Patients are continually seeking alternative approaches beyond traditional pharmaceutical treatments for mental health issues. Nootropics such as peptides, which are small chains of amino acids, often enhance the body’s natural functions and can help alleviate various mental health symptoms. The role of peptides in mental health is an emerging and promising area of treatment. In my new integrative mental health practice, I have expanded my treatment options to include peptide therapy and other holistic modalities. Following are some of the therapies that have shown benefits.
Cognitive functioning can be boosted with NAD+ (nicotinamide adenine dinucleotide), a naturally occurring coenzyme whose levels decline with age. NAD+ supplementation has been studied, and the results show that it enhances energy levels, elevates mood, and offers protection against oxidative damage in neural cells. Other studies have indicated early signs of enhanced memory and cognitive function, along with increased cerebral blood flow. Most studies have been conducted on animals, and although some involved humans, further validation is needed, but it is naturally occurring and appears to have minimal risks beyond injection site injuries. I have been using this peptide as a neuronal stimulant that supports cognition and energy, thereby fostering improved focus. It functions similarly to an ADHD medication—but unlike Adderall, it has significantly fewer side effects.
Many of my perimenopausal patients report that this supplement has helped with their brain fog and memory, issues they noticed emerging during perimenopause. A potential side effect is occasional heart racing when the medication is administered. I typically administer this medication via intramuscular injection once a week; alternatively, it can be compounded into a troche, similar to a mint, which dissolves sublingually and must be taken daily. An additional benefit may be NAD+’s capacity to bolster the immune system and potentially shorten the duration of illnesses such as influenza and other viral infections.
Peptide therapy may also support mood stabilization and mitigate anxiety symptoms. Specifically, some peptides may positively influence levels of serotonin, a neurotransmitter linked to feelings of well-being. For example, treatment with Selank has been correlated with increased levels of leu-enkephalin, a natural opioid peptide that may alleviate anxiety. I administer Selank via nasal spray. Additionally, oxytocin nasal spray has demonstrated efficacy in delivering rapid stress reduction by enhancing social bonding. It has also been advantageous during couples counseling to foster positive interactions and facilitate progress.
A better-known group of peptides are GLP-1 agonists, mostly used for the treatment of diabetes and for weight loss which appear to have the off-label uses of a wonder drug. In my practice, I have used compounded semaglutide and tirzepatide, not only for weight management related to psychotropic medication side effects but also as effective interventions for binge eating and alcohol binging. This approach has proven highly effective, with many patients experiencing a significant reduction in alcohol consumption and related risks. Some clients have made more progress with GLP-1 agonists than with naltrexone; however, a combined approach remains the most effective approach for serious addiction issues. For alcohol addiction, I use semaglutide and tirzepatide—usually compounded, as the cost of branded medication, if not covered by insurance, can be prohibitive. There are also troches of compounded formulations that are effective if injections are not feasible.
I encourage other mental health professionals to consider novel treatments for mental health with peptides. I have found them to be safe and effective and a valuable addition to our arsenal of treatment options.
