Interview with Dr. Dan Amen

Daniel G. Amen, MD Founder, Amen Clinics

Costa Mesa, Los Angeles, and Walnut Creek, CA Seattle, Atlanta, DC, NYC, Chicago

Over the last 30 years, you have developed and relied on brain SPECT imaging to diagnose and manage all kinds of neuro-psychiatric disorders. Why is brain SPECT an essential part of your practice?

When I was a young US Army soldier, I was trained as an x-ray technician. As our professors used to say, “How do you know unless you look?”. During medical school, someone I loved tried to kill herself and I took her to see a wonderful psychiatrist. I came to realize that if he helped her, which he did, it wouldn’t just help her. It would help her children and even grandchildren. I fell in love with psychiatry because I realized it had the potential to change generations of people; but psychiatry is the only medical specialty that virtually never looks at the organ it treats. SPECT completely changed the paradigm and gave us an elegant way to look at brain function. It has taught us many important lessons, such as all psychiatric illnesses are not single or simple disorders. ADHD, depression, bipolar disorder, violence, etc., all have multiple types that each require their own treatments. This completely changed how we treat patients. In addition, we learned that mild-to-moderate traumatic brain injuries ruin people’s lives and few professionals know it, because they never look at brain function. The most exciting lesson we have learned with SPECT is that you are not stuck with the brain you have, you can make it better and we can prove it.

You have been a very vocal advocate of brain health. What is brain health? In the era of Alzheimer’s disease, TBI and PTSD, how can people develop, maintain or regain a healthy brain?

Funny, but being a physician and double board- certified psychiatrist, until I started to look at the brain with SPECT, I never really cared about my  own  brain.  After  having  scanned  tens  of thousands of people, and myself and family, I came to realize that success starts in the physical well-being of the brain. When your brain works right, you work right; and when your brain is troubled for whatever reason, you are much more likely to have trouble in your life. Over the years I have been able to simplify brain health into three categories: brain envy (you must care about it); avoid things that hurt it; and engage in regular brain healthy habits. My book Memory Rescue was just published. In it I argue that if you want to prevent Alzheimer’s Disease and cognitive decline with age,  you must prevent or treat the 11 major risk factors that steal your mind. And the good news is that nearly all the risk factors are either preventable or treatable. My team and I developed the mnemonic BRIGHT MINDS to help people remember these risk factors: Blood flow, Retirement/aging, Genetics, Head trauma, Toxins, Mental health issues, Immunity/ Infections, Neurohormone deficiencies, Obesity and Sleep. If you love yourself, doing the right things for the health  of your  brain becomes easier over time.

What are the Amen Clinics?

We now have eight Amen Clinics across the United States, where we see people with complex psychiatric issues. On average our patients have 4.2 diagnoses and have failed 3.3 professionals and 5 medications. Yet after six months, if we treat them, 84% report being significantly better. We believe the reason is something we call the Amen Clinics Method, which involves detailed clinical histories (patient fill out 25 pages of information), brain SPECT imaging, neuropsychological testing, and laboratory screening that lead to more specific diagnosis and targeted treatments. In addition, we always attempt to plant brain healthy lifestyle habits in our patients lives. We have added three major innovations: neuroimaging, integrative medicine and the use of nutritional supplementation when possible. As opposed to many of our physician colleagues who report high levels of burn out, our physicians are motivated and happy, because people get better at higher than typical rates.

Personalized medicine, molecular imaging and treatment targeting are becoming an integral part of the practice of medicine. Will they play a major role in the future of neuro-psychiatry ?

Yes, we believe they already are at Amen Clinics today. Psychiatry desperately needs a better way. Drugging the brain into submission is just not working. Dr. Thomas Insel, former Director of the National Institutes of Mental Health, recently wrote, “For the antidepressants … the rate of response continues to be slow and low. In the largest effectiveness study to date, with more than 4,000 patients with major depressive disorder in primary care and community settings, only 31 percent were in remission after 14 weeks of optimal treatment … in most double-blind trials of antidepressants, the placebo response rate hovers around 30 percent… The unfortunate reality is that current medications help too few people to get better and very few people to get well.” Studies that looked at the published data from the pharmaceutical companies on antidepressant trials and the unpublished data obtained from the Freedom of Information Act found that antidepressants, except for the most severely depressed patients, worked no better than placebos or sugar pills.

To your opinion, what role do you see the Pangea-ePatient magazine play for nuclear medicine practice?

I love this magazine because it brings the latest innovations to the nuclear medicine community, which has yet to seriously embrace molecular imaging in psychiatry. There are tens of millions of people who suffer with mental health issues who could benefit from brain SPECT and PET.