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{{for|the journal formerly titled ''Orthomolecular Psychiatry''|Journal of Orthomolecular Medicine}}
'''Orthomolecular psychiatry''' is a branch of ] whose proponents claim that dietary supplements and other treatments can be effective in treating ].


'''Orthomolecular psychiatry''' is the use of ] for ]. Orthomolecular psychiatry has been rejected by evidence-based medicine and has been called quackery. The approach uses unorthodox forms of individualized testing and diagnosis to attempt to establish an ] for each patient's specific ]s, and claims to tailor the treatment accordingly, using a combination of nutrients, dietary changes and ]s that are claimed to enhance quality of life and functionality as well as to reduce or eliminate symptoms and the use of ] drugs. Scientific studies have shown mixed results; although there are some promising results from ], some forms of orthomolecular psychiatry are ineffective.
Mainstream medical experts agree that some nutritional and dietary supplements have value in treating mental illness, such as the use of ]s with ].<ref>{{cite journal |author=Stoll AL, Locke CA, Marangell LB, Severus WE |title=Omega-3 fatty acids and bipolar disorder: a review |journal=Prostaglandins Leukot. Essent. Fatty Acids |volume=60 |issue=5-6 |pages=329–37 |year=1999 |pmid=10471117 |doi=}}</ref> The earliest assertions by proponents of orthomolecular psychiatry, whose claims were emphatically endorsed by Nobel Laureate chemist ],<ref name="Pauling2">{{cite book |coauthors=Hawkins, D | last = Pauling | first = L | authorlink = Linus Pauling |title=Orthomolecular Psychiatry: Treatment of Schizophrenia |publisher=Freeman |location= San Francisco |year= 1973 |pages= 697|isbn=??}} </ref> were rejected in 1973 by a panel of the ],<ref name="Pauling">{{cite journal |author=Pauling L, Wyatt RJ, Klein DF, Lipton MA |title=On the orthomolecular environment of the mind: orthomolecular theory |journal=The American journal of psychiatry |volume=131 |issue=11 |pages=1251-67 |year=1974 |pmid=4608217 |doi=}}</ref> which instead used its own broader defined, different methodologies which included many patients who were subsequently recognized in conventional psychiatry to have had different psychiatric conditions.<ref name="Beersheva"/> Orthomolecular psychiatry subsequently found scant support among, and endured many accusations of quackery by, mainstream psychiatrists.<ref name=QW>{{cite web | url = http://www.quackwatch.org/01QuackeryRelatedTopics/ortho.html | title = Orthomolecular Therapy | last = Barrett M.D.| first = Stephen | authorlink = Stephen Barrett | publisher = ] | date = 2000-07-12 | accessdate = 2008-01-02 }}</ref>


== History == ==History==
Orthomolecular psychiatry began with ] and ] in the 1950s and was continued by ],<ref name=CarlPheifferBio>{{cite web |last=Saul |first=AW |author2=Jolliffe M |author3=Hoffer A |title=Bibliography of the Publications of Carl Pfeiffer, MD, PhD |url= http://www.doctoryourself.com/biblio_pfeiffer_ed.html |publisher=doctoryourself.com |access-date=2007-04-19}}</ref> although proponents of orthomolecular psychiatry say that the ideas behind their approach can be traced back to the 1920s and '30s.<ref>{{cite journal |last=Reiter |first=PJ |title=Behandlung von Dementia Praecox mit metallsalzen. Mangan. Z |journal= Neur |volume=108 |pages=464–80 |year=1927 |doi=10.1007/bf02863975}} as cited in {{cite journal |last1=Pfeiffer |first1=C |last2=LaMola |first2=S |title=Zinc and Manganese in the Schizophrenias |journal= Journal of Orthomolecular Psychiatry |volume=12 |issue=3 |year=1983}}</ref><ref>{{cite book |author=Kay Lily E |title=The molecular vision of life: Caltech, the Rockefeller Foundation, and the rise of the new biology |publisher=Oxford University Press |location=Oxford |year=1993 |isbn=978-0-19-511143-9}}</ref> Orthomolecular psychiatry's goal of weaning patients from conventional neuroleptic drugs<ref name=Edelman/> follows "Pfeiffer's Law", "For every drug that benefits a patient, there is a natural substance that can achieve the same effect".<ref>{{cite book |last=Barney |first=Paul |title=Doctor's guide to natural medicine |publisher=Woodland |location=Pleasant Grove, Utah |year=1998 |isbn=978-1-885670-84-7}}</ref> In 1968, ] first used the term ''orthomolecular''.<ref>{{cite journal |author=Pauling L |title=Orthomolecular psychiatry. Varying the concentrations of substances normally present in the human body may control mental disease |journal=] |volume=160 |issue=3825 |pages=265–71 |year=1968 |pmid=5641253 |url=http://profiles.nlm.nih.gov/MM/B/B/J/Q/_/mmbbjq.pdf |doi=10.1126/science.160.3825.265 |bibcode=1968Sci...160..265P|s2cid=20153555 }}</ref><ref name=Pauling2>{{cite book |author2=Hawkins, D |last=Pauling |first=Linus |author-link=Linus Pauling |title=Orthomolecular psychiatry: treatment of schizophrenia |publisher=W.H. Freeman |location=San Francisco |year= 1973 |isbn=978-0-7167-0898-8 |page=697}}</ref>


Hoffer's therapies focused on using ], among other nutrients, to treat what he diagnosed as acute ] based on an unaccepted test. In 1973, a task force of the ] examined niacin monotherapy of patient populations with chronic schizophrenia and ] and rejected the practice along with the reliability of Hoffer's diagnostic approach.<ref name=Menolascino>{{cite journal |vauthors=Menolascino FJ, Donaldson JY, Gallagher TF, Golden CJ, Wilson JE |title=Orthomolecular therapy: its history and applicability to psychiatric disorders |journal=Child Psychiatry Hum Dev |volume= 18 |issue=3 |pages=133–50 |year=1988 |pmid=2898324 |doi=10.1007/BF00709727|s2cid=38354755 }}</ref>
The origins of orthomolecular psychiatry can be traced to as early as 1927.<ref>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</ref> Orthomolecular psychiatry ''per se'' is, however, generally accepted to have begun in the 1950s with the work of ] and Humphry Osmond in Canada. Later proponents include ], ],<ref></ref> and ].<ref>{{cite journal |author=Pauling L |title=Orthomolecular psychiatry. Varying the concentrations of substances normally present in the human body may control mental disease |journal=Science |volume=160 |issue=825 |pages=265–71 |year=1968 |pmid=5641253 |doi=| url = http://profiles.nlm.nih.gov/MM/B/B/J/Q/_/mmbbjq.pdf }}</ref>


The assertions by proponents of orthomolecular psychiatry were rejected in 1973 by a panel of the ].<ref name=Menolascino/><ref name=Pauling>{{cite journal |vauthors=Pauling L, Wyatt RJ, Klein DF, Lipton MA |title=On the orthomolecular environment of the mind: orthomolecular theory |journal=American Journal of Psychiatry |volume= 131 |issue=11 |pages=1251–67 |year=1974 |pmid=4608217|doi=10.1176/ajp.131.11.1251|url=https://ajp.psychiatryonline.org/doi/abs/10.1176/ajp.131.11.1251}}</ref><ref name=NIMHtrial>{{cite web |title=Treatment of acute schizophrenia with vitamin therapy |url=http://clinicaltrials.gov/ct2/show/NCT00140166?show_desc=Y#desc |publisher=Clinicaltrials.gov |date=2005-08-31 |last=Lerner |first=V |access-date=2008-01-15}}</ref> However, the underpinning ideas of orthomolecular psychiatry have become popular in alternative medical circles as a means to explain conditions such as ], ], and chronic inflammatory disease. After 1975, orthomolecular psychiatry research was primarily reported in ''Orthomolecular Psychiatry'', now the '']'', a publication founded by Hoffer to counter what he considered to be a medical conspiracy against his ideas.<ref name=history>{{cite journal |author=Hoffer, Abram |title=The History of the Journal of Orthomolecular Medicine |journal=J Orthomol Med |url=http://www.orthomed.org/jom/jomhistory.html |access-date=2011-06-18 |archive-url=https://web.archive.org/web/20110520122017/http://orthomed.org/jom/jomhistory.html |archive-date=2011-05-20 |url-status=dead }}</ref>
== Diagnoses, treatments, and scope ==
Proponents of orthomolecular psychiatry claim to have identified the causes of some psychiatric syndromes, particularly of those that cause ]; testing for these causes guides diagnosis and treatment. These include ], histadelia (elevatedhistamine and basophiles), histapenia with high serum copper (low histamine with high copper), ], ], ] in the presence of normal thyroid values, ] intoxications, as well as other rarer conditions.<ref name = Edelman>{{cite book |author=Eva Edelman |title=Natural Healing for Schizophrenia: And Other Common Mental Disorders |publisher=Borage Books |location= |date=2001 |pages= |isbn=0-9650976-7-6 |oclc= |doi=}}</ref> Diagnostic measures and therapies commonly employed include individual biochemical workup, ], identifying ], dietary changes, ], ], and other pharmacologic nutrients.<ref name = Edelman/> 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 histadelia.<ref name = Edelman/> Not infrequently, the improvements orthomolecular psychiatrists can adduce are sufficient to allow patients to reduce, but not eliminate, their reliance on conventional psychotropics.


==Diagnosis==
Hoffer and Osmond developed and used the "HOD test" as well as biochemical research to identify and monitor schizophrenia patients' progress, much different methods than the testing and patient selection used by the ]. The use of the ] to evaluate patients is also being explored.<ref>{{cite web | url = http://www.ness-foundation.org.uk/Niacin-Abnormalities.htm | title = Niacin Abnormalities | publisher = The Ness Foundation}}; {{dlw| url = http://www.ness-foundation.org.uk/Niacin-Abnormalities.html |date=20050309011253}}</ref> Many orthomolecular physicians still prescribe ]s for ] patients, initially. However, the long-term avoidance of antipsychotics, which are notorious for side-effects such as ], and a return to health is the main goal. The goal of orthomolecular psychiatry to wean patients from conventional neuroleptic drugs<ref name = Edelman/> follows Dr. Carl Pfeiffer's dictum known as "Pfeiffer's Law" that states, "For every drug that benefits a patient, there is a natural substance that can achieve the same effect".<ref>''Doctor's Guide to Natural Medicine'', Paul Barney, M.D., Woodland Publishing, March 1998, ISBN 1885670842</ref>
Proponents of orthomolecular psychiatry claim to have identified the causes of some psychiatric syndromes, in particular those that cause ]; according to orthomolecular proponents, testing for these causes guides diagnosis and treatment. Diagnostic measures and therapies commonly employed include "individual biochemical workup", ], identifying suggested ], dietary changes, ], ]s, and other so-called "pharmacologic nutrients".<ref name=Edelman>{{cite book |author= Edelman Eva |title=Natural Healing for Schizophrenia: And Other Common Mental Disorders |publisher=Borage Books |year=2001 |isbn=978-0-9650976-7-3}}</ref> These diagnoses have not been accepted by mainstream medicine.<ref name=QW/>


==Specific conditions==
The aminoacid ], a precursor of ], is also used to treat some forms of depression; very significant differences were found between plasma tryptophan levels in patients suffering from depression and healthy controls.<ref name="Breverman">{{cite book |coauthors=Breverman MD ER | last = Pfeiffer MD PhD | first = Carl | authorlink = Carl Pfeiffer |title=The Healing Nutrients Within |publisher=Basic Health Publications |location= San Francisco |year= 2003|pages= 448|isbn=1591200377}} </ref> There are reports that tryptophan is effective in the treatment of mania.<ref>{{cite journal |author=Chouinard G et al |title=A controlled clinical trial of L-tryptophan in acute mania. |journal=Biol Psychiatry |volume=20|issue=5 |pages=546-57 |year=1985|pmid=10471117 |doi=}}</ref> Mainstream psychiatry often treats depression with ] that prevent the ] of serotonin.
Orthomolecularists claim that the causes of psychotic disorders include ], ], ] in the presence of normal thyroid values, ] intoxications including those allegedly due to ], as well as several hypothesised conditions they call ''pyroluria'', ''histadelia'' and ''histapenia''.<ref name=Edelman/>


===Pyroluria===
The aminoacid ] and the coenzyme ] have been found to be effective in treating some forms of depression, as Pfeiffer and others report.<ref name = Pfeiffer>{{cite book |author=Pfeiffer, Carl C. |title=Nutrition and Mental Illness: An Orthomolecular Approach to Balancing Body Chemistry |publisher=Healing Art Press |location= |year= |pages= |isbn=0-89281-226-5}}</ref><ref name="Geriatric">
''Pyroluria'' (or ''malvaria'' from the term ''mauve factor'') involves hypothetical excessive levels of ]s in the body resulting from improper hemoglobin synthesis.<ref name=LaPerchia>{{Cite journal| pmid = 2963502| year = 1987| last1 = Laperchia | first1 = P.| title = Behavioral disorders, learning disabilities and megavitamin therapy| volume = 22| issue = 87| pages = 729–738| journal = Adolescence}}</ref> ] believed that pyroluria is a form of ] ], similar to ] where both ]s and ]s are excreted in the ] to an excessive degree.<ref name=NH>{{cite web |title=Pyroluria |publisher=nutritional-healing.com |url=http://www.nutritional-healing.com.au/content/articles-content.php?heading=Pyroluria |access-date=2008-02-17 |url-status=dead |archive-url=https://web.archive.org/web/20080226083527/http://www.nutritional-healing.com.au/content/articles-content.php?heading=Pyroluria |archive-date=2008-02-26 }}</ref> and orthomolecular psychiatrists have alleged that pyroluria is related to diagnoses of ], ], ], ], ], ], ], ], ], and ].<ref name="Urinary Pyrrole">{{cite journal |author1=Jackson James A |author2-link=Hugh D Riordan |author2=Riordan Hugh D |author3=Neathery Sharon |author4=Riordan Neil H |url=http://www.orthomolecular.org/library/jom/1997/pdf/1997-v12n02-p096.pdf |title=Urinary pyrrole in health and disease |journal=The Journal of Orthomolecular Medicine |volume=12 |issue=2nd Quarter |year=1997 |pages=96–8 |access-date=2008-02-17}}</ref> Pfeiffer's methods have not been rigorously tested,<ref name=Skertic>{{cite news |first=Mark |last=Skertic |title=For some, a question of balancing nutrients |publisher=SunTimes.com |date=April 21, 2002}} Available at Retrieved on 2008-02-17</ref> and pyrroles are not considered to be related to schizophrenia. Studies have either failed to detect hemopyrrole and kryptopyrrole in the urine of normal controls and schizophrenics, or found no correlation between these chemicals and mental illness.<ref>{{cite journal |author=Holman, Paul |url=http://www.acnem.org/journal/pdf_files/14-1_july_1995/14-1_pyridoxine-vitamin_b6.pdf |title=Pyridoxine - Vitamin B-6 |journal=Journal of Australian College of Nutritional & Environmental Medicine |volume=14 |issue=1 |date=July 1995 |pages=5–16 |access-date=2007-04-19 |archive-url = https://web.archive.org/web/20070508011442/http://www.acnem.org/journal/pdf_files/14-1_july_1995/14-1_pyridoxine-vitamin_b6.pdf |archive-date = 2007-05-08}}</ref><ref>{{Cite journal| pmid = 696910| year = 1978| last1 = Cruz| first1 = R| last2 = Vogel| first2 = WH| title = Pyroluria: a poor marker in chronic schizophrenia| volume = 135| issue = 10| pages = 1239–40| journal = The American Journal of Psychiatry| doi = 10.1176/ajp.135.10.1239 }}</ref><ref>{{Cite journal| pmid = 627053| year = 1978| last1 = Gendler| first1 = PL| last2 = Duhan| first2 = HA| last3 = Rapoport| first3 = H| title = Hemopyrrole and kryptopyrrole are absent from the urine of schizophrenics and normal persons| volume = 24| issue = 2| pages = 230–3| journal = Clinical Chemistry| doi = 10.1093/clinchem/24.2.230}}</ref><ref>{{Cite journal| pmid = 1120177| year = 1975| last1 = Jacobson| first1 = SJ| last2 = Rapoport| first2 = H| last3 = Ellman| first3 = GL| title = The nonoccurrence of hemo- and kryptopyrrole in urine of schizophrenics| volume = 10| issue = 1| pages = 91–3| journal = Biological Psychiatry}}</ref><ref>{{Cite journal| pmid = 7428279| year = 1980| last1 = Gorchein| first1 = A| title = Urine concentration of 3-ethyl-5-hydroxy-4,5-dimethyl-delta 3-pyrrolin-2-one ('mauve factor') is not causally related to schizophrenia or to acute intermittent porphyria| volume = 58| issue = 6| pages = 469–76| journal = Clinical Science| doi=10.1042/cs0580469}}</ref><ref name="pmid10197889">{{Cite journal| pmid = 10197889| year = 1999| last1 = Vaughan | first1 = K.| last2 = McConaghy | first2 = N.| title = Megavitamin and dietary treatment in schizophrenia: a randomised, controlled trial| volume = 33| issue = 1| pages = 84–88| journal = The Australian and New Zealand Journal of Psychiatry| doi = 10.1046/j.1440-1614.1999.00527.x| s2cid = 38857700}}</ref> Few, if any, medical experts regard the condition as genuine, and few or no articles on pyroluria are found in modern medical literature;<ref>{{cite web |last=National Library for Health |title=What is pyroluria, is it an accepted clinical entity and what are the treatment? |date=2005-10-05 |url=http://www.clinicalanswers.nhs.uk/index.cfm?question=1208 |archive-url = https://web.archive.org/web/20070211000315/http://www.clinicalanswers.nhs.uk/index.cfm?question=1208 |archive-date = 2007-02-11}}</ref> the approach is described as "snake oil" by pediatrician and author Julian Haber.<ref name=Skertic/>
{{cite web
| title = Investigating SAM-e
| publisher = Geriatric Times
| date = 2001
| url = http://www.geriatrictimes.com/g010923.html
| accessdate = 2006-12-08 }}
</ref><ref name="Oral S-adenosylmethionine in depression: a randomized, double-blind, placebo-controlled trial">
{{cite journal
| title = Oral S-adenosylmethionine in depression: a randomized, double-blind, placebo-controlled trial
| last=Kagan | first=BL | coauthors=Sultzer, DL; Rosenlicht, N; Gerner, RH
| journal = Am J Psychiatry
| year = 1990
| volume = 147
| pages = 591–595
| pmid = 2183633
| url = http://www.ajp.psychiatryonline.org/cgi/content/abstract/147/5/591
| accessdate = 2007-02-16 }}
</ref><ref name="The antidepressant potential of oral S-adenosyl-l-methionine">
{{cite journal
| title = The antidepressant potential of oral S-adenosyl-l-methionine
| last=Rosenbaum | first=JF | coauthors=Fava, M; Falk, WE; Pollack, MH; Cohen, LS; Cohen, BM; Zubenko, GS
| journal = Acta Psychiatrica Scandinavica
| year = 1990 | month = May
| volume = 81 | issue = 5
| pages = 432–436
| pmid = 2113347
| accessdate = 2007-02-16 }}
</ref> One paper in the ] reported that methionine in the form of S-adenosylmethionine was as effective as conventional antidepressants, and linked depression to a disorder of ],<ref name="Reynolds">
{{cite journal
| title = Methylation and mood.
| last=Reynolds| first=EH | coauthors=Carney MW, Toone BK.
| journal = Lancet
| year = 1984 | month = Jul
| volume = 28| issue = 2(8396)
| pages = 196-8
| pmid = 6146753
| accessdate = 2008-01-9}}
</ref> one of Pfeiffer's theses.<ref name = Edelman/>


===Histadelia===
These and other methods have been claimed to treat ],<ref name = Warren>{{cite book |author=Warren, Tom |title=Beating Alzheimer's: a step towards unlocking the mysteries of brain diseases |publisher=Avery Pub. Group |location=Wayne, N.J |year=1991 |pages= |isbn=0-89529-488-5 |oclc= |doi=}}</ref> ],<ref name = Warren/> ],<ref>{{cite journal| url = http://orthomolecular.org/library/jom/1999/abstracts/1999-v14n01-p028.shtml | title = The adverse effects of manganese deficiency on reproduction and health: A literature review | first = Tuula | last = Tuormaa | journal = J Orthomolecular Med | volume = 11 | issue = 2 | year = 1996 | accessdate = 2007-12-18}}</ref> ]<ref name = Eaton>{{cite journal |pmid = 16423158 |first = A.E. |last = Kalaydjian |coauthors = Eaton W., Cascella N. & Fasano A. | year = 2006 |title = The gluten connection: the association between schizophrenia and celiac disease |journal = Acta Psychiatr Scand |volume = 113| issue = 2 | pages = 82-90}}</ref> and ].<ref name = Edelman/>
''Histadelia'' is a condition hypothesised by Carl Pfeiffer<ref name=pfeiffer>{{cite journal |vauthors=Pfeiffer Carl C, etal |title=Blood histamine levels, basophil counts, and trace metals in the schizophrenias |journal=Psychopharmacol Bull |date=July 1971 |volume=7 |issue=3 |pages=37 |pmid=5117854}}</ref><ref name=pfeiffer2>{{cite journal |author=Pfeiffer Carl C |title=Extreme basophil counts and blood histamine levels in schizophrenic outpatients as compared to normals |journal=Res Commun Chem Pathol Pharmacol |date=July 1972 |pages= 51–9 |volume=4 |issue=1 |pmid=4671910 |last2=Smyrl |first2=EG |last3=Iliev |first3=V}}</ref> to involve elevated serum levels of ] and ],<ref name=Edelman/> which he says can be treated with ] and vitamin B<sub>6</sub> megadoses.<ref name=nutrition>{{cite book |author=Pfeiffer Carl C |title=Nutrition and Mental Illness: An Orthomolecular Approach to Balancing Body Chemistry |publisher=Healing Arts Press |year=1988 |isbn=978-0-89281-226-4 |url=https://archive.org/details/nutritionmentali00pfei }}</ref> Pfeiffer claims that "histadelia" can cause depression with or without psychosis, but no published clinical trials have tested the effectiveness of this therapy.<ref name=Pfeiffer>{{cite book |author=Pfeiffer, Carl C |title=Nutrition and Mental Illness: An Orthomolecular Approach to Balancing Body Chemistry |publisher=Healing Art Press |year=1987 |isbn=978-0-89281-226-4 |url=https://archive.org/details/nutritionmentali00pfei }}</ref>


== Criticisms == ===Histapenia===
''Histapenia'' in orthomolecular medicine is the condition of high serum copper with low histamine.
Orthomolecular psychiatry is controversial, having been rejected by the mainstream medical community. Critics have noted that the claims advanced by its proponents are considered unsubstantiated, and even false, by conventional psychiatry. Authoritative bodies such as the National Institute of Mental Health<ref name = QW>{{cite web | url = http://www.quackwatch.org/01QuackeryRelatedTopics/ortho.html | title = Orthomolecular Therapy | last = Barrett M.D.| first = Stephen | authorlink = Stephen Barrett | publisher = ] |date=2000-07-12 | accessdate = 2008-01-02 }}</ref> and American Academy of Pediatrics<ref>{{cite web | url = http://pediatrics.aappublications.org/cgi/content/abstract/72/5/707 | title = Vitamin and Mineral Supplementation in Down's Syndrome | first = Forrest C. | last = Bennett | accessdate = 2007-02-13}}</ref> have criticized orthomolecular treatments as ineffective and potentially toxic.


==Relationship to mainstream psychiatry==
A 1973 task force of the American Psychiatric Association charged with investigating orthomolecular claims, but instead focused on niacin monotherapeutically<ref name="Pauling"/> (the earliest version of treatment, ca. 1952) for a different kind of patient population, concluded:
Orthomolecular psychiatry has been rejected by the mainstream medical community.<ref>{{cite journal |author=Miller M |title=Diet and psychological health |journal=Altern Ther Health Med |volume=2 |issue=5 |pages=40–8 |year=1996 |pmid=8795935}}</ref> Critics have noted that the claims advanced by its proponents are unsubstantiated, and even false. Authoritative bodies such as the ]<ref name=QW>{{cite web |url=http://www.quackwatch.org/01QuackeryRelatedTopics/ortho.html |title=Orthomolecular Therapy |last= Barrett MD |first=Stephen |author-link=Stephen Barrett |publisher=] |date=2000-07-12 |access-date=2008-01-02}}</ref> and ]<ref>{{cite journal |url=http://pediatrics.aappublications.org/cgi/content/abstract/72/5/707 |title=Vitamin and mineral supplementation in Down's syndrome |first=Forrest C |last=Bennett|journal=Pediatrics |date=November 1983 |volume=72 |issue=5 |pages=707–713 |doi=10.1542/peds.72.5.707 |pmid=6226926 |s2cid=1888682 }}</ref> have criticized orthomolecular treatments as ineffective and toxic.
<blockquote>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.


A 1973 task force of the American Psychiatric Association charged with investigating orthomolecular claims concluded:
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.<ref name=QW/></blockquote>
<blockquote>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.<ref>{{Cite book |vauthors=Lipton M, etal |title=Task force report on megavitamin and orthomolecular Therapy in psychiatry |location=Washington DC |year=1973 |publisher=]}}; as cited in {{cite web |url=http://www.quackwatch.org/01QuackeryRelatedTopics/ortho.html |title=Orthomolecular Therapy |last=Barrett MD |first=Stephen |author-link=Stephen Barrett |publisher=] |date=2000-07-12 |access-date=2008-01-02}}</ref></blockquote>


==References==
A study of the effectiveness of an orthomolecular treatment for acute schizophrenia began in 2005, attempting to adequately address the failings of previous APA studies to use an appropriate treatment group and intervention. <blockquote>Controlled studies using the orthomolecular approach have been few. Those that were done were performed in chronic schizophrenia or in populations that included bipolar and schizoaffective patients. Both of these diagnostic groups are not today considered to benefit from the orthomolecular approach. Moreover, some negative studies of high-dose niacin were done in patients who were not otherwise given general counseling for good diet.";<ref name="Beersheva">{{cite web | title = Treatment of Acute Schizophrenia With Vitamin Therapy | url = http://www.clinicaltrials.gov/ct/show/NCT00140166;jsessionid=B752ABAB3127A0E34C6EEFF5F0D3ABCE?order=46 | source = Beersheva Mental Health Center | year = 2005}}</ref> compared with a basic, modern orthomolecular regimen.</blockquote>
{{Reflist|3}}


==Bibliography==
Proponents consider the 1973 APA task force report error laden with sweeping, scientifically unfounded conclusions,<ref name="Pauling"/> highly politicized, and that its studies failed to use similar methods, materials and subjects as the original work.<ref>{{cite web | url = http://www.iahf.com/orthomolecular/reply_to_apa_tfr_7.pdf | title = Megavitamin Therapy In Reply To Task Force Report on Megavitamin and Orthomolecular Therapy in Psychiatry | source = Canadian Schizophrenia Foundation | year = 1976}}</ref> The APA report's criticism alleges inadequate controlled trials because ] quit running additional blinded tests that he had come to view as unethical for his patients, especially since the results of his previous double blinded tests went unheeded.<ref>{{cite book | first = Abram | last = Hoffer | title = Adventures in Psychiatry: The Scientific Memoirs of Dr. Abram Hoffer | publisher = KOS Publishing | location = Toronto | year = 2005}} </ref> The APA's assertion is made despite Hoffer's claim to have run the first double blind controlled test in psychiatry, on megavitamin therapies, with a total four double blinded tests, up to 19 years before the APA task force report, as well as being supported by two independent double blinded tests
* {{cite book |last1=Braverman |first1=Eric R |first2=Carl Curt |last2=Pfeiffer |first3=Kenneth |last3=Blum |first4=Richard |last4=Smayda |title=The healing nutrients within: facts, findings, and new research on amino acids |edition=3rd |publisher=Basic Health |location=North Bergen, New Jersey |year=2003 |isbn=978-1-59120-037-6}}
<ref name = witten>{{cite journal |author=Wittenborn JR, Weber ES, Brown M |title=Niacin in the long-term treatment of schizophrenia |journal=Arch. Gen. Psychiatry |volume=28 |issue=3 |pages=308-15 |year=1973 |pmid=4569673 |doi=}}</ref> and an extensive biochemical research program.<ref>{{cite journal | url = http://www.orthomolecular.org/library/jom/1999/pdf/1999-v14n01-p049.pdf | first = A | last = Hoffers | coauthors = Osmond, H. | title = The adrenochrome hypothesis | journal = Journal of Orthomolecular Medicine | volume = 14 | issue = 1 | year = 1999}}</ref> One of the APA report's five authors, psychologist JR Wittenborn, reacting to Hoffer's specific criticisms, later re-analyzed his original double blind study<ref name = witten/> favorably with respect to orthomolecular psychiatry, obtaining the same result as Hoffer,<ref>{{cite journal |author=Wittenborn JR |title=A search for responders to niacin supplementation |journal=Arch. Gen. Psychiatry |volume=31 |issue=4 |pages=547-52 |year=1974 |pmid=4607587 |doi=}}</ref> and never received NIMH or APA support again.<ref>{{cite web | url = http://www.doctoryourself.com/hoffer_paradigm.html | first = Abram | last = Hoffer | title = The Vitamin Paradigm Wars, Townsend Letter for Doctors and Patients | year = 1996}}</ref> Another of the APA report's authors, then NIMH member ], later resigned from the American Psychiatric Association in total disgust,<ref> Loren R. Mosher, M.D. to Rodrigo Munoz, M.D., President of the American Psychiatric Association (APA), Letter of Resignation from the American Psychiatric Association, 4 December 1998</ref> and referred to the organization as a "drug company patsy."<ref>{{cite news | url = http://www.washingtonpost.com/wp-dyn/articles/A63107-2004Jul19.html | last = Bernstein | first = Adam | title = Contrarian Psychiatrist Loren Mosher, 70 (obituary}| publisher = ] |date=2004-07-20 | accessdate = 2007-12-18}}</ref>
* {{cite book |last1=Pauling |first1=Linus |last2=Hawkins |first2=D. |author-link=Linus Pauling |title=Orthomolecular psychiatry: treatment of schizophrenia |publisher=W.H. Freeman |location=San Francisco |year=1973 |page=697 |isbn=978-0-7167-0898-8}}
* {{cite book |last=Pfeiffer |first=Carl J |author-link=Carl Pfeiffer (pharmacologist) |title=Nutrition and mental illness: An orthomolecular approach to balancing body chemistry |publisher=Healing Arts |year=1987 |isbn=978-0-89281-226-4 |url=https://archive.org/details/nutritionmentali00pfei }}
* {{cite book |last=Werbach |first=Melvyn R |title=Nutritional influences on mental illness: a sourcebook of clinical research |publisher=Third Line |location=Tarzana, California |year=1999 |isbn=978-0-9618550-8-6}}


==External links==
== Current research ==
*

===Food allergies===

Orthomolecular psychiatry has not been studied extensively by mainstream science. Despite this, there is some evidence that specific hypotheses of practitioners have merit, and one of their hypotheses is being investigated in similar contexts. A 2006 literature review found that the removal of ] from the diet of a subset of ] patients resulted in a drastic reduction of symptoms.<ref name = Eaton/> Removing gluten had long been recommended by orthomolecular psychiatrists when indicated.<ref name = Edelman/><ref name = Pfeiffer</ref> J. ], the inventor of ] and an academic physician at the University of Florida found links between certain foods and autism and schizophrenia.<ref name=cade> Washington Post, Wednesday, November 28, 2007; B07</ref>

===Copper===

Until recently, the scientific consensus was that the only illness causing dementia involving an accumulation of copper to toxic levels was ]. Carl Pfeiffer reported that a form of schizophrenia or ] he named histapenia involved the accumulation of ] without the liver damage copper toxicity causes in Wilson's disease;<ref name = Pfeiffer/> his beliefs were dismissed by the mainstream medical community. More recently there has been considerable interest in, and initially considerable controversy around, the theory that at least some cases of ] are caused by a toxic buildup of copper in the brain, and an effort to bring a medication to market that ] copper from the brain as a treatment for these cases,<ref>{{cite news | url = http://www.usatoday.com/tech/news/techinnovations/2003-12-26-alz-advance_x.htm | title = Scientist is winning converts on Alzheimer's | publisher = ] | last = Wysocki | first = Bernard |date=2003-12-26 | accessdate = 2007-12-19}}</ref> a development that does not prove Pfeiffer's histapenia claims. A scientist specifically pursuing research in orthomolecular psychiatry has found that women who suffer from postpartum depression on average have a strongly significant higher level of plasma copper than women who haven't suffered from postpartum depression.<ref>{{cite journal |author=Crayton JW et al. |title=Elevated serum copper levels in women with a history of post-partum depression. |journal=J Trace Elem Med Biol. |volume=21|issue=1 |pages=17-21 |year=2007|pmid=17317521 |doi=}}</ref>, and that males with a history of violence and assault have a significantly higher median blood copper / zinc ratio.<ref>{{cite journal |author=Walsh JW et al. |title=Elevated blood copper/zinc ratios in assaultive young males. |journal=Physiol Behav. |volume=62|issue=2 |pages=327-329 |year=2007|pmid=9251975 |doi=}}</ref>

===Violent and delinquent behavior===

William Walsh of the ] has dedicated himself to investigating the causes of violent and delinquent behavior using the diagnostics of orthomolecular psychiatry, with promising results.<ref name = Edelman/>

==Notable patients==
] reports that actress ] credits orthomolecular psychiatry with helping her overcome bipolar disorder.<ref>{{cite book | first = Abram | last = Hoffer | title = Masks of Madness: Orthomolecular Treatment of Mental Illness | publisher = Quarry Press | isbn= 1550822608 | year = 2001}} </ref> Kidder lobbied successfully for the creation of the first public clinic that provides treatment according to the precepts of orthomolecular medicine, in Kent, Washington.{{Fact|date=January 2008}}<!-- <ref>Manthey as accessed Jan 4 2008] </ref> PER WP:BLP, THIS NEEDS A BETTER SOURCE THAN WHAT APPEARS TO BE A 'SOME WEBSITE' SOURCE - IF THIS IS TRUE, IT SHOULD BE SOURCED TO KIDDER HERSELF OR TO ANOTHER RELIABLE SOURCE--> ] attributed his recovery from schizophrenia to orthomolecular psychiatry and advocated its adoption by mainstream medicine, but later chose to disavow his statements.<ref name = Edelman/>

== References ==
{{reflist}}

== Bibliography ==
* {{cite book |author=Braverman, Eric R. |title=The Healing Nutrients Within: Facts, Findings, and New Research on Amino Acids |publisher=Basic Health Publications |location= |year= 2003|pages= |isbn=1-59120-037-7 |oclc= |doi=}}<!-- 2003 VERSION IS A SINGLE AUTHOR -->
*{{cite book |coauthors=Hawkins, D MD| last = Pauling PhD | first = Linus | authorlink = Linus Pauling |title=Orthomolecular Psychiatry: Treatment of Schizophrenia |publisher=Freeman |location= San Francisco |year= 1973 |pages= 697}}
*{{cite book |author=Pfeiffer, Carl J. | authorlink = Carl Pfeiffer (pharmacologist) |title=Nutrition and Mental Illness: An Orthomolecular Approach to Balancing Body Chemistry |publisher=Healing Art Press |location= |year= |pages= |isbn=0-89281-226-5 |oclc= |doi=}}
* {{cite book |author=Werbach, Melvyn R. |title=Nutritional influences on mental illness: a sourcebook of clinical research |publisher=Third Line Press |location=Tarzana, Calif |year=1999 |pages= |isbn=0-9618550-8-8 |oclc= |doi=}}

== External links ==

*
* , orthomolecular treatment center whose predecessor was founded by ]
* , an orthomolecular research and treatment institute
*


] ]
] ]
] ]

]

Latest revision as of 14:12, 12 September 2024

For the journal formerly titled Orthomolecular Psychiatry, see Journal of Orthomolecular Medicine.

Orthomolecular psychiatry is the use of orthomolecular medicine for mental illness. Orthomolecular psychiatry has been rejected by evidence-based medicine and has been called quackery. 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. Scientific studies have shown mixed results; although there are some promising results from nutritional psychiatry, some forms of orthomolecular psychiatry are ineffective.

History

Orthomolecular psychiatry began with Abram Hoffer and Humphry Osmond in the 1950s and was continued by Carl Pfeiffer, although proponents of orthomolecular psychiatry say that the ideas behind their approach can be traced back to the 1920s and '30s. 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". In 1968, Linus Pauling first used the term orthomolecular.

Hoffer's therapies focused on using niacin, among other nutrients, to treat what he diagnosed as acute schizophrenia based on an unaccepted test. In 1973, a task force of the American Psychiatric Association examined niacin monotherapy of patient populations with chronic schizophrenia and bipolar disorder and rejected the practice along with the reliability of Hoffer's diagnostic approach.

The assertions by proponents of orthomolecular psychiatry were rejected in 1973 by a panel of the American Psychiatric Association. However, the underpinning ideas of orthomolecular psychiatry have become popular in alternative medical circles as a means to explain conditions such as autism, heavy metal toxicity, and chronic inflammatory disease. After 1975, orthomolecular psychiatry research was primarily reported in Orthomolecular Psychiatry, now the Journal of Orthomolecular Medicine, a publication founded by Hoffer to counter what he considered to be a medical conspiracy against his ideas.

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, amino acids, and other so-called "pharmacologic nutrients". These diagnoses have not been accepted by mainstream medicine.

Specific conditions

Orthomolecularists claim that the causes of psychotic disorders include food allergy, hypoglycemia, hypothyroidism in the presence of normal thyroid values, heavy metal intoxications including those allegedly due to dental fillings, as well as several hypothesised conditions they call pyroluria, histadelia and histapenia.

Pyroluria

Pyroluria (or malvaria from the term mauve factor) involves hypothetical excessive levels of pyrroles in the body resulting from improper hemoglobin synthesis. Carl Pfeiffer believed that pyroluria is a form of schizophrenic porphyria, similar to acute intermittent porphyria where both pyrroles and porphyrins are excreted in the human urine to an excessive degree. and orthomolecular psychiatrists have alleged that pyroluria is related to diagnoses of ADHD, alcoholism, autism, depression, down syndrome, manic-depression, schizophrenia, celiac disease, epilepsy, and psychosis. Pfeiffer's methods have not been rigorously tested, and pyrroles are not considered to be related to schizophrenia. Studies have either failed to detect hemopyrrole and kryptopyrrole in the urine of normal controls and schizophrenics, or found no correlation between these chemicals and mental illness. Few, if any, medical experts regard the condition as genuine, and few or no articles on pyroluria are found in modern medical literature; the approach is described as "snake oil" by pediatrician and author Julian Haber.

Histadelia

Histadelia is a condition hypothesised by Carl Pfeiffer to involve elevated serum levels of histamine and basophils, which he says can be treated with methionine and vitamin B6 megadoses. Pfeiffer claims that "histadelia" can cause depression with or without psychosis, but no published clinical trials have tested the effectiveness of this therapy.

Histapenia

Histapenia in orthomolecular medicine is the condition of high serum copper with low histamine.

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 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.

References

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  2. Reiter, PJ (1927). "Behandlung von Dementia Praecox mit metallsalzen. Mangan. Z". Neur. 108: 464–80. doi:10.1007/bf02863975. as cited in Pfeiffer, C; LaMola, S (1983). "Zinc and Manganese in the Schizophrenias". Journal of Orthomolecular Psychiatry. 12 (3).
  3. 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 978-0-19-511143-9.
  4. ^ Edelman Eva (2001). Natural Healing for Schizophrenia: And Other Common Mental Disorders. Borage Books. ISBN 978-0-9650976-7-3.
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  6. Pauling L (1968). "Orthomolecular psychiatry. Varying the concentrations of substances normally present in the human body may control mental disease" (PDF). Science. 160 (3825): 265–71. Bibcode:1968Sci...160..265P. doi:10.1126/science.160.3825.265. PMID 5641253. S2CID 20153555.
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  9. Pauling L, Wyatt RJ, Klein DF, Lipton MA (1974). "On the orthomolecular environment of the mind: orthomolecular theory". American Journal of Psychiatry. 131 (11): 1251–67. doi:10.1176/ajp.131.11.1251. PMID 4608217.
  10. Lerner, V (2005-08-31). "Treatment of acute schizophrenia with vitamin therapy". Clinicaltrials.gov. Retrieved 2008-01-15.
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  12. ^ Barrett MD, Stephen (2000-07-12). "Orthomolecular Therapy". Quackwatch. Retrieved 2008-01-02.
  13. Laperchia, P. (1987). "Behavioral disorders, learning disabilities and megavitamin therapy". Adolescence. 22 (87): 729–738. PMID 2963502.
  14. "Pyroluria". nutritional-healing.com. Archived from the original on 2008-02-26. Retrieved 2008-02-17.
  15. Jackson James A; Riordan Hugh D; Neathery Sharon; Riordan Neil H (1997). "Urinary pyrrole in health and disease" (PDF). The Journal of Orthomolecular Medicine. 12 (2nd Quarter): 96–8. Retrieved 2008-02-17.
  16. ^ Skertic, Mark (April 21, 2002). "For some, a question of balancing nutrients". SunTimes.com. Available at the internet archive. Retrieved on 2008-02-17
  17. Holman, Paul (July 1995). "Pyridoxine - Vitamin B-6" (PDF). Journal of Australian College of Nutritional & Environmental Medicine. 14 (1): 5–16. Archived from the original (PDF) on 2007-05-08. Retrieved 2007-04-19.
  18. Cruz, R; Vogel, WH (1978). "Pyroluria: a poor marker in chronic schizophrenia". The American Journal of Psychiatry. 135 (10): 1239–40. doi:10.1176/ajp.135.10.1239. PMID 696910.
  19. Gendler, PL; Duhan, HA; Rapoport, H (1978). "Hemopyrrole and kryptopyrrole are absent from the urine of schizophrenics and normal persons". Clinical Chemistry. 24 (2): 230–3. doi:10.1093/clinchem/24.2.230. PMID 627053.
  20. Jacobson, SJ; Rapoport, H; Ellman, GL (1975). "The nonoccurrence of hemo- and kryptopyrrole in urine of schizophrenics". Biological Psychiatry. 10 (1): 91–3. PMID 1120177.
  21. Gorchein, A (1980). "Urine concentration of 3-ethyl-5-hydroxy-4,5-dimethyl-delta 3-pyrrolin-2-one ('mauve factor') is not causally related to schizophrenia or to acute intermittent porphyria". Clinical Science. 58 (6): 469–76. doi:10.1042/cs0580469. PMID 7428279.
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  26. Pfeiffer Carl C (1988). Nutrition and Mental Illness: An Orthomolecular Approach to Balancing Body Chemistry. Healing Arts Press. ISBN 978-0-89281-226-4.
  27. Pfeiffer, Carl C (1987). Nutrition and Mental Illness: An Orthomolecular Approach to Balancing Body Chemistry. Healing Art Press. ISBN 978-0-89281-226-4.
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Bibliography

External links

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