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Orthomolecular psychiatry is the use of orthomolecular medicine for mental illness. The approach uses unorthodox forms of individualized testing and diagnosis to attempt to establish an etiology for each patient's specific symptoms, and claims to tailor the treatment accordingly, using a combination of nutrients, dietary changes and medications that are claimed to enhance quality of life and functionality as well as to reduce or eliminate symptoms and the use of xenobiotic drugs.

Abram Hoffer in the 1950s was the first major practitioner. Hoffer's therapies focused on using niacin, among other nutrients, to treat acute schizophrenia, which was identified using the Hoffer-Osmond test. In 1973, a task force of the American Psychiatric Association examined and rejected the practice. Currently there is a clinical trial being conducted on the basis that previous trials were done without taking into account Hoffer's distinction between acute and chronic schizophrenia.

History

The origins of orthomolecular psychiatry can be traced to as early as 1927, and the broad roots of modern orthomolecular medicine involving Linus Pauling trace back to the 1930s. Orthomolecular psychiatry per se is generally accepted to have begun in the 1950s with the work of Abram Hoffer and Humphry Osmond, continued by the work of Carl Pfeiffer. For a time in the late 1950s and early 1960s, research into orthmolecular treatments was given much more prominence but the availability of faster acting tranquilizers and antidepressants, with clinically proven effects, began to dominate conventional psychiatric practice. In 1968, Linus Pauling gave the name and principle to the discipline of 'orthomolecular psychiatry'.

The earliest assertions by proponents of orthomolecular psychiatry were rejected in 1973 by a panel of the American Psychiatric Association. Orthomolecular psychiatry has subsequently found scant support in mainstream psychiatry and is currently considered to be an unproven system of treatments. After 1975, research directly associated with orthomolecular psychiatry was primarily reported in Orthomolecular Psychiatry, now the Journal of Orthomolecular Medicine. A National Institute of Mental Health listed, randomized controlled trial of treatment, with two additional orthomolecular related nutrients originated later in the 1950s, is being tested, and is expected to be complete in 2009.

Diagnosis

Proponents of orthomolecular psychiatry claim to have identified the causes of some psychiatric syndromes, in particular those that cause psychosis; according to orthomolecular proponents, testing for these causes guides diagnosis and treatment. Diagnostic measures and therapies commonly employed include "individual biochemical workup", fasting, identifying suggested allergies, dietary changes, "megavitamin" therapy, aminoacids, and other so-called pharmacologic nutrients.

Treatment

Treatment generally involves the administration of the 'right' substances (ortho meaning right in Greek); generally this involves administration of high doses of vitamins, essential fatty acids and other substances already produced or required by the body. Orthomolecular psychiatrists do not categorically refuse to prescribe psychotropic medications; antipsychotics are often used to stabilize a patient, and anti-epileptics (dilantin in particular) are occasionally used to treat the conditon called by orthomolecular doctors, 'histadelia.'

Specific conditions

Schizophrenia

According to orthomolecular psychiatry, the causes of psychotic disorders include pyroluria, histadelia (elevated histamine and basophiles), histapenia with high serum copper (low histamine with high copper), food allergy, hypoglycemia, hypothyroidism in the presence of normal thyroid values, heavy metal intoxications, as well as other rarer conditions.

Hoffer and Osmond developed and used the "Hoffer-Osmond Diagnostic test" of perception, their biochemical research as available in the 1950s and 1960s, and length of illness, acute vs. chronic, to identify, differentiate and monitor schizophrenic patients' progress, with more specific classifications in schizophrenia for orthomolecular treatment than the then accepted, broader classifications of the schizophrenizas. Many orthomolecular physicians still prescribe an initial course of antipsychotics for schizophrenic patients with the long-term goal returning patients to health, and avoiding antipsychotics due to their side-effects. Orthomolecular psychiatry's goal of weaning patients from conventional neuroleptic drugs follows 'Pfeiffer's Law', "For every drug that benefits a patient, there is a natural substance that can achieve the same effect".

A single study of megavitamin and dietary therapy to treat schizophrenia was tested in 1999 and found to be effective at increasing serum levels of vitamins, but did not show any impact on symptoms of schizophrenia.

Depression

The orthomolecular treatment of depression generally consists of treating histadelia, which can cause depression with and without psychosis, with methionine, or augmenting other amino acid imbalances. Orthomolecular psychiatry proponenents advocate the use of methionine to treat some forms of depression, but have not published any clinical trials that would test the effectiveness of this therapy. Mainstream psychiatry is, however, coming to report that some depressive disorders linked to suicide are linked to very elevated rates of methylation.

Treatment centers

Currently, orthomoleculary psychiatry continues to be investigated by a small number of researchers. The Pfeiffer Treatment Center is dedicated to the research and use of orthomolecular psychiatry in the treatment of schizophrenia, bipolar disorder, autism, and violent criminal behavior.

Relationship to mainstream psychiatry

Orthomolecular psychiatry has been rejected by the mainstream medical community. Critics have noted that the claims advanced by its proponents are unsubstantiated, and even false. Authoritative bodies such as the National Institute of Mental Health and American Academy of Pediatrics have criticized orthomolecular treatments as ineffective and toxic.

A 1973 task force of the American Psychiatric Association charged with investigating orthomolecular claims unanimously concluded:

This review and critique has carefully examined the literature produced by megavitamin proponents and by those who have attempted to replicate their basic and clinical work. It concludes in this regard that the credibility of the megavitamin proponents is low. Their credibility is further diminished by a consistent refusal over the past decade to perform controlled experiments and to report their new results in a scientifically acceptable fashion. Under these circumstances this Task Force considers the massive publicity which they promulgate via radio, the lay press and popular books, using catch phrases which are really misnomers like "megavitamin therapy" and "orthomolecular treatment," to be deplorable.

Amalgam paranoia

Between 1997 and 1999 the Journal of Orthomolecular Medicine published articles that suggested there was a correlation between amalgam fillings and schizophrenia, bipolar disorder, and multiple sclerosis. These ideas are not supported by scientific evidence, and a recent meta-analysis of four epidemiological studies found significant differences between the findings of the individual studies, but on average no significant association between amalgam fillings and multiple sclerosis. The United States Public Health Service and American Dental Association's position statements on dental amalgams is that they do not pose a significant risk of adverse health consequences and are a cost-effective, durable and effective option for dental fillings, though an FDA panel felt that there was insufficient research for an unequivocal statement on the safety of amalgams for children, pregnant women and individuals sensitive to mercury.

Notable patients

Abram Hoffer reports that actress Margot Kidder credits orthomolecular psychiatry with helping her overcome bipolar disorder. Mark Vonnegut attributed his recovery from schizophrenia to orthomolecular psychiatry and advocated its adoption by mainstream medicine, but later disavowed his statements.

References

1. Menolascino FJ, et al. "Orthomolecular Therapy: Its History and Applicability to Psychiatric Disorders", Child Psychiatry and Human Development, Vol.18(3), Spring 1988, pp 140-1
2. ^ Lerner, V (2005-08-31). "Treatment of Acute Schizophrenia With Vitamin Therapy". Clinicaltrials.gov. Retrieved 2008-01-15.
3. Reiter PJ: Behandlung von Dementia Praecox mit metallsalzen. Mangan. Z. Neur., 108:464-480, 1927 As quoted in Carl C. Pfeiffer, Ph.D., M.D. and Scott LaMola, B.S. Zinc and Manganese in the Schizophrenias, Journal of Orthomolecular Psychiatry, Vol. 12, No. 3, 1983
4. Kay, Lily E. (1993). The molecular vision of life: Caltech, the Rockefeller Foundation, and the rise of the new biology. Oxford : Oxford University Press. ISBN 0195111435.
5. Olson, G (2006-04-01). "Orthomolecular medicine: Vitamins are key to mental health". Common Ground. Retrieved 2008-01-15.
6. Pauling L (1968). "Orthomolecular psychiatry. Varying the concentrations of substances normally present in the human body may control mental disease" (PDF). ]. 160 (825): 265–71. PMID 5641253.
7. Pauling, L (1973). Orthomolecular Psychiatry: Treatment of Schizophrenia. San Francisco: Freeman. p. 697. ISBN 0716708981. {{cite book}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
8. Pauling L, Wyatt RJ, Klein DF, Lipton MA (1974). "On the orthomolecular environment of the mind: orthomolecular theory". The American Journal of Psychiatry. 131 (11): 1251–67. PMID 4608217.{{cite journal}}: CS1 maint: multiple names: authors list (link)
9. ^ Barrett M.D., Stephen (2000-07-12). "Orthomolecular Therapy". Quackwatch.org. Retrieved 2008-01-02. Cite error: The named reference "QW" was defined multiple times with different content (see the help page).
10. ^ Eva Edelman (2001). Natural Healing for Schizophrenia: And Other Common Mental Disorders. Borage Books. ISBN 0-9650976-7-6.
11. Paul Barney. Doctor's Guide to Natural Medicine: The Complete and Easy-To-Use Natural Health Reference from a Medical Doctor's Perspective. Pleasant Grove, UT: Woodland Publishing. ISBN 1-885670-84-2.
12. Vaughan K, McConaghy N (1999). "Megavitamin and dietary treatment in schizophrenia: a randomised, controlled trial". Aust N Z J Psychiatry. 33 (1): 84–8. doi:10.1046/j.1440-1614.1999.00527.x. PMID 10197889.
13. Pfeiffer, Carl C. Nutrition and Mental Illness: An Orthomolecular Approach to Balancing Body Chemistry. Healing Art Press. ISBN 0-89281-226-5.
14. Poulter MO (2008). "GABAA receptor promoter hypermethylation in suicide brain: implications for the involvement of epigenetic processes". Biol Psychiatry. 64 (8): 645–52. PMID 18639864.
15. Miller M (1996). "Diet and psychological health". Altern Ther Health Med. 2 (5): 40–8. PMID 8795935.
16. Bennett, Forrest C. "Vitamin and Mineral Supplementation in Down's Syndrome". Retrieved 2007-02-13.
17. Lipton M; et al. (1973), Task Force Report on Megavitamin and Orthomolecular Therapy in Psychiatry, Washington D.C.: American Psychiatric Association {{citation}}: Explicit use of et al. in: |author= (help); as cited in Barrett M.D., Stephen (2000-07-12). "Orthomolecular Therapy". Quackwatch.org. Retrieved 2008-01-02.
18. Sibelrud RL; et al. (1999). "Psychometric evidence that dental amalgam mercury may be an etiological factor in schizophrenia" (pdf). J Orthomolecular Med. 14 (4): 201–209. Retrieved 2008-01-12. {{cite journal}}: Explicit use of et al. in: |author= (help)
19. Sibelrud RL; et al. (1998). "Psychometric evidence that dental amalgam mercury may be an etiological factor in manic depression" (pdf). J Orthomolecular Med. 13 (1): 31–40. Retrieved 2008-01-12. {{cite journal}}: Explicit use of et al. in: |author= (help)
20. Sibelrud RL; et al. (1997). "Evidence that mercury from silver dental fillings may Be an etiological factor in reduced nerve Conduction velocity in multiple sclerosis patients" (pdf). J Orthomolecular Med. 12 (3): 169–172. Retrieved 2008-01-12. {{cite journal}}: Explicit use of et al. in: |author= (help)
21. Aminzadeh KK, Etminan M (2007). "Dental amalgam and multiple sclerosis: a systematic review and meta-analysis". J Public Health Dent. 67 (1): 64–6. doi:10.1111/j.1752-7325.2007.00011.x. PMID 17436982.
22. ^ "Questions and Answers on Dental Amalgam". Food and Drug Administration. 2006-10-30. Retrieved 2008-01-04.
23. "ADA Statement on Dental Amalgam". American Dental Association. 2007-04-06. Retrieved 2008-01-04.
24. Hoffer, Abram (2001). Masks of Madness: Orthomolecular Treatment of Mental Illness. Quarry Press. ISBN 1550822608.

Bibliography

• Braverman, Eric R. (2003). The Healing Nutrients Within: Facts, Findings, and New Research on Amino Acids. Basic Health Publications. ISBN 1-59120-037-7.
• Pauling PhD, Linus (1973). Orthomolecular Psychiatry: Treatment of Schizophrenia. San Francisco: Freeman. p. 697. {{cite book}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
• Pfeiffer, Carl J. Nutrition and Mental Illness: An Orthomolecular Approach to Balancing Body Chemistry. Healing Art Press. ISBN 0-89281-226-5.
• Werbach, Melvyn R. (1999). Nutritional influences on mental illness: a sourcebook of clinical research. Tarzana, Calif: Third Line Press. ISBN 0-9618550-8-8.

External links

• Orthomolecular Medicine Online
• The Earth House, orthomolecular treatment center whose predecessor was founded by Carl Pfeiffer
• Orthomolecular Vitamin Information Centre.

• Orthomolecular medicine
• Psychiatry
• Psychiatric treatments