Research

EMPowerplus Q96, the most researched MicroNutrient in the world is unlike any other multi-vitamin and mineral supplement.

   
 25 Medical Journal Publications

  • The most respected evidence-based reports available to medical professionals that highlight new advances in the medical field.
  • Research has been published in 25 medical journals over the past decade proving the effectiveness of the EMPowerplus Q96™ formulation.
  • Including a newly released double blind study, which is the Gold Standard of medical research. For details of this specific study please CLICK HERE
  • The founders have been approached by 41 independent researchers over the last decade who have contributed to ongoing studies.
  • The research that has resulted has been positive and has shown significant improvement in the lives of those with mood disorders.
  • The EMPowerplus Q96™ formulation has been studied around the world including at 15 renowned universities.
  • Since the reach of the EMPowerplus Q96™  research has been phenomenal, it has spread throughout the world and has taken place across North America, Europe, New Zealand,  and Australia
Click on the Medical Journal icons below to read the entire study (PDF) or read abstracts here


Empowerplus Q96 RESEARCH #1 : EFFICACY AND COST OF MICRONUTRIENT TREATMENT OF CHILDHOOD PSYCHOSIS
2012 study on an 11-year old boy who transitioned from medication to micronutrients for help with psychosis.

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EMPowerplus Q96 RESEARCH #2: FEASABILITY OF A NUTRITIONAL SUPPLEMENT AS TREATMENT FOR PEDIATRIC BIPOLAR SPECTRUM DISORDERS
2012 open-label study on the effect of EMPowerplus on 10 children with bipolar spectrum disorders.
EMPOwerplus Q96 RESEARCH #3: EFFECTS OF MICRONUTRIENTS ON STRESS AND TRAUMA AFTER AN EARTHQUAKE
2012 study on the effect of EMPowerplus on adults with ADHD experiencing stress.
Q96 RESEARCH #4: POST-EARTHQUAKE PSYCHOLOGICAL FUNCTIONING IN ADULTS WITH ATTENTION-DEFICIT/HYPERACTIVITY DISORDER
2010 study on the positive effects of EMPowerplus on the resilience of adults with ADHD.
EMPowerplus Q96 RESEARCH #5: MICRONUTRIENTS REDUCE STRESS AND ANXIETY IN ADULTS WITH ATTENTION-DEFICIT/HYPERACTIVITY DISORDER FOLLOWING A 7.1 EARTHQUAKE
2011 study on the effect of EMPowerplus on adults with ADHD following a 7.1 earthquake.
EMPowerplus Q96 RESEARCH #6: CAN MICRONUTRIENTS IMPROVE NEUROCOGNITIVE FUNCTIONING IN ADULTS WITH ADHD AND SEVERE MOOD DYSREGULATION? A PILOT STUDY.
2011 study on the effect of EMPowerplus on cognitive functioning in adults with ADHD.
Q96 RESEARCH #7: SYSTEMATIC REVIEW OF SAFETY AND TOLERABILITY OF A COMPLEX MICRONUTRIENT FORMULA USED IN MENTAL HEALTH
2011 published compilation of all known safety and tolerability data on EMPowerplus.
EMpowerplus Q96 RESEARCH #8: EFFECT OF MICRONUTRIENTS ON BEHAVIOR AND MOOD IN ADULTS WITH ADHD
2011 study on the effect of EMPowerplus on adults with ADHD.
EMPowerplus Q96 RESEARCH #9: DATABASE ANALYSIS OF CHILDREN AND ADOLESCENTS WITH BIPOLAR DISORDER CONSUMING A MICRONUTRIENT FORMULA
2010 database compilation study on the effect of EMPowerplus on children and adolescents with bipolar disorder.

EMPowerplus Q96 RESEARCH #10: SUCCESSFUL TREATMENT OF BIPOLAR DISORDER II AND ADHD WITH A MICRONUTRIENT FORMULA: A CASE STUDY
2010 case report on the effect of EMPowerplus on a 21-year-old female with bipolar II disorder, ADHD, society anxiety and panic disorder.
EMpowerplus Q96 RESEARCH #12: DATABASE ANALYSIS OF ADULTS WITH BIPOLAR DISORDER CONSUMING A MICRONUTRIENT FORMULA
2009 database analysis of the effect of EMPowerplus on adults with bipolar disorder.
EMPowerplus Q96 RESEARCH #13: SUCCESSFUL TREATMENT OF OCD WITH A MICRONUTRIENT FORMULA FOLLOWING PARTIAL RESPONSE TO COGNITIVE BEHAVIORAL THERAPY (CBT): A CASE STUDY
2009 case study on the effects of EMPowerplus on an 18-year-old male with OCD.
EMpowerplus Q96 RESEARCH #14: MULTINUTRIENT SUPPLEMENT AS TREATMENT: LITERATURE REVIEW AND CASE REPORT OF A 12-YEAR-OLD BOY WITH BIPOLAR DISORDER
2009 case study on the effect of EMPowerplus on a 12-year-old boy with bipolar disorder.
EMPowerplus Q96 RESEARCH #15: IMPROVED MOOD AND BEHAVIOR DURING TREATMENT WITH A MINERAL-VITAMIN SUPPLEMENT: AN OPEN-LABEL CASE SERIES OF CHILDREN
2004 case report on the effect of EMPowerplus on children with unstable mood and behavioral problems.
EMpowerplus Q96 RESEARCH #16: DIET CAN STIMULATE FUNCTIONAL RECOVERY AND CEREBRAL PLASTICITY AFTER PERINATAL CORTICAL INJURY IN RATS
Research on the effect of EMPowerplus on brain injury recovery in rats.

EMpowerplus Q96 RESEARCH #17: TREATMENT OF MOOD LABILITY AND EXPLOSIVE RAGE WITH MINERALS AND VITAMINS: TWO CASE STUDIES IN CHILDREN
2002 case study on the effect of EMPowerplus on two children with explosive rage.
Empowerplus Q96 RESEARCH #18: NUTRITIONAL APPROACH TO BIPOLAR DISORDER
2003 commentary by Miles Simmons, M.D. on 19 patients and their response to EMPowerplus.
Empowerplus Q96 RESEARCH #19: DO VITAMINS OR MINERALS HAVE MOOD-STABILIZING EFFECTS?
2001 commentary by Charles W. Popper, M.D. (of Harvard Medical School) on 22 patients and their response to EMPowerplus.

Empowerplus Q96 RESEARCH #21: USE OF MICRONUTRIENTS ATTENUATES CANNABIS AND NICOTINE ABUSE AS EVIDENCED FROM A REVERSAL DESIGN
2013 case study by Rachel Harrison on the impact of EMPowerplus on nicotine and cannabis drug abuse.

Empowerplus Q96 RESEARCH #22: COULD YEAST INFECTIONS IMPAIR RECOVERY FROM MENTAL ILLNESS?
2013 case study by Julia Rucklidge on the connection between gut health and the efficacy of EMPowerplus.
EMPOWERPLUS Q96 RESEARCH #23: Vitamin-mineral treatment of attention-deficit hyperactivity disorder in adults: double-blind randomised placebo-controlled trial
Published January 2014

EMPOWERPLUS Q96 RESEARCH #24 :Psychological functioning 1 year after a brief intervention using micronutrients to treat stress and anxiety related to the 2011 Christchurch earthquakes: a naturalistic follow-up

EMPOWERPLUS Q96 RESEARCH #25 : Vitamin-mineral treatment of attention-deficit hyperactivity disorder in adults: double-blind randomised placebo-controlled trial.

ABSTRACTS

ABSTRACTS OF PUBLISHED EMPIRICAL REPORTS

1.Megan Rodway, Annette Vance, Amany Watters, Helen Lee, Elske Bos, Bonnie J Kaplan Efficacy and cost of micronutrient treatment of childhood psychosis, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada, Mood and Anxiety Disorders Clinic, Calgary, Alberta, Canada, Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada, Center for Integrative Psychiatry, Groningen, The Netherlands, Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada BMJ Case Reports 2012; doi:10.1136/bcr- 2012-007213  Abstract  Psychosis is difficult to treat effectively with conventional pharmaceuticals, many of which have adverse long-term health consequences. In contrast, there are promising reports from several research groups of micronutrient treatment (vitamins, minerals, amino acids and essential fatty acids) of mood, anxiety and psychosis symptoms using a complex formula that appears to be safe and tolerable. We review previous studies using this formula to treat mental symptoms, and present an 11-year-old boy with a 3-year history of mental illness whose parents chose to transition him from medication to micronutrients. Symptom severity was monitored in three clusters: anxiety, obsessive compulsive disorder and psychosis. Complete remission of psychosis occurred, and severity of anxiety and obsessional symptoms decreased significantly (p<0.001); the improvements are sustained at 4-year follow-up. A cost comparison revealed that micronutrient treatment was <1% of his inpatient mental healthcare. Additional research on broad-spectrum micronutrient treatment is warranted.  2. Frazier E, Fristad M, Arnold E. Feasibility of a Nutritional Supplement as Treatment for Pediatric Bipolar Spectrum Disorders, Dept. Psychiatry, Ohio State University. The Journal of Alternative and Complementary Medicine Vol 18, Num 7, 2012, pp. 678-685 AbstractObjectives: Current psychotropic medications for childhood bipolar spectrum disorders (BPSD) are associated with significant adverse events. As nutrients play an important role in physical and mental health, they may be useful in treating mood disorders with few side-effects. This open-label study explored the feasibility of testing therapeutic effects of a multinutrient supplement, EMPowerplus_ (EMP + ), for pediatric BPSD. Design: EMP+ was started at one capsule t.i.d. and escalated to a goal of four capsules t.i.d., which eight children attained. Four (4) of these increased to the maximum dose, five capsules t.i.d. Mood symptoms were assessed seven times over 8 weeks. Subjects: Ten (10) children, age 6–12 with BPSD, were enrolled in 6.5 months. Seven (7) participants completed the full trial. Three (3) dropped out due to palatability and/or adherence issues. Results: Mean medication adherence was 91%. With one-tailed nonparametric Fisher’s randomization tests, intent-to-treat analyses demonstrated a 37% decrease in depression scores ( p < 0.06) and a 45% decrease in mania scores ( p < 0.01) from the start of treatment through final visit, suggesting improvement and possible treatment response. Study completers demonstrated significant decreasing trends in both depression and mania scores from baseline to final visit ( p < 0.05). Side-effects were minor and transient, mostly temporary gastric discomfort. Conclusions: Future randomized, placebo-controlled trials of EMP+ are warranted and feasible

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3. Rucklidge J, Andridge R, Gorman B, Blampied N, Gordon H, Boggis A. Effects of Micronutrients on stress and trauma after an earthquake: RCT evidence comparing formulas and doses. Hum. Psychopharmacol Clin Exp (2012) DOI: 10.1002/hup  AbstractObjective – To compare two micronutrient (vitamins and minerals) formulas (BeroccaTM and CNETM) and assess their impact on emotions and stress related to the 6.3 earthquake on February 22nd 2011 in Christchurch, New Zealand.  Methods – 91 adults experiencing heightened anxiety or stress 2–3 months following the earthquake were randomized to BeroccaTM, CNETM low dose (CNE4), or CNETM high dose (CNE8), for 28 days and monitored weekly via on-line questionnaires and followed 1 month post-trial. A nonrandomized control group (n = 25) completed questionnaires at baseline and 4 weeks.  Results – All treatment groups experienced significant declines in psychological symptoms (p<.001). CNETM groups experienced greater reduction in intrusive thoughts as compared with BeroccaTM (p = .05), with no group differences on other measures of psychological symptoms. However, CNE8 group reported greater improvement in mood, anxiety, and energy (p<.05) with twice as many reporting being “much” to “very much” improved and five times more likely to continue taking CNETMpost-trial than BeroccaTM group. Treated participants had better outcomes on most measures over 4 weeks as compared to controls.  Conclusions – This study supports micronutrients as an inexpensive and practical treatment for acute stress following a natural disaster with a slight advantage to higher doses  4. Rucklidge J, Blampied N, Post – Earth Psychological Functioning in Adults with Attention – Deficit / Hyperactivity Disorder: Positive Effects of Micronutrients on Resilience. New Zealand Journal Vol. 40, No. 4 2011  Abstract The September, 2010, 7.1 magnitude earthquake in Christchurch, New Zealand, provided an opportunity to study the after-effects of a major earthquake where death and injury were absent. It created a natural experiment into the protective effects on well-being of taking EMPowerplus (EMP+), a micronutrient supplement, in a group of 33 adults diagnosed with ADHD who had been assessed prior to the earthquake. Fortuitously, 16 were currently taking the supplement as part of on-going research at the time of the quake, while 17 were not (they had completed their trial of EMP+ or were waiting to begin consumption). The Depression Anxiety and Stress Scale (DASS-42) which had been administered at varying times before the earthquake on recruitment into the micronutrient study was re-administered by telephone 7-10 and again 14-18 days post-earthquake to volunteer, earthquake-exposed participants. A modified Brinley plot analysis of the individual DASS-42 scores showed that the 16 participants on the nutritional supplement were more resilient to the effects of the earthquake than the 17 individuals not taking the supplement. This effect was particularly marked for Depression scores.  5. Rucklidge J, Johnstone J, Harrison R, Boggis A. Micronutrients reduce stress and anxiety in adults with Attention- Deficit/Hyperactivity Disorder following a 7.1 earthquake. Psychiatry Res. 2011 Jul 29. Abstract The role of good nutrition for resilience in the face of stress is a topic of interest, but difficult to study. A 7.1 earthquake took place in the midst of research on a micronutrient treatment for Attention-Deficit/Hyperactivity Disorder (ADHD), providing a unique opportunity to examine whether individuals with ADHD taking micronutrients demonstrated more emotional resilience post-earthquake than individuals with ADHD not taking micronutrients. Thirty-three adults with ADHD were assessed twice following the earthquake using a measure of depression, anxiety and stress also completed at some point pre-earthquake (baseline). Seventeen were not taking micronutrients at the time of the earthquake (control group), 16 were (micronutrient group). While there were no between-group differences one week post-quake (Time 1), at two weeks post-quake (Time 2), the micronutrient group reported significantly less anxiety and stress than the controls (effect size 0.69). These between group differences could not be explained by other variables, such as pre-
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earthquake measures of emotions, demographics, psychiatric status, and personal loss or damage following the earthquake. The results suggest that micronutrients may increase resilience to ongoing stress and anxiety associated with a highly stressful event in individuals with ADHD and are consistent with controlled studies showing benefit of micronutrients for mental health. 6. Rucklidge, J. J., Johnstone, J., Harrison, R. (in press). Effect of micronutrients on neurocognitive functioning in adults with ADHD and Severe Mood Dysregulation: A pilot study. Journal of Alternative and Complementary Medicine.  AbstractObjectives: Little research has investigated how micronutrients (minerals and vitamins) affect cognitive functioning despite preliminary studies showing they may improve psychiatric functioning. Intervention: This pilot study investigated the impact of a 36 ingredient micronutrient formula consisting mainly of vitamins and minerals on neurocognitive functioning in 14 adults with Attention-Deficit/Hyperactivity Disorder (ADHD) and severe mood dysregulation (SMD). Design: The formula was consumed in an open-label trial over an 8 week period.Outcome Measures: The participants completed tests of memory (Wide Range Assessment of Memory and Learning) and executive functioning (Delis-Kaplan Executive Functioning System and Conners Continuous Performance Test) at baseline and at the end of the trial. A gender and age matched control group of 14 non-ADHD adults not taking the formula were assessed on the same tests 8 weeks apart in order to investigate the impact of practice on the results. Results: There were no group differences in ethnicity, socio-economic status and estimated IQ. Significant improvement was observed in the ADHD group, but not the control group, across a range of verbal abilities including verbal learning, verbal cognitive flexibility and fluency, and verbal inhibition. These neurocognitive improvements were large and consistent with improved psychiatric functioning. No changes were noted above a practice effect in visual-spatial memory and there were no improvements noted in reaction time, working memory or rapid naming for either groups. Conclusions: Although the pilot and open label design of the study limits the generalizability of the results, it supports a growing body of literature recognizing the importance of nutrients for mental health and cognition. The results also provide evidence supporting the need for randomized clinical trials of micronutrients as well as other experimental studies in order to better assess whether improved neurocognitive functioning may contribute to improved psychiatric symptoms.  7. Simpson, JSA, Crawford, SG, Goldstein, ET, Field, C, Burgess, E, Kaplan, BJ (2011). Safety and tolerability of a complex micronutrient formula used in mental health: A compilation of eight datasets.BMC Psychiatry. 11:62. AbstractBackground: Theoretically, consumption of complex, multinutrient formulations of vitamins and minerals should be safe, as most preparations contain primarily the nutrients that have been in the human diet for millennia, and at safe levels as defined by the Dietary Reference Intakes. However, the safety profile of commercial formulae may differ from foods because of the amounts and combinations of nutrients they contain. As these complex formulae are being studied and used clinically with increasing frequency, there is a need for direct evaluation of safety and tolerability.Objectives: The aim of this project was to compile all known safety and tolerability data collected on one complex nutrient formula.Data sources and results: Data were assembled from all the known published and unpublished studies for the complex formula with the largest amount of published research in mental health. Biological safety data from 144 children and adults were available from six sources: there were no occurrences of clinically meaningful negative outcomes/effects or abnormal blood tests that could be attributed to toxicity. Adverse event (AE) information from 157 children and adults was available from six studies employing the current version of this formula, and only minor, transitory reports of headache and nausea emerged. Only one of the studies permitted a direct comparison between micronutrient treatment and medication: none of the 88 pediatric and adult participants had any clinically meaningful abnormal laboratory values, but tolerability data in the group treated with micronutrients revealed significantly fewer AEs and less weight gain.Conclusions: This compilation of safety and tolerability data is reassuring with respect to the broad spectrum approach that employs complex nutrient formulae as a primary treatment.
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8. Rucklidge, J. J., & Harrison, R. (2010). Successful treatment of Bipolar Disorder II and ADHD with a micronutrient formula: A case study. CNS Spectrums.  Abstract Bipolar Disorder with co-occurring Attention-Deficit/Hyperactivity Disorder (ADHD) is a challenge to treat. Ten previous reports have shown potential benefit of a micronutrient treatment (consisting mainly of vitamins and minerals) for various psychiatric symptoms, including mood and ADHD. This case study aimed to investigate the longer impact of the micronutrients on both psychiatric and neurocognitive functioning in an ABAB design with one year follow up. A 21-year old female with Bipolar II Disorder, ADHD, Social Anxiety and Panic Disorder entered an open-label trial using a nutritional treatment following a documented 8 year history of on-going psychiatric symptoms not well managed by medications. After 8 weeks on the formula she showed significant improvements in mood, anxiety and hyperactivity/impulsivity. Blood test results remained normal after 8 weeks on the formula. She did not report any adverse side effects associated with the treatment. She then chose to come off the formula; after 8 weeks her depression scores returned to baseline, and anxiety and ADHD symptoms worsened. The formula was reintroduced, showing gradual improvement in all psychiatric symptoms. KT’s case represents a naturalistic ABAB design showing on- off control of symptoms. After one year, she is now in remission of all mental illness. Neurocognitive changes mirrored behavioral changes, showing improved processing speed, variability in response and verbal memory. A placebo response and expectancy effects cannot be ruled out although previous poor response to treatment and the duration of the current positive response decrease the likelihood these other factors better explain change. These consistently positive outcomes alongside an absence of side effects indicate that further research, particularly larger and more controlled trials, is warranted using this multinutrient approach.  9. Rucklidge, J.J., Gately, D., Kaplan, B.J. (2010). Database analysis of children and adolescents with Bipolar Disorder consuming a micronutrient formula. BMC Psychiatry, 10:74 AbstractBackground: Eleven previous reports have shown potential benefit of micronutrient treatment for psychiatric symptoms. The current study asked whether children (7-18 years) with pediatric bipolar disorder (PBD) benefited from the same micronutrient formula; the impact of Attention-Deficit/Hyperactivity Disorder (ADHD) on their response was also evaluated.Methods: Data were available from 120 children whose parents reported a diagnosis of PBD; 79% were taking psychiatric medications that are used to treat mood disorders; 24% were also reported as ADHD. Using Last Observation Carried Forward (LOCF), data were analyzed from 3 to 6 months of micronutrient use.Results: At LOCF, mean symptom severity of bipolar symptoms was 46% lower than baseline (effect size (ES) >0.78) (p < 0.001). In terms of responder status, 46% experienced >50% improvement at LOCF, with 38% still taking psychiatric medication (52% drop from baseline) but at much lower levels (74% reduction in number of medications being used from baseline). The results were similar for those with both ADHD and PBD: a 43% decline in PBD symptoms (ES = 0.72) and 40% in ADHD symptoms (ES = 0.62). An alternative sample of children with just ADHD symptoms (n = 41) showed a 47% reduction in symptoms from baseline to LOCF (ES = 1.04). The duration of reductions in symptom severity suggests that benefits were not attributable to placebo/expectancy effects. Similar findings were found for younger and older children and for both sexes.Conclusions: The data are limited by the open label design, the lack of a control group, and the inherent self-selection bias. While these data cannot establish efficacy, the results are consistent with a growing body of research suggesting that micronutrients appear to have therapeutic benefit for children with PBD with or without ADHD in the absence of significant side effects and may allow for a reduction in psychiatric medications while improving symptoms. The consistent reporting of positive changes across multiple sites and countries are substantial enough to warrant a call for randomized clinical trials using micronutrients.
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10. Mehl-Madrona, L., Leung, B., Kennedy, C., Paul, S., Kaplan, B.J. (2010). Micronutrients versus standard medication management in autism: A naturalistic case-control study. Journal of Child and Adolescent Psychopharmacology.  Abstract Autism spectrum disorder (ASD) is often accompanied by self-injurious behavior (SIB), aggression, and tantrums, symptoms that have reportedly improved with micronutrient (vitamins and minerals) treatment. The current study took advantage of naturally-occurring differences in parental preferences for treatment approaches. The Micronutrient Group asked for treatment without pharmaceuticals (n = 44, aged 2 – 28 yrs at entry (M = 8.39, + 5.58)). Their records were matched with those of 44 similar children whose families requested conventional treatment (Medication Group). Both groups improved on both the Childhood Autism Rating Scale and the Childhood Psychiatric Rating Scale (all p’s < 0.0001). Both groups also exhibited significant decreases in total Aberrant Behavior Checklist scores, but the Micronutrient Group’s improvement was significantly greater, p < 0.0001. SIB Intensity was lower in the Micronutrient Group at the end of the study (p = 0.005), and improvement on Clinical Global Impressions was greater for the Micronutrient Group, p = 0.0029. It is difficult to determine whether the observed changes were exerted through improvement in mood disorder or through an independent effect on autistic disorder. There were some advantages to treatment with micronutrients: lower activity level, less social withdrawal, less anger, better spontaneity with the examiner, less irritability, lower intensity SIB, markedly fewer adverse events, and less weight gain. Advantages of medication management were insurance coverage, fewer pills, and less frequent dosing.  11. Rucklidge, J.J., Taylor, M. R., Whitehead, K. A. (2010). Impact of a micronutrient formula on ADHD and mood dysregulation in adults with ADHD: Evidence from an 8-week open label trial with natural follow-up. Journal of Attention Disorders.  AbstractObjective: To investigate the impact of a 36-ingredient micronutrient formula consisting mainly of minerals and vitamins in the treatment of adults with both Attention-deficit/hyperactivity Disorder (ADHD) and severe mood dysregulation (SMD).Method: 14 medication-free adults (9 men, 5 women; 18-55 years) with ADHD and SMD completed an 8-week open- label trial.Results: A minority reported transitory mild side effects. Significant improvements were noted across informants (self, observer, clinician) on measures of inattention and hyperactivity/impulsivity, mood, quality of life, anxiety, and stress all with medium to very large effect sizes (all ps < .01); however, the mean of inattention remained in a clinical range whereas the means on measures of mood and hyperactivity/impulsivity were normalized. Follow-up data showed maintenance of changes or further improvement for those who stayed on the micronutrients.Conclusions: Although this study, as an open trial, does not in itself prove efficacy, it provides preliminary evidence supporting the need for a randomized clinical trial of micronutrients as treatment for the more complex presentations of ADHD.  12. Gately, D., Kaplan, B.J. (2009). Database analysis of adults with bipolar disorder consuming a micronutrient formula. Clinical Medicine: Psychiatry. 4:3-16.  AbstractBackground: Bipolar disorder is a lifelong problem with imperfect available treatments. Recent research has shown potential benefit of nutritional treatment for mood symptoms. The goal of the current study was to determine whether adults with bipolar disorder reported treatment benefit from consuming a micronutrient formula.Methods: Self-report data were available from 682 adults who reported a diagnosis of bipolar disorder; 81% were taking psychiatric medications. Those reporting additional diagnoses were excluded, as well as those who provided data <60 times during 180 days of using the micronutrients, leaving 358 for analysis.Results: Mean symptom severity was 41% lower than baseline after 3 months (effect size = 0.78), and 45% lower after 6 months (effect size = 0.76) (both paired t-tests significant, p < 0.001). In terms of responder status, 53% experienced >50% improvement at 6 months. Half the sample were taking medications approved for bipolar disorder (lithium, anticonvulsants, atypical antipsychotics), and half were either medication-free or taking other medications: the
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magnitude of treatment benefi t did not differ between these two groups. Regression analyses indicated that decreased symptom severity over the 6 months was associated with increasing micronutrient dosage and with reducing medication. Symptom improvements were significant and sustained at 6 months, suggesting that benefits were not attributable to placebo/expectancy effects. Conclusions: Further research on this micronutrient formula is warranted.13. Rucklidge, J. J. (2009). Successful treatment of OCD with a micronutrient formula following partial response to  CBT: A case study. Journal of Anxiety Disorders. 23: 836–840.  Abstract Obsessive Compulsive Disorder (OCD) affects 0.5–2% of young people many of whom are resistant to conventional treatments. This case study describes an 18-year-old male with OCD who first underwent cognitive behavioral therapy (CBT) for a 1-year period with a modest response (his OCD had shifted from severe to moderate). Within a year, his anxiety had deteriorated back to the severe range and he now had major depression. He then entered an ABAB design trial using a nutritional formula consisting mainly of minerals and vitamins (together, known as micronutrients). After 8 weeks on the formula, his mood was stabilized, his anxiety reduced, and his obsessions were in remission. The treatment was then discontinued for 8 weeks, during which time his obsessions and anxiety worsened and his mood dropped. Reintroduction of the formula again improved the symptoms. This case illustrates the importance of considering the effect micronutrients have on mental illness.  14. Frazier, E.A., Fristad, M., Arnold, L.E. (2009). Multinutrient Supplement as Treatment: Literature Review and Case Report of a 12-year-old Boy with Bipolar Disorder. Journal of Child and Adolescent Psychopharmacology. 19:453-460.  Abstract Early-onset bipolar disorder has significant morbidity and mortality. Development of safe, effective treatments to which patients will adhere is critical. Pharmacologic interventions for childhood bipolar spectrum disorders are limited and are associated with significant risk for adverse events (Kowatch et al 2005). Diet and nutrition research suggests vitamins, minerals, and other nutrients are important underpinnings of general physical and mental health; further, they may even be useful in treating mood dysregulation by providing a more favorable risk-benefit ratio than contemporary psychotropic agents (Kaplan, Crawford, Field, & Simpson 2007). This article reviews the literature on multinutrient supplementation and mental health, and examines a case study of a 12-year-old boy with bipolar disorder and comorbid diagnoses treated for 6 years with conventional medication and finally a multinutrient supplement. The multinutrient supplement in this case study is EMPowerplus (EMP+), a 36-ingredient supplement containing sixteen minerals, fourteen vitamins, three amino acids and three antioxidants. It was used to treat a 12-year-old boy initially diagnosed with bipolar disorder-not otherwise specified (BP-NOS) at age 6, whose diagnosis evolved by age 10 to bipolar I (BP-I), mixed, with psychotic features. He also met criteria for generalized anxiety disorder by age 8 and obsessive-compulsive disorder by age 10. After six years of conventional treatment (ages 6-12), he received fourteen months of EMP+. Symptom manifestation over seven years is described in conjunction with treatment history. EMP+ resulted in superior outcome to conventional treatment. This report adds to accumulating preliminary evidence that further basic science and clinical studies of multinutrient supplements are warranted.  15. Kaplan, B.J., Fisher, J.E., Crawford, S.G., Field, C.J., Kolb, B. (2004). Improved mood and behavior during treatment with a mineral-vitamin supplement: An open-label case series of children.Journal of Child and Adolescent Psychopharmacology, 14(1), 115-122.  Abstract Several studies have demonstrated that psychiatric symptoms such as depression, mood swings, and aggression may be ameliorated by supplementation with broad-based nutrient formulas containing vitamins, minerals, and sometimes essential fatty acids. These findings have been reported in young criminal offenders as well as in adults with mood disturbance and other psychiatric disorders. The purpose of the current case series was to explore the potential efficacy of a nutrient supplement in children. Children with mood and behavioral problems (N = 11; 7 boys, 4 girls; 8–15 years
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old) participated; 9 completed this open-label trial. Parents completed the Child Behavior Checklist (CBCL), Youth Outcome Questionnaire (YOQ), and Young Mania Rating Scale (YMRS) at entry and following at least 8 weeks of treatment. Intent-to-treat analyses revealed decreases on the YOQ (p < 0.001) and the YMRS (p < 0.01) from baseline to final visit. For the 9 completers, improvement was significant on seven of the eight CBCL scales, the YOQ, and the YMRS (p values from 0.05–0.001). Effect sizes for all outcome measures were relatively large. The findings suggest that formal clinical trials of broad nutritional supplementation are warranted in children with these psychiatric symptoms. 16. Halliwell C, Kolb B. (2003). Diet can stimulate functional recovery and cerebral plasticity after perinatal cortical injury in rats. Soc Neuro Abs. 29:459-411.  Abstract Early cortical injury has been attributed to the consequential effects of various factors, such as alcohol, drug addiction, smoking, and inadequate nutrient intakes during periods of pregnancy and lactation, or delivery of infants by forceps, and premature deliveries. These are only a few examples of circumstances, or “injury”, that may result in disorders ranging from mild learning difficulties to aggressive behavior. Injury to the cortex during the early years of development has been known to result in poor behavioral outcome into adulthood. Presently, the most common form of treatment includes a pharmacological agent, which may be accompanied with behavioral modification therapies supported by families. As an alternative form of therapy towards the treatment of early cortical injury, choline and a vitamin and mineral supplement (EM Power+) were used to determine the possibilities of nutrition intervention in an animal model. The injuries were incurred by aspiration lesion at days three, (Exp.l) and four, (Exp.2) and lesions were localized to the midline medial frontal cortex in some rats, while a different group of rats received lesions in the posterior parietal cortex. The pre and postnatal choline treated animals showed favorable results for the medial frontal lesions, and the postnatal vitamin supplement treated animals showed favorable results for treatment in both medial frontal and posterior parietal lesions. All animals were tested in adulthood indicating that nutrition intervention is very beneficial for alleviating some of the functional deficits commonly seen from early cortical injury.  17. Kaplan, B. J., Crawford, S. G., Gardner, B., & Farrelly, G. (2002). Treatment of mood lability and explosive rage with minerals and vitamins: Two case studies in children. Journal of Child and Adolescent Psychopharmacology. 12(3), 203-218. 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). 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.
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18. Simmons, M. (2003). Nutritional Approach to Bipolar Disorder. Letter to the Editor. Journal of Clinical Psychiatry. 64, 338.  Summary In a letter to the editor of the Journal of Clinical Psychiatry Dr. Miles Simmons, a psychiatrist in private practice in Brunswick, Maine reported on his clinical experience with EMPowerplus. Impressed by a striking response in a patient who approached him, and after discussing the issues with several of his treatment-resistant patients he conducted an open trial study with 19 patients from his private practice under careful supervision. His results corroborate Dr. Kaplan’s initial findings. All patients met the DSM-IV criteria for bipolar I (n = 14) or bipolar II (n = 5) and were followed for a mean of 13 months. Of the 19, 16 were already taking medications (mean = 2.7 psychiatric medications). Dr. Simmons observed that “12 of the 19 patients showed marked clinical improvement, 3 showed moderate improvement, and 1 showed mild improvement” (84%). Thirteen of the 16 medicated patients were able to completely discontinue psychiatric medications over an average of 5.2 weeks (range, 3 to 10 weeks) and maintained stability on EMPowerplus alone.  19. Popper, C. W. (2001). Do vitamins or minerals (apart from lithium) have mood-stabilizing effects? [Commentary]. Journal of Clinical Psychiatry. 62, 933-935.  Summary Harvard University (McLean Hospital) clinician, Psycho-pharmacologist and Psychiatrist, Dr. Charles Popper, published a commentary which included the results of his clinical experience with EMPowerplus. In his practise, of 22 patients (10 adult, 9 adolescent, 3 preadolescent), who clinically met criteria for bipolar disorder, 19 showed what he judged to be a positive response. Of the 15 patients who were being treated with medications when they began the nutritional supplement, 11 patients have been stable for 6 to 9 months without psychiatric medications. Dr. Popper’s findings support Dr. Kaplan’s observations that over 80% of patients saw significant improvement. Popper’s report represents a response of more  20. Kaplan, B. J., Simpson, J. S. A., Ferre, R. C., Gorman, C., McMullen, D., & Crawford, S. G. (2001). Effective mood stabilization in bipolar disorder with a chelated mineral supplement. Journal of Clinical Psychiatry. 62, 936-944.  AbstractBackground: To determine in open trials the therapeutic benefit of a nutritional supplement for bipolar disorder. Method: The sample consisted of 11 patients with DSM-IV-diagnosed bipolar disorder aged 19 to 46 years, who were taking a mean of 2.7 psychotropic medications each at a study entry. Three additional patients dropped out prematurely. The intervention is a broad-based nutritional supplement of dietary nutrients, primarily chelated trace minerals and vitamins, administered in high doses. At study entry and periodically thereafter, patients were assessed with the Hamilton Rating Scale for Depression (HAM-D), the Brief Psychiatric Rating Scale (BPRS), and the Young Mania Rating Scale (YMRS).Results: For those who completed the minimum 6-month open trial, symptom reduction ranged from 55% to 66% on the outcome measures; need for psychotropic medications decreased by more than 50%. Paired t tests revealed treatment benefit on all measures for patients completing the trial: HAM-D mean score at entry =19.0, mean score at last visit = 5.4, t = 5.59, df = 9, p< .01; BPRS mean score at entry = 35.3, mean score at last visit = 7.4, t = 2.57, df = 9, p < .05; YMRS mean score at entry = 15.1, mean score at last visit = 6.0, t = 4.11, df = 9, p < .01. The effect size for the intervention was large (> .80) for each measure. The number of psychotropic medications decreased significantly to a mean ± SD of 1.0 ± 1.1 (t = 3.54, df = 10, p < .01). In some cases, the supplement replaced psychotropic medications and the patients remained well. The only reported side effect (i.e. nausea) was infrequent, minor, and transitory. Conclusion: Some cases of bipolar illness may be ameliorated by nutritional supplementation. A randomized, placebo controlled trial in adults with bipolar I disorder is currently underway, as well as open trials in children. than 86% with more than 73% of those on medications being able to eliminate their medications.  21. Use of Micronutrients Attenuates Cannabis and Nicotine Abuse as Evidenced From a Reversal Design: A Case Study  Harrison R, Rucklidge JJ, Blampied N  Journal of Psychoactive Drugs, Volume 45, Issue 2, 2013 –
DOI:10.1080/02791072.2013.785840
ABSTRACT:Prior research shows that micronutrients, particularly amino acids, can assist individuals with substance dependence to quit various drugs of abuse, including cannabis, alcohol, and cocaine. As part of a wider investigation of the impact of micronutrients (mostly vitamins and minerals) on psychiatric symptoms, such as Attention-Deficit/Hyperactivity Disorder (ADHD), depression, and anxiety, we observed that many participants reduced or eliminated use of alcohol, cigarettes, and cannabis. One case using a single-case reversal (off-on-off-on-off) design is presented and shows not only on-off control of psychiatric symptoms as micronutrients are consumed or withdrawn, but also simultaneous on-off use of cannabis and cigarettes, despite not directly targeting this substance use as part of the treatment protocol.
This case adds to a growing body of research supporting the use of micronutrients in the treatment of psychiatric symptoms and suggests it may extend to substance dependence. Micronutrients, by assisting with mood regulation and reductions in anxiety, may assist with successful cessation of drug use. Alternatively, they may directly impact on the brain reward circuitry believed to be involved in the expression of addictions, thereby providing the appropriate precursors and cofactors necessary for adequate neurotransmitter synthesis. This case should continue to stimulate researchers to consider the role of nutrients, in particular vitamins and minerals, in drug treatment programs and encourage more rigorous trials.  page12image1136  22.Could yeast infections impair recovery from mental illness? A case study using micronutrients and olive leaf extract for the treatment of ADHD and depression  Rucklidge JJ  Advances in Mind-Body Medicine Journal, Summer 2013 – Vol 27, No. 3 ABSTRACT:Micronutrients are increasingly used to treat psychiatric disorders including attention-deficit/hyperactivity disorder (ADHD), mood disorders, stress, and anxiety. However, a number of factors influence optimal response and absorption of nutrients, including the health of the gut, particularly the presence of yeast infections, such as Candida. As part of a wider investigation into the impact of micronutrients on psychiatric symptoms, many participants who experienced a yeast infection during their treatment showed a diminished response to the micronutrients. One case was followed systematically over a period of 3 y with documentation of deterioration in psychiatric symptoms (ADHD and mood) when infected with Candida and then symptom improvement following successful treatment of the infection with olive leaf extract (OLE) and probiotics. This case outlines that micronutrient treatment might be severely compromised by infections such as Candida and may highlight the importance of gut health when treating psychiatric disorders with nutrients. Given the role that inflammation can play in absorption of nutrients, it was hypothesized that the infection was impairing absorption of the micronutrients.  25.Vitamin-mineral treatment of attention-deficit hyperactivity disorder in adults: double-blind randomised placebo-controlled trial  Julia J. Rucklidge, Chris M. Frampton, Brigette Gorman and Anna Boggis  The British Journal of Psychiatry, Published online ahead of print January 30, 2014, doi: 10.1192/bjp.bp.113.132126
BACKGROUND: The role of nutrition in the treatment of attention-deficit hyperactivity disorder (ADHD) is gaining international attention; however, treatments have generally focused only on diet restriction or supplementing with one nutrient at a time.

AIMS: To investigate the efficacy and safety of a broad-based micronutrient formula consisting mainly of vitamins and minerals, without omega fatty acids, in the treatment of ADHD in adults.

METHOD: Intent-to-treat analyses showed significant between-group differences favouring active treatment on self- and observer- but not clinician-ADHD rating scales. However, clinicians rated those receiving micronutrients as more improved than those on placebo both globally and on ADHD symptoms. Post hoc analyses showed that for those with moderate/severe depression at baseline, there was a greater change in mood favouring active treatment over placebo. There were no group differences in adverse events.

CONCLUSIONS: This study provides preliminary evidence of efficacy for micronutrients in the treatment of ADHD symptoms in adults, with a reassuring safety profile.

Review Articles on Micronutrients in Mental Health
1. Hurt E., Lofthouse N., Arnold L.E. (2011) Complementary and Alternative Biomedical Treatments for ADHD. Psychiatric Annals. 41:1. 2. Kaplan BJ, Leung B: Micronutrient treatment of mental disorders. Integr Med Clin J. In press. 3. Shaw I., Rucklidge J. J., Hughes R. N. (2010). A possible biological mechanism for the B Vitamins altering behaviour in ADHD. Pharmaceutical Medicine. 24 (5): 1-6. 4. McCann JC, Ames BN. (2009). Vitamin K, an example of triage theory: Is micronutrient inadequacy linked to diseases of aging? Am J Clin Nutr. 90:889-907. 5. Rucklidge JJ, Johnstone J, Kaplan BJ. (2009). Nutrient supplementation approaches in the treatment of ADHD. Expert Review of Neurotherapeutics. 9(4), 461-476. 6. Kaplan BJ, Crawford S, Field C, Simpson JSA. (2007). Vitamins, minerals, and mood. Psychological Bulletin. 33(5):747- 760. 7. Kaplan BJ, Shannon S. (2007). Nutritional aspects of child and adolescent psychopharmacology.Psychiatric Annals. 37(7):519-528. (Reprinted in Pediatrics Annals. 2007 36(9):600-609. 8. Kaplan, BJ and Shannon, S (2007). Nutritional aspects of child and adolescent psychopharmacology.Psychiatric Annals, 37(7), 519-528. (reprinted in Pediatrics Annals, 36(9), 600-609). 9. Ames BN. (2004). A role for supplements in optimizing health: The metabolic tune-up. Arch Biochem Biophys. 423:227-234

page2image1136Empirical Reports on EMPowerplus®

1.Megan Rodway, Annette Vance, Amany Watters, Helen Lee, Elske Bos, Bonnie J Kaplan Efficacy and cost of micronutrient treatment of childhood psychosis, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada, Mood and Anxiety Disorders Clinic, Calgary, Alberta, Canada, Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada, Center for Integrative Psychiatry, Groningen, The Netherlands, Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada BMJ Case Reports 2012; doi:10.1136/bcr- 2012-0072132. Frazier E, Fristad M, Arnold E. Feasibility of a Nutritional Supplement as Treatment for Pediatric Bipolar Spectrum Disorders, Dept. Psychiatry, Ohio State University. The Journal of Alternative and Complementary Medicine Vol 18, Num 7, 2012, pp. 678-685 3. Rucklidge J, Andridge R, Gorman B, Blampied N, Gordon H, Boggis A. Effects of Micronutrients on stress and trauma after an earthquake: RCT evidence comparing formulas and doses. Hum. Psychopharmacol Clin Exp (2012) DOI: 10.1002/hup 4. Rucklidge J, Johnstone J, Harrison R, Boggis A. Micronutrients reduce stress and anxiety in adults with Attention- Deficit/Hyperactivity Disorder following a 7.1 earthquake. Psychiatry Res. 2011 Jul 29.5. Rucklidge J, Blampied N, Post – Earth Psychological Functioning in Adults with Attention – Deficit / Hyperactivity Disorder: Positive Effects of Micronutrients on Resilience. New Zealand Journal Vol. 40, No. 4 2011 6. Rucklidge, J. J., Johnstone, J., Harrison, R. Effect of micronutrients on neurocognitive functioning in adults with ADHD and Severe Mood Dysregulation: A pilot study. Journal of Alternative and Complementary Medicine.  7. Simpson, JSA, Crawford, SG, Goldstein, ET, Field, C, Burgess, E, Kaplan, BJ (2011). Safety and tolerability of a complex micronutrient formula used in mental health: A compilation of eight datasets. BMC Psychiatry. 11:62. http://www.biomedcentral.com/1471-244X/11/62  8. Rucklidge, J. J., Taylor, MR, Whitehead, KA. (2011). Effect of micronutrients on behaviour and mood in adults with ADHD: Evidence from an 8-week open label trial with natural extension, Journal of Attention Disorders. 2011;15(1):79- 91.  9. Rucklidge, J. J., Gately, D., Kaplan, B.J. (2010). Database analysis of children and adolescents with Bipolar Disorder consuming a micronutrient formula, BMC Psychiatry, 10:74. doi:10.1186/1471-244X-10-74  10. Rucklidge, J. J., & Harrison, R. (2010). Successful treatment of Bipolar Disorder II and ADHD with a micronutrient formula: A case study, CNS Spectrums. 15(5):231-237.  11. Mehl-Madrona, L., Leung, B., Kennedy, C., Paul, S., Kaplan, B.J. (2010). Micronutrients versus standard medication management in autism: A naturalistic case-control study, Journal of Child and Adolescent Psychopharmacology. 20(2): 95-103.  12. Gately, D., Kaplan, B.J. (2009). Database analysis of adults with bipolar disorder consuming a micronutrient formula. Clinical Medicine: Psychiatry. 4:3-16.  13. Rucklidge, J. J. (2009). Successful treatment of OCD with a micronutrient formula following partial response to CBT: A case study. Journal of Anxiety Disorders, 23: 836–840.14. Frazier, E.A., Fristad, M., Arnold, L.E. (2009). Multi-nutrient Supplement as Treatment: Literature Review and Case Report of a 12-year-old Boy with Bipolar Disorder. Journal of Child and Adolescent Psychopharmacology, 19:453-460.  15. Kaplan, B.J., Fisher, J.E., Crawford, S.G., Field, C.J., Kolb, B. (2004). Improved mood and behavior during treatment with a mineral-vitamin supplement: An open-label case series of children. Journal of Child and Adolescent Psychopharmacology, 14(1), 115-122.  16. Halliwell C, Kolb B. (2003). Diet can stimulate functional recovery and cerebral plasticity after perinatal cortical injury in rats. Soc Neuro Abs, 29:459-411.  17. Kaplan, B. J., Crawford, S. G., Gardner, B., & Farrelly, G. (2002). Treatment of mood lability and explosive rage with minerals and vitamins: Two case studies in children. Journal of Child and Adolescent Psychopharmacology, 12(3), 203- 218.  18. Simmons, M. (2003). Nutritional approach to bipolar disorder (Letter). Journal of Clinical Psychiatry, 64, 338. 19. Popper, C. W. (2001). Do vitamins or minerals (apart from lithium) have mood-stabilizing effects? [Commentary].  20. Kaplan, B. J., Simpson, J. S. A., Ferre, R. C., Gorman, C., McMullen, D., & Crawford, S. G. (2001). Effective mood stabilization in bipolar disorder with a chelated mineral supplement. Journal of Clinical Psychiatry, 62, 936-9
Journal of Clinical Psychiatry, 62, 933-935.
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