Facebook Live: The Role of Mental Health in Brain Optimization

Apollo Health’s Chief Science Officer, Dr. Dale Bredesen, and Chief Health Liaison Julie Gregory were joined in this Facebook Live by Dr. Daniel Amen, who is a physician, adult and child psychiatrist, and founder of Amen Clinics, that has a brain-based approach to treating mental illness that goes beyond traditional psychiatry. They discussed the overlap between mental health and Alzheimer’s, and how addressing either one will improve both conditions.

We’ve included a complete recording of the session and a full transcript below for your convenience.

Watch here:

Transcript:

Dr. Dale Bredesen (00:00): Hi, everybody, and welcome to Facebook live. I’m in my car here because I’m actually at the Los Angeles Convention Center. There’s an international meeting, the Society for Brain Mapping & Therapeutics, where we just finished a very interesting group talking about Alzheimer’s disease. I’m thrilled today to have Dr. Daniel Amen, colleague, and friend for many years. Daniel is really a remarkable innovator and prolific author and psychiatrist. And so just thrilled to have Daniel here with Julie Gregory to talk a little bit about mental health, about his new book, You, Happier and about how he really started on such an innovative path years ago. Daniel, welcome, thank you so much for joining us today.

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Dr. Daniel Amen (00:52): Hi, Dale. Hi, Julie. What a pleasure to be with you. It actually makes me happy Dale to see you. I just finished You, Happier, it comes out in a couple of weeks, and one of the things that makes people happy is really noticing, I call them, the micro moments of happiness. People think happiness is when you graduate from college or when you get married or when you have a baby or get a big award. Those things actually can be the enemy of happiness. Happiness is a daily practice. And so, meeting with another colleague that’s trying to change the world, that makes me happy.

Dr. Daniel Amen (01:44): As you said, I’m a psychiatrist, so why do I actually care about the brain? I belong to the only medical specialty that virtually never looks at the organ it treats. I was taught to diagnose insanity, and that’s insane to think you can make diagnoses from symptom clusters with no biological data. That’s just crazy. Because what you realize is depression or memory problems, they have many different causes. And so, assuming there’s one cause of Alzheimer’s disease, both you and I know that’s insane, that there are many different roads to dementia. There are many different roads to anxiety disorders. There are many different roads to depression or ADHD or addiction and understanding that just makes you a better doctor.

Dr. Dale Bredesen (02:51): Absolutely. I was just commenting to Julie a few minutes before you came on that I’m at a meeting where the whole idea of Alzheimer’s is changing. People don’t really know what to do about it. The classical treatments and the new treatments, the pharmaceuticals, are simply not working. You have really changed the whole field of psychiatry. So I’d love to know, when you started out as a psychiatrist, Daniel, what led you to say, “Hey, you know what? We need to things differently.”? Obviously it’s been extremely productive to do that. What was it that triggered you to say, “I need to do this a different way.”?

Dr. Daniel Amen (03:30): When I was 18, I was drafted and became an infantry medic, where my love of medicine was born. But about a year into it, I was actually stationed in West Germany, so I’m getting a little bit of PTSD. We were protecting Western Europe from the Soviets, so the whole thing in Ukraine is troubling for sure. But about a year to be an infantry medic, I realized I didn’t like being shot at, it just wasn’t my thing. Some people like it, not me. So I got retrained as an X-ray technician, and I loved medical imaging. Our professors used to say, “How do you know unless you look?”

Dr. Daniel Amen (04:11): And then in 1979, I’m a second-year medical student, I just get married, and two months later, my wife tried to kill herself. I took her to see a wonderful psychiatrist, and I came to realize if he helped her, which he did, it wouldn’t just help her. It would ultimately help her children and her grandchildren because they would be shaped by someone who was happier and more stable. So I fell in love with psychiatry. I’ve loved it every day for the last 43 years, but I fell in love with the only medical specialty that never looks at the organ it treats. I knew then it was wrong, and I knew it would change. I just had no idea I’d be part of the change.

Dr. Daniel Amen (04:58): Look, see, I remember even back when I was a second-year medical’s student, I hated the term mental illness. I’m like, “Well, nobody would want one of those, right? Call somebody mental and you shame them. But if you call them a brain, you elevate them.” And so I’d been thinking, “We have to look. We have to see these as brain health issues rather than as mental health issues.” And when I got the opportunity to start looking in 1991 with the study we do called SPECT, it just changed everything. I realized depression’s not one thing, and if you don’t look, you don’t know. You’re guessing and guessing to hurting people. And then I’m like, “Oh, maybe I should think about natural ways to heal the brain because of some of our medications were actually toxic for brain function.”

Dr. Daniel Amen (05:56): And now if we think of Aricept and Namenda, they may help for six months, but over time they actually make people worse, that when you look at the brain and you see things that make people worse, you remember, “First do no harm. Use the least toxic, most effective treatments.” And then it just became this wild, crazy ride where we have ten clinics around the country. We’ve just gone over 200,000 scans. It’s a completely new paradigm, much like you’re trying to do with Alzheimer’s disease. We need to break the paradigm that we have because it’s ineffective. Nobody really wants to be part of the old paradigm, right, wait until you really can’t remember things, get a diagnosis, and then they tell you, “Well, there’s really nothing we can do about it. Get your affair in order. Maybe these meds will help, maybe they won’t.”

Dr. Dale Bredesen (07:00): Yeah.

Dr. Daniel Amen (07:01): And I’m like, “No, that’s just wrong.” The same program to prevent Alzheimer’s disease is the same program to prevent depression. The brain and body are completely connected to each other, and so, for example, if you’re overweight, you’re much more likely to be depressed. You’re much more likely to be anxious. You’re much more likely to have relationship problems because it damages your frontal lobes.

Dr. Dale Bredesen (07:41): Yeah, very interesting. You’re right, it used to be that there were neuro psychiatrists. They’ve split in two. There are now neurologists and psychiatrists. But of course, Freud originally trained as a neurologist. And these are really coming back together. As you say, this is all together. So if you could a little bit about the SPECT scans you’ve done. If someone has cognitive decline or risk for cognitive decline, what could they learn from a SPECT scan?

Dr. Daniel Amen (08:10): Well, I actually think SPECT is the most practical study to look at cognitive decline. There are over 2,400 scientific abstracts on spec and Alzheimer’s disease and other forms of dementia. Even when I started in 1991, there was a classic pattern for Alzheimer’s disease. If you put your hands on your back of your head and your thumbs in your ears, that’s an Alzheimer’s pattern. It’s bilateral, both sides, parietal, temporal lobe, hypoperfusion. And your brain changes decades before you have any symptoms.

Dr. Daniel Amen (08:54): When I turned 50, my doctor wanted me to have a colonoscopy. I looked at him and said, “Why don’t you want to look at my brain? Isn’t the other end of my body just as important?” And SPECT is a leading indicator. SPECT is a nuclear medicine study, stands for single-photon emission computed tomography. It’s a nuclear medicine study that looks at blood flow and activity in the brain. As opposed to an MRI or a CT, they look at structure. They’re a lagging indicator of trouble, so they’re going to change last. Function changes first, which is why we call it a leading indicator.

Dr. Daniel Amen (09:46): I wrote a book called Memory Rescue and I went, “Okay, here are 11 roads to Alzheimer’s disease, SPECT can actually show you ten of them.” So, I have a mnemonic called BRIGHT MINDS. SPECT is a blood flow study. Low blood flow is the number one brain imaging predictor of Alzheimer’s disease. SPECT is a blood flow study, so you’ll see that. R is retirement, and aging is your brain older than you are. When I first scanned myself at 37, I did my 60-year-old mother the week before, her brain looked younger than mine. That meant I needed to get much more serious about brain health. The I is inflammation. I don’t know if you’ve been seeing this, but COVID is not good for the brain, because COVID causes.

Dr. Dale Bredesen (10:42): Absolutely.

Dr. Daniel Amen (10:42): … inflammation in the limbic or emotional structures of the brain, which makes people way more vulnerable after they got COVID to get anxious, to get depressed. The G is genetics. I don’t really see genetics, but we know things run in family. H is head trauma, and head trauma is a major cause of dementia. And people don’t know about it because most people never look at the brain with a functional imaging study. We know President Reagan had Alzheimer’s disease, but it was only after the fall from the horse and the subdural bleed that his condition really accelerated. T is toxins. We live in a toxic soup, for example, mold exposure or carbon monoxide. Almost all the firefighters I see have toxic-looking brains. Alcohol is not a health food when it comes to the brain for sure.

Dr. Daniel Amen (11:50): M is mental health issues. Depression doubles the risk of Alzheimer’s disease in women and quadruples it in men. The second I is immunity and infections. The Journal of Alzheimer’s Disease actually published this great review paper signed by I think it was 33 scientists from around the world saying that the Alzheimer’s community is completely missing the boat because they’re not really investigating infectious causes of Alzheimer’s disease. So COVID’s going to be one, Lyme disease, herpes, toxoplasmosis, Epstein-Barr.

Dr. Daniel Amen (12:36): We need to do a much better job of hunting down infectious disease in the brain. N is neuro hormone disorders, which I know you know about. D is “diabesity.” I have published three studies now, the last one on 33,000 scans, showing as your weight goes up, the actual physical size and function of your brain goes down, which means 72% of Americans are overweight, 42% are obese, this is the biggest brain drain in the history of our country. We need to get much smarter about our weight. I was horrified during the pandemic, vaccination, vaccination, vaccination, vaccination, nothing about health. That was just bad messaging. And I’m vaccinated, so it’s not an anti-vaccine comment. It’s ridiculous public health message that didn’t address what we really know were the risk factors for mortality from COVID. And then S is sleep. 60 million Americans have sleep-related issues, and SPECT will actually pick up sleep apnea. It actually looks like early Alzheimer’s disease on scans.

Dr. Daniel Amen (14:01): One of the reasons I love imaging is it won’t just … Like the pad amyloid studies, Alzheimer’s yes or no, and they’re actually not very good because normal people can have a whole bunch of amyloid. I think you taught me amyloid is protective. What SPECT will do … And I actually lectured at the same conference you’re at, and I talked about how SPECT… So pad amyloid studies, Alzheimer’s yes or no for about $3,000, for about half that cost, SPECT will go, Alzheimer’s yes or no, frontal temporal lobe dementia yes or no, lower body dementia yes or no, because it affects the occipital lobes. And then, is it head trauma? Is it toxic? Or is it pseudo dementia?

Dr. Daniel Amen (14:56): This is why I got so interested in imaging, the month after I started looking at scans at a 69-year-old woman who has admitted to the hospital because she nearly burned down her house. She’d been diagnosed with Alzheimer’s disease, the sister, she had five daughters, they were fighting over, “You need to put her in a home.” She didn’t want to go, and they said, “Well, we’re going to put her in the hospital one more time.” I had just started imaging. I thought she had Alzheimer’s disease by listening to the history. When I scanned her, she had a freaking beautiful brain. She did not have the pattern at all. But her emotional brain was stirred up, and her decline started about five years ago after her husband had died. And so, it was really severe depression. When I put her on Wellbutrin, a really good antidepressant, within three weeks, her personality brightens, her memory’s back, she starts leading cooking classes on the ward in the hospital, and I’m like, “Well, how would I ever know unless I looked?”

Dr. Dale Bredesen (16:10): Yeah, exactly. Very interesting. So could you talk a little bit about your new book, You, Happier, in particular about the relationship because we have so many people who are interested in cognition and cognitive decline and prevention or reversal of cognitive decline? You’ve already mentioned the relationship with depression. What’s your sense about what should people do in terms of being happier and in terms of preserving their excellent cognition?

Dr. Daniel Amen (16:40): And so, for this book, I did a study of 500 consecutive patients at Amen Clinics, and we gave them the Oxford Happiness Questionnaire. And then, as we do with all of our patients, we scanned them, and we found the people who had high happiness had much better frontal lobe blood flow and people who are unhappy had significantly lower blood flow in the front part of their brain. This is why you should never let a child hit a soccer ball with their head or play tackle football. Anything you do that damages the frontal lobes will decrease cognitive function, but also decrease happiness. In the book, I argue that happiness is a moral obligation. I grew up in the San Fernando Valley, went to Catholic school through new ninth grade, and I guarantee you, that idea of happiness is a moral obligation was nowhere to be found.

Dr. Daniel Amen (17:42): But if you think of someone who is raised by an unhappy parent or married to an unhappy spouse and you ask them whether or not happiness is an ethical issue, I guarantee you, they will say yes because of how you impact other people. In the book, I have these seven strategies like supplementing your brain, only love food that loves you back, mastering your mind, but the healthier you get your brain, the happier you will be. For people who order or pre-order the book, if they go to youhappier.com, we’ll actually give them a bottle of Happy Saffron, one of my favorite supplements that I helped create. Why? Saffron has 24 randomized, placebo-controlled trials showing it to be equally effective to antidepressants, head-to-head, Prozac, Paxil, Zoloft, Effexor, Wellbutrin, Imipramine. And instead of decreasing your sexual function, which many antidepressants do, it increases your sexual function. And then if you read the science on saffron, it’s actually been shown to be helpful for people who have mild cognitive impairment and Alzheimer’s disease. And I’m like, “So better mood, better sex, and a better memory. I think I’m going to take this.”

Dr. Dale Bredesen (19:18): Sign me up. I mean …

Dr. Daniel Amen (19:20): They also get our 30-Day Happiness Challenge. So based on the concept in the book, I created a video course, our 30-Day Happiness Challenge. And at the end of 30 days, according to the Oxford Happiness Questionnaire, they’re 30% happier. So I love that. So youhappier.com, if people pre-order the book, we have those bonuses for them.

Dr. Dale Bredesen (19:44): Fantastic. One of the things that really comes through, Julie wrote a wonderful chapter for The First Survivors of Alzheimer’s. You’ve just met Julie, but she’s APOE 4/4, has been through reversal of cognitive decline and just done absolutely beautifully, now writing her own books and things like this, wrote a large part of the handbook for the second book. Interestingly, if you read her story, which is just truly a remarkable story, you can see a change in her mood just reading the story through that. And just the feeling that you get from it early on compared to the feeling that you’re getting as you’re doing all these things, truly remarkably different. Julie started ApoE4.Info, which is a remarkable website with over 3,000 people who are ApoE4-positive, who are doing various things and sharing. So really a social networking to understand and prevent cognitive decline. Julie, has ApoE4.Info discussed this issue about happiness and cognition?

Julie Gregory (21:02): Not specifically. I mean, I think the idea of depression has come up, and people that are dealing with depression worry about which medications will be most helpful in terms of preventing cognitive decline or worsening it. Things like that have come up. The biggest thing that I want to say about happiness that I think is so important about what you and I are doing, Dale, and about what Daniel is doing as well, is we’re providing hope for people like me who ten years ago I was told, “Good luck with that.” There was no hope. And of course, that led to depression because we know Alzheimer’s is a progressive fatal illness. And so, by not believing that and by challenging it and by fighting it, I was able to turn the paradigm around. And I think that’s really one of the most important things that we’re all doing, we’re breaking the stigma and showing that cognitive decline isn’t a death sentence. People do get better, and it’s possible, and there’s amazing happiness on the other side.

Dr. Daniel Amen (22:12): Well, and if the brain is the organ of happiness, right, we’d agree on that, the brain is the organ of happiness, when you have cognitive decline, it means the brain is struggling, and you then give it the nutrients it needs, whether it’s the food it needs or the supplements it needs or the thyroid or testosterone it needs. And as you get it healthy, well, then you can experience happiness and joy. All the happiness books out there, they don’t really say, “The foundational secret to happiness is the actual physical functioning of your brain.” I think, Dale, that’s your work, it’s we got to get the foundation of your brain healthy because then you’ll be able to remember things, but equally important, you’ll be able to feel joy.

Dr. Dale Bredesen (23:16): Yeah. And we increasingly see Alzheimer’s disease as a network insufficiency. You’ve got this remarkable network, this absolutely beautiful brain that is not being supported enough because of all the reasons you’ve talked about. Before we take the questions, I want to mention a remarkable study that you published a number of years ago. You looked at people who had chronic traumatic encephalopathy, and of course, we recognize many people who have cognitive decline even diagnosed as Alzheimer’s, one of the contributors is trauma, as you mentioned earlier. And so, if you could just comment a little about the study you published on taking people who already had trauma-related dementia, or NCI, and then treating them and showing that you could improve them.

Dr. Daniel Amen (24:04): Let may just clarify that a little bit. CTE, or chronic traumatic encephalopathy, is an autopsy diagnosis, so I can’t see that on SPECT. But what I can see are the chronic effects of traumatic brain injury. I did the big NFL study at a time when the NFL was lying, they had a problem. They knew they had a problem, but like many corporations, they were protecting their pocketbook and not the people who built the NFL, the players. And so, Anthony Davis, the Hall of Fame running back from USC, came to see me in 2007, and he got so much better. He’s like, “Hey, doc, we have to talk about this.” Together with the Los Angeles chapter of the NFL Players Association, we did the first, the largest study on active and retired NFL players. We’ve now scanned well over 300 players from all the teams, every position, and saw high levels of damage.

Dr. Daniel Amen (25:13): And oh, by the way, they had four times the level of depression as the general population. We put them on a program to love their brains. We supported them, multiple vitamins, high-dose, high-quality fish oil, a brain boost that works in six different ways, and 80% of our players showed improvement in as little as two months. One of my favorite players, Freddie Dreyer from the Los Angeles Rams said, “I had no idea how much cognitive function I had lost until you helped me get it back.” It just transformed his life. And Anthony Davis, so that was 2007, we’re 14 years, and his brain is healthier and younger now than it was when he was 54. So imagine that your brain can be better 15 years from now if you do the right things.

Dr. Daniel Amen (26:19): But nobody loves their brain, right? I mean, I think that’s one of the biggest things the images did for me is I developed a concept I love called brain envy. You brought up Freud, Freud was wrong, penis envy is not the cause of anybody’s problem. I’ve not seen it once in 40 years. No, it’s brain envy. When I saw my mom’s beautiful 60-year-old brain and my ugly 37-year-old brain, I wanted her brain. And I think the last 30-some years, that’s what I do every day. I’m like, “Is this good for my brain or bad for it?” If we can teach people to love their brains, they’re going to behave better.

Dr. Dale Bredesen (27:04): Yeah. I mean, this is such an interesting point to me because to me, one of the most exciting things when you see people reverse their cognitive decline is the fact that they can then sustain it. You talked about 15 years. The first people with cognitive decline who went on our program were ten years ago now, and they’ve sustained. Now, not every single one of them, but the ones that got good optimization and stuck with it have, by and large, sustained their improvements, and it’s really exciting to see. We talked about that a little bit in the book. Of course, Julie is a fantastic example. I would say beyond sustaining, she’s done better and better and better. So just fantastic to see that when you get at what’s actually driving the problem that you can get these sustained improvements. So congratulations. It’s really an important study and a great outcome.

Dr. Dale Bredesen (27:57): I know, Julie, you were going to go through some questions. Since I’m on the iPhone here, I cannot see the questions coming through the way I usually can on the computer. I know there’s some good questions. In fact, the first one I saw was one on dose of saffron, but they’re going by here.

Dr. Dale Bredesen (28:12): Daniel, what’s your favorite dose of saffron?

Dr. Daniel Amen (28:17): So almost all the studies is 30 milligrams of saffron gets you the effect you want for your mood and for memory. As I said, I make something called Happy Saffron. It’s got saffron, zinc, and curcumins. We use a special extract called Affron that’s been found in studies to boost mood in teenagers and in older people. So, 30 milligrams is the clinically effective dose.

Dr. Dale Bredesen (28:56): Fantastic. And Julie, I’m sorry I interrupted you here, please go ahead.

Julie Gregory (29:00): Okay. Our first question is from Tim, and he asks, “Why is the anti-hypertensive Losartan in higher doses making me feel depressed?”

Dr. Daniel Amen (29:14): Because it’s probably lowering his blood pressure too much, which then he’ll get lower blood flow to the brain. What’s interesting is hypertension in midlife is a risk factor for Alzheimer’s disease, but low pressure in later life is also a risk factor. And so, making sure he is not on too high a dose. Or it may have a secondary effect at which point he should change. Now, should talk about antihypertensives, you should also talk about statins. One of the things most people don’t know is low cholesterol’s not good for you. So you want to balance level of cholesterol, so you don’t want high cholesterol, although I think what most cardiologists think high cholesterol over 200. Your best cognitive effect, if I understand, Dale, the research, is about 220 or 225. When you lower it below total cholesterol below 160, you have a higher incidence of depression and suicide and death from all causes, even homicide, because your brain needs fat, and it needs a minimum of cholesterol.

Julie Gregory (30:40): Right.

Dr. Dale Bredesen (30:41): It’s a really good point, and we always suggest to people, “Please don’t drop it below 150 and preferably without using statins.” Of course, we’ve talked to Dayan Goodenowe, a biochemist who was on with this several weeks ago, his point was the same. The people that he sees who are doing the best are hanging out around 225, just as you suggested. Julie?

Julie Gregory (31:04): Okay, Marley asks, “Are day naps beneficial, or is it just best to wait for nighttime repair?”

Dr. Daniel Amen (31:13): Day naps can be great. It’s not consecutive sleep, it’s the total number of hours a day. But sleep is really important because when we sleep, the brain cleans or washes itself. You want to target, at least my reading of the research, is you want to get seven hours of sleep a night. Now, too much, some people get nine or ten hours, that may actually be counterproductive for them, but naps absolutely can be helpful.

Julie Gregory (31:46): I love that. Penny asks, “Have any of you been able to reverse moderate advanced Alzheimer’s with biotoxin illness and herpes 1 and 2?”

Dr. Dale Bredesen (31:57): I always point out that we’ve had people with MoCA scores of zero who have improved. We have not yet seen someone go from zero to 30, and that’s the goal, if we could have someone. But we’d like to get people in early. The bottom line is there’s no one place where we say, “Oh, past this you can’t get it.” It’s just that you get diminishing returns. And Daniel, I don’t know if you’ve seen the same sort of thing that as you have more and more and more advanced, it tends to be tougher and tougher to get a complete return.

Dr. Daniel Amen (32:32): Oh, no question about that. It depends how much brain tissue has died. I often say we can get the struggling brain tissue better, but we don’t have the Lazarus treatment yet to bring the dead back to life. That’s why I recommend screening, right? If you have Alzheimer’s disease in your family, you should probably get scanned in your forties. If you don’t, I think all of us should be scanned in our fifties. Why are they looking at my colon and not my brain?

Dr. Dale Bredesen (33:10): Yeah, great point. In Marama, which is an assisted living facility, they are seeing people who relatively late stages, Dr. Heather Sandison started this wonderful assisted living facility doing this protocol that we’ve talked about, and she is seeing improvements. Sometimes getting back your speaking, getting back your ability to dress yourself, getting back some of your activities of daily living, even though you may not come all the way back to perfect, sometimes can make a big difference. I got a nasty letter from a guy saying, “How dare you say people come in as early as possible. My wife has a MoCA score of zero, she’s done much better. You should be telling everybody.” So I’m careful not to say, “Give up.” At the same time, just as you, Daniel, I would say the earlier, the better.

Julie Gregory (33:58): Absolutely.

Dr. Daniel Amen (33:59): Well, and sometimes slowing the progression is equally as important, that families, if they can keep someone with some clarity longer, that’s what they want. But one of my big beefs is people will go into the homes or facilities and then they’ll give them a menu of crap to eat. I’m like, “Look, if you want to accelerate them, let them choose cake and brownies and donuts and pudding for dessert.” It’s like inflammation is just going to accelerate this. And because they don’t have great frontal lobe function, they’re going to pick the things that make them feel good now but not later. And so, I really like in facilities, can you get them to at least get the food right? Because that will help them think right.

Julie Gregory (34:58): Yes.

Dr. Dale Bredesen (34:58): Huge. Yeah, this is critical.

Julie Gregory (35:00): Great point. Marley asked do we have any tips for improving vision?

Dr. Daniel Amen (35:10): Your eyes are the only part of your brain that’s uncovered. And so, if you are doing the things that I recommend or that Dale recommends, because I think they’re pretty similar, that your vision is going to be better.

Julie Gregory (35:28): I think so.

Dr. Dale Bredesen (35:30): Such a great point.

Julie Gregory (35:31): I should mention that I’m using Dr. Dayan Goodenowe’s plasmalogen supplement. I used to need glasses for near vision, which I am wearing now but only because I have contacts on, but if I don’t have my contacts on, my near vision is now perfect. So I’ve experienced significant improvement there.

Dr. Dale Bredesen (35:53): We’re in the middle of this Arc Project, so we’re looking at other neurodegenerative diseases as well, and of course, macular degeneration is the first thing we’re looking at. With that, again, it’s very much like what Daniel’s talked about, very much like what we’ve talked about with Alzheimer’s disease, there is a critical balance, in this case, blood flow is critical. The macular is the area where tremendous metabolic activity and most people with macular degeneration have some degree of atherosclerosis, some degree of reduced flow, some degree of inflammation, some degree of decrease in things like lutein and zeaxanthin and vitamin D and things like that. All of these things come back, and it’d be very interesting to see, but I know that people who are improving flow, improving oxygenation, which is another risk factor, tend to do better. There’s another interesting study coming out of the UK showing mild stimulation with red light also improved age-related decrease in vision. So again, as with these other things, I think there is a tremendous amount that can be done.

Julie Gregory (37:05): Wonderful. Linda asks, “Any statin that you recommend? My cholesterol’s extremely high. My doc wants to put me on pravastatin.”

Dr. Dale Bredesen (37:13): Dan, would you …

Dr. Daniel Amen (37:19): Well, I think the first thing to do is make sure you get your diet right. That’s the first thing to do. It’s not decreasing cholesterol; it’s actually decreasing simple carbohydrates. For me if I was you, I would do it for two months where you’re really eating a brain-healthy diet and then test it again. And if it’s stubborn and it still won’t move, some people use red rice yeast extract. Among the statins, I don’t have a particular favorite. Dale, do you?

Dr. Dale Bredesen (37:58): Well, in general, the hydrophilic ones are probably a little better than the hydrophobic if you’ve got to use one. But I agree with you, Daniel, first of all, check your LDL particle number. Don’t just go by your cholesterol, so check something that’s more important. And then the second thing, I would strongly recommend getting a calcium score. If your cholesterol is high but your coronaries are completely clean, you maybe want to be very careful about messing with that. So I would make sure. And then, of course, also check the other risk factors, homocysteine and your HSCRP. Let’s see if you’ve got other things that are actually contributing. If you’ve got clean coronaries and you’ve got a good LDL particle number and your homocysteine is not high and your HSCRP is normal, then I would not push too much or just minimally. And maybe things like bergamot, bergamot has some excellent results with lipid without getting you into a statin.

Dr. Dale Bredesen (38:59): When we looked at two-thousand different drugs that were all FDA approved, looking at “did anything change the balance in the brain of your APP cleavage?” The one that popped out was statins. They actually pushed your APP signaling in a negative direction instead of a positive. I worry about statins.

Julie Gregory (39:22): Agreed. Maria asks, “What are some safer antidepressants for people who have Alzheimer’s or other dementias?”

Dr. Daniel Amen (39:35): That’s a great question. And I would answer, it depends on the kind of depression you have, that if you have a worried depression where you think about the bad things over and over and over and over again, that probably an SSRI can help. I mean, there’s this exciting research on COVID that Luvox was actually, which is an SSRI, fluvoxamine is the generic name, was found to be a treatment, an effective treatment for decreasing the progression of COVID to big trouble. And they also found people who are taking SSRI like Prozac or Paxil or Lexapro, they got significantly less hurt if they got COVID. I like that a lot. If you have the low energy depression, sort of the cognitive decline depression that goes with Alzheimer’s disease and Parkinson’s, I tend to use Wellbutrin because it’s the most stimulating of all of the approved antidepressants.

Julie Gregory (40:51): Okay, terrific.

Dr. Dale Bredesen (40:52): Fantastic.

Julie Gregory (40:53): I’ve got a question here from Leah. She says, “I’m worried about the accuracy of the SPECT scan. I did one in January of 2020, the radiological part indicated issues in every area of the brain, and every one of my physicians who looked over it said that my clinical presentation, I’m a professor of English and so on,” she continues to write, “win competitive grants, et cetera, did not match the radiological report.” Do you want to comment on that one?

Dr. Daniel Amen (41:31): I do …

Julie Gregory (41:32): Okay.

Dr. Daniel Amen (41:32): … because SPECT is a leading indicator of trouble where MRI is a lagging indicator of trouble. So, you might have perfectly normal MRI, but if your SPECT scan is showing global decreased activity, you want to find out why. This person’s obviously really bright, and you know, Dale, about cognitive reserve and that for people who are really well educated, they actually get diagnosed later and their brains look way worse. And so, what I would say is if the scan was done at a good place and they have good experience, or if we did the scan and we saw global decreases, I would take that very seriously and go, “I wonder why it’s decreased. What can we do to increase?” Because it’s easy to find other people to tell you that another doctor’s work is nonsense, right? Both Dale and I have experienced that a lot in our careers. So you can find the answer you’re looking for, but if there’s evidence of low blood flow, I would just say probably a good idea to hunt it down and take it seriously.

Julie Gregory (42:56): Okay-

Dr. Dale Bredesen (42:58): I would just add, Julie, you and I have dealt with this a lot, that doctors don’t tend to look for the root cause, they don’t tend to dive deep enough, and we just see people all the time who have toxin exposures that haven’t been recognized, or they will have tick-borne illnesses that haven’t been recognized. And obviously you’ve had experience with that sort of thing. I do think that if you see these sorts of changes, you want to start looking more deeply into what might be causing this. Because, as Daniel’s saying, this doesn’t happen for no reason, something is out there. And as he pointed it out, this is a leading indicator. I know we’re getting short on time, but I wanted to thank you, Daniel. It’s truly an honor to have you on there. I hope everyone will take a look at your latest book, You, Happier. Fantastic. And thank you for your many, many years of commitment and your paradigm-shifting work in psychiatry and neurology. We really appreciate it.

Dr. Daniel Amen (44:03): Thank you, Dale. Julie, what a pleasure to be with you. Dale, I’m just so grateful for your work. It’s just so nice to have a colleague… Our work just dovetails so beautifully.

Dr. Dale Bredesen (44:18): Absolutely. Thank you again. And Julie, thank you. Thank you, Daniel. Great to talk to you. We look forward to talking to you again. We’ll take the other questions online. Thanks very much.

Julie Gregory (44:29): All right, take care.