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Orthomolecular psychiatry

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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 niacin monotherapy of patient populations with chronic schizophrenia and bipolar disorder and rejected the practice.

History

Orthomolecular psychiatry began with Abram Hoffer and Humphry Osmond in the 1950s and was continued by Carl Pfeiffer of the Pfeiffer Treatment Center, although proponents of orthomolecular psychiatry say that the ideas behind their approach can be traced back to the 1920s and 1930s. 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 used the term "orthomolecular".

The assertions by proponents of orthomolecular psychiatry were rejected in 1973 by a panel of the American Psychiatric Association. Orthomolecular psychiatry has subsequently found little support in mainstream psychiatry 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 Journal of Orthomolecular Medicine.

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

According to orthomolecular psychiatry, the causes of psychotic disorders include pyroluria, histadelia, histapenia, food allergy, hypoglycemia, hypothyroidism in the presence of normal thyroid values, heavy metal intoxications, as well as other rarer conditions.

Pyroluria

Pyroluria (or malvaria from the term mauve factor) in orthomolecular medicine is the condition, initially described by Abram Hoffer, of excessive levels of any of several pyrrole molecules in the body, sometimes said to be caused by improper hemoglobin synthesis. According to Carl Pfeiffer, 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. These pyrroles are then said to bind to vitamin B6 and zinc, leading to elimination through urine and causing deficiencies of these compounds; large-dose supplementation is said to return health. Pyrolurics are also said to become deficient in omega-6 fatty acids (specifically arachidonic acid). Pyroluria is variously claimed to affect people diagnosed with ADHD, alcoholism, autism, depression, down syndrome, manic-depression, schizophrenia, coeliac disease, epilepsy, or psychosis. Pyroluria is sometimes claimed to have a genetic origin and be activated by stress.

The Pfeiffer Treatment Center claims an 85% success rate for treating ADHD, autism, and schizophrenia, though these methods have not been rigorously tested. 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. 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; the approach is described as "snake oil" by critics, such as the pediatrician and author Julian Haber.

Histadelia

Histadelia is a condition hypothesised by orthomolecular psychiatrists to involve elevated serum levels of histamine and basophils. It was identified by Carl Pfeiffer. Practitioners treat it using the aminoacid methionine, vitamin B6, as well as other supplements.

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.

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 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.

Dental amalgams

Main article: Dental amalgam controversy

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

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Bibliography

  • Braverman, Eric R; Pfeiffer, Carl Curt; Blum, Kenneth; Smayda, Richard (2003). The healing nutrients within: facts, findings, and new research on amino acids (3rd ed.). North Bergen, New Jersey: Basic Health. ISBN 1591200377.
  • Pauling, Linus; Hawkins, D (1973). Orthomolecular psychiatry: treatment of schizophrenia. San Francisco: W.H. Freeman. p. 697. ISBN 0716708981.
  • Pfeiffer, Carl J (1987). Nutrition and mental illness: An orthomolecular approach to balancing body chemistry. Healing Arts. ISBN 0892812265.
  • Werbach, Melvyn R (1999). Nutritional influences on mental illness: a sourcebook of clinical research. Tarzana, California: Third Line. ISBN 0961855088.

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