Jay Goldstein

Jay A. Goldstein (born May 8, 1943) is an American physician and author. He trained in psychiatry but is board-certified in family practice. After his studies, he focused on the field of neurology and neuropharmacology, inventing what he calls neurosomatic medicine. For two decades he treated primarily patients with chronic fatigue syndrome and fibromyalgia, which he considers to be neurosomatic illnesses.
Goldstein has published over 40 papers in peer-reviewed journals about many different subjects, primarily related to pharmacotherapy, often pioneering the use of a medication for an off-label use. He has authored five medical books, most of them about chronic fatigue syndrome. Since 1988 Goldstein has contributed extensively to the CFS publications The CFIDS Chronicle and The National Forum. He has also helped to organize several conferences about the illness.
Goldstein is now retired from medical practice. According to the Medical Board of California Web Site, he surrendered his license in November 2003 to resolve a disciplinary action. No practice is permitted.
Neurosomatic medicine
With the term "neurosomatic" Goldstein refers to illnesses which he believes to stem from dysfunctional information processing in the brain. According to him this neurological dysfunction may be caused by "complex interaction of genetic, developmental, and environmental factors". According to Goldstein the dysfunction can be fixed by the use of appropriate neuromodulatory drugs which act on neurotransmitters or their receptors. The term neurosomatic should not be confused with "psychosomatic".
Jay Goldstein is known for his use of medications for off-label uses, such as H2 receptor antagonists for infectious mononucleosis and chronic fatigue syndrome. His practice utilized many different pharmaceuticals in the form of eyedrops and nasal sprays, based on the theory that they directly affect the receptors on the trigeminal nerve. Another peculiar part of his treatment protocol is the administration of several medications with a rapid onset (such as eyedrops, intravenous infusions and mouth swirls) during the course of an office visit, until the patient got better or the time ran out.
Goldstein used over one hundred medications in the treatment of chronic fatigue syndrome. The medications were selected based on the patient's symptomatology, but even more importantly on their reactions to previous treatments, whether positive or negative. He has even devised an "algorithm" to aid the selection of medication, which is detailed in his book Tuning the Brain."
Other illnesses Goldstein considers to be neurosomatic in origin include chemical sensitivity, seborrheic dermatitis, adrenal insufficiency, irritable bowel syndrome, endometriosis, temporomandibular dysfunction, bruxism, carpal tunnel syndromes, reflex sympathetic dystrophy, attention deficit disorder, sleep apnea, interstitial cystitis and "virtually all psychiatric conditions".
Bibliography
* Chronic Fatigue Syndrome: The Struggle for Health (1990)
* Could Your Doctor Be Wrong? (1991)
* Chronic Fatigue Syndromes: The Limbic Hypothesis (1993)
* Betrayal By The Brain: The Neurologic Basis of Chronic Fatigue Syndrome, Fibromyalgia Syndrome, and Related Neural Network Disorders (1996)
* Tuning the Brain: Principles and Practice of Neurosomatic Medicine (2004)
Selected publications
* Goldstein JA. Rapid relief of bizarre and delusional behavior. Psychotherapy. 1973;10(2):159-62.
* Goldstein JA. Lithium and DDAVP in ADD with depression. J Clin Psychiatry. 1983; 44(9):353.
* Goldstein JA. Clonidine as an analgesic. Biol Psychiatry. 1983;18(11):1339-40.
* Goldstein JA. Cimetidine and mononucleosis. Ann Intern Med. 1983 Sep;99(3):410-1.
* Goldstein JA. Hydroxychloroquine for asthma. Am Rev Resp Dis. 1983;128(6):100-1.
* Goldstein JA. Nitroglycerin therapy of asthma. Chest. 1984 Mar;85(3):449.
* Goldstein JA. Calcium channel blockers in the treatment of panic disorder. J Clin Psychiatry. 1985 Dec;46(12):546.
* Goldstein JA. Lithium treatment of central pain. J Clin Psychiatry. 1985 Oct;46(10):453-4.
* Goldstein JA. Danazol and the rapidly cycling affective patient. J Clin Psychiatry. 1986 May;47(3):153-4.
* Goldstein JA. Nonsteroidal anti-inflammatory drugs and panic disorder. J Clin Psychiatry. 1986 May;47(5):277.
* Goldstein JA. Erectile function and naltrexone. Ann Intern Med. 1986 Nov;105(5):799.
* Goldstein JA. Nifedipine treatment of Tourette's syndrome. J Clin Psychiatry. 1984 Aug;45(8):360.
* Goldstein JA. Treatment of chronic Epstein-Barr virus disease with H2 blockers. J Clin Psychiatry. 1986 Nov;47(11):572.
* Heuser G, Mena I, Goldstein JA, et al. NeuroSPECT findings in patients exposed to neurotoxic chemicals. Clin Nucl Med. 1993;18(10):923.
* Goldstein JA, Mena I, Yunus MB. Regional cerebral blood flow by SPECT in chronic fatigue syndrome with and without fibromyalgia syndrome. Arthr Rheum. 1993;39(9) Suppl.:205.
* Goldstein JA. Fibromyalgia syndrome: a pain modulation disorder related to altered limbic function? Baillieres Clin Rheumatol. 1994 Nov;8(4):777-800.
* Goldstein JA. Could low levels of cerebrospinal fluid endothelin explain the vasoconstrictive response to nimodipine seen in pre- and post- treatment brain SPECT of CFS/FMS patients? J Musculoskelet Pain. 1995;3 Suppl 1:14.

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