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'''Orthomolecular psychiatry''' is the use of ] for ]. 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.

] in the 1950s was the first major practitioner. Hoffer's therapies focused on using ], among other nutrients, to treat acute schizophrenia, which was identified using the Hoffer-Osmond test. In 1973, a task force of the ] examined niacin monotherapy of patient populations with chronic schizophrenia and bipolar disorder and rejected the practice.<ref name="Menolascino">{{cite journal |author=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 |url=}}</ref>

== History ==

Orthomolecular psychiatry began with ] and ] in the 1950s and was continued by ] of the ]<ref name ="CarlPheifferBio">
{{cite web
|last=Saul
|first=AW
|coauthors=Jolliffe M, Hoffer A
|title=Bibliography of the Publications of Carl Pfeiffer, MD, PhD
|url=http://www.doctoryourself.com/biblio_pfeiffer_ed.html
|publisher=doctoryourself.com
|accessdate=2007-04-19
}}</ref>, although proponents of orthomolecular psychiatry say that the ideas behind their approach can be traced back to the 1920s and 1930s.<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}} 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
|pmid=
|doi=
}}</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
|pages=
|isbn=0195111435
}}</ref> Orthomolecular psychiatry's goal of weaning patients from conventional neuroleptic drugs<ref name=Edelman /> follows '] 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
|pages=
|isbn=1885670842
}}</ref> In 1968, ] 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-link=Science (journal)
|journal=Science
|volume=160
|issue=825
|pages=265–71
|year=1968
|pmid=5641253
|url=http://profiles.nlm.nih.gov/MM/B/B/J/Q/_/mmbbjq.pdf
|format=PDF
}}</ref><ref name="Pauling2">
{{cite book
|coauthors=Hawkins, D
|last=Pauling
|first=Linus
|authorlink=Linus Pauling
|title=Orthomolecular psychiatry: treatment of schizophrenia
|publisher=W.H. Freeman
|location=San Francisco
|year=1973
|isbn=0716708981
|page=697
}}</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
|author=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=
}}</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
|accessdate=2008-01-15
}}</ref> Orthomolecular psychiatry has subsequently found little support in mainstream psychiatry<ref name=QW>
{{cite web
|url=http://www.quackwatch.org/01QuackeryRelatedTopics/ortho.html
|title=Orthomolecular therapy
|last=Barrett
|first=Stephen
|authorlink=Stephen Barrett
|publisher=]
|date=2000-07-12
|accessdate=2008-01-02
}}</ref> and is currently considered to be unproven and potentially harmful. After 1975, research directly associated with orthomolecular psychiatry was primarily reported in ''Orthomolecular Psychiatry'', now the '']''.

== Diagnosis ==
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 |location= |year=2001 |pages= |isbn=0965097676 |oclc= |doi=}}</ref> These diagnoses have not been accepted by mainstream medicine.<ref name=QW />

==Specific conditions==
According to orthomolecular psychiatry, the causes of psychotic disorders include ''pyroluria'', ''histadelia'', ''histapenia'', ], ], ] in the presence of normal thyroid values, ] intoxications, as well as other rarer conditions.<ref name = Edelman/>

===Pyroluria===
''Pyroluria'' (or ''malvaria'' from the term ''mauve factor'') in orthomolecular medicine is the condition, initially described by ], of excessive levels of any of several ] molecules in the body, sometimes said to be caused by improper hemoglobin synthesis.<ref name ="LaPerchia">{{cite journal |author=LaPerchia P |title=Behavioral disorders, learning disabilities and megavitamin therapy |journal=Adolescence |volume=22 |issue=87 |pages=729–38 |year=1987 Fall |pmid=2963502}}</ref><ref name ="Heleniak">{{cite journal |author=Heleniak E, Lamola S |title=A new prostaglandin disturbance syndrome in schizophrenia: delta-6-pyroluria |journal=Med Hypotheses |volume=19 |issue=4 |pages=333–8 |year=1986 |pmid=3520252 |doi=10.1016/0306-9877(86)90106-4}}</ref><ref>{{cite journal |author=Irvine DG, Bayne W, Miyashita H, Majer JR |title=Identification of kryptopyrrole in human urine and its relation to psychosis |journal=Nature |volume=224 |issue=5221 |pages=811–3 |year=1969 |pmid=5361661 |doi=10.1038/224811a0}}</ref><ref>{{cite journal |author=Irvine DG |title=Hydroxy-hemopyrrolenone, not kryptopyrrole, in the urine of schizophrenics and porphyrics |journal=Clin. Chem. |volume=24 |issue=11 |pages=2069–70 |year=1978 |pmid=709853 |url=http://www.clinchem.org/cgi/pmidlookup?view=long&pmid=709853 |month=Nov |day=01}}</ref> According to ], pyroluria is a form of schizophrenic ], 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 |accessdate=2008-02-17}}</ref> These pyrroles are then said to bind to ] and ], leading to elimination through urine and causing deficiencies of these compounds; large-dose supplementation is said to return health.<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=1987 |pages= |isbn=0892812265}}</ref> Pyrolurics are also said to become deficient in ]s (specifically ]). Pyroluria is variously claimed to affect people diagnosed with ], ], ], ], ], ], ], ], ], or ].<ref name="Urinary Pyrrole">{{cite journal |author=Jackson James A; Riordan Hugh D; Neathery Sharon; Riordan Neil H | url=http://www.orthomolecular.org/library/jom/1997/pdf/1997-v12n02-p096.pdf |title=Urinary pyrrole in health and disease | format = PDF |journal=The Journal of Orthomolecular Medicine |volume=12 |issue=2nd Quarter |year=1997 |pages = 96–8 |accessdate=2008-02-17}}</ref><ref>{{cite web |title =Pyroluria and Elevated Kryptopyrrole | publisher = Direct Healthcare Access II Laboratory Inc |url=http://www.kryptopyrrole.com |accessdate=2008-02-17 }}</ref> Pyroluria is sometimes claimed to have a genetic origin and be activated by stress.<ref name=Edelman>{{cite book |last=Edelman |first =Eva |title=Natural Healing for Schizophrenia and Other Common Mental Disorders |publisher=Borage Books |edition=3rd |year=2001 |isbn=0965097676 }}</ref><ref name="Urinary Pyrrole"/><ref>{{cite journal |author=Walsh WJ, Glab LB, Haakenson ML |title=Reduced violent behavior following biochemical therapy |journal=Physiol Behav |volume=82 |issue=5 |pages=835–9 |year=2004 |pmid=15451647 |doi=10.1016/j.physbeh.2004.06.023}}</ref>

The ] claims an 85% success rate for treating ], ], and ], though these 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=] ]}} Available at Retrieved on ]</ref> Pyrrole molecules are not considered related to schizophrenia, and studies have either failed to detect hemopyrrole and kryptopyrrole in the urine of either normal controls or 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 = Pyroxidine - Vitamin B-6 |format=PDF |journal=Journal of Australian College of Nutritional & Environmental Medicine | volume = 14 | issue = 1 |month=July |year=1995 |pages=5–16 |accessdate=2007-04-19}}</ref><ref>{{cite journal |author=Cruz R, Vogel W |title=Pyroluria: a poor marker in chronic schizophrenia |journal=Am J Psychiatry |volume=135 |issue=10 |pages=1239–40 |year=1978 |pmid=696910}}</ref><ref>{{cite journal |author=Gendler PL, Duhan HA, Rapoport H |title=Hemopyrrole and kryptopyrrole are absent from the urine of schizophrenics and normal persons |url=http://www.clinchem.org/cgi/reprint/24/2/230 |journal=Clin Chem |volume=24 |issue=2 |pages=230–3 |year=1978 |pmid=627053 |month=Feb |day=01}}</ref><ref>{{cite journal |author=Jacobson SJ, Rapoport H, Ellman GL |title=The nonoccurrence of hemo- and kryptopyrrole in urine of schizophrenics |journal=Biol Psychiatry |volume=10 |issue=1 |pages=91–3 |year=1975 |pmid=1120177}}</ref><ref>{{cite journal |author=Gorchein 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 |journal=Clin. Sci. |volume=58 |issue=6 |pages=469–76 |year=1980 |pmid=7428279}}</ref><ref>{{cite journal |author=Vaughan K, McConaghy N |title=Megavitamin and dietary treatment in schizophrenia: a randomised, controlled trial |journal=Aust N Z J Psychiatry |volume=33 |issue=1 |pages=84–8 |year=1999 |pmid=10197889 |doi=10.1046/j.1440-1614.1999.00527.x}}</ref> Proponents claim that pyroluria is relatively common, but 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://web.archive.org/web/20070211000315/http://www.clinicalanswers.nhs.uk/index.cfm?question=1208}}</ref> the approach is described as "snake oil" by critics, such as the pediatrician and author Julian Haber.<ref name=Skertic/>

===Histadelia===
''Histadelia'' is a condition hypothesised by orthomolecular psychiatrists<ref name="pfeiffer"> {{cite journal |author=Pfeiffer Carl C et al. |title=Blood histamine levels, basophil counts, and trace metals in the schizophrenias |journal=Psychopharmacol Bull |year=1971 |month=July |volume=7 |issue=3 |pages=37 |pmid= |doi=}}</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 |year=1972 |month=July |volume=4 |issue=1 |pages=51-9|pmid= |doi=}}</ref> to involve elevated serum levels of ] and ].<ref name="edelman"><!-- suspected duplicate --> Edelman, E, Natural Healing for Schizophrenia, Borage Books, 3rd edition, 2001</ref> It was identified by ] Practitioners treat it using the aminoacid ], vitamin B<sub>6</sub>, as well as other supplements.<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=}}</ref>

Orthomolecular pracitioners suggest that "histadelia" can cause depression with or without psychosis, and they aim to treat it with methionine or augmenting other hypothesised amino acid imbalances. No published any clinical trials test 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 |location= |year=1987 |pages= |isbn=0892812265}}</ref>

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

==Treatment centers==
Currently, orthomoleculary psychiatry continues to be investigated by a small number of researchers. The ] is dedicated to the research and use of orthomolecular psychiatry in the treatment of ], ], ], and violent criminal behavior.{{cn}}

== Relationship to mainstream psychiatry ==
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 |doi=}}</ref> 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<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}}</ref> have criticized orthomolecular treatments as ineffective and toxic.

A 1973 task force of the American Psychiatric Association charged with investigating orthomolecular claims unanimously concluded:
<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>{{citation |author=Lipton M, et al. |title=Task force report on megavitamin and orthomolecular Therapy in psychiatry |location=Washington DC |year=1973 |publisher=] |pmid= |doi=}}; as cited in {{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></blockquote>

== Dental amalgams ==
{{main|Dental amalgam controversy}}
Between 1997 and 1999 the Journal of Orthomolecular Medicine published articles that suggested there was a ] between ] fillings and schizophrenia,<ref >
{{cite journal
|format=PDF
|url=http://orthomolecular.org/library/jom/1999/pdf/1999-v14n04-p201.pdf
|author=Sibelrud RL, et al.
|year=1999
|title=Psychometric evidence that dental amalgam mercury may be an etiological factor in schizophrenia |journal=J Orthomolecular Med
|volume=14
|issue=4
|pages=201–209
|pmid=
|doi=
}}</ref> bipolar disorder,<ref>
{{cite journal
|url=http://orthomolecular.org/library/jom/1998/pdf/1998-v13n01-p031.pdf
|format=PDF
|author=Sibelrud RL, et al.
|year=1998
|title=Psychometric evidence that dental amalgam mercury may be an etiological factor in manic depression
|journal=J Orthomolecular Med
|volume=13
|issue=1
|pages=31–40
|pmid=
|doi=
}}</ref> and ].<ref>
{{cite journal
|url=http://orthomolecular.org/library/jom/1997/pdf/1997-v12n03-p169.pdf
|format=PDF
|author=Sibelrud RL, et al.
|year=1997
|title=Evidence that mercury from silver dental fillings may Be an etiological factor in reduced nerve conduction velocity in multiple sclerosis patients
|journal=J Orthomolecular Med
|volume=12
|issue=3
|pages=169–172
|accessdate=2008-01-12
}}</ref> These ideas are not supported by scientific evidence, and a recent ] of four ] studies found significant differences between the findings of the individual studies, but on average no significant association between amalgam fillings and multiple sclerosis.<ref>
{{cite journal
|author=Aminzadeh KK, Etminan M
|title=Dental amalgam and multiple sclerosis: a systematic review and meta-analysis
|journal=J Public Health Dent
|volume=67
|issue=1
|pages=64–6
|year=2007
|pmid=17436982
|doi=10.1111/j.1752-7325.2007.00011.x
}}</ref> The ] and ]'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,<ref name=FDA>
{{cite web
|url=http://www.fda.gov/cdrh/consumer/amalgams.html
|title=Questions and answers on dental amalgam
|date=2006-10-30
|accessdate=2008-01-04
|publisher=US ]
|accessdate=
}}</ref><ref>
{{cite web
|url=http://www.ada.org/prof/resources/positions/statements/amalgam.asp
|title=ADA statement on dental amalgam
|date=2007-04-06
|accessdate=2008-01-04
|publisher=]
}}</ref> though an ] 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.<ref name=FDA />

==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> ] attributed his recovery from schizophrenia to orthomolecular psychiatry and advocated its adoption by mainstream medicine, but later disavowed his statements.<ref name = Edelman/>

== References ==
{{reflist|3}}

== Bibliography ==
* {{cite book |last=Braverman |first=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 |pages= |isbn=1591200377}}
* {{cite book |last2=Hawkins |first2=D| last1=Pauling |first1=Linus |authorlink=Linus Pauling |title=Orthomolecular psychiatry: treatment of schizophrenia |publisher=W.H. Freeman |location=San Francisco |year=1973 |page=697 |isbn=0716708981}}
* {{cite book |last=Pfeiffer |first=Carl J |authorlink=Carl Pfeiffer (pharmacologist) |title=Nutrition and mental illness: An orthomolecular approach to balancing body chemistry |publisher=Healing Arts |location= |year=1987 |pages= |isbn=0892812265 }}
* {{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 |pages= |isbn=0961855088}}

== External links ==
*
* , orthomolecular treatment center whose predecessor was founded by ]
*

]
]
]

]

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