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Zoloft Tapering | Do it Right, Naturally!

Last Updated on July 3, 2024 by Diane Ridaeus

Alternative to Meds Editorial Team
Medically Reviewed by Dr Samuel Lee MD

The same strategies that ease Zoloft tapering can also improve mental health naturally. This provides the great advantage of significantly reducing or eliminating unwanted symptoms while safely weaning off Zoloft.

If you have found SSRI treatment less than satisfactory, you may want to consider the option of Zoloft tapering, and a transition to drug-free protocols for true symptom relief.  Learn about Zoloft and what to expect during tapering.  On our services overview page you will explore drug-free strategies to discuss with your prescriber or caregiver as you plan your personal journey to natural mental health.  Or plan a stay with us. We are here to help. 


Time to get off the rollercoaster ride?
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Alternative to Meds has been an antidepressant tapering and titration help authority for more than 17 years. We have independently documented published evidence regarding our success. Even if a person had what might be considered the most off-the-wall symptoms, these same symptoms are much more common than what is being admitted to. Not only do we specialize in these symptoms, but many of us have also had to endure them ourselves in order to become the teachers that we are.
Does it seem that you have been through the drug treatment mill so many times, or for so long that you cannot be helped? Are you afraid that you’ve tried everything and that this is your life from now on? That there is no hope for you? The woman in this video was on antidepressants and benzodiazepines for decades. She suffered much suffering. She eventually reached out to Alternative to Meds for help. After successfully completing the program, she turned her life around. Her story is riveting. We encourage you to watch so that you can gain hope for your situation.

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Safe Zoloft Tapering

Zoloft tapering merits careful preparation and realistic goals, and knowledgeable guidance along the way. It is possible to learn how to get off Zoloft using trusted and proven methods to reduce the discomforts that could otherwise make Zoloft cessation intolerable. This guidance is provided at Alternative to Meds Center in its inpatient programs for clients trying to quit Zoloft and other medications. Where multiple medications are in use, a program would be designed to proceed in the safest and best order, to minimize any shock or discomfort that otherwise may occur.

FDA WARNING:   It bears repeating that the FDA warns against abruptly stopping Zoloft. To do so can be injurious to health. Tapering Zoloft gradually can make the process more tolerable, and can actually prevent much of the harsh discomfort associated with trying to quit Zoloft or similar medications too quickly.4

Does Zoloft Create Dopamine or Serotonin?

No, Zoloft does not create new serotonin or dopamine. SSRIs spend what’s there to spend. And, like a bank account, continual withdrawals without replenishment cause bankruptcy. Research is still searching to understand the mechanics behind antidepressants. Drugmakers admit the mechanism of action of SSRI drugs in treating depression is unknown.26-28 Zoloft is classed as an SSRI medication that is designed to manipulate the distribution or availability of serotonin in the body. The serotonin theory of depression is plagued by controversy, presumptions, and imperfect understanding. It has nonetheless served as a credible sounding sales pitch in advertising. Childlike images and colorful animations suggest the serotonin-depression theory is reliable and trustworthy.25 Despite the aesthetics of the advertising world, one is not obliged to accept questionable theories as factual. As serious research shows, “the science” is nowhere near as perfect on the subject as has been claimed.24

zoloft's effect on dopamineThere is a lot that remains unknown about how SSRIs “work” — but what can be said is, whether starting on or stopping Zoloft, the way serotonin is distributed in the body will be affected. SSRI drugs accelerate how quickly any available serotonin gets used up. The temporary concentration of serotonin becoming suspended at the nerve synapses is what is believed to create a lift in tone, hence the term “antidepressants.” But this process is also likely to ultimately leave a deficit of your body’s natural neurochemicals in its wake. Serotonin, when suspended by an SSRI, is subject to degradation and decomposition by certain enzymes in the bloodstream, and this results in accelerated serotonin loss overall.19 This could be likened to the way alcohol impairs the uptake and metabolism of certain nutrients, leaving a deficiency in its wake. The next day, these impairments and created deficits contribute to the misery that is most often referred to as a “hangover.” Zoloft also affects various natural chemicals in similar ways, such as norepinephrine and dopamine — these are targeted to a lesser extent, but the likelihood of deficiency is similar.9,20

As stated above, Zoloft does not create dopamine but is thought to affect dopamine, sometimes called the pleasure or “reward” hormone. Zoloft is designed to stop the normal passage of dopamine and instead, to cause a build-up at the pleasure centers in the brain. While suspended, however, enzymes can break down these molecules, causing their loss. In the same way, sertraline also affects norepinephrine, a natural stimulant. Suspension of these neurochemicals at the synapse is the presumed cause for an enhanced, but temporary, lift in mood. Of all of the SSRIs, sertraline (Zoloft) was the only one found to increase extracellular dopamine amounts in the nucleus accumbens and striatum (dopamine receptor sites in the brain) of rats.7,21,22

Over time, however, these natural neurochemicals — which are blocked from reabsorption by the drug — will be lost, as previously described, from enzymaic decomposition.19  At this point, a person may begin to notice that the Zoloft “isn’t working anymore.” A person may resort to taking larger and larger doses to get the same effects. But this is a dwindling spiral that only leads to worsened outcomes.  The body creates its own neurotransmitters if given the right raw materials, and that is nutrition-based, not drug-based.   That is why ATMC utilizes an orthomolecular approach to neurotransmitter repair. 

As drug efficacy wanes over time. a person may begin to consider alternative treatments and seek help with getting off Zoloft altogether. It is advisable that one first learns as much as possible about Zoloft tapering before embarking on the process. Zoloft cessation may be made more difficult than it has to be; in fact, the process could be disastrous if one goes at it too fast and without proper guidelines and preparation. Do not try it all on your own.

Zoloft Discontinuation Syndrome

zoloft discontinuation syndromeZoloft discontinuation syndrome has been studied minimally in clinical trials, especially in light of the fact that SSRI medications are so widely prescribed. Outside of limited clinical trials and a prevalence of anecdotal reporting, very little research has been done on the problems encountered with Zoloft tapering.10 However, there is some consensus that abrupt dose reduction can generate intense and long-lasting adverse reactions. This is sometimes misdiagnosed as a relapse.11 This can, in turn, lead to further mismanagement of the condition.

At Alternative to Meds, we find very often that clients were never fully briefed by their prescribing physicians about the potential challenges of Zoloft tapering or information on how to get through it successfully. Indeed, their physicians may not have known themselves.16 The subject is not covered in medical school. Many of our clients have said that had they known how hard it would be to stop, they would have never started taking antidepressants in the first place, but would have sought non-drug-based treatments. Quite a significant number of clients have been referred to us by their prescribers who felt that a residential treatment center would be a much better option than struggling with Zoloft tapering without a high level of attentive care. However, we understand that not everyone can seek inpatient treatment. In this case, it is safest to find a medical professional with experience, and who you trust, to help you in an outpatient setting.

Zoloft Tapering Guidelines

Always seek medical oversight and guidance before beginning to taper Zoloft. Each person is unique and will need personal guidance, and assistance from trusted people around you, especially in an outpatient treatment plan. Having a well-informed support team of family or friends to assist you is a good strategy, so let them know how they can best support you in the process. You may consider asking for help around the house, cleaning up, cooking, or doing errands while you rest. You may want a trusted companion or family member to be close by, or just for the company at certain intervals. Don’t be afraid to ask for what you want, because most people really enjoy helping others and will try their very best to accommodate you.

Inpatient help for Zoloft tapering is the safest and most comfortable treatment choice.

The guidelines below are not intended to be used without medical oversight but can help start the conversation with your prescriber who choose to help guide you to gradually taper off Zoloft. This information may be very useful to both you and your doctor, as physicians are not trained in medical school on tapering methods. A naturopath may be quite helpful in choosing drug-free treatments for physical comfort and healing, though they will likely not be able to prescribe the drug during your taper. You’ll need to coordinate your treatment team so all bases are covered. In any case, do not attempt to taper Zoloft without medical support.

Ask your prescribing physician to help in prescribing lower doses, whether in pill or liquid form or in the actual cutting of pills if that is required. In the case of Zoloft, the lowest pill dosage is 25mg. Configuring dosages precisely will be easier by using the smallest pills your doctor can prescribe for you. You should expect to be taking less than the smallest pill towards the end of the taper and this should be discussed and arranged beforehand with your medical support.

Zoloft Tapering Guidelines Include:
  • zoloft tapering guidelinesThe FDA recommends gradual reduction, not stopping abruptly.4
  • Get the smallest dose pill available. Your physician can assist in cutting the pill if needed. For Zoloft, the smallest dosage pill is 25mg. A liquid form may also be available for precise measurement.
  • Inform your prescriber of any sensitivity issues or reactions you may experience during Zoloft tapering. The dosage may need to be adjusted to compensate. Emerging suicidality should be reported to your prescriber without delay.
  • A slow rate of reduction (10-25% adjusted as needed) per 1, 2, or more weeks.12
  • Towards the end of the taper, you may be taking sub-therapeutic dosages – certainly less than 25mg, taking fractional cuts at around 1-2 week intervals, or longer, and certainly not until the reactions settle out at each reduction.
  • There are non-drug supplements30,31, physical therapies, and dietary recommendations 29 that can help bridge over rough patches that may occur. We recommend looking into implementing more holistic strategies such as neurotransmitter rehabilitation for relief of mental health symptoms. Rely on your naturopath in choosing supplements carefully.
  • Ensure adequate rest — arrange your schedule to allow time off work or school until a stable point is reached and you have recouped enough energy to cope with regular daily routines.
  • Your prescribing physician will want to allow some time to settle things out after each reduction, before recommending further adjustments to dosage. Do not rush the process.
  • You may expect discontinuation symptoms to emerge around the drug’s half-life range. (1 day) 13
  • It is not uncommon to see an increased challenge toward the end of the Zoloft taper — your prescriber may advise you to slow the pace at that point. Stay in close contact with your prescribing physician so that your journey can proceed as smoothly as possible.

Your doctor should advise you of the possibility of a protracted withdrawal which may make continuing on your own impassable. Alternative to Meds Center specializes in this phenomenon and we can help.

Are Brain Zaps Always Part of Coming Off Zoloft?

While brain zaps are commonly reported during Zoloft cessation, a proper Zoloft tapering regimen can tend to lessen or even eliminate these reactions entirely. There are ways to support the taper by bolstering the neurochemistry with naturally occurring substances that will tend to combat any deficiency of serotonin or other dysfunctional neurotransmitters during the process. This may reduce the frequency and severity of brain zaps during Zoloft tapering.29

Zoloft Tapering and Pregnancy

Zoloft increases birth defects and stillbirths in animals, according to clinical trials discussed in the FDA drug labeling information.4 It is something of a tragedy that Zoloft is still legal for prescribing to women of childbearing age, whether the woman is pregnant or not. However, a woman taking Zoloft who is planning on becoming pregnant may opt for tapering off as a precaution before getting pregnant.

WARNING:  Both the FDA and the CDC caution against Zoloft use during pregnancy, due to potential birth defects that the drug may cause.5,6,8,18,23

zoloft increased risk of birth defectsWomen who are considering starting Zoloft or other SSRI-type medication may not always be informed of the 3-5% increased risk of birth defects compared to placebo according to trials that have been done.1 An infant born to a mother taking Zoloft may suffer profound adverse reactions in addition to the risks of various birth defects.17 Again, to avoid these complications and risks, we would advise considering Zoloft tapering before one becomes pregnant, both for the future health of the baby and the health of the mother.

Pharmaceutical companies are not required by law to do human clinical trials on SSRI drugs on pregnant women. Some research may have been done on animals but their results may not have been vigorously disseminated to prescribing doctors or the public at large. Women and all parents-to-be would be well-advised to do their own careful research before continuing SSRI medications especially if they are planning a pregnancy.5

Please note that NIMH has published findings regarding increased instances of infants with clubfoot born to mothers taking Zoloft, which may be of particular interest to research on the subject of women’s health.2,4,6,23

Again, we stress for the sake of an unborn child’s health, women are advised to do their own research to make the best decisions concerning health and pregnancy. Speak to your doctor before getting pregnant if you are taking Zoloft.

Long-Term Zoloft Use and Neuroadaptation

zoloft zombie SSRIs like Zoloft (sertraline) are endocrine-disruptive as demonstrated in rat studies.14 These effects are thought to explain the sexual dysfunction linked to such medications. The neuroadaptive capabilities of the CNS are geared to attempt to normalize despite the drug-induced flooding of serotonin into the nervous system. Antidepressant patients can develop chronic apathy and worsened depression after long-term use of SSRIs. This is not a mental illness returning; this is the possible effect that serotonergic medications have on the human body. This antidepressant-induced apathy creates “zombie-like” or deadened feelings. Clinicians sometimes refer to the effect as “SSRI-induced indifference” or “SSRI-induced apathy.”15 Elderly patients with dementia are particularly susceptible to antidepressant-induced chronic apathy.3

A person may wish to avoid these potential risks and can do so by initiating gradual reduction from Zoloft and also by not staying on an antidepressant for very long. A person suffering from this chronic apathy may require some help in the form of encouragement from family members or others who can support their loved one through the process of Zoloft tapering.

Zoloft Adverse Reactions

A person taking antidepressant medication may be subject to various adverse reactions, and these are DIRECTLY INDUCED drug effects that can dominate one’s overall health.

Zoloft adverse reactions may include:
  • Suicidality
  • Paranoia
  • Anxiety
  • Convulsions
  • Spams of muscles, movement disorder
  • Akathisia
  • Grinding of the teeth
  • Racing heartbeat
  • Difficulty breathing
  • Rash (can be severe enough to warrant emergency/hospital care)
  • Sexual dysfunction

And many, many others.

Each person is a distinct and unique expression of health and therefore can often react to medications in unpredicted or surprising ways. This unpredictability and the severity of certain drug reactions may present other reasons a person may consider tapering off Zoloft to get a firm foothold on improving one’s health.

Alternative to Meds Inpatient Zoloft Tapering Support

zoloft tapering support sedona drug rehabOur Zoloft tapering programs are designed to mitigate or completely eliminate the most difficult reactions you may be experiencing, or that you are worried may occur. There are many actions that we deliver to prepare such as lab testing before the medically supervised tapering process actually begins as well as during the process so that your Zoloft taper is the smoothest and most problem-free experience possible.

The extensive use of holistic protocols makes Zoloft tapering much easier to tolerate, including the use of neurotoxin removal, neurotransmitter rehabilitation, environmental medicine, acupuncture, correction of diet including prescribed supplementation, therapeutic massage, nebulized glutathione, yoga, equine-assisted therapy, CBT and other counseling, peer support programs, co-occurring disorders holistic treatment, holistic pain management, Qi Gong, colon hydrotherapy, and many, many other adjunct services and proven strategies for improvements in overall health and well-being.

The Alternative to Meds Center programs for stopping Zoloft and other medications seek to prepare a person in several fundamental ways even before Zoloft tapering begins. It can seem a particularly daunting task to taper from Zoloft, especially if trying it all on your own — which is not recommended. At the very least we would recommend working with a medical professional who is familiar with tapering from SSRI medications. You may find a search at IMMH.org helpful to find such a practitioner in your local area. 

We have seen the benefits of inpatient treatment which relieves the burden of stress on the family as well as the person in treatment. We have helped many thousands of clients and we would like to be able to assist you or your loved one as well

We are insurance friendly, and it may be more possible than imagined to come to Alternative to Meds Center. Call us for more detailed information on our safe and gradual Zoloft tapering program, delivered in a luxurious, warm, nurturing inpatient setting and always with 24/7 oversight and care.

1 (800) 301-3753 for Zoloft Tapering Help

Sources:

1. Jefferies A L “Selective serotonin reuptake inhibitors in pregnancy and infant outcomes.” Canadian Paediatric Society [INTERNET] 2011 Nov 11 reaffirmed 2018 Feb 18 [cited 2022 July 6]

2. Yazdy MM, Mitchell AA, Louik C, Werler MM. Use of selective serotonin-reuptake inhibitors during pregnancy and the risk of clubfoot. Epidemiology. 2014 Nov;25(6):859-65. doi: 10.1097/EDE.0000000000000157. PMID: 25171134; PMCID: PMC4180776. [cited 2022 July 6]

3. MDs Wamsley, Byerley, McConnell, Dawson, Grosser “Receptor Alterations Associated With Serotonergic Agents: An Autoradiographic Analysis” Clinical Journal of Psychiatry, 1987 [cited 2022 July 6]

4. FDA Zoloft label [approval 1991] [cited 2022 July 6]

5. “Pregnant or Thinking of Getting Pregnant?” CDC Pregnancy Homepage (N.D.) [published online] [cited 2022 July 6]

6. FDA Drug Safety Communication, Zoloft [INTERNET] [cited 2022 July 6]

7. Kitaichi Y et al “Sertraline increases extracellular levels not only of serotonin, but also of dopamine in the nucleus accumbens and striatum of rats” PubMed, [INTERNET] 2010 Nov 10 [cited 2022 July 6]

8. EMC Patient Leafleft Sertraline [cited 2022 July 6]

9. Ryle PR, Thomson AD. Nutrition and vitamins in alcoholism. Contemp Issues Clin Biochem. 1984;1:188-224. PMID: 6400499. [cited 2022 July 6]

10. Haddad PM. Antidepressant discontinuation syndromes. Drug Saf. 2001;24(3):183-97. doi: 10.2165/00002018-200124030-00003. PMID: 11347722. [cited 2022 July 6]

11. Haddad P. Newer antidepressants and the discontinuation syndrome. J Clin Psychiatry. 1997;58 Suppl 7:17-21; discussion 22. PMID: 9219489. [cited 2022 July 6]

12. Glenmullen J, “The Antidepressant Solution- A Step-by-step Guide to Safely Overcoming Antidepressant Withdrawal, Dependence, and “addiction’” [book] published 2005 by Simon and Schuster ISBN 0743269721, 9780743269728 [cited 2022 July 6]

13. DeVane CL, Liston HL, Markowitz JS. Clinical pharmacokinetics of sertraline. Clin Pharmacokinet. 2002;41(15):1247-66. doi: 10.2165/00003088-200241150-00002. PMID: 12452737. [cited 2022 July 6]

14. Cecilie Hurup Munkboel, Lizette Weber Larsen, Johan Juhl Weisser, David Møbjerg Kristensen, Bjarne Styrishave, Sertraline Suppresses Testis and Adrenal Steroid Production and Steroidogenic Gene Expression While Increasing LH in Plasma of Male Rats Resulting in Compensatory Hypogonadism, Toxicological Sciences, Volume 163, Issue 2, June 2018, Pages 609–619, https://doi.org/10.1093/toxsci/kfy059 [cited 2022 July 6]

15. Barnhart WJ, Makela EH, Latocha MJ. SSRI-induced apathy syndrome: a clinical review. J Psychiatr Pract. 2004 May;10(3):196-9. doi: 10.1097/00131746-200405000-00010. PMID: 15330228. [cited 2022 July 6]

16. Informed Consent AMA Principles of Medical Ethics: I, II, V, VIII [cited 2022 July 6]

17. Levinson-Castiel, R., Merlob, P., Linder, N., Sirota, L. & Klinger, G. Neonatal abstinence syndrome after in utero exposure to selective serotonin reuptake inhibitors in term infants. Arch. pediatrics Adolesc. Med. 160, 173–176, https://doi.org/10.1001/archpedi.160.2.173 (2006). [cited 2022 July 6]

18. Reefhuis J, Devine O, Friedman JM, Louik C, Honein MA, and the National Birth Defects Prevention Study. Specific SSRIs and birth defects: bayesian analysis to interpret new data in the context of previous reports. BMJ. 2015 published online CDC Key Findings – A Closer Look at the Link Between Specific SSRIs and Birth Defects [cited 2022 July 6]

19. Prah A, Purg M, Stare J, Vianello R, Mavri J. How Monoamine Oxidase A Decomposes Serotonin: An Empirical Valence Bond Simulation of the Reactive Step. J Phys Chem B. 2020;124(38):8259-8265. doi:10.1021/acs.jpcb.0c06502 [cited 2022 July 6]

20. Singh HK, Saadabadi A. Sertraline. [Updated 2022 May 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547689/ [cited 2022 July 6]

21. Schmitt JA, Ramaekers JG, Kruizinga MJ, van Boxtel MP, Vuurman EF, Riedel WJ. Additional dopamine reuptake inhibition attenuates vigilance impairment induced by serotonin reuptake inhibition in man. J Psychopharmacol. 2002 Sep;16(3):207-14. doi: 10.1177/026988110201600303. PMID: 12236626. [cited 2022 July 6]

22. Ahrold TK, Meston CM. Effects of SNS activation on SSRI-induced … effects differ by SSRI. J Sex Marital Ther. 2009;35(4):311-9. doi: 10.1080/00926230902851322. PMID: 19466669; PMCID: PMC4426856. [cited 2022 July 6]

23. Mitchell AA, Gilboa SM, Werler MM, Kelley KE, Louik C, Hernandez-Diaz S, and the National Birth Defects Prevention Study. Medication use during pregnancy, with particular focus on prescription drugs: 1976-2008. Am J Obstet Gynecol. 2011;205(1):51.e1-8. [cited 2022 July 6]

24. Moncrieff, J., Cooper, R.E., Stockmann, T. et al. The serotonin theory of depression: a systematic umbrella review of the evidence. Mol Psychiatry (2022). [cited 2023 Feb 13]

25. Goldman R, Montagne M. Marketing ‘mind mechanics’: decoding antidepressant drug advertisements. Soc Sci Med. 1986;22(10):1047-58. doi: 10.1016/0277-9536(86)90205-4. PMID: 2426792. [cited 2023 Feb 13]

26. FDA label Prozac [cited 2023 Feb 13]

27. FDA label Celexa [cited 2023 Feb 13]

28. Harmer CJ, Duman RS, Cowen PJ. How do antidepressants work? New perspectives for refining future treatment approaches. Lancet Psychiatry. 2017 May;4(5):409-418. doi: 10.1016/S2215-0366(17)30015-9. Epub 2017 Jan 31. PMID: 28153641; PMCID: PMC5410405. [cited 2023 Feb 14]

29. LaChance LR, Ramsey D. Antidepressant foods: An evidence-based nutrient profiling system for depression. World J Psychiatry. 2018 Sep 20;8(3):97-104. doi: 10.5498/wjp.v8.i3.97. PMID: 30254980; PMCID: PMC6147775. [cited 2023 Feb 14]

30. Sarris J, Ravindran A, Yatham LN, Marx W, Rucklidge JJ, McIntyre RS, Akhondzadeh S, Benedetti F, Caneo C, Cramer H, Cribb L, de Manincor M, Dean O, Deslandes AC, Freeman MP, Gangadhar B, Harvey BH, Kasper S, Lake J, Lopresti A, Lu L, Metri NJ, Mischoulon D, Ng CH, Nishi D, Rahimi R, Seedat S, Sinclair J, Su KP, Zhang ZJ, Berk M. Clinician guidelines for the treatment of psychiatric disorders with nutraceuticals and phytoceuticals: The World Federation of Societies of Biological Psychiatry (WFSBP) and Canadian Network for Mood and Anxiety Treatments (CANMAT) Taskforce. World J Biol Psychiatry. 2022 Jul;23(6):424-455. doi: 10.1080/15622975.2021.2013041. Epub 2022 Mar 21. PMID: 35311615. [cited 2023 Feb 14]

31. Sarris J, Panossian A, Schweitzer I, Stough C, Scholey A. Herbal medicine for depression, anxiety and insomnia: a review of psychopharmacology and clinical evidence. Eur Neuropsychopharmacol. 2011 Dec;21(12):841-60. doi: 10.1016/j.euroneuro.2011.04.002. Epub 2011 May 23. PMID: 21601431. [cited 2023 Feb 14]

Originally Published Nov 3, 2019 by Lyle Murphy


This content has been reviewed and approved by a licensed physician.

Dr. Samuel Lee

Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente.  He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.

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