Orthomolecular psychiatry - curing schizophrenia?

25 May 2003

Published in The Age

...there are thousands of people...who, if they would omit from their diet foods to which they are symptom reactive, could be socially and professionally efficient, honored and successful, but who if they continue frequent contact with these foods, can become psychotic, with life passing them by.

That's American psychiatrist Dr William Philpott, writing in his book Brain Allergies.

In the 1970s Dr Philpott tried an unusual experiment. He tested his schizophrenic patients for reactions to common foods and chemicals. To his surprise, he induced psychiatric symptoms in 92 percent of them.

Of these schizophrenics, 64 percent manifested symptoms in reaction to wheat, 51 percent to corn, 51 percent to cow's milk, 30 percent to petrochemicals, and 75 percent to tobacco.

Dr Philpott now talks (somewhat radically) of "cereal grain-induced depression" and "tobacco psychosis". And of withdrawing cigarettes to "turn a patient's delusion off".

He believes that dealing with the allergies underlying an illness has great potential long-term. Just dealing with symptoms via anti-psychotic drugs (on the other hand) can create side-effects which are often catastrophic.

Whilst there is only a handful of its practitioners in Australia, more than 100 doctors across North America have reported good results with this approach - which goes by the name of Environmental Medicine (EM).

The North Nassau Mental Health Center, in Manhasset, New York - one of the world's largest psychiatric clinics - used to see their average schizophrenic patient about 150 times a year. After switching to Environmental Medicine, their schizophrenic patients require only about 15 visits a year, with recovery rates improved from less than 40 percent to over 75 percent.

An EM patient is often treated by withdrawal of all food for four days, then by re-introducing foods (and other suspected allergens) one at a time. Once things that cause a reaction have been eliminated, the patient goes on a rotation diet - in which no one food is consumed too often.

If there are deficiencies, vitamins (sometimes megadoses) are administered. The ones most used are B3, B6 and ascorbic acid. This approach is borrowed from the complementary - indeed overlapping - discipline of Orthomolecular Psychiatry (OP).

But is it all truly scientific? I decided to go to the source on this one. 82-year-old Dr Abram Hoffer is the man who introduced dual Nobel Prize winner Linus Pauling to vitamin therapy in the 1960s. Dr Hoffer, who still practises full-time in Canada, told me that he and colleague Humphrey Osmond have conducted six successful double-blind trials on Orthomolecular Psychiatry. (These are the "gold standard" in clinical research.)

Indeed, in 1953 "Hoffer and Osmond" conducted the first two double-blind trials in the history of psychiatry. In the words of Dr Hoffer, these two trials proved that acute schizophrenics

"who were given vitamin B3 in doses of at least three grams per day had a much better prognosis compared to those who received placebo [an inert substance to test the vitamin against]. We concluded that the addition of this vitamin to the standard treatment of that day doubled the two year recovery rate of acute schizophrenics."

Dr Hoffer is at pains to point out that vitamin therapy generally has no side-effects. This is in sharp distinction to anti-psychotic drugs, whose symptoms include lethargy, incoordination, tremor, fatigue, impotence, excessive weight gain, poor concentration and depression:

"Eventually the entire schizophrenic psychosis has been replaced by the tranquilizer psychosis. The major difference is that society is much more tolerant of the latter psychosis than it is of the first."

Vitamins act slowly, so Hoffer often uses drugs and vitamins together at first. Later the drug dosage is wound back - sometimes eventually to nothing. The process can take weeks, or months.

For schizophrenia, Dr Hoffer told me that - half a century on from his ground-breaking trials - vitamin B3 is still the most powerful weapon in his armory. "This is the best treatment available. Without it very few will recover."

His ten-year follow-up study of 27 schizophrenics has (for psychiatry) an unusually happy conclusion:

"From this group of 27 patients treated over ten years, 18 are now well, three are much improved, five are improved and one is the same as he was at the beginning of this study. The one not improved did not remain on the program... None are worse."

Other studies proved that OP patients consistently do better than patients on drug therapy alone. Critically, they also commit suicide less often.

Of course psychological problems are caused by more things than allergens and vitamin deficiencies. Environmental Medicine and Orthomolecular Psychiatry are not panaceas. However their apparent success in treating many individual cases of schizophrenia, alcoholism, autism, drug addiction and childhood hyperactivity, among others, suggests that they warrant more comprehensive clinical trials.

"Mental illness" exists on a spectrum. Many of us are adversely affected by our food and environment. Whilst not making us "mentally ill", environmental agents may impair the quality of our thinking, feeling and physical lives.

The successes of Dr Hoffer, and others, suggest that the power to change these things may be in our hands.