This case study followed one woman who took a micronutrient formula called EMP+. She was 21. At age 20 she met diagnostic criteria for ADHD combined type, bipolar II disorder, social phobia, and panic disorder with agoraphobia. She had an 8 year history of symptoms that medications, mainly methylphenidate and fluoxetine, had not managed well. She was taking no psychiatric medication when she joined an 8 week open-label trial in 2008. The study then went on as an off-on-off-on design with 1 year of follow-up.
After 8 weeks on the formula, the authors report clear gains in mood, anxiety and hyperactivity. Her depression, as rated by a clinician, was in remission. Her own ratings of mood swings, hyperactivity and impulsivity improved a lot. Observers saw smaller changes, and her inattention changed little.
She then chose to stop the formula. Eight weeks later her depression scores were back where they started, and the authors state her anxiety and ADHD symptoms got worse. Back on the formula, she improved gradually. At 12 months the authors describe her as in remission of all mental illness. Tests of memory and processing speed also improved, but the authors urge caution, since repeat testing alone can shift scores.
The authors state that a placebo response and expectations cannot be ruled out, and her diet was not properly assessed. They call for larger and more controlled trials.
Talk to a clinician about your own situation.
The numbers Stats and what the terms mean
The statistics behind the plain-language claims above.
- Rucklidge, 2010: clinician-rated depression (MADRS), 25 at baseline, 7 after 8 weeks on EMP+ (reported as a 72% reduction from baseline), 24 after 8 weeks off the formula, and 0 at 12 months back on it.
- Rucklidge, 2010: inattention at 12 months back on EMP+ (CAARS), fell from baseline by 37% (self-rated) and 33% (observer-rated), both reported as changes greater than 2 SD.
- Rucklidge, 2010: hyperactivity/impulsivity at 12 months back on EMP+ (CAARS), fell by 33% (self-rated, 2 SD) and 10% (observer-rated, .5 SD).
- Rucklidge, 2010: processing speed and verbal memory from baseline to 1 year after the open-label trial, processing speed index SS 103 to 117 and verbal memory index SS 91 to 105 (each almost 1 SD); visual memory unchanged (SS 88); working memory SS 103 to 94, which the authors call comparable.
- Rucklidge, 2010: attention test results (CPT-II), response variability 54th to 21st percentile (1 SD), hit reaction time 81st to 31st percentile (more than 1 SD), omissions unchanged (45th percentile), and commission errors worse, 28th to 79th percentile (1 SD), still within a normal nonclinical range. What the terms mean:
- Open-label A study where both the person taking part and the researchers know what treatment is given. Here, she knew she was taking the formula.
- Self-report A measure where people rate themselves, such as rating their own symptoms on a questionnaire. Here, her CAARS self-ratings.
- MADRS A depression scale scored by a clinician. Here, her score fell from 25 to 7 and later to 0.
- CAARS A rating scale for adult ADHD symptoms, filled in by the person and by an observer.
- SD Standard deviation, a measure of how spread out scores usually are. Here it shows how far her scores moved.
- SS A standard score, which places a test result on a common scale.
- CPT-II A computer test of attention that tracks response speed, consistency and errors.
- Percentile Where a score falls compared with other people's scores.
Source: Rucklidge J, Harrison R. Successful Treatment of Bipolar Disorder II and ADHD with a Micronutrient Formula: A Case Study. CNS Spectrums (2010). doi:10.1017/S1092852900027516