The manager of Sankalpa Dr. Tom O Brien talks openly about the making of ‘The Pharm’ and the value of film making as a model of adult learning and personal development. Currently Sankalpa is making two new films, one looking at elderly abuse and another exploring long term methadone maintenance.
Sankalpa is a holistic centre that works with people who are seeking support to detox off methadone.
Meeting Room – a film about Concerned Parents Against Drugs
March 30th, 2013
New Stabilization Service in Sankalpa
March 16th, 2013
Is there a way out of this clinic?
March 1st, 2013
Useful Apps for within Addiction and Mental Health.
February 2nd, 2013
Sankalpa embraces the Community Reinforcement Approach
November 4th, 2012
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Archive for November, 2010
Wähling C, Wegener T, Tschaikin M. Triple herbal combination: An effective alternative to benzodiazepines.Zeitschrift fur Phytotherapie. 2009;30:69-72.
Benzodiazepines are prescribed as a sedative or tranquilizer. Chronic use leads to dependency and tolerance. When benzodiazepines are discontinued, the dose should be tapered down to avoid rebound (or withdrawal) phenomena (return of symptoms that are more severe than the original symptoms).
Herbs that help with sleep are popular to take during the benzodiazepine withdrawal phase. Kytta-Sedativum®Dragees (Merck Selbstmedikation GmbH; Darmstadt, Germany) is a triple herbal combination composed of standardized extracts from valerian (Valeriana officinalis, Valerianaceae; 3-6:1, extractant: ethanol 70% v/v) root, hops (Humulus lupulus, Cannabaceae; 4-8:1, extractant: ethanol 40% v/v) strobiles, and passionflower (Passiflora incarnata, Passifloraceae; 4-7:1, extractant: ethanol 50% v/v) whole herb. The purpose of this study was to assess the safety, tolerability, and efficacy of Kytta-Sedativum Dragees (sugar coated tablet) during and after benzodiazepine withdrawal.
Patients (59 women, 48 men; ages 19-80 years) with moderate sleep disorders on average (not associated with mental or neurologic disorders) who needed to discontinue benzodiazepine use participated in this prospective, multicenter, observational study. The study was planned and conducted according to the regulations of the German Drug law for such studies and followed recommendations of recognized societies, e.g., the German Society of Phytotherapy.
A 2-week withdrawal phase was followed by a 4-week phase of treatment with Kytta-Sedativum tablets. During the 2-week withdrawal period the benzodiazepine dose was tapered-down. Kytta-Sedativum was prescribed to 86% of the patients starting at the beginning of the withdrawal period; 97% of the patients were taking Kytta-Sedativum during the second week, and 100% of the patients took it from the third week. In the majority of cases, 1 coated tablet per day was prescribed in the first week, and 2 coated tablets from the second week until week 6. Physicians and patients rated their symptoms.
The mean duration of benzodiazepine treatment had been 6.8 months. Benzodiazepine therapy was switched for 1 or more reasons: in 89% of cases on the physician’s recommendation, in 51% upon the patient’s request, and in 70% due to poor tolerability. After 2 and 6 weeks, all clinical symptoms improved from the screening visit. At 6 weeks, general unrest had improved in 71% of patients, concentration disorders had improved in 51% of patients, “depressive symptoms” had improved in 51% of patients, and impaired general state of health had improved in 71% of patients. Most of the patients (96%) rated tolerability as “very good” or “good,” compared to 99% as rated by physicians. The number of patients suffering from difficulty in falling asleep increased during the withdrawal phase from 66% to 79%, but decreased again to 49% after single-agent treatment with Kytta-Sedativum. Compared with the screening visit, 68% of the patients thought that their sleep quality improved by the end of the 6-week treatment with Kytta-Sedativum. At the end of the observation period, 74% of patients indicated having more motivation and drive than at the beginning. Day-time tiredness also improved; 83% of patients were affected by this at the screening visit, 56% were affected after withdrawal, and only 27% were affected after 6-weeks of treatment. Eighty percent of the physicians judged Kytta-Sedativum to be “good” or “very good,” and 74% of the patients judged it to be “good” or “very good.” At the end of the study, 64% of the patients said that they would continue therapy with Kytta-Sedativum, while 34% improved sufficiently to discontinue therapy.
The authors state that the “study once more confirmed the positive benefit-risk-ratio” of the herbal combination. Furthermore, they considered it a success that one-third of the patients terminated Kytta-Sedativum therapy at the time of the final visit due to improvement of their symptoms, while the vast majority of the rest continued with it.
The authors’ overall conclusion was: “Regarding the problems of dependency and tolerability of benzodiazepines, the presented observations indicate that Kytta-Sedativum Dragees is an effective alternative.”
The limitations of an open study should be taken into consideration when making definitive conclusions. As the study was observational and not blinded or placebo-controlled, it cannot be considered as a proof of efficacy in such a clinical situation according to the standards of evidence-based medicine. However, the benefits of this trial can be viewed as a reflection of the daily reality in prescribing practice. Such daily practice is difficult to replicate in a controlled clinical trial. Further, it may be constructive to compare results of this trial with those of others, although one of the study’s authors has indicted that, to his knowledge, such studies are not yet available. Although this trial shows patient improvement, there is no way to know to what extent the benefit was an herbal effect, a placebo effect, and/or a further natural reduction of withdrawal symptoms. Due to the overall good tolerability and lack of adverse events, more rigorous studies should be performed to provide greater evidence of Kytta-Sedativum’s ability to replace or reduce daily dosages of benzodiazepines.
—Heather S. Oliff, PhD
HerbalGram. 2010;85:26-27 American Botanical Council
1. Don’t compare your life to others’. You have no idea what their journey is all about.
2. Try not to have negative thoughts about things you cannot control. Instead invest your energy in the positive present moment
3. Don’t over do; know what your limits are
4. Don’t take yourself so seriously; no one else does!
5. Don’t waste your precious energy on gossip
6. Dream more while you are awake
7. Life is too short to waste time hating anyone.
8. Make peace with your past so it won’t spoil the present
9. No one is in charge of your happiness except you
10.You don’t have to win every argument. Agree to disagree.
And our favourites here at Sankalpa:
What other people think of you is none of your business
No matter how you feel, get up, dress up and show up!
Source: Arun Ghosh
‘The Pharm’ is a short film made by local people from Finglas and Cabra who attend the Sankalpa addiction rehabilitation program. The film is about addiction to valium and alcohol and focuses on the plight on a mother who is struggling with life in Finglas. The central character Deborah (Amanda Doonan) is not only struggling with the stresses and strains of her own life, she also has a teenage daughter Laura (Lynne Murray) who has started to mirror her mother’s behaviour. Deborah turns to her Doctor (Ray Higgins) for support who in turn prescribes her valium without an adequate assessment of her needs and in the end the prescription reinforces her isolation and sense of despair. Laura eventually convinces her mother to go to FAST (Finglas Addiction Support Team) but Debora is reluctant to admit she needs support.
- Cabbage – this is a cruciferous vegetable and is full of phytonutrients, which are helpful in preventing cancer. This green vegetable lowers your risk of lung colon and stomach cancer. Try eating some three to five times a week
- Grapefruit has a compound called Naringen, which is found in some citrus fruits. It helps repair damaged genetic material. Repairing DNA stops cancer cells from multiplying and spreading.
- Kale, very like cabbage good for cleansing the liver
- Chilli peppers contains a substance called Capsaicin which reduces inflammation and can stop the spread of prostrate cancer cells
- Carrots contain compound called Falcarinol, which reduces the risk of cancer in the lung, and prostrate.
- Garlic – reduces risk of developing several types of cancer and is especially beneficial against gastrointestinal cancers.
- Turmeric is a spice that can help prevent and slow down the growth of oesophageal, stomach, breast and skin cancer.
Damien talks to Anne Marie about his detox from methadone, valium and anti-depressants. He is very positive about his experience in Sankalpa. He recognizes that there is not enough support in the clinics for people who do want to detox and that there should be more funding for centres like Sankalpa to support people to detox at their own pace over time, with the support of a team of people delivering a range of services including key working, psychotherapy, employment support, educational and creative programs.
At a recent conference in Wexford of the Psychological Society of Ireland, Ian McKenna of NUI Maynooth gave a lecture on the power of the unconscious in relation to food and the signals it sends out to us. He carried out an experiment involving 128 people with one half considered normal weight and the other half with an average BMI of 50, which would be considered obese.
As a result of various images of healthy and unhealthy foods being shown with each person having not eaten for two hours – the results showed that people of normal weight found images of healthy food made them hungry while those categorised as overweight or obese found images of unhealthy food made them hungry. (Irish Times, Monday, Nov 9)
While there might be many flaws to this kind of experiment it does suggest that if we habitually consume too much food or food that is unhealthy for our bodies, we do adapt to a pattern of continuing to ingest the food that is damaging to us in spite of how we look and feel. Something has broken down in the journey from food as nutrition and health and pleasure to food that feeds a need to satiate or comfort or numb out. Could we start a food revolution like Jamie Oliver?
David Moore talks to Kelly Anne about the “Return to Learning” course at NUI Maynooth which he started in September 2010.
This Certificate level course is designed as a stepping stone for those who wish to return to study, but have not studied in any formal way for a number of years. Participants will be given an opportunity to sample a number of academic subjects so that they will be able to make a more informed choice when selecting subjects later.
The course aims to familiarise people with the structure and requirements of third level education; to equip them with some of the necessary skills required and help them identify the subjects or courses that they may later wish to undertake.
Study Finds Chamomile Effective in Treating Generalized Anxiety Disorder
Reviewed: Amsterdam JD, Li Y, Soeller I, Rockwell K, Mao JJ, Shults J. Randomized, double-blind, placebo-controlled trial of Matricaria recutita (Chamomile) extract therapy for generalized anxiety disorder. J Clin Psychopharmacol. 2009;29:378-382.
Generalized anxiety disorder (GAD) is a chronic disorder often treated with pharmaceuticals. These pharmaceuticals can produce unwanted adverse effects and dependence. Chamomile (Matricaria recutita, Asteraceae; syn. Chamomilla recutita) has long been used as a traditional herbal remedy for its relaxing and calming effects. Although there have been no controlled clinical trials evaluating chamomile’s effect on people with GAD, the authors hypothesized that chamomile would have superior anxiolytic efficacy, yet a similar safety profile, when compared with placebo.
Fifty-seven patients (≥ 18 years of age) were referred by the Department of Family Medicine and Community Health outpatient clinic at the University of Pennsylvania Medical Center in Philadelphia for participation in this randomized, double-blind, placebo-controlled trial. These patients had a Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) Axis I diagnosis of GAD and a baseline total Hamilton Anxiety Rating (HAM-A) score ≥ 9. Patients with minor depression were not excluded if the depression was not a primary disorder. Patients were excluded if they had a diagnosis of major depressive disorder, bipolar disorder, panic disorder, phobic disorder, obsessive-compulsive disorder, post-traumatic stress disorder, acute stress disorder, substance-induced anxiety disorder, psychosis, dementia, or substance abuse or dependence within the preceding 3 months. Participants were not allowed to use other anxiolytics, antidepressants, mood stabilizers, sedatives, or complementary and alternative medicine (CAM) remedies during the study.
Patients were randomized to receive either placebo (n = 29) containing lactose monohydrate (National Formulary) or pharmaceutical grade German chamomile extract (n = 28) standardized to contain 1.2% apigenin (Spectrum Pharmacy Products; New Brunswick, NJ).
Chamomile aroma was blinded by inserting a disk impregnated with 1 drop of chamomile oil (for placebo) or 1 drop of neutral oil (for chamomile) into the lid of each airtight medication container. Chamomile therapy was initiated at 220 mg/day for the first week and increased to 440 mg/day during the second week of therapy. Patients with ≤ 50% reduction in total HAM-A score (vs. baseline) were increased to 660 mg/day during week 3 and 880 mg/day during week 4 of therapy. Patients who continued to have ≤ 50% reduction in baseline HAM-A score were increased to 1100 mg/day during weeks 5 through 8 of therapy. To maintain blinding, patients in both treatment groups had increases in the number of capsules consumed each week when patients had ≤ 50% reduction in total HAM-A score vs. baseline. Dose reductions could occur at any time based upon tolerability of the material. Outcome measurements occurred at baseline and after 2, 4, 6, and 8 weeks of treatment.
There were no significant differences between treatment groups in any baseline variable. There was no significant difference between groups in the mean daily capsule intake.
Patients treated with chamomile had a significantly greater reduction over time in the mean total HAM-A score (primary outcome measure) compared with placebo-treated patients (P = 0.047; 57% and 38%, respectively). According to the authors, the study was not powered to detect small to moderate group differences in secondary outcomes, but rather to find trends. There were clinically meaningful improvements in the chamomile-treated patients according to the Beck Anxiety Inventory, Psychological General Well Being Index, and Clinical Global Impression Severity Score, and more chamomile-treated patients than placebo-treated patients showed improvement on most of these scales.
One patient in each group discontinued due to an adverse event (AE). The chamomile-treated patient discontinued due to stomach discomfort. There were 11 AEs in the chamomile group and 22 in the placebo group that were rated as possibly, probably, or definitely related to treatment (no significant differences between groups). The specific AEs were not listed or described. There was no increase in AEs at higher chamomile doses.
The authors conclude that chamomile was clinically meaningful and statistically superior to placebo in reducing total HAM-A scores in patients with mild to moderate GAD. The authors chose the starting dose of chamomile based on authoritative reviews. It is possible that higher daily doses would be more effective.
The dose-escalating design of the study is typical for studies that evaluate novel psychopharmaceuticals. It is also known that clinical trials of psychopharmaceuticals report a strong placebo effect. It is possible that a larger population size and longer duration of action would produce a more robust effect in favor of chamomile. The authors had a unique method of blinding the well-known smell of chamomile; it is unknown whether there has been prior testing to evaluate the effectiveness of essential oil-impregnated disks in masking placebo.
The researchers used careful methodology in the study design, presentation of findings, and rigorous statistical analysis. This is the first randomized, double-blind, placebo-controlled study to demonstrate that the use of chamomile can lead to modest improvement in symptoms of anxiety in patients with mild to moderate GAD. It also demonstrates safety and tolerability. Although the results are limited by the small size, variability in dosing regimen, and short duration of the study (8 weeks), the positive findings of efficacy support the use of chamomile as a complementary treatment in mild to moderate GAD and indicate the need for further studies.
—Heather S. Oliff, PhD
HerbalGram. 2010;86:32 American Botanical Council
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