For elderly with leg cramps, particularly during the night, is there a powder supplement you’d recommend for those having trouble with pills? I’m assuming the issue is either B vitamin deficiency or electrolytes, specifically magnesium. Also, would Kavinace be helpful for this issue in generally healthy 100-year-old?

That’s awesome, 100 years old. We should all be so fortunate. Magnesium, definitely would start there, and you could try ​Natural Calm​, which is a powder-based magnesium citrate supplement. There are also other powdered forms of magnesium, but that is a good starting place. My assumption would be that in this situation ​Kavinace​ could be effective, but I’m not sure. It sounds like you might not have heard that Kavinace has been—and all of the sleep supplements that contain phenibut, which is the one of the main ingredients in Kavinace—have been discontinued because the FDA has now prohibited them from being included in over-the-counter sleep products.

The ingredient that’s referred to as phenibut is 4-amino-3-phenylbutyric acid HCl, which is a form of GABA that does cross the blood–brain barrier, and that’s exactly why it is effective, whereas many other forms of GABA that don’t cross the blood–brain barrier aren’t effective. But I think the FDA decided to remove this from the market because there was the potential of abuse. People taking too much of the Kavinace, using it almost to produce benzodiazepine effects, and then there was some evidence that at very high doses over a long period of time, it could become addictive. Unfortunately, Kavinace and other products that contain phenibut are not going to be available. I think there’s still some online retailers that have stock of Kavinace and are selling it until they run out, but they’re going to have to stop selling it at a certain period.

I think a couple good options for someone at that age, or anyone, actually, who has been taking Kavinace or who you might have been thinking of prescribing Kavinace to would be CBD, cannabidiol. That can have some similar effects in terms of the calming neuron activity in the brain, and then melatonin. Melatonin production declines as we age, and at 100 years old, it’s almost certain that his melatonin production—his or her, I guess, I didn’t see whether it was a male or female—it’s almost certain the melatonin production would be decreased and that he or she would benefit from some melatonin, and so I would try melatonin and CBD.