t take brilliance to figure out that after rehab, an addict is severely deficient.  The alcohol/opiate bowel blocks nutrients from being pulled from protein, fat and carbohydrates.  These deficiencies cause cravings which can lock in an addiction for years.  Most addiction centers add antidepressants to their treatment.  Physicians and patients fail to understand that it’s harder to get off antidepressants and benzos than heroin, oxycontin and alcohol.  Antidepressants cause extremely difficult neurological symptoms.

Peter Breggin, an American psychiatrist critical of shock treatment and antidepressants, has all the research on Breggin.com, which is a wealth of information.  Breggin has testified in over 150 court cases on the damage caused by psychiatric medication.  A Netflix special was released on the same topic called Medicating Normal.  There are points in a person’s life where stress can be overwhelming and paralyzes their physical and mental health.  Just treating the head with talk therapy and antidepressants can be good in the short term, but not for years, according to Breggin. 

Addicts will do whatever it takes every day to avoid getting dope sick—bent over vomiting with abdominal pain like the worst flu on the planet.  The symptoms from antidepressant withdrawal are worse with the addition of neurological symptoms (for example “brain zaps” that feel like electricity just shot through your brain), suicidal thoughts, anxiety and depression.  Patients prescribed antidepressants experience side effects, prompting the physician to add more medication.  By the end of the first year, the addict who’s trying like hell to get off alcohol or opiates is now on a whole new drug regimen that can lead to severe damage to the prefrontal cortex, according to Breggin.

Physical Activity Helps Addicts

Endurance exercises that elevate the heart rate above 100 beats per minute help an addict deal with cravings.  The Odyssey House addiction center in New York trains addicts for the New York City Marathon.  That’s running 26.2 miles—quite the feat—but the feeling of training with a group of people with a common goal is about as motivating as it gets for a lot of folks.  Our need for affiliation and healing as a group hands down is better than trying to defeat addiction alone.

I can relate as a former long-distance endurance athlete.  The reason I started running marathons while I was a paramedic was to associate with a different tribe than the paramedics, nurses and police I hung out with who were often self-medicating with alcohol.  During a marathon, when your head says quit, you focus, dig deep, compartmentalize the 100-degree heat, the pain with each foot strike and the mindfuck of having 10 long highway miles to the finish line.  All you’re trying to do is move forward ten feet at a time.  When you cross the finish line and get your blood glucose back up you immediately think anything is possible.  

Some people say that psychedelics do the same—expand their minds.  For me, the preparation for a long-distance event takes years.  Knowing how your metabolism will react in extremely tough environmental conditions is like getting a Ph.D. in your own physiology.  The pain you experience is like a rebirth, a cleansing, a reset.  Weeks after the race I would just bask in the afterglow.  At first, I couldn’t believe I finished, then I broke down the race each mile at a time, visualized and thought of options for next time. After 10 years of this training and racing I was shocked to discover I had damaged my metabolism almost beyond repair.  That’s a separate story that you’ll find in my first book, American Biohacker.

That was the long way of saying besides the nutritional and hormonal treatment, testing the microbiome and mitochondrial function, Bob and I wanted to hire coaches to take over the exercise training for our new program.   Exercise elevates the feel-good neurotransmitters serotonin, dopamine and norepinephrine.  We partnered with a special laboratory that can test neurotransmitter levels, which helps us personalize treatments based on the unique biochemistry of each patient.  No one program works for everyone.

A Way Out of Antidepressant Hell

If a patient comes out of rehab and wants to stop antidepressants, this can take 12 to 24 months while constantly testing multiple metabolic pathways to insure peak organ functionality.  Anytime a patient swallows a pill or capsule it must first pass though the liver, which has two detoxification pathways.  The patient that needs more of a drug is a fast metabolizer.  A patient the needs less is a slow metabolizer.  This is important to understand during the rehab process where a patient may need a bump of alcohol or opiates every four hours.

Tough love is letting the patient know this process may take a few years.  No one wakes up one day and says I need heroin or alcohol.  This behavior takes years to lock into long-term storage and be part of everyday behavior.  Billions of venture dollars are flooding into behavioral health.  Yet, it’s far from enough.  There are still major gaps to overcome and opportunities that have not been addressed.

Our antidepressant withdrawal program builds on the work of experts like Peter Breggin and adds advanced testing for nutritional and hormonal deficiencies that affect the brain.  We keep the weekly counseling during the 12- to 24-month process.  Our lab tests are not offered in conventional medicine, so we are way out front in this area.  Folks, if you like this quick overview, share it!

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