AS
Avena Sativa and it’s Possible Benefit for Anti-
Depressant Discontinuation Syndrome.
With the growing amount of Depressive Disorders, many people have been advised by doctors to be put on second generation pharmaceutical anti-depressants. Depressive disorders currently estimate to affect 350 million people worldwide, with about 1 in 20 people reporting an episode of depression each year (Wilson & Lader, 2015). As antidepressants are the primary treatment option for depression and anxiety, between 1998 and 2012, there was a 165% increase recorded for the prescription of antidepressant drugs in England (Wilson & Lader, 2015). Antidepressants have been in circulation for over 50 years, with the first one, iproniazid, being a monoamine oxidase inhibitor (MAOI’s) (Wilson & Lader, 2015). The second one introduced being a tricyclic antidepressant (TCA) which focussed on blocking the reuptake of noradrenaline and serotonin (Wilson & Lader, 2015). In recent decades, scientists created selective serotonin reuptake inhibitors (SSRI’s) and noradrenaline reuptake inhibitors (SNRI’s) to combat overdose toxicity and undesired side effects (Wilson & Lader). With most things that cause many benefits, there can normally be some drawbacks. “Second generation antidepressants have been reported to be associated with a discontinuation syndrome upon withdrawal (Wilson & Lader, 2015).
According to Wilson & Lader, discontinuation syndrome can be described as a cluster of symptoms following the discontinuation of a SSRI, not due to other factors (2015). Symptoms can include dizziness, disturbance of balance, headache, nausea, insomnia, vivid dreams, paraesthesia, ‘electric-shock’-like sensations, depersonalization and irritability, and even visual and auditory hallucinations that can even resemble a stroke (Wilson & Lader, 2015). According to Adele Framer, it is even suggested that these newer antidepressants used for anxiety disorders have similar, if not more intense problems than the highly addictive benzodiazepines, which have been used less due to this side effect (2021). In addition to severe side effects, many times the symptoms of discontinuation can get misdiagnosed as relapse, causing the patients to go back on the medication that they would like to get off in the first place (Framer, 2021). According to Adele Framer, even with an upwards of 40% recorded antidepressant withdrawal syndromes, there is still a lack of medical information on how to safely come off the drugs (2021). Most doctors tend to focus and educate patients on the acute withdrawal syndromes, which can last anywhere from 1-8 weeks; however, there are less talked about post-acute withdrawal syndromes which can last from 6 months to years similar to other addictive medications. (Framer, 2021). With more and more people going onto these addictive medications, and a lack of western medical research support for guiding the discontinuation stage for when patients eventually want to come off them, we will need other alternatives to support the nervous system while dealing with these excruciating side effects.
Intense nervous system support could be the key to treating antidepressant discontinuation syndrome as the nervous system is becoming destabilized and are the unwinding of drug-induced neurophysiological adaption (Framer, 2021). Part of this reason, could be due to the emerging evidence that antidepressants deplete some key minerals and vitamins that would otherwise support a healthy functioning nervous system. If the body has been severely lacking in these supportive minerals and vitamins, once the support of the medication has been withdrawn from the patient, could patients now be in a vulnerably depleted state? Dr. Thomas Wnorowski, from bodybio.com, provides evidence that second generation antidepressants can deplete calcium and vitamin D levels in the body (2023), while Joelvill_admin from Revive Life Clinic says it also can deplete magnesium and B vitamins (n.d), which are all essential in healthy nervous system function. While no studies seem to be done on which vitamins and minerals are lacking in the body while going through antidepressant discontinuation syndrome, it would be safe to bet that supplementation and/or herbal medicine could play a huge function in nervous system support.
Avena sativa, otherwise known as Milky Oats in herbal medicine, is a nutrient dense nervous system trophorestorative (Marciano, n.d.). Dr. Marisa Marciano, a Naturopathic Herbalist writes,
“One of the loveliest nervous system trophorestoratives. Is nutritive in cases of debility from anxiety & fatigue. Avena “feeds” the nervous system especially when under stress. It is specific in cases of nervous debility and exhaustion, especially when associated with depression. It may be used with most of the other nervines, both relaxant and stimulatory, to strengthen the whole of the nervous system.”
Kiva Rose, another Herbalist, also adds that,
“Avena is quite helpful helpful where there is mental and physical exhaustion along with inability to focus, heart palpitations, loss of libido, irritability and potential addiction issues. This isn’t a random list of symptoms, it’s a real pattern that’s worth keeping in mind (Rose, n.d.).”
A trophorestorative in herbal medicine is defined as a substance which has a healing and restorative action on a specific organ or tissue (Herbal Reality, n.d.), while a nerve tonic is defined as a plant remedy that strengthens, feeds, and restores nervous system tissues directly (Marciano, n.d.). Avena sativa is mineral dense, packed with proteins, vitamin E, B vitamins, iron, manganese, zinc, and calcium (Marciano, n.d.). Not only does it help to restore the nervous system, but it’s also traditionally used as a cardio tonic (cardiovascular strengthening) and anxiolytic (anxiety reducing) (Marciano, n.d.). Avena sativa is high in silica, which combined with minerals such as calcium and others are used to strengthen bone health, something that long term users of antidepressants may be lacking in (Marciano, n.d.). As mentioned in a study by Emily S. Mohn et al, they say this:
“Numerous studies have reported a significant association between the use of selective serotonin reuptake inhibitors (SSRIs) and risk of osteoporosis, with considerable evidence indicating these drugs increase the risk of fracture in a dose- and duration-dependent manner [168,169,170]. Additional evidence indicates SSRIs may also decrease BMD [315]. However, collective findings from cohort and case–control studies report the increased risk of fracture from SSRIs may be independent of BMD [356]. The mechanism of action underlying this relationship is not fully elucidated, although studies have shown serotonin receptors are present on osteoblasts, osteoclasts, and osteocytes, indicating SSRIs may influence bone formation and resorption through the activation of serotonin receptors [357](2018)."
Another indication that there is heavy deficiencies within long term antidepressant use. In addition to it’s nutritional profile, Avena sativa has also been studied for helping improve cognitive help, which could support the symptoms of any cognitive disturbance during discontinuation stages of antidepressants. According to Emma Wilson & Malcom Lader at, short-term chronic supplementation resulted in a significant improvement in cognitive function (2015). Although the results aren’t favourable for long-term supplementation, Avena could be of possible use during the acute stages of antidepressant withdrawal. Speaking of withdrawal, are there any studies to indicate it’s use overall in withdrawal?
Although there are no studies done on milky oats helping specifically with antidepressant withdrawal, there are plenty of studies done to show it’s use with opiod withdrawal which can have similar symptoms as antidepressant discontinuation syndrome (Framer, 2015). A study performed with an alcoholic extract of avena sativa in combination with hypericum perforatum, passiflora incarnata, and lavandula officinalis showed to significantly reduce morphine withdrawal symptoms (Ebrahimie et al, 2015). Another study performed on male lab rats, found that an ethanol extract of Avena sativa significantly and dose-dependently decreased the number of jumping in morphine dependent mice (Nori et al, 2015). The finding for this study believes it could be due to the antidepressant and sedative properties of Avena sativa (Nori et al, 2015).
A possible reason why Avena sativa may be of benefit to antidepressant withdrawal, is through it’s ongoing studies of antidepressant effects—specifically on the monoaminergic system. According to a study performed on mice done in as recent as 2024, three different strength alcoholic extracts of Avena sativa were all reported to cause significant antidepressant effects upon the mice through a tail suspension test(Arraey et al, 2024). Traditionally, Avena sativa has been recorded to be used for depression, probably through it’s potent nutritive make up (Herbal Reality, n.d.). As many of the symptoms associated with post discontinuation syndrome surround a resurgence of depression-like symptoms, using a herb such as Avena sativa to replace what the antidepressant medication was doing could be of possible benefit. Hopefully we will see studies done on humans in the future to measure the success of Avena sativa for depression.
Discontinuation syndrome is complex, with many doctors not having enough education on the matter to understand how to navigate the symptoms for their patients. It may be that Avena sativa could be of possible benefit in treating discontinuation syndrome, but it is unlikely that Avena sativa alone could be the only treatment. Through a pdf file found on Guido Mase’s website grianherbs.com, many other herbs including their mechanism of action are listed (2007). Considering that discontinuation syndrome is multifaceted, he lists and suggests using target herbs for the circulation system, digestive system, nervous system, and nutritional system (Mase, 2007). Another mechanism could be through providing patients with a tapering schedule (Wilson & Lader, 2015). Rather than taper quickly like most modern doctors are guilty of suggesting today, more information is coming out on slower tapering down strategies that allow enough time for the body to regulate itself before lowering the next dose (Wilson & Lader, 2015). Vitamins and mineral supplementation could be of great benefit for managing discontinuation syndrome with a study suggesting success using supplements such as amino acids, B-complex, much studied EMPower plus, SameE, inositol, and ect (Brogan & Siefert, n.d.).
In conclusion, discontinuation syndrome is becoming a growing concern with more and more people being dispensed addictive second-generation antidepressants and a future of these people who will want to come off them at some point in their lives. Having the right tools and education available for these patients will be crucial in the years to come. Avena sativa could be a great aid and one piece of the puzzle for supporting patients going through discontinuation syndrome, but unlikely to be the only solution to help with the possibility of excruciating symptoms that come along with it. Not only is more research needed for Avena sativa, more studies in general are needed for the condition in general. Hopefully in the future there will be more education in this field, and a better well-balanced tapering plan with lifestyle, diet, herbal, and supplemental support that can be offered to these suffering patients while they go through the different stages of withdrawal.
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References:
Dr. Mariano, M. (NODATE). Avena Sativa. The Naturopathic Herbalist. https://
thenaturopathicherbalist.com/herbs/a-2/avena-sativa-oats/
Rose, K. (NODATE). Mothers Milk Nourishment + Avena. Enchanters Green. https:// enchantersgreen.com/oats
Ville, J. (NODATE). 8 Important Nutrients Depleted by Mood Medications. Revive Life Clinic. https://revivelifeclinic.com/are-your-mood-medications-causing-nutrient-deficiencies/
Framer, A. (2021, March 16). What I Have Learnt From Helping Thousands of People Taper Off Antidepressants and Other Psychotropic Medications. Therapeutic Advances in Psychopharmacology. https://journals.sagepub.com/doi/full/10.1177/2045125321991274
Brogen, K., & Siefert, A. (2019). Successful Discontinuation of Chronic Polypsychotropic Regimen and Resolution of Withdrawal Syndrome Through Nutrition and Lifestyle Interventions: A Case Report. Advances Journal. http://kajabi-storefronts-production.s3.amazonaws.com/ sites/53102/themes/2147951893/downloads/ cgZffQWTRRqt5NYCqoU2_ChronicPolypsychotropicRegimen.pdf
Wilson, E. & Lader, M. (2015, October 28). A Review of the Management of Antidepressant Discontinuation Symptoms. Sage Journals: Therapeutic Advances in Psychopharmacology. https://journals.sagepub.com/doi/full/10.1177/2045125315612334#body-ref- bibr36-2045125315612334
Kaur, S., Bhardwaj, R.D., Kapoor, R., & Grewal, S.K. (2019, August). Biochemical characterization of oat (Avena sativa L.) Genoytypes with high nutritional potential. Science Direct. https://www.sciencedirect.com/science/article/abs/pii/S0023643819303755
Khayyat Nori, M. H., Mosavi, S. Z., Abbasi Maleki, S., Abbasi Maleki, F., & Najafi, G. (2015). Effect of hydroalcoholic extract of Avena sativa L. on morphine withdrawal signs in male mice. Journal of Sabzevar University of Medical Sciences, 20(4), 408-415.
Arraey, H., Abbasi-Maleki, S., Mohammadi Motamed, S., & Mousavi*, Z. (2024). Hydroalcoholic Extract of Avena sativa Exerts Antidepressant-like Effects Through the Monoaminergic System. Research Journal of Pharmacognosy, 11(2), 11-18. doi: 10.22127/rjp. 2024.412073.2201
Ebrahimie, M., Bahmani, M., Shirzad, H., Rafieian-Kopaei, M., & Saki, K. (2015, March 26). A Review Study on the Effect of Iranian Herbal Medicines on Opioid Withdrawal Syndrome. Sage Journals: Journal of Evidence-Based Integrative Medicine. https://journals.sagepub.com/doi/ full/10.1177/2156587215577896
Nutrition Review. (2016, December 11). A Practical Guide to Avoiding Drug-Induced Nutrient Depletion. Nutrition Review. https://nutritionreview.org/2016/12/practical-guide-avoiding-drug- induced-nutrient-depletion/