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Clinical Case Studies The following cases are representative examples of the many clinical situations in which R. rosea may be beneficial. Although the presentation of individual cases does not carry the weight of double-blind placebo-controlled trials, the authors hope that these samples from their larger case series may help to generate interest and funding for future controlled clinical trials to explore the medical applications of this multipotent medicinal herb. Note that in some cases the patients served as their own controls by discontinuing R. rosea, relapsing, and then improving upon resumption of treatment. Ms. W., a 45-year-old writer, never quite finished her doctoral thesis. A "block" prevented her from completing any manuscripts for publication. Seven years of psychotherapy did not alleviate the problem. After "drifting" for years and being terrified of taking any more prescription antidepressants, she tried 100 mg extract of R. rosea (Rosavinª, a preparation standardized to 1 percent salidroside and 3 percent rosavin, Ameriden International, Fallbrook, CA) twice a day. Although she had not considered herself to be depressed (and did not meet criteria for dysthymic disorder), within 6 weeks she experienced a new sense of enthusiasm and increased productivity. She became able to complete writing projects and to feel happy with herself. She was well for over two years on R. rosea. However, feeling recovered and happily married, she decided on her own to stop the herbal medicine and gradually relapsed over 6 months. Upon resuming the R. rosea, she again improved with full recovery. Ms. P., a 50-year-old computer analyst, complained of constant fatigue, dragging herself out of bed every morning, and dreading encounters at work. Because she was highly sensitive to side effects of any psychotropic medication, she began with one pinch (equivalent to about 50 mg) of R. rosea extract (Rosavinª) in her morning tea. Within a few days her fatigue was gone. She had the energy and confidence to deal more effectively with the inevitable conflicts at work. Ms. B., a 45-year-old mental health professional, had refractory depression and fibromyalgia for 5 years. Her symptoms were completely unresponsive to multiple trials of psychotropic medication. She had a partial response to the antidepressant sertraline (Zoloft¨, a selective serotonin reuptake inhibitor, SSRI), but this was not adequate for her to do more than carry out her daily job. The addition of 600 mg/day R. rosea extract (Rosavinª) enabled her to return to normal enjoyment and full productivity in life. It took about 2 months to see these effects. After 6 months, the patient began to doubt that she needed the R. rosea and discontinued it on her own, only to relapse over the next 3 weeks. Upon reinstitution of the R. rosea, she returned to full remission and remains well 2 years later on sertraline and R. rosea. Mr. S., a 74-year-old man, had suffered from Parkinson's disease for 10 years. Despite conventional treatment with pramipexole (Mirapex¨), levodopa/carbidopa (Sinemet¨), donepezil (Aricept¨), and rivastigmine (Exelon¨) for motoric and cognitive deficits, he was functioning poorly. He spent most of the day sitting in a chair, rarely speaking or initiating any activities. His wife, a practicing neurologist, carefully observed his clinical status and reported that within one week of starting 300 mg R. rosea extract (Rosavinª) twice daily he began to recover with marked progressive improvements in his abilities to think, speak, read, and initiate independent activities. Because of some residual cognitive impairment, galanthus (Galanthus spp., Amaryllidaceae) an herbal extract (customized formula by Ameriden International containing 100 mg R. rosea, 200 mg galanthus, and 50 mg plant cell-derived vitamin C) was added with consequent additional improvement. Ms. A., an athletic 62-year-old Oriental woman, was diagnosed with infiltrating ductal carcinoma of one breast. She began chemotherapy but suffered extreme fatigue and suppression of her white and red blood cell counts to the point where, despite conventional treatment adjuvants, the chemotherapy regimen had to be repeatedly interrupted. A trial of 150 mg R. rosea extract (Rosavinª) twice daily restored her energy and completely normalized her white and red blood cell counts, allowing completion of chemotherapy. Four months after mastectomy and chemotherapy, Ms. A. resumed her usual rigorous martial arts practice.
