CENTER ON BEHAVIORAL MEDICINE
BODY-MIND CONNECTION

ESSENTIAL NUTRIENTS

Essential Nutrients-Mood:  Research Article

Essential Nutrients Menu


Treatment of Mood Lability and Explosive Rage with Minerals and Vitamins


CITATION:  Kaplan, B. J., Crawford, S.G., et al.  (2002)  Treatment of Mood Lability and Explosive Rage with Minerals and Vitamins: Two Case Studies in Children Journal of Child and Adolescent Psychopharmacology.  Volume 12, Number 3, 2002 Pp. 205–219.

ABSTRACT:  A micronutrient supplement containing a broad range of dietary minerals and vitamins is being examined for the treatment of mood lability in both adults and children (Kaplan et al. 2001; Popper 2001). To participate, the child simply had to exhibit mood lability, irritability, uncontrollable temper outbursts, or aggression.  During pilot work, two medication-free boys with mood lability and explosive rage were studied in an open-label treatment followed by reversal and retreatment.

One child was an 8-year-old with atypical obsessive-compulsive disorder, and the other was a 12-year-old with pervasive developmental delay. Both boys were monitored using the mood and temper items from the Conners Parent Rating Scale, as well as the Child Behavior Checklist. 

In addition, the boy with atypical obsessive-compulsive disorder was monitored with the child version of the Yale-Brown Obsessive Compulsive Scale. Both boys benefited from the micronutrient supplement when examined in ABAB designs: mood, angry outbursts, and obsessional symptoms improved when initially treated, returned when not taking the supplement, and remitted when the micronutrient supplement was reintroduced. 

Both boys have been followed and are stable on the nutritional supplement for over 2 years. These cases suggest that mood lability and explosive rage can, in some cases, be managed with a mixture of biologically active minerals and vitamins, without using lithium or other traditional psychopharmacologic agents.


TABLE 1  Ingredients of E.M. Power                                                                       


32 Caps
8 Caps
Children's RDA
Vitamin A (as retinyl palmitate) 9,600 IU 2,400 IU 5,000 IU
Vitamin C (as ascorbic acid) 1,000 mg 250 mg 60 mg
Vitamin D (as cholecalciferol) 1,600 IU 400 IU 400 IU
Vitamin E (as d-alpha tocopheryl succinate) 400 IU 100 IU 30 IU
Vitamin B1 (as thiamine mononitrate) 20 mg 5 mg 1.5 mg
Vitamin B2 (as riboflavin) 22 mg 5.5 mg 1.7 mg
Vitamin B3 (as niacinamide) 100 mg 25 mg 20 mg
Vitamin B6 (as pyridoxine hydrochloride) 28 mg 7 mg 2.0 mg
Vitamin B9 (as folic acid) 1,600 mcg 400 mcg 400 mcg
Vitamin B12 (as cyanocobalamin) 1,000 mcg 250 mcg 6.0 mcg
Biotin 100 mcg 25 mcg 10 mcg
Pantothenic acid (as d-calcium pantothenate) 24 mg 6 mg 10 mg
Calcium (as calcium complex,a calcium
     amino acid chelate) 
2,200 mg 550 mg 1 g
Iron (as iron amino acid chelate, iron complexa) 24 mg 6 mg 18 mg
Phosphorous (phosphorous complexa) 1,400 mg 350 mg 1 g
Iodine (from kelp) 300 mcg 75 mcg 150 mcg
Magnesium (as magnesium amino acid chelate, 
     magnesium complexa)
1,000 mg 250 mg 400 mg
Zinc (as zinc amino acid chelate, zinc complexa) 80 mg  20 mg  10–15 mg
Selenium (as selenium amino acid chelate, 
     selenium complexa)
400 mcg 100 mcg None
Copper (as copper amino acid chelate, 
     copper complexa)
12 mg 3 mg 2 mg
Manganese (as manganese amino acid chelate, 
     manganese complexa)
16 mg 4 mg None
Chromium (as chromium amino acid chelate, 
     chromium complexa)
1,000 mcg 250 mcg None
Molybdenum (as molybdenum amino acid chelate,
     molybdenum complexa)
264 mcg 66 mcg None
Potassium (as potassium complexa) 400 mg 100 mg None
    

Note: Treatment began with 32 capsules/day; maintenance dose was 8 capsules/day.

There is currently a proprietary blend, for which daily values are not established: dl-phenylalanine, glutamine (as l-glutamine), citrus bioflavonoids (from peel), grape seed (Vitis vinitera), choline (as choline bitartrate), inositol, Ginkgo biloba (from leaf), methionine (as l-methionine), germanium (as Germanium sesquioxide), boron (as boron amino acid chelate), vanadium (as vanadium amino acid chelate, vanadium complexa), and nickel (as nickel amino acid chelate, nickel complexa). Other ingredients include gelatin, magnesium stearate, microcrystalline cellulose, and silicon dioxide. Manufactured for The Synergy Group of Canada, by Evince International, Farmington, Utah. RDA = recommended daily allowance.

aSaccharide complex.

References

Achenbach TM: Manual for the Child Behavior Check List /4–18 and 1991 Profile. Burlington: University of Vermont, 1991.

Arnold LE, Pinkham SM, Votolato N: Does zinc moderate essential fatty acid and amphetamine treatment of attention-deficit/hyperactivity disorder? J Child Adolesc Psychopharmacol 10:111–117, 2000.

Arnold LE, Votolato NA, Kleykamp D, Baker GB, Bornstein RA: Does hair zinc predict amphetamine improvement of ADD/hyperactivity? Int J Neurosci 50:103–107, 1990.

Benton D: Micro-nutrient supplementation and the intelligence of children. Neurosci Biobehav Rev 125:297–309, 2001.

Benton D, Cook R: Selenium supplementation improves mood in a double-blind crossover trial. Psychopharmacology 102:549–550, 1990.

Benton D, Cook R: The impact of selenium supplementation on mood. Biol Psychiatry 29:1092–1098, 1991.

Benton D, Donohoe RT: The effects of nutrients on mood. Public Health Nutr 2:403–409, 1999.

Benton D, Griffiths R, Haller J: Thiamine supplementation mood and cognitive functioning. Psychopharmacology 129:66–71, 1997.

Benton D, Haller J, Fordy J: Vitamin supplementation for 1 year improves mood. Neuropsychobiology 32:98–105, 1995.

Benton D, Roberts G: Effect of vitamin and mineral supplementation on intelligence of a sample of school children. Lancet 1(8578) 140–143, 1988.

Carroll D, Ring C, Suter M, Willemsen G: The effects of an oral multivitamin combination with calcium, magnesium, and zinc on psychological well-being in healthy young male volunteers: A double-blind placebocontrolled trial. Psychopharmacology (Berl), 150:
220–225, 2000.

Conners CK: Conners’ Rating Scales Manual. Toronto: Multi-Health Systems, 1991.

Dubovsky S, Murphy J, Thomas M, Rademacher J: Abnormal intracellular calcium ion concentration in platelets and lymphocytes of bipolar patients. Am J Psychiatry 149:118–120, 1992.

Dubovsky S, Thomas M, Hijazi A, Murphy J: Intracellular calcium signalling in peripheral cells of patients with bipolar affective disorder. Eur Arch Psychiatry Clin Neurosci 243:229–234, 1994.

English WM: Report of the treatment with manganese chloride of 181 cases of schizophrenia, 33 of manic depression, and 16 other defects of psychoses at the Ontario Hospital, Brockville, Ontario. Am J Psychiatry 9:569–580, 1929.

Hoobler BR: Symptomatology of vitamin B deficiency in infants. JAMA 91:307–310, 1928.

Kaplan BJ, Fisher JE, Crawford SG, Field CJ, Kolb B: Improved mood and behavior during treatment with a mineral-vitamin supplement: An open-label case series (submitted).

Kaplan BJ, Simpson JSA, Ferre RC, Gorman CP, McMullen DM, Crawford SG: Effective mood stabilization in bipolar disorder with a chelated mineral supplement. J Clin Psychiatry 62:936–944, 2001.

Linder J, Brimar K, Granberg PO, Wetterberg L, Werner S: Characteristic changes in psychiatric symptoms, cortisol and melatonin but not prolactin in primary hyperparathyroidism. Acta Psychiatr Scand 78:32–40, 1988.

Maes M, D’Haese PC, Scharpe S, D’Hondt P, Cosyns P, De Broe ME: Hypozincemia in depression. J Affect Disord 31:135–140, 1994.

Maes M, Vandoolaeghe E, Neels H, Demedts P, Wauters A, Meltzer HY, Altamura C, Desnyder R: Lower serum zinc in major depression is a sensitive marker of treatment resistance and of the immune/inflammatory response in that illness. Biol Psychiatry 42:349– 358, 1997.

McLeod MN, Gaynes BN, Golden RN: Chromium potentiation of antidepressant pharmacotherapy for dysthymic disorder in 5 patients. J Clin Psychiatry 60: 237–240, 1999.

Okamoto T, Gerstein HC, Obara T: Psychiatric symptoms, bone density and non-specific symptoms in patients with mild hypercalcemia due to primary hyperparathyroidism:  A systematic overview of the literature. Endocr J 44:367–374, 1997.

Penland JG, Sandstead HH, Alcock NW, Dayal HH, Chen XC, Li JS, zhao F, Yang JJ: A preliminary report: Effects of zinc and micronutrient repletion on growth and neuropsychological function of urban Chinese children. J Am Coll Nutr 16:268–272, 1997.

Popper CW: Do vitamins or minerals (apart from lithium) have mood-stabilizing effects? [commentary]. J Clin Psychiatry 62:933–935, 2001.

Reed GE: Use of manganese chloride in dementia praecox. Can Med Assoc J 21:46–49, 1929.

Sandstead HH: Zinc: Essentiality for brain development and function. Nutr Rev 43:129–137, 1985.

Sandstead HH, Frederickson CJ, Penland JG: History of zinc as related to brain function. J Nutr 130:496S–502S, 2000.

Sandstead HH, Penland JG, Alcock NW, Dayal HH, Chen XC, Li JS, Zhao F, YAng JJ: Effects of zinc and other micronutrients on neuropsychologic performance and growth of Chinese children. Am J Clin Nutr 68:470S–475S, 1998.

Scahill, L, Riddle MA, McSwiggin-Hardin M, Ort SI, King RA, Goodman WK, Cicchetti D, Leckman JF: Children’s Yale-Brown Obsessive Compulsive Scale: Reliability and validity. J Am Acad Child Adolesc Psychiatry 36:844–852, 1997.

Schlebusch L, Bosch BA, Polglase G, Kleinschmidt I, Pillay BJ, Cassimjee MH: A double-blind, placebo-controlled, double-centre study of the effects of an oral multivitamin-mineral combination on stress. S Afr Med J 90:1216–1223, 2000.

Strain JJ, Caballero B: Encyclopedia of Human Nutrition. San Diego, (California), Academic Press, 1999.

Toren P, Eldar S, Sela BA, Wolmer L, Weitz R, Inbar D, Koren S, Reiss A, Weizman R, Laor N: Zinc deficiency in attention-deficit hyperactivity disorder. Biol Psychiatry 40:1308–1310, 1996.

Walsh WJ, Isaacson HR, Rehman F, Hall A: Elevated blood copper/zinc ratios in assaultive young males. Physiol Behav 62:327–329, 1997.

Werbach MR: Nutritional influences on mental illness: A Sourcebook of Clinical Research, 2nd ed. Tarzana (California), Third Line Press, 1999.