Ask the Doctor: Flaxseed & Brain Health; Multiple System Atrophy; Ativan Withdrawal Symptoms

Q: Why is consuming flaxseed so beneficial for the brain?

A: Flaxseed, also called linseed, provides the brain with powerful antioxidants, along with the essential polyunsaturated omega-3 and omega-6 fats, which help build cell membranes throughout the body and must be derived from the diet. These fats comprise a high proportion of the brain’s fats, and both are necessary for optimal brain health. The fats and fiber in flaxseed help to lower blood pressure and reduce “bad” LDL cholesterol and inflammation, as well as lower risk for diabetes—all effects that can protect the brain from harm. Research suggests that omega-3 helps protect brain cells from the damaging effects of aging, stress, and inflammation, reduces risk for blood clots, and helps prevent negative changes to the brain’s white matter, among other benefits. A study published in the March 2017 issue of the journal Biochimica et Biophysica Acta suggests that omega-3s may even help protect cells from the negative effects of air pollution. In modest amounts, omega-6 fatty acids can help protect cells against damage associated with inflammation and promote cell repair. The optimal ratio between omega-6 and omega-3 is thought to be 4 to 1 or lower; however, most Americans consume a ratio of 10 to 1 or worse. Since flaxseeds supply four times as much omega-3 as omega-6, one-to-two tablespoons a day of the ground seeds provide an excellent way to boost omega-3 levels. It’s best to check with your doctor before adding flaxseed to your diet, as its blood-thinning effects can interfere with some medications.

Q: What is multiple system atrophy and how is it treated?

A: Multiple system atrophy (MSA) is a progressive neurological disease whose cause is unknown. MSA usually strikes people in their 50s and is thought to affect from 25,000 to 100,000 Americans, although it is probably under-diagnosed. It affects the autonomic nervous system, causing symptoms such as problems with blood pressure, fainting, loss of bladder control, erectile dysfunction, muscle rigidity, tremor and loss of coordination. Recent studies suggest the symptoms of MSA are related primarily to the degeneration of the myelin sheath that surrounds and insulates nerve axons, which results in the impairment of transmission of nerve impulses from cell to cell along the axon. At this time, treatment options are limited to medical management of symptoms, with medications to control blood pressure abnormalities, urinary dysfunction, erectile dysfunction, and movement disorders. These therapies may slow, but they do not halt, progression of symptoms. There is currently no cure for MSA.

Q: Can stopping the anti-anxiety drug Ativan cause withdrawal symptoms?

A: Ativan (lorazepam) affects the central nervous system and, by reducing tension and relaxing muscles, produces feelings of calm. It is commonly prescribed for anxiety, but may also be used to address insomnia, alcohol withdrawal, seizures, irritability, and agitation. Although it is intended for short-term use, the drug is often used for longer periods or at higher doses than recommended. In some of these cases, dependency may develop and cessation of the medication can cause serious, and even potentially dangerous withdrawal symptoms. These may include:

  • Increased blood pressure, rapid heart rate or heart palpitations
  • Nausea, vomiting, weight loss
  • Seizures, headache, tremors
  • Confusion, difficulty concentrating
  • Difficulty sleeping
  • Irritability, malaise, depression, anxiety, mood swings, or panic attacks

Because of the potentially serious consequences of withdrawal, professional advice is prudent during the process. Treatment usually consists of slowly reducing dosage levels over time.

—Editor-in-Chief Maurizio Fava, MD

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