Vous êtes sur la page 1sur 16

The

Orthomolecular
Treatment of
Schizophrenia:
A Primer for Clinicians
by Jonathan E. Prousky, ND, FRSH
The Canadian College of Naturopathic Medicine
Introduction can cause a clinical syndrome in The majority of schizophrenic
Schizophrenia affects one to normal individuals that would be patients (about 90%) who receive
two percent of the population. clinically indistinguishable from mainstream treatments remain
This disease is characterized by a schizophrenia. unwell and nonfunctional for
combination of perceptual changes Hoffer noticed that mescaline the rest of their lives despite
(e.g., hallucinations) and thought had a similar chemical structure receiving the most advanced drugs
disorder (e.g., delusions).' These to that of adrenaline, and since and social services currently
aberrant mental states, which can both can be converted to available.' Estimates of first
lead to psychotic behavior, cause indoles in the body, the potential episode schizophrenics are a little
a tremendous amount of emotional schizophrenic toxin might be an more optimistic, reporting that of
and psychological suffering. indole derivative of adrenaline five recently diagnosed patients,
The cause of schizophrenia is with similar neurochemical one will recover sufficiently to
the subject of much debate. It is properties to that of mescaline or live an almost normal life without
considered a biochemical disease, LSD. He eventually deduced that medication or with very low doses
although certain genetic factors the schizophrenic toxin was an of medication.*" The economic
most certainly play a role. oxidized derivative of adrenaline costs of schizophrenia to society
The majority of scientists known as adrenochrome. Since the are enormous, amounting to
and psychiatrists subscribe to early 1950s. Hoffer's adrenochrome approximately two million dollars
the dopamine excess theory of theory has been validated due to for each schizophrenic patient over
schizophrenia - that too much the following findings: a 40-year course of the illness.^
dopamine is largely responsible • that adrenochrome and its close In a recent publication
for the symptoms of psychosis. relatives - dopaminochrome examining the economic burden
However, since 1952, Dr. Abram (from dopamine) and of schizophrenia in Canada, the
Hoffer, the founding father of noradrenochrome (from direct and non-direct heath care
orthomolecular medicine, has noradrenaline) - are present in costs associated with this disease
researched, published, and the human brain,'^ were estimated to be 2.02 billion
expanded upon the adrenochrome • that these compounds probably Canadian dollars in 2004.'" In
theory of schizophrenia.'- He and induce a combination of addition, when these figures were
his colleagues, Drs. Osmond and neurotoxic and mind-mood- added to the high unemployment
Smythies, came to this theory by altering effect, and' •' rate with additional productivity,
studyingand researching the effects • that reducing adrenochrome morbidity, and mortality losses,
of substances such as mescaline, and its close relatives is the estimate reached 4.83 billion
lysergic acid diethylamide (LSD), therapeutic for the treatment of Canadian dollars, for a total cost
and amphetamines - all of which schizophrenia.'' estimate of 6.85 billion Canadian

TOWNSEND LETTER - FEBRUARY/MARCH 200


dollars in 2004. The authors of APDs pose the same risks for the Orthomolecular Treatment of
this report arrived at the following development of Parkinsonian Schizophrenia
conclusion: "Despite significant symptoms as do the older APDs." Orthomolecular substances are
improvements in the past decade The majority of schizophrenic found naturally in the human body
in pharmacotherapy, programs, patients are also provided and include amino acids, essentUii
and services available for patients with a supplementary cocktail fatty acids, minerals, and vitamins.
with schizophrenia, the economic of medications consisting of To effectively use orthomoleculai
burden of schizophrenia in Canada benzodiazepines, antidepressants, substances, it is necessary that
remains high." and, sometimes, additional atypical they be prescribed in the correct
The purpose of the report is to APDs. amounts, which typically means
highlight the problems with the Schizophrenic patients taking the use of optimum therapeutic
standard medical treatment of one or two of the atypical APDs dosages that are individualized to
schizophrenia and to demonstrate are at high risk for brain damage, suit each schizophrenic patient.
that the addition of orthomolecuiar cardiac arrhythmias, diabetes The main orthomolecular strategies
medicine provides patients with mellitus, sedation, sexual that are required for the effective
the best opportunity of living a dysfunction, akathisia, and weight treatment of schizophrenia
reasonable quality of life. Common gain.'- Often patients experience include; (1) dietary and lifestyle
orthomolecular treatments are a vague dysphoria from their adjustments; (2) vitamin B3 (niacin
reviewed, including summaries medications, a sense of unease or niacinamide); (3) vitamin C
of relevant clinical studies and that something isn't quite right.** (ascorbic acid); (4) zinc and vitamin
prescribing information. Four Hoffer has written extensively B6 (pyridoxine); (5) selenium: and
patient cases are described to about the side effects caused (6) omega-3 essential fatty acids.
show the reader the potential by the atypical APDs, which he
benefits of this approach, as well as calls the "tranquilizer psychosis." Dietary and Lifestyle
the difficulties with this approach This occurs when patients are Adjustments
when certain essential treatment taken from a psychotic state (with All processed foods, refined
components are lacking. symptoms that are best described sugars, and stimulants (e.g., caffeine
as "hot") to a new medicated and black tea) should be avoided
Standard Medical Treatment of psychotic state (where they now Strict avoidance of common food
Schizophrenia display symptoms that are best allergens (e.g., milk, dairy, wheat
Schizophrenic patients will described as "cold").'-' corn, and eggs) should be highly
remain ill and less capable of Hot symptoms denote extreme considered since about 50% of all
engaging in a normal quality of life changes in personality (e.g., chronic cases of schizophrenia
as long as their treatments involve paranoid delusions, auditory are caused by unrecognized food
only standard medical treatments. and/or visual hallucinations) and allergies.'^ A combination of a bad
Standard treatments use powerful behavior (e.g., agitation and/or diet, poor lifestyle behaviors, and
atypical anti psychotic drugs (APDs) suicidal tendencies) that attract the common food allergens increase.s
such as aripiprazole, clozapine, attention of friends, relatives, and/ the production of adrenaline
olanzapine. quetiapine, and or coworkers. Patients displaying and consequently increases thi
risperidone. These drugs primarily hot symptoms typically receive the production of adrenochrome iii
act on dopamine receptors within medical care they need because schizophrenic patients.'^"'
the central nervous system and their symptoms are so obvious The ideal diet for the majorit\
reduce symptoms of the disease and abnormal. Cold symptoms of schizophrenic patients should
by about 15-20%." Additional are a medicated and dampened be high in protein and fat and low
medications are often prescribed version of the hot symptoms. Even in carbohydrates. Such a diet has
to control the Parkinsonian/ though schizophrenic patients are been clinically proven to correct
extrapyramidal symptoms (e.g., easier to manage while on atypical hypoglycemia, increase the
involuntary movements, tremors, APDs, when their symptoms therapeutic effectiveness of vltamiii
and rigidity) that can result from become cold, they fare no better. B3, and reduce schizophreni(
their use. They remain debilitated by this symptoms.'' Cigarette smokinij,
When they were first introduced, tranquilizer psychosis and will be alcohol consumption, and the use
the atypical APDs were thought unable to live a normal quality of of mind-altering substances (e.g..
to produce less Parkinsonian life unless they are lucky enough to hashish and marijuana) must be
symptoms. However, recent receive adjunctive orthomolecular avoided. Continued use of such
research has demonstrated that, treatments. substances will significantly
at high dosages, the atypical interfere with the effectiveness ol
this approach. >

WNSENO LETTER - FEBRUARY/MARCH 2007


Schizophrenia and NADH are available, then the necessary regulators of this
oxidized adrenaline is reconverted biochemical pathway and should bi
to adrenaline. These back-and- capable of restoring homeostasis
Vitamin B3 forth processes continue to occur Although these findings are ver>
(Niacin or Niacinamide) in the presence of sufficient vitamin important and relevant, they are ntii
B3 coenzymes. However, in the novel. In 1973, Hoffer hypothesize(i
To reduce the production
absence of enough NAD and NADH, that there are defects in thf
of adrenochrome, Hoffer and his
the oxidized adrenaline loses an metabolism of tryptophan and tha!
team decided upon the methyl
additional electron and becomes such defects or deficiencies in tht
acceptor vitamin B3 (either
adrenochrome. This last reaction is ensuing reactions would cause <i
niacin or niacinamide). This
irreversible and presumably occurs back-up of indole metabolites in
vitamin had previously been used
in much greater concentrations in the precursor chain.'^ He further
in to treat pellagra (a disease
the schizophrenic brain. hypothesized that such defects
clinically indistinguishable from
Another potential mechanism would lead to an underproduction
schizophrenia), and it had relevant
for Vitamin B3 has to do with of NAD.
biochemical properties.'- Hoffer
and his team researched the recent postmortem findings of The first report on thi
metabolism of adrenaline. They schizophrenic brain tissues."* therapeutic use of vitamin B3 for
knew that the reaction involving In this report, an upregulation schizophrenia was presented in 19.SL'
noradrenaline to adrenaline of the enzyme tryptophan 2,3 at the Saskatchewan Committei
required the addition of one dioxygenase (TD02) was found on Schizophrenia. At this meetins^
methyl group. Vitamin B3 was among schizophrenic patients but eight cases were presented, eacli
known to function as a methyl not among the controls who were demonstrating favorable effect .^
acceptor. Hoffer's team thought examined. The brain tissues of the from giving one to ten grams (g) ol
that an optimum dose of niacin schizophrenic patients showed vitamin B3 and, in the majority <n
might decrease the amount of significant elevations of kynurenine cases, equal amounts of vitamin C,
noradrenaline that would be (1.9 fold, p = 0.02), TD02 mRNA (1.7 After a more involved pilot stud>
converted to adrenaline. Since fold, p^O.049), and the density of of 29 patients also demonstrated
adrenochrome was thought to be an TD02-positive white matter glial excellent therapeutic responses t(>
oxidized derivative of adrenaline, cells (p=0.01). In schizophrenia, vitamin B3,' the first double-blind
vitamin B3 could help to reduce the TD02 enzyme was found placebo-controlled experiment
the quantity of adrenochrome to be upregulated, causing an in psychiatry was undertakeii
by limiting the production of over-production of pathway to assess whether or not this
adrenaline. intermediates (e.g., kynurenine). vitamin was effective. The stud>
This upregulation might be which began in 1952 but was noi
Hoffer and his team also responsible for the evolution of published until 1957, involved 'M^
discovered an additional bio- some schizophrenic symptoms. acute schizophrenic patients who
chemical property of vitamin Instead of linking this upregulation were each randomized to placebo
B3 that would help to explain its to some defective factor in the niacinamide, or niacin.'- They werr
therapeutic efficacy. Vitamin B3 Is a TD02 gene, the authors suggested given 1 g three times daily for 3ii
precursor to nicotinamide adenine that it might be due to a diminished days, and then followed for om
dinucleotide, which is present in niacin effect - possibly the result of year. After the year, the patients
both oxidized (NAD) and reduced depressed production or reduced given vitamin B3 with the standarii
forms (NADH) in the body. In the signal transduction via the niacin treatments at that time had mon
brain, adrenaline becomes oxidized receptor. They recommended than double the recovery ratr
and loses one electron to become that niacin or its congeners are (80%) compared to patients in
oxidized adrenaline. If enough NAD the placebo group (33%). Table 1
summarizes the findings from this
Table 1. Summary of the First Clinical Study Using Vitamin B3 initial clinical study.
Number on Number Sent Other clinical studies sooi i
Days in Eiectroconvulsive to Weyburn Number followed that involved more patients
Treatment Number Hospital Treatment (ECT) (Mental Hospitai) Well and longer treatment durations
Placebo 9 63 6 0 3 The goals were to validate the initia I
Niacin 10 60 7 1 8 findings and ascertain if there wen
other benefits and therapeutic
Niacinamide 11 72 7 2 9
effects from the administration
(Adapted from; Hoffer A. Vitamin 8-3 & Schizophrenia. Discovery. Recovery. Controversy. Kingston, Ontario:
Quarry Press. Inc,;1998:51, These findings were first reported in: Hoffer A. Osmond H, Callbeck MJ. Kahan 1.
of vitamin B3. In 1955, Hoffer and
Treatment of schizophrenia with nicolinic acid and Nicotinamide, J Ctin Exp Psychopath. 1957:18 131-158. 1 his team reported on their results

TOWNSEND LETTER - FEBRUARY MARCH 2


involving 171 patients: 73 patients data involved the following groups
received vitamin treatment with of patients: (1) those who only took
Schizophrenia
niacin or niacinamide and were vitamin B3 while in the hospital and
compared to 98 patients having not in the community; (2) patients when in the hospital and in the
received standard treatment (i.e., who did not take vitamin B3 when community.
a combination of ECT. insulin in the hospital but did take the Hoffer followed patients from
subcoma, and psychotherapy).' vitamin when in the community; (3) 1953 to 1960 and published a total
(Table 2 summarizes these patients who took vitamin B3 when of six double-blind, randomized
findings.) They concluded, "When in the hospital and community; and controlled clinical trials. All these
used in adequate dosages, nicotinlc (4) patients who never took vitamin trials confirmed the positive effects
acid and nicotinamide materially
contributed to the recovery of
schizophrenic patients." Vitamin The results of this review demonstrated
B3 reduced the number of suicides
to zero and imposed much less that patients who had taken vitamin B3
of a burden upon the health care
system, since less patients in the
fared much better than patients who were
vitamin group were sent to the not given the vitamin.
mental hospital and subsequently
spent less time in the mental
hospital upon admission. B3. The results demonstrated that that vitamin B3 had upon the
patients in the community who recovery of acute schizophrenic
In their second double-blind, patients and verified that the use of
were taking niacin (groups 2 and
placebo-controlled experiment, this vitamin substantially reduced
3) had more community years that
Hoffer and his team used only niacin patients' reliance upon the health
were free of readmissions compared
and placebo.'^" The study lasted 33 care system.- Hoffer even followed
to patients not taking vitamin B3
days and involved 82 patients (43 patients who were being treated by
(groups 1 and 4): 91% versus 62%
in the placebo group and 39 in the other psychiatrists from October
of the community years free of
niacin group). (The results of this 1. 1955 to December 31. 1962.' The
readmissions. The entire niacin
study are summarized in Table 3.) results of this review demonstrated
group (group 3) was readmitted 38
As can be seen, vitamin B3 once that patients who had taken
times for 67 readmissions (average
again contributed significantly to vitamin B3 fared much better than
was 64 days per patient), and this
the recovery of acute schizophrenic patients who were not given the
was much better than the placebo/
patients. vitamin. The patients on vitamin B3
non-niacin group (group 4) that
Other parameters were was readmitted 36 times for 81 had fewer hospital readmissions,
evaluated and reported by Hoffer readmissions (average was 147 days required hospitalization for fewer
and his team including the number per patient), Once all the data was days, and had no suicides.
of patients readmitted, the number combined, the results revealed that In terms of treating chronic
of readmissions, the number of the most five-year cures and best schizophrenic patients, Hoffer's
patients well or much improved, treatment responses were among early studies did not show a
and the number of patients who the patients who took vitamin B3
were considered cured.''" This
Table 2. Effects of Vitamin 63 Against Standard Treatment

Group Number Mean Days Number Sent to Mental Hospitai Mean Days Number of
in Hospital After Treatment in Mental Hospitall Suicides
Treatment 73 63 7 234 0
Comparison 98 50 47 319 4
(Adapted from: Hoffer A. Niacin Therapy In Psychiatry. Springfield, IL: Charles C Thomas: 1962:108.)

Table 3. Results from the Second Double-Blind, Controllec1 Experiment

Group Number Mean Number that Mean Number of Days Not Improved
Age Received ECT in the Hospital Improved (Percentage Improved)
Placebo 43 31.9 21 73.8 25 18(41.9%)
Niacin 39 30.3 15 72 8 31 (79.5%)
(Adapted from: Hoffer A. Niacin Therapy In Psychiatry. Springfield, IL: Charles C Thomas; 1962:42-46.)

WNSEND LETTER - FEBRUARY/MARCH 2007


Schizophrenia including both acute and chronic under close supervision.^^ [n my
patients, need to be treated with clinical experience, niacin is more
vitamin B3 as quickly as possible effective and better-tolerated than
favorable response among chronic and for the duration of their niacinamide for schizophrenia.
schizophrenic patients who were lives. Vitamin B3 treatment offers Some patients prefer niacinamide,
ill longer than one year. However, significant hope of a reasonable since it does not cause flushing
when Hoffer reviewed this problem quality of life among patients as well as the other cutaneous
more substantially, he discovered who would otherwise remain reactions. Nausea and dry mouth
that the treatment duration was incapacitated and in and out of are much more common with
not long enough to have produced hospitals for the remainder of their the use of niacinamide than with
adequate results. Chronic patients lives. niacin. The daily dosages of
required vitamin B3 treatment for The starting dose of niacin for niacinamide should not exceed
five or more years in order to derive adults is 1000 milligrams (mg) three 6,000 mg, since the likelihood of
observable benefits.' -' In one study times daily. In my opinion, the daily nausea accompanied with vomiting
involving 32 chronic patients, dose needs to be slowly increased is much greater.-'*
all the patients failed to respond to 4,500-18,000 mg to achieve the
to vitamin B3 after two years best possible outcome. Patients Vitamin C (Ascorbic Acid)
of use. Nineteen of the patients need to be educated about the In their early pilot and
discontinued the vitamin, and the flushing, heat, itchiness, pruritis, controlled clinicai studies. Hoffer
remaining 13 patients continued redness, and tingling that they and his team also used vitamin
with the vitamin treatment. Data will transiently experience. These C since its powerful antioxidant
was obtained for the years, 1956- benign cutaneous reactions usually properties would also diminish
1957, 1958-1959. 1960-1961, 1962- begin 15 minutes after taking the double oxidation of adrenalin
1963. and 1964.' Of the patients niacin for the first time, and are to adrenochrome and prevent its
not on niacin, the mean number first noticed around the forehead, auto-oxidation in critical brain
of days spent in hospital were 691 then descend to the thorax, and areas.--' This vitamin is also an
compared to 79 in the niacin group. sometimes to the feet. These effective anti-stress nutrient that
Also, the proportion of time spent reactions typically abate in one to helps schizophrenic patients
in the hospital was substantially two hours following the ingestion cope more effectively.-' There is
less for the chronic patients who of niacin. Niacin causes these recent evidence that high-dose
remained on the vitamin. cutaneous reactions by inducing the vitamin C (3,000 mg of sustained-
In a more recent analysis of 27 production of prostaglandin D^ in release daily) is indeed an anti-
chronic schizophrenic patients who the skin, leading to vasodilation and stress nutrient, since it was able to
had been under treatment for at a marked increase of its metabolite, subjectively reduce psychological
least ten years, consistent treatment 9a, UP-PGF2. in the plasma.-^ Niacin stress, decrease blood pressure,
with vitamin B3 produced the is its own anti-flushing agent, and and lower cortisol levels in healthy
following results: 11 patients were taking it regularly depletes the skin men after 14 days of use.-" A report
able to work: two patients were of prostagiandin D2 and prevents by Smythies described additional
able to marry and look after their subsequent cutaneous reactions. At roles that vitamin C has upon
families and homes; two patients 3,000 mg daily, the flush and other the brain including the following:
were single mothers able to take symptoms will cease to be an issue (1) its ability to protect NMDA
care of their children; and three following the first two to three days receptors from glutamate toxicity
patients were able to manage their of treatment and will practically within the brain; (2) its antagonism
own businesses.-' These results are disappear thereafter. If patients of the effects of amphetamines;
remarkable when one considers are not consistently taking these (3) its enhancement of older
the state of these patients prior high-milligram doses throughout APDs like haloperidol; and (4)
to receiving orthomolecular care. the day, they will continually its ability to prevent the auto-
The average age of these patients re-experience these cutaneous oxidation of dopamine to its toxic
was 40. The majority of them had reactions. The concern over liver derivatives.^^ Vitamin C also
been ill for seven years before toxicity is very minor if immediate- conserves intracellular glutathione
they sought treatment from Hoffer, release niacin preparations and is likely a redox glutathione
and all had been unresponsive to are used.-'-"' Sustained-release cofactor.^" This is important since
previous treatments. preparations (and likely other glutathione S-transferases are
preparations such as timed- or important enzymes that facilitate
If one is to look at the enormity slow-release ones) can cause liver the conjugation of glutathione to
of this data, as I have, the only toxicity and are not recommended adrenochrome. dopaminochrome,
reasonable conclusion to be made for schizophrenic patients unless and noradrenochrome and render
is that all schizophrenic patients.

BEST OF NATUROPATHIC MEDICINE Y/MARCH


these toxic metabolites non-toxic that a combination of genetic and
nutritional-environmental factors
Schizophrenia
by the production of unreactive
glutathione conjugates.^' The gene cause a higher degree of "tissue "schizophrenic patients require
for glutathione S-transferase is unsaturation" among the acute higher levels of vitamin C than the
defective in schizophrenia.^ I believe schizophrenic patients. suggested optimal ascorbic acid
that this defect might be partially In another study using chronic requirement for healthy humans."
remedied by supplementation with schizophrenic patients, the plasma
high dosages of vitamin C, which and urinary vitamin C levels of Vitamin B6 (Pyridoxine) and
would preserve glutathione in its 35 schizophrenic patients were Zinc
reduced state and increase the compared to an equal number of Many schizophrenic patients test
amount of available glutathione controls.'' All subjects were given positive in the urine for a compound
that could be used for the synthesis the same hospital diet and 70 mg known as kryptopyrrole, which is
of the glutathione S-transferase of vitamin C daily for four weeks. associated with physiological and/
enzyme. Baseline plasma vitamin C values or psychological stress.''' Hoffer
Vitamin C should be prescribed were lower in the schizophrenic compiled data from thousands of
at 1,000 mg three times daily and patients (p < 0.05), but normalized patients and found abnormal levels
then eventually increased to the to be approximately the same as of kryptopyrrole in the urine of
sub-laxative dose. There are reports the control group values after different types of psychiatric and
suggesting that acute and chronic the four weeks of treatment. The non-psychiatric disorders (Table
schizophrenic patients require mean vitamin C levels as measured
in a six-hour urine collection 4).'
more of it. In one study, the fraction Kryptopyrrole combines ir-
of urinary vitamin C was evaluated were different among the low
excretors of both groups, and reversibly with pyridoxine and
in 44 recently hospitalized acute then with zinc, and this creates a
schizophrenic patients and was this difference reached statistical
significance (p<0.05) - 15.9 mg for combined deficiency syndrome.^^'
compared to 44 other subjects Some common clinical symptoms
serving as the control group.-'- schizophrenics and 39.5 mg for the
controls, When all theschizophrenic of patients having high amounts
All the subjects were given 1.76 of kryptopyrrole in their system
g of vitamin C orally and had and control subjects were given a
loading test of 1 g of vitamin C after are white areas in the fingernails,
their urinary levels of vitamin C stretch marks on the body, and
measured every two hours during the four weeks of 70 mg of oral
vitamin C daily, the schizophrenic female premenstrual syndrome."
a six-hour collection period. The Many of the clinical features of
schizophrenic patients differed patients continued to excrete lower
amounts of vitamin C in their urine patients excreting high amounts
significantly from the control group of kryptopyrrole resemble those of
in their elimination of ascorbic compared to the control values.
After the loading test, the plasma schizophrenia.'^ Even though it is
acid. Seventy-six percent of the possible to test for this compound,
schizophrenic subjects were low levels of vitamin C were different,
with the schizophrenic patients I choose not to do so, and I
excretors, which means that less prescribe these nutrients to all of
than 17% of the administered oral having a lower mean value than
the controls (p<0.05). After one my schizophrenic patients. They
dose of vitamin C was recovered are relatively free of side effects
in their urine samples. This result month of supplementation with 1
g of vitamin C, the plasma levels of and often help to reduce symptoms.
was 2.5 times the incidence of the The daily dosages that 1 routinely
control group, which demonstrated each group equalized, as did their
six-hour urinary excretion rates. prescribe are 250 mg of pyridoxine
that only 30% from this group were and 50 mg of zinc. ^
low excretors. The authors of this study were in
agreement with the hypothesis that
In this same study, the low
excretors of both groups were
given additional vitamin C for Table 4. Psychiatric and Non-Psychiatric Groups with
seven days (approximately 10 Abnormal Urine Levels of Kryptopyrrole
g), and urine samples were Group Percentage with Abnormal Urine Levels
collected on the eighth day. In the
control group, the low excretor Acute schizophrenics 75
group went from 7/16 to 5/16 and Chronic schizophrenics 50
remained essentially unchanged. All non-psychotics 25
In the schizophrenic group, the
Physically ill patients 5
low excretors decreased from 9/11
to 3/11, a substantial change. The Normal subjects 0
authors of this study concluded Recovered schizophrenics

OWNSEND LETTER - FEBRUARY/MARCH 2007


Schizophrenia glutathione peroxidase activity,
and ensure the proper production
Omega-3 Essential Fatty Acids
from Fish - Docosahexaenoic
and action of prostaglandins. In Acid and Eicosapentaenoic Acid
Selenium that same report, Foster discussed Schizophrenia is characterized
I recommend that all the relationship between niacin by lipid membrane abnormalities
schizophrenic patients take 200- and selenium, in that niacin being (a.k.a., the phospholipid membrane
400 micrograms (meg) of selenium a methyl acceptor might slow hypothesis) that include
daily. Several published reports down the metabolism of selenium abnormal brain phospholipid
indicate a potential need for this (since its metabolism involves turnover, increased levels of
trace mineral among schizophrenic methylation) and prolong its action phospholipase A2, reduced niacin
patients. In one report. Brown in the body. Berry was the first to skin flush response, abnormal
and Foster linked a deficiency of report on the potential relationship electroretinogram, and reduced
this trace mineral to an increased between selenium and niacin.'* He cell membrane levels of omega-3
and omega-6 polyunsaturated fatty
acids.^"^' Fish oils, particularly
Regardless of when the orthomolecular the eicosapentaenoic acid (EPA)
content (as opposed to the
treatments begin to demonstrate their docosahexaenoic acid [DHA]), have
been shown to help with both the
effectiveness, it Is paramount that, positive (e.g., hallucinations and
delusions) and negative symptoms
once initiated, they are never discontinued. (e.g., flat affect, depression, and
isolation) of schizophrenia when
prevalence of schizophrenia in reported that a certain sub-type used as an adjunct to standard
regions of the United States where of schizophrenia might be due to treatment.'- The optimal daily dose
fodder crops had the lowest levels a defective selenium transport should provide at least 2 g of EPA.
of selenium.-"' They calculated the protein and to low levels of this
selenium-related relative risk to trace mineral in the body. Niacin's Treatment Strategies
be 1.77:1 in these areas. According antipsychotic properties, according Even though all the nutrients
to these authors, some of the to Berry, are possibly due to its just described are essential, the
biological consequences ol selen- prolongation of selenium within the most important are vitamins B3
ium deficiency (i.e., prostaglandin body, which would correct both and C. I recommend that these
imbalances, viral mutation, the defective transport protein and particular vitamins be given to
excess 12-HPETE production, and its deficiency. schizophrenic patients initially,
decreased glutathione peroxidase Foster also reported on an and the others then added over
activity) might be related to the additional reason why selenium several months. Of course, success
etiopathology of schizophrenia. would appear to be useful for the is invariably dependent on the
They also reviewed additional treatment of schizophrenia.•'•' He patient's willingness to comply and
evidence of a negative correlation noted some evidence that showed the skill of the prescribing clinician.
in schizophrenic patients between that the desiccated or pure form of Compliance is a significant issue
glutathione peroxidase activity thyroid hormone achieved better with all schizophrenic patients.
and brain damage (i.e., brain cure rates for schizophrenia when At the beginning of this report. I
atrophy and increased ventricle- compared to untreated patients mentioned that one out of five first-
brain ratios), which was not found and to patients receiving standard episode schizophrenic patients
among a group of controls. In tranquilizers. He suggested that have a chance at living a near-
another report, Foster suggested the triiodothyronine component normal existence. Of the remaining
that selenium might be tried as accounted for the favorable four, only one patient will comply
a treatment for schizophrenia clinical results, as this hormone with his medications; one patient
since it protects against free would reverse the toxic effects of will not take his medications
radical damage and is probably excess adrenochrome. Since the continuously due to side effects:
antagonistic to adrenaline and deiodinase enzyme that converts and the remaining two patients
therefore to adrenochrome." He thyroxine to triiodothyronine will be lost to follow-up.^ They
also hypothesized that, when requires selenium, he hypothesized need to be informed that their
supplementing with essential that an effective treatment protocol orthomolecular treatments are
fatty acids, selenium is essential, should include both selenium and equally as important as are their
as it would prevent the excessive thyroid hormone. antipsychotic medications. Results
oxidation of the fatty acids, restore are sometimes seen after the first

TOWMSEND LETTER - FEBRUARY/MARCH 2007


two months," and sometimes three 1. Freedom from signs and Schizophrenia
to six months are necessary before symptoms (1 point)
clinical benefits are observed.*' 2. Ability to get on reasonably well
For chronic patients having had with family (1 point) disease, they will have greater
schizophrenia for five or more 3. Ability to get on reasonably well chances of recovering. According
years, the necessary treatment with the community (1 point) to Hoffer's eariy placebo-controllec!
time is at least five years before 4. The ability to work at a job or clinical trials and his many
benefits are noticed. Regardless
of when the orthomolecular
to be productive in the same
manner as before the illness
published clinical reports spanning
more than 50 years, patients can I
treatments begin to demonstrate struck expect certain prognoses once
their effectiveness, it is paramount orthomolecular treatments are
Patients who have never been
that, once initiated, they are never initiated.'^ Table 5 indicates the
engaged in some type of job or
discontinued. Medications should expected results from the addition
productive work can be judged
likewise not be discontinued but, of orthomolecular treatments to
by their ability to perform any
with the cooperation of the patient's the standard approach.
useful work. (1 point)
psychiatrist, can be reduced very
slowly over the course of many Patients are categorized as Schizophrenic Cases
months to several years once "well" if they have achieved 4 I have chosen four cases from
the orthomolecular treatments points, "much improved" if they my naturopathic medical practice.
are helping. Abrupt cessation of achieved 3 points, "improved" The first two cases represent the
atypical APDs will cause a relapse, when they have achieved 2 points, effectiveness of this approach. The
as will too much of a decrease and "not improved" if they only latter two cases demonstrate the
or too early of a decrease in acquired 1 point. I also use a difficulties that patients and their
medication. The orthomolecular questionnaire, known as the HOD families have with this approach,
approach requires a tremendous test (Hoffer-Osmond Diagnostic especially when necessary
amount of patience from the test for schizophrenia), to monitor treatment components are missing
prescribing clinician, since results and evaluate my patients. This or not sufficiently followed.
take a long time to materialize. true/false test assesses the
Likewise, schizophrenic patients overall intensity of the disease by Case#l
and their respective families and/ providing a total score (TS). The This 24-year-old female first
or caregivers need to have the HOD test also provides scores for presented to my private practice on
necessary patience and motivation common schizophrenic symptoms October 1, 2005. She was formally
to stay the course. of perception (PerS), paranoia diagnosed with schizophrenia
(PS), and depression (DS). If a in March 2005 when she was
Measuring Patient Progress and patient achieves a high TS (>30) hospitalized for two-and-a-half
Prognosis or a high score (>3) in any of the months due to paranoid ideation
Once orthomolecular treatments individual categories, this would that involved worries about
are started, how is the clinician indicate pronounced illness. Once being poisoned, social isolation
able to monitor his/her patients' orthomolecular treatments begin and withdrawal, and significant
progress? Hoffer has published to show effectiveness, the scores impairments in maintaining
a practical system that can be decrease. This test has been shown healthy relationships. Prior to her
used to determine how a patient to be valid in terms of its ability to formal diagnosis, she reported
is responding to orthomolecular detect (diagnose) schizophrenia several years of intermittent
treatments.-' He has four measures and to assess the severity of the paranoid ideation; she had abused
of recovery: drugs such as cocaine, heroin,
and methamphetamine, felt that
In terms of prognosis, if the certain noises were causing her
orthomolecular program is started to be crazy, thought she could
early in the course of the patients'

Table 5. Expected Results from Orthomolecular Treatments

I
Group Duration of Treatment Well and Much Improved
Sick one year, or in second or third relapse Up to one year 90%
Sick two to five years Up to five years 73%
Sick over five years, but out of mental hospital Five or more years 50%
Sick over five years and in mental hospital Five or more years 25%

TOWNSENO LETTER - FEBRUARY/MARCH 2007


Schizophrenia enough. In November 200,5. she
was hospitalized a second time for
patient's response to the adjunctive
orthomolecular treatments.
severe auditory hallucinations, but This patient has continued
read people's minds, and felt only for the night and was then to do exceptionally well. In June
unable to hold down jobs. During discharged the next day. At the time 2006, I wrote to her family doctor
the previous six years, she was of my initial consultation, she was about the benefits of thyroid
enrolled in a geography program unemployed and unable to pay for medication for the treatment of
at Carleton University in Ottawa, her rent and other living expenses. schizophrenia (Hoffer, 2001b). The
but had to drop out since she could She was living part of the time with patient was prescribed desiccated
not handle the course load. She her mother, but would also live in thyroid and has been taking it
had some boyfriends while living an apartment that was financed by daily. I also corresponded with her
in Ottawa, but the relationships her mother. Although she was not psychiatrist, and in early June 2006
failed since she became very acutely psychotic, she continued her olanzapine was reduced to 20
suspicious of each boyfriend and to exhibit schizophrenic symptoms mg daily. As of my last visit with
thought he was trying to poison such as social isolation and her. August 20. 2006, she remained
her. She also thought her family frequent auditory hallucinations. well and free of all schizophrenic
members were out to poison her She was taking 1 mg of risperidone symptoms. Even though her initial
and that her mother wanted her and 30 mg of olanzapine at that HOD scores were within normal
dead because she was not Jewish time. Table 6 sumnfiarizes the limits, they must have been

Table 6. Case #1: Patient's Response to Adjunctive Orthomolecular Treatments

Consultation Dates October 1, 2005 November 26. 2005 January 21, 2006 May 27, 2006

Clinical Presentation Regularly hearing More engaged with her Psychiatrist approved Working at a major
voices, unable to attend family. Heard voices the reduction in meds. Montreal hotel and has
University full-time one to two nights Patient no longer gained acceptance to a
(taking one course), during the past month. hearing any voices. community college for
antisocial behavior. Continues to watch lots is full of energy and hotel management. No
watching lots of TV, and of TV, but wants to start is exercising three schizophrenic
sleeping more than 11 volunteering next week. times each week. symptoms.
hours each night. In the last month, had Quit smoking since
pizza once, avoided November. Received a
all alcohol, and only B+ last semester and
smoked two to three is enrolled in another
cigarettes. course.

Current Psychiatric 1 mg of risperidone and Same. 1 mg of risperidone and 1 mg of risperidone and


Medications 30 mg of olanzapine 25 mg of olanzapine 25 mg of olanzapine
daily daily. daily.

Orthomolecular 3 g of niacin, 3 g of Increased niacin to 2,000 Added 200 mg daily of Plan was modified to
Treatments & Plan vitamin C, 250 mg of mg three times daily. Ginkgo biloba extract. include 500 meg of
pyridoxine, 50 mg of Added a caffeine-free Instructed patient to chromium twice daily.
zinc, 2 teaspoons of extract of green tea to continue with the current and herniacin was
highly concentrated help with acne. Letter program. Discontinued increased to 6,500 mg
fish oil, and 5 mg of sent to psychiatrist about the methylcobalamin daily
methylcobalamin. Patient reducing olanzapine to due to acne.
advised to quit smoking 25 mg daily.
and cut out all dairy,
wheat, and alcohol.

HOD Results Not Assessed.


TS (normal <30) 27 13 3
PerS (normal <3) 4 4 4
PS (normal <3) 2 0 2
DS (normal <3) 0 0 0
Category of Recovery Not improved. Improved. Well. Well.

TOWNSEND LETTER - FEBRUARY/MARCH 200


abnormal for her, since she was program in the fall of 2006. and her Schizophrenia
very symptomatic, and her clinical disease is clinically in remission.
picture improved dramatically as I instructed her to remain on Case#2
these scores decreased. In August the current program and to not This 36-year-old male patient
2006, I spoke with the patient's change anything without first presented to the Robert Schad
mother about her daughter's consulting me. She will still have Naturopathic Clinic on May 23.
progress. The mother said that regular visits with me, but not as 2006 with a chief complaint
the "orthomolecular treatments frequently. I expect her to remain of schizophrenia. I supervise
have given her daughter back well, for she has not had a relapse naturopathic interns on this clinical
her life." Per her mother's report, since commencing treatment. She shift, so a fourth-year clinical
the patient is a lot slimmer, had a has many of the essentials of good Intern and myself evaluated thi.s
boyfriend during the summer, and response, which include a strong patient. The patient's goal was to
is working every day and paying all desire to get well, the cooperation eventually get off his medication
of her expenses including rent and of an open-minded psychiatrist, due to troublesome side effects
groceries. She is looking forward and a very supportive and caring of fatigue and weight gain. Since
to starting a community college family. January 2006, the patient was

Table 7. Case #2: Patient's Response to Adjunctive Orthomolecular Treatments

Consultation Dates May 23, 2006 May 30. 2006 July 25, 2006 August 15, 2006

Clinical Presentation Very talkative. Expressed strong Hearing fewer voices Continues to experience
disorganized speech, desire to get off his than the previous visits. fatigue. His voices are
and thought blocking. medications. Very Continues to be tired still present, but remain
Described his drowsy and sleeping and fatigued most of the as per the last visit.
schizophrenia as some ten to 12 hours each time, which he feels is Continues to be very
type of gift from God. day. Complained of due to the medication. Is interactive with coherent
Also believed that there muscular contractions sleeping ten to 12 hours speech and less thought
were supernatural around his head, which each day. More coherent blocking.
beings and angels he felt was due to the speech and less thought
following him and medication. Believed blocking.
looking after his that he has clairvoyant
well-being. Described abilities.
various instances of
seeing supernatural
beings that no one else
could see.

Current Psychiatric 450 mg of clozapine Same. Same Same.


Medications daily.

Orthomolecutar None prescribed. 1,000 mg of both niacin 2,000 mg of niacin Given an intramuscular
Treatments & Plan and vitamin C three three times daiiy. injection of vitamin
times daiiy. Omega-3 Vitamin C the same as B12 (1,000 meg). Letter

I
fatty acids providing before. Ginkgo biioba sent to patient's
a daily dose of 3,600 extract at 240 mg psychiatrist requesting
mg of EPA and 1,800 daily. Added 250 mg of a minor decrease in his
mg of DHA. Given an pyridoxine and 50 mg medication to 425 mg
intramuscular injection of zinc. daily.
of vitamin B12 (5,000
meg).

HOD Results Not assessed. Not assessed.


TS (normal <30) 32 5
PerS (normal <3) 11 1
PS (normal <3) 2 0
DS (normal <3) 2 1

Category of Recovery Improved. Improved. Improved. Improved.

TOWNSEND LETTER - FEBRUARY/MARCH 2007


Schizophrenia included loxapine, quetiapine, could not be ascertained due to the
olanzapine, and risperidone. He patient's difficulties with timelines.
was also given lorazepam in the During the initial interview, he was
on clozapine at a daily dose of past, but was no longer taking it. very talkative, had disorganized
450 mg. He was required to get His most recent hospitalizations speech, and demonstrated
blood tests every two weeks due were in January and March of thought blocking. He described his
to the potentially life-threatening 2006. He was considered a chronic schizophrenia as some type of gift
agranulocytosis. Previously, he patient since his schizophrenia from God. He also believed that
had been resistant to a number had lasted more than five years, there were supernatural beings
of antipsychotic medications that but the year of his initial diagnosis and angels (which he could see)

Table 8. Case 3: Patient's Response to Adjunctive Orthomolecular Treatments

Consultation Dates August 30, 2004 September 18. 2004 October 16. 2004 November 13, 2004

Clinical Presentation Thought blocking, Patient was more Auditory hallucinations Patient reported
difficulty concentrating. positive and motivated have stopped smoking less. Living
difficulty answering compared to the - no longer hearing in new group home,
routine questions, initial visit. Reported death threats in his and has more privacy.
and comprehension some muscle tension head. Reduced the Is volunteering as a
problems. Reported in his neck. Was niacinamide to 1,500 salesperson. Auditory
constant auditory encouraged to remain mg daily. Anxiety hallucinations continue
hallucinations, on all the prescribed has decreased, and to be absent. Anxiety
and some visual supplements. patient exhibited better and diaphoresis have
hallucinations. Very eye contact. Less not worsened since the
anxious, restless and diaphoretic than the last visit.
visibly diaphoretic initial visit.

Current Psychiatric 20 mg of olanzapine Same. Same. 1 mg of risperidone at


Medications daily, 0.5 mg of bedtime in addition to
clonazepam twice daily, the other medications.
1 mg of apobenztropine
daily, 37.5 mg of
venlafaxine, and an
injection of 40 mg
flupenthixol every 2
weeks.

Orthomolecular 1,000 mg of Niacinamide was Patient instructed to Niacinamide was


Treatments & Plan niacinamide three reduced to 1,000 mg stay on all supplements. discontinued. 1.000 mg
times daily, 1,000 mg of twice daily. Was also Was given an of niacin three times
vitamin C three times prescribed 500 meg of intramuscular injection daily was prescribed.
daily, 2 teaspoons of chromium three times of 5 mg of folic acid and Given an intramuscular
liquid fish oil (2,100 daily, to help with the 1,500 meg of vitamin injection of 5 mg of folio
mg of EPA and 1,500 hypertriglyceridemia. B12. acid and 1.500 meg of
mg of DHA), 50 mg of weight gain, and vitamin B12.
zinc, and 250 mg of dysinsulinemia
pyridoxine. associated with the
use of atypical APDs.
He was given an
intramuscular injection
of 5 mg of folic acid and
1,500 meg of vitamin
B12.

HOD Results Not assessed. Not assessed.


TS (normal <30) 50 36
PerS (normal <3) 10 6
PS (normal <3) 10 4
DS (normal <3) 1 5

Category of Recovery Not improved. Not improved. Not improved. Improved.

TOWNSEND LETTER- FEBRUARY/MARCH


following him and looking after questions. He sweated profusely Schizophrenia
his well-being. He lived with his during the visit and frequently
parents who were doing whatever drank water from a large water he was finally able to engage
they could to make his life as bottle. He was having constant in some type of regular work.
productive and comfortable as auditory hallucinations and His HOD scores reflected these
possible. Table 7 summarizes the occasional visual hallucinations. He clinical improvements as well. His
patient's response to the adjunctive described himself as an antisocial "Category of Recovery" went from
orthomolecular treatments. person. He was living in a group "not improved" to "improved" in
This patient has not been on the home for mentally ill patients, under three months of treatment.
orthomolecular program for a long but purposely kept his distance Sadly, from the early part of
time. Since my initial consultation, from the other residents. He was December to February 2005, the
he has shown a positive response
by having fewer auditory
hallucinations. This change was also The orthomolecular approach requires a tremendous
reflected by the decreases in his amount of patience from the prescribing clinician,
TS and PerS HOD scores. To derive since results take a long time to materialize. Likewise,
the most benefits, he will need
to remain on the orthomolecular schizophrenic patients and their respective families and/
program for at least five years, but or caregivers need to have the necessary patience and
the duration of his life would be motivation to stay the course.
preferable. Although his "Category
of Recovery" did not change in
this short time, he showed modest not exercising regularly and was patient was very inconsistent with
improvements and was able to smoking 12-15 cigarettes daily. He the orthomolecular treatments
complete his examination for a was last employed in 2000 as a and even did some drugs for a
plumbing license. I believe he has bus boy, which involved washing few weeks during the Christmas
a very good chance of recovering dishes and cleaning up, but this holidays. He had a significant
since he has the necessary only lasted a few months. His relapse that caused a return of his
components for favorable response goals were to eventually get off his previous symptoms, including the
(e.g., a supportive and caring medications, to experience fewer constant auditory hallucinations.
family, proper psychiatric care, and side effects, to live independently, In each visit with me, the
orthomolecular treatment). and to work. He also reported patient expressed a dislike for his
having anxiety, difficulty breathing, living situation. He lived in three
Case#3 light sensitivity, a feeling of not different residences during the six
This 30-year-oId male patient being grounded, and problems with months of active orthomolecular
presented to my office on August involuntary movements. Table 8 treatment. On numerous occasions,
30, 2004. He reported that his summarizes the patient's response I expressed concern about his
schizophrenic symptoms began to the adjunctive orthomolecular living situation with each of his
when he was 15 years old. At that treatments. parents. I explained to his parents
time, he was having paranoid On November 25, 2004, a that this treatment would work
thoughts that involved abduction letter was sent to the patient's best if their son were provided
and death threats. For the next psychiatrist. After reviewing the with a decent place to live, privacy,
eight years, his symptoms letter, the psychiatrist discontinued security, and encouragement to
progressively worsened, and by the antipsychotic injection, the follow through with the treatments.
risperidone, and the venlafaxine. I recommended that the patient live
1997. he was having constant visual with one of them for at least three
hallucinations. In that same year, he The patient remained on the same
doses of apobenztropine and to six months, after which, he would
had a difficult time dealing with the likely learn to comply on his own.
end of a relationship with a woman. clonazepam, but the olanzapine
was increased to 30 mg daily. Neither parent would allow him to
He was hospitalized in December live at their respective places of
of 1997 and has been hospitalized He was also prescribed 50 mg of
fluvoxamine daily. Overall, the residence. I also discussed the
15 additional times, with the latest relationship between nicotine and
one occurring in March 2004. In addition of the orthomolecular
treatments allowed this patient to vitamin B3, in that smoking reduces
1998, the patient was formally the clinical effectiveness of the
be more positive and motivated,
diagnosed with schizophrenia. At vitamin. Unfortunately, the patient
to be less anxious, and to exude
my initial consultation, he reported was unwilling to quit smoking
more confidence. His auditory
having trouble thinking clearly
hallucinations disappeared, and
and difficulty an.swering routine

TOWNSEND LETTER - FEBRUARY/MARCH 2007


in an adult learning program so did not control her symptoms
Schizophrenia that she would not need to attend Her psychiatrist then prescribed
classes during the day. Then she 10 mg of olanzapine and 1 niL;
despite my encouragement. As began to isolate herself from her of apo-haloperidol daily. When
of August 2006, the patient is family. She even blasted the music she finally came to my office for
living in his fourth group home, on her portable headset so that a consultation, her medication
is unemployed, smokes at least she would be unable hear anyone. regiment had not changed, but
one-half a pack of cigarettes daily, She complained of bad thoughts neither had her symptoms. Sht
is symptomatic, and is no longer and started to hear voices from her continued to hear voices constantly,
mom's purse. She became paranoid had difficulty focusing and was
on any of the orthomolecular
that there were recorders and worried about being monitored
treatments that I prescribed.
monitoring devices documenting and followed all the time. She had
her every move. Finally, in June gained about 15 pounds since
Case #4 starting the medications. Table !'
A 17-year-old female presented 2005, she asked her mother for
help and was taken to the local summarizes the patient's response
to my office in January 2006 with a to the adjunctive orthomolecular
chief complaint of psychosis. Her hospital for evaluation. Although
the diagnosis of schizophrenia was treatments.
symptoms began in February 2005
when she refused to go to high never mentioned, she was told that One week after the March 4tli
school. She informed her parents she had had a psychotic episode. visit, her parents took her off both
that she had been the victim of She was placed on risperidone psychiatric medications despite m\
bullying and harassment from other and quetiapine, but discontinued instructions to the contrary. From
students. Her parents enrolled her these medications since they the second week in March to April,
the patient's condition continued
to decline. 1 spoke to the patients
Table 9. Case #4: Patient's Response to Adjunctive
father and reiterated to him that
Orthomolecular Treatments
not enough time had elapsed since
Consultation Dates January 7. 2006 March 4, 2006 commencing the orthomolecular
treatments. I explained to him
Clinical Presentation Auditory hallucinations, No change in symptoms. the connection between food
paranoid ideation, thought TSH normal. Serum vitamin allergies and schizophrenia
blocking, shaking, and B12was145pmol/L(in Since the patient had extreme
restlessness. the possibly B12 deficient sugar cravings and would eat as
range). much sugar as she could possibl>
consume, we decided to eliminate
Current Psychiatric 10 mg of olanzapine and 1 lOmgofolanzapineand 1 mg all sugar from her diet. A few days
Medications mg of apo-haloperidol of apo-haloperidol daily.
daily.
later, I received a telephone call
Her father was amazed. When
Orthomolecular 1,000 mg of niacinamide Niacinamide was the patient was off sugar, she was
Treatments & Plan three times daily. 1,000 discontinued. Switched to practically normal. The momenl
mg of vitamin C three 1,500 mg of niacin three she resumed eating sugar, all her
times daily. 2 teaspoons times daily. Added 2,500 mg psychotic symptoms returned
of liquid fish oil (2,100 mg of glycine at bedtime to help However, the patient was unwillinjj
of EPA and 1,500 mg of with sleep, 100 mg of B6, 50 to give up sugar and was unable
DHA), and 1,000 meg of mg of zinc, and 240 mg of to apprehend the connection
B12 sublingually daily. She Ginkgo biloba extract. between sugar elimination
was given an intramuscular
and less psychotic symptoms.
Injection of 5,000 meg of
B12. following blood serum
Eventually, she discontinue( i
B12 and TSH tests. Patient all the nutritional treatments
instructed to take the HOD and opted to try clozapine as n
test. last resort. As of April 2006, the
patient was started on clozapine
HOD Results Not assessed. and has done reasonably well.
TS (normal <30) 76 Although she continues to have
PerS (normal <3) 14 psychotic symptoms, the auditory
PS (normal <3) 10 hallucinations are much more
DS (normal <3) 5 tolerable than before. She is able
Not improved.
to attend a special high school
Category of Recovery Not improved.

TOWNSEND LETTER - FEBRUARY/MARCH 2


each day and has even tnodified hopes that many of you will do Schizophrenia
her diet to include more fruits so and continue the exceptional
and vegetables. 1 personally and important work of Dr. Abram Notes
worry about her future, since she Hoffer. 1. Hofler A. Vitamin B-3 & Schizophrenia.
has opted to not resume any of Discovery. Recovery, Controversy Kingston.
the adjunctive orthomolecular Ontario: Quarry Press, Inc., 1998;28-76.
Acknowledgements 2. Hoffer A. Adventures !n Psychiatry. The
treatments. Written consent was obtained from Scientific Memoirs of Dr. Abram Hoffer, KOS
The patients cited in the first the four patients for publication of Publishing Inc. Caledon. ON, 2005:50-99.
this report. The author would like to 3. Smythies .IR. Endogenous neuroloxlns
two cases continue to do well since relevant to schizophrenia. J R Soc Med.
they both have all the components thank Dr. Abram Hoffer for reviewing 1996:89:679-680.
this report, Mrs. Erynn Marcus for her 4. Smythies JR. Oxidative reactions and
for a successful response to thorough editing, and Mr. Robert Sealey schizophrenia: a revlew-d[8cussion.5c/»zop/(j
treatment: (a) shelter; (b) decency, for his expert editing and sui^jjestions. Res 1997:24:357-364.
understanding, support, safety, and
privacy; (c) psychiatric treatment; F () R M A T E I)
and (d) orthomolecular treatment.'
All these components are equally
important. If one component is •
missing, the chances of success
are diminished. In Case #3, the
patient did not have adequate
shelter and was not able to receive
LIQUI-D3 I
support, safety, and privacy in
the various group homes in which
he lived. He lacked the guidance
A Dietary Supplement Providing •
from one caregiver to ensure that 2000IU ofCholecaldferol
he remained consistent with his
psychiatric and orthomolecular per Drop* I
medications. In Case #4, the patient
was not on the orthomolecular 1 FI. Oz. (30 ml)
approach for a sufficient period One Drop Provides:
of time. She was also unwilling to Calories <0.5
Calories from Fal 0.5
give up refined sugar when I was Rx Vitamins' Total Fat 0.026g
actively treating her, even though Cholesterol 0 mg


her response to sugar significantly Total Carbohydrates 0 nig
Protein 0 mg
contributed to her psychosis.
Thus, patients who are receiving
all of these necessary components
LIQU1-D3
DiETARVSlJFrUMtM
Viiamin D (as cholecalciferol)
Other Ingrediems: Olive Oil
2000 I.U.

I
Recommended Usage;
(Cases #1 and #2) show more Hypo-AlltTgmc As a dietary supplement, one < I) drop daily or as
improvements than patients who directed by your health care professional.
do not (Cases #3 and #4).

Conclusion
As clinicians we need to offer LIQUI-D3 provides cholecalciferol, a highly bioavailable form
restorative care to patients who of Vitamin D, in a nutritious, olive oil base. Vitamin D has been the
suffer with schizophrenia, a subject of intensive research which has greatly increased our
severe and often chronic mental understanding of vitamin D deficiency. This research has also
illness. If the information in this expanded the range of therapeutic applications available for
report is reviewed carefully cholecalciferol. Physiologic requirements for vitamin D may be as
and implemented, I believe that high as 4000 IU per day.
many schizophrenic patients will
improve substantially and achieve RxViu For more informalion ahtnil our full proJiici line or lo place an order call:
a reasonable quality of life. Some amins
,^.^-^.....»»., l-800-Rx2-2222 or 914-592-2323
might improve so much that they Svientifically .iilvanved
,\utritional .SiipptemenLs fax orders toll free to 1-888-800-8068
achieve clinical remission. Since
not enough clinicians utilize visit US at www.rxvitamins.com • email: info@irxvitamins.com
k iQEcmcni hu ooi htn c iirJ by itic F(K«1 inil Draj Ailminmiitimi Thii proJuci a niii inttnfltil to iliijooie, ii«L i-oic ur prcvtm any
orthomolecular treatments with
schizophrenic patients, this author O I* I I M A I I K I I I <> N A I Si l» IM ) U

TOWNSEND LETTER - FEBRUARY/MARCH 2007


2L Holfer A. Vitamin B-li and schizophrenia. .17, Foster HI). Schizophrenia, thyroid hormone
Schizophrenia Townsend Lett Doctors Patients. 2O0l;213:20-
23.
and selenium. J Orthomol Med. 2002:17:55-511
38. Fenton WS, Hibbelln J. Knable M. Essenti..
22. Paterson ET. Vitamin B3 and liver toxicity. fattyacids. lipid membrane abnormalitie.s,ani;

I
Townsend Lett Doctors Patients. 2001:207:23. the diagnosis and treatment of schizophrenia,
Smytliles JR. The adrenochrome hypothesis Biol Psychiatry 2000:47:8-2!.
of schizophrenia revisited. Neurotox Res. 23. Mullen CE, Greenspan JK, Mitchell MC.
Fulminant hepatic faiiure after ingestion o\ 39. Peet M. Eicosapeiitaenoic acid In the
sustained-release nicotinic acid. Ann Intern treatmeni of schizophrenia and depression:
6. Hoffer .\. The adrenochrome hypothesis and Med 1989:111:253.255. Rationale and preiiminary double-blind
psychiatry. yOr;/)omo/Aferf. 1999:14:49-62. clinicai trial results, Prostuitlandms Leukot
24. Hoffer A. Vitamin B-3: niacin and its amide.
7. Hoffer A, Heatini) Scliizophrenia. Toronto. Essent Fatty Acids. 2003:69:477-485.
Ontario: CCNM Press Inc. 2()(>4;7-21. Townsend Lett Doctors Patients. 1995:147:30-
39. 40. Emsley R. Oosthuizen P, van Rensburg b'
8. Horrnbii; D. The Madness of Adam and Eve. Clinical potential of oniega-3 (atty acids in
Lotidrm. England: Corgi Books, 201)l;149-151. 25. Hoffer A. Oxidation reduction and the brain. J
Orthomol Psychiatr 1983:12:292-301. the treatment of schizophrenia, CNS Drugs
9. Hoffer A. Treating chronic schizophrenic 2003:17:1081-1091.
patients. J Orthomol Med. 2002:17:25-41. 26. Brody S. Preut R. Schornmer K, Schurmeyer
TH. A randomized controlled trial of high 41. Hawkins D, Orthomolecuiar psychiatry:
10. Goeree R, FarahatI F. Burke N, et ai. The dose ascorbic acid for reduction of blood treatment of schizophrenia. In. eds. Hawkins
economic burden of schizophrenia in Canada pressure, cortisol. and subjective responses D. Pauling L, Orthomolecular Psychiatry. San
in 2004. Curr Med Res Opirt. 2005;2]:2017- to psycholoyical stress. Psychopharmacology. Francisco, CA: W.H. Freeman And Company:
2028. CBerl) 2002:159:319.324. 1973:631-673.
11 Rochnn PA, Stukel TA. Sykora K. et al. Atypical
27. Smythies JR. The role of ascorbate in brain: 42. Neziroglu F. The relationship amonu
antipsychotks and Parkinsonism. Arch Intern the Hoffer-Osmond Diagnostic Test, tlv
Med 2005:165:1882-1888. Therapeutic implications. J R Soc Med,
i996:89:24I. Minnesota Multiphaslc Personality inventor\
12 Prou.sky JE, Hayinan R, Orlhomolecular and and Independent clinical diagnoses. J Chn
botanical treatments to help alleviate the 28. Meister A. (JIutattiione, ascorbate, and cellular
protection. Cancer Res. l994:54:i969S-1975S. Psydwl. 197.5:31:430-433,
side effects o( alypicai antipsychotic dru^s. J
29. Baez S. Segura-Aguilar .1, Widerslen M, 43. Hoffer A, Healing Schizophrenia. Toronto.
OrihomolMed 200(!: 21:17-3;). Ontario: CCNM Press Inc. 2004:152-155.
Johansson A-S. Mannervik B. Glutathione
13 Hoffer A. Atypical aiiti-psyctiotics create
transferases catalyse the detoxification
dependency disorders. J Orthomol Med o( oxidized metabolites (o-quinones)
2004:I9::!-iO. of catecholaniines and may serve as an
M Hoffer A. Orlhoniolecuiar psychiatry In antioxidant system preventing degenerative
theory and practice. Townsend LeII Doctors cellular processes. Biochem J. 1997:324:25-28.
15 Hoffer A. Of ambulant sciiizophrenics with
31). Pauling L, Robinson AB. Oxiey SS. et al.
Results of a loadinfj test of ascorbic acid,
vitamin B3and relative hypoglycemic diet. J niacinamide. and pyridoxine in schizophrenic
Orf/jomo/,V/et/i<W9:14:23-27. subjects and controls. In. eds. Hawkins I),
16 Miller CL, Llen.os IC. Dulay JR. Weis S. Pauling L. Orlhomolecular Psychiatry. San
Upreguiatlon of the initiating step of the Francisco, CA: W.H. Freeman And Company:
kynurenine pathway in postmortem anterior 1973:18-34.
ciitgulate cortex (rom individuals with
schizophrenia and bipolar disorder. Brain 31. Suboticanec K, Fohiegovic-Smalc V.
Res. 2006:1(173-1074:25-37. Korbar M, ol al. Vitamin C status in chronic
schizophrenia. BinI Psychiatry. 1990:28:9.'J9-
17. Hofler A. Mechanism of action ol nicotinic 966.
acid and iiicotinamide In the treatment of
schizophrenia, in iiawitlns D. Pauling L, eds. 32. Jackson JA. Riordan HD. Neathery SS. Mayer
Orthomolecular Psydiialry. San Francisco, CA: K. Urine pyrroles revisited, J Orthomol Med
W.H. Freeman And Company; 1973:202-262. 2000:15:47-48.
18. Hoffer A. Niacin Therapy In Psychiutry. 33. PfeiKer C, l.aMola S. Zinc and manganese
Springfield, Illinois: Charles C Thomas. In the schizophrenias. J Orthomol Med.
1962:35-71. 1999:14:28-48.
19 Hoffer A. Chronic schizophrenic patients 34. Brown JA. Foster HD. Schizophrenia: An
treated ten years of more. J Orthomol Med update of the selenium deficiency hypothesis.
1994:9:7-37, JOrihomolMed 1996:11:211-222.
Morrow JD, Parsons WG. Roberts LJ. 35. Foster HD. The biochemical treatment of
20
schizophrenia revisited. J Orthomol Med. Dr. Jonathan Prousky is the Chief
Release o( markedly increased quantities
oi prostaHltindin U2 in vivo in humans 1999:14:110-112. Naturopathic Medical Officer of the
fuilowing the administration ot nicotinic acid. 36. Berry T. An alternative e.'<planatlon of the Robert Schad Naturopathic Clinic,
Prostaglandins. 1989:38:263-274. psychotropic effect of niacin in schizophrenia.
J Orthomol Med. 1994;9:58. the teaching clinic of The Canadian
College of Naturopathic Medicine. In
addition, Dr. Prousky is an Associate
Professor of Ciinicai Nutrition and
ANCIENT FORMULAS, INC. teaches the third-year clinical
Producer/Manufacturer of Heaith Formuiations nutrition course at the college. He
also operates a private practice
HYPERTENSION • ALLERGIES • ARTHRITIS • DIABETES specializing in the orthomolecular
For the past 15 years, Ancient Formulas, Inc. has been mantjfacturing a full line of unique herbal products treatment of mental health
based on ancient Persian text, specializing in doctor-tesfed and approved formulations addressing
hypertension, allergies, diabetes, prostatitis, uritiary tract infections, hyper-cholesterotetnia. acne,
disorders. In April 2006, CCNM
arthritis, and joint inflammation, constipation, detoxification, thyroidism, weight loss, edema, Press published Dr. Prousky's book,
sport injuries and support for menopause, besides private labeling and formulations. Anxiety: Orthomolecular Diagnosis
We are pleased to announce Ihal Ancienl Formulas, Inc, has moved to and Treatment. Please send
a new. larger facility- Our new address is:
correspondences to: J. Prousky,
638 W. 33rd St. North • Wichita, Kansas 67204 ND. FRSH, CCNM, 1255 Sheppard
Ave. E., Toronto. Ontario.. M2K 1E2;
For product infornnation and orders please call 800-543-3026 email: jprousky@ccnm.edu.

BEST OF NATUROPATHIC MEDICINE TOWNSEND LETTER - FEBRUARY/MARCH 2007