Orthomolecular psychiatry
Encyclopedia
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 symptom
s, and claims to tailor the treatment accordingly, using a combination of nutrients, dietary changes and medication
s 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 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.
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 '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
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, orthomolecular psychiatry research was primarily reported in Orthomolecular Psychiatry, now the Journal of Orthomolecular Medicine
, a fringe publication founded by Abram Hoffer to counter what he considered to be a medical conspiracy against his ideas.
; 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 acid
s, and other so-called "pharmacologic nutrients". These diagnoses have not been accepted by mainstream medicine.
, 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. These conditions are not recognized by the conventional medical community.
s 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 pyrrole
s and porphyrin
s 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.
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.
A 1973 task force of the American Psychiatric Association charged with investigating orthomolecular claims unanimously concluded:
Studies since then have tended to confirm that while other medical conditions may respond to diet and/or vitamin treatments, psychiatric conditions do not respond to them at all.
Orthomolecular medicine
Orthomolecular medicine is a form of complementary and alternative medicine that seeks to maintain health and prevent or treat diseases by optimizing nutritional intake and/or prescribing supplements...
for mental illness
Mental illness
A mental disorder or mental illness is a psychological or behavioral pattern generally associated with subjective distress or disability that occurs in an individual, and which is not a part of normal development or culture. Such a disorder may consist of a combination of affective, behavioural,...
. The approach uses unorthodox forms of individualized testing and diagnosis to attempt to establish an etiology
Etiology
Etiology is the study of causation, or origination. The word is derived from the Greek , aitiologia, "giving a reason for" ....
for each patient's specific symptom
Symptom
A symptom is a departure from normal function or feeling which is noticed by a patient, indicating the presence of disease or abnormality...
s, and claims to tailor the treatment accordingly, using a combination of nutrients, dietary changes and medication
Medication
A pharmaceutical drug, also referred to as medicine, medication or medicament, can be loosely defined as any chemical substance intended for use in the medical diagnosis, cure, treatment, or prevention of disease.- Classification :...
s that are claimed to enhance quality of life and functionality as well as to reduce or eliminate symptoms and the use of xenobiotic
Xenobiotic
A xenobiotic is a chemical which is found in an organism but which is not normally produced or expected to be present in it. It can also cover substances which are present in much higher concentrations than are usual...
drugs.
Abram Hoffer
Abram Hoffer
Abram Hoffer was a Canadian biochemist, physician and psychiatrist. Hoffer developed a theory that nutrition and vitamins may be effective treatments for schizophrenia...
in the 1950s was the first major practitioner. Hoffer's therapies focused on using niacin
Niacin
"Niacin" redirects here. For the neo-fusion band, see Niacin .Niacin is an organic compound with the formula and, depending on the definition used, one of the forty to eighty essential human nutrients.Niacin is one of five vitamins associated with a pandemic deficiency disease: niacin deficiency...
, among other nutrients, to treat what he diagnosed as acute schizophrenia
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
based on an unaccepted test. In 1973, a task force of the American Psychiatric Association
American Psychiatric Association
The American Psychiatric Association is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the most influential worldwide. Its some 38,000 members are mainly American but some are international...
examined niacin monotherapy of patient populations with chronic schizophrenia and bipolar disorder
Bipolar disorder
Bipolar disorder or bipolar affective disorder, historically known as manic–depressive disorder, is a psychiatric diagnosis that describes a category of mood disorders defined by the presence of one or more episodes of abnormally elevated energy levels, cognition, and mood with or without one or...
and rejected the practice along with the reliability of Hoffer's diagnostic approach.
History
Orthomolecular psychiatry began with Abram Hoffer and Humphry OsmondHumphry Osmond
Humphry Fortescue Osmond was a British psychiatrist known for inventing the word psychedelic and for using psychedelic drugs in medical research...
in the 1950s and was continued by Carl Pfeiffer of the Pfeiffer Treatment Center
Pfeiffer Treatment Center
The Pfeiffer Treatment Center is a U.S. clinic devoted to orthomolecular psychiatry and medical research particularly pertaining to autism and pyroluria, and the neurobiology of criminal behavior.- About the Center:...
, 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
Linus Pauling
Linus Carl Pauling was an American chemist, biochemist, peace activist, author, and educator. He was one of the most influential chemists in history and ranks among the most important scientists of the 20th century...
used the term "orthomolecular".
The assertions by proponents of orthomolecular psychiatry were rejected in 1973 by a panel of the American Psychiatric Association
American Psychiatric Association
The American Psychiatric Association is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the most influential worldwide. Its some 38,000 members are mainly American but some are international...
. Orthomolecular psychiatry has subsequently found little support in mainstream psychiatry and is currently considered to be unproven and potentially harmful. After 1975, orthomolecular psychiatry research was primarily reported in Orthomolecular Psychiatry, now the Journal of Orthomolecular Medicine
Journal of Orthomolecular Medicine
The Journal of Orthomolecular Medicine was established in 1967 by Abram Hoffer. It publishes studies in nutritional and orthomolecular medicine...
, a fringe publication founded by Abram 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 psychosisPsychosis
Psychosis means abnormal condition of the mind, and is a generic psychiatric term for a mental state often described as involving a "loss of contact with reality"...
; according to orthomolecular proponents, testing for these causes guides diagnosis and treatment. Diagnostic measures and therapies commonly employed include "individual biochemical workup", fasting
Fasting
Fasting is primarily the act of willingly abstaining from some or all food, drink, or both, for a period of time. An absolute fast is normally defined as abstinence from all food and liquid for a defined period, usually a single day , or several days. Other fasts may be only partially restrictive,...
, identifying suggested allergies, dietary changes, megavitamin therapy
Megavitamin therapy
Megavitamin therapy is the use of large doses of vitamins, often many times greater than the recommended dietary allowance in the attempt to prevent or treat diseases...
, amino acid
Amino acid
Amino acids are molecules containing an amine group, a carboxylic acid group and a side-chain that varies between different amino acids. The key elements of an amino acid are carbon, hydrogen, oxygen, and nitrogen...
s, 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 allergyFood allergy
A food allergy is an adverse immune response to a food protein. They are distinct from other adverse responses to food, such as food intolerance, pharmacological reactions, and toxin-mediated reactions....
, hypoglycemia
Hypoglycemia
Hypoglycemia or hypoglycæmia is the medical term for a state produced by a lower than normal level of blood glucose. The term literally means "under-sweet blood"...
, hypothyroidism
Hypothyroidism
Hypothyroidism is a condition in which the thyroid gland does not make enough thyroid hormone.Iodine deficiency is the most common cause of hypothyroidism worldwide but it can be caused by other causes such as several conditions of the thyroid gland or, less commonly, the pituitary gland or...
in the presence of normal thyroid values, heavy metal intoxications including those allegedly due to dental fillings
Dental amalgam controversy
The dental amalgam controversy refers to the conflicting views over the use of amalgam as a filling material mainly because it contains the element mercury...
, as well as several hypothesised conditions they call pyroluria, histadelia and histapenia. These conditions are not recognized by the conventional medical community.
Pyroluria
Pyroluria (or malvaria from the term mauve factor) involves hypothetical excessive levels of pyrrolePyrrole
Pyrrole is a heterocyclic aromatic organic compound, a five-membered ring with the formula C4H4NH. It is a colourless volatile liquid that darkens readily upon exposure to air. Substituted derivatives are also called pyrroles, e.g., N-methylpyrrole, C4H4NCH3...
s in the body resulting from improper hemoglobin synthesis. Carl Pfeiffer believed that pyroluria is a form of schizophrenic porphyria
Porphyria
Porphyrias are a group of inherited or acquired disorders of certain enzymes in the heme bio-synthetic pathway . They are broadly classified as acute porphyrias and cutaneous porphyrias, based on the site of the overproduction and accumulation of the porphyrins...
, similar to acute intermittent porphyria
Acute intermittent porphyria
Acute intermittent porphyria is a rare autosomal dominant metabolic disorder affecting the production of heme, the oxygen-binding prosthetic group of hemoglobin. It is characterized by a deficiency of the enzyme porphobilinogen deaminase. Acute intermittent porphyria is the second most common...
where both pyrrole
Pyrrole
Pyrrole is a heterocyclic aromatic organic compound, a five-membered ring with the formula C4H4NH. It is a colourless volatile liquid that darkens readily upon exposure to air. Substituted derivatives are also called pyrroles, e.g., N-methylpyrrole, C4H4NCH3...
s and porphyrin
Porphyrin
Porphyrins are a group of organic compounds, many naturally occurring. One of the best-known porphyrins is heme, the pigment in red blood cells; heme is a cofactor of the protein hemoglobin. Porphyrins are heterocyclic macrocycles composed of four modified pyrrole subunits interconnected at...
s are excreted in the human urine to an excessive degree. and orthomolecular psychiatrists have alleged that pyroluria is related to diagnoses of ADHD, alcoholism
Alcoholism
Alcoholism is a broad term for problems with alcohol, and is generally used to mean compulsive and uncontrolled consumption of alcoholic beverages, usually to the detriment of the drinker's health, personal relationships, and social standing...
, autism
Autism
Autism is a disorder of neural development characterized by impaired social interaction and communication, and by restricted and repetitive behavior. These signs all begin before a child is three years old. Autism affects information processing in the brain by altering how nerve cells and their...
, depression
Clinical depression
Major depressive disorder is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities...
, down syndrome
Down syndrome
Down syndrome, or Down's syndrome, trisomy 21, is a chromosomal condition caused by the presence of all or part of an extra 21st chromosome. It is named after John Langdon Down, the British physician who described the syndrome in 1866. The condition was clinically described earlier in the 19th...
, manic-depression
Bipolar disorder
Bipolar disorder or bipolar affective disorder, historically known as manic–depressive disorder, is a psychiatric diagnosis that describes a category of mood disorders defined by the presence of one or more episodes of abnormally elevated energy levels, cognition, and mood with or without one or...
, schizophrenia
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
, celiac disease, epilepsy
Epilepsy
Epilepsy is a common chronic neurological disorder characterized by seizures. These seizures are transient signs and/or symptoms of abnormal, excessive or hypersynchronous neuronal activity in the brain.About 50 million people worldwide have epilepsy, and nearly two out of every three new cases...
, and psychosis
Psychosis
Psychosis means abnormal condition of the mind, and is a generic psychiatric term for a mental state often described as involving a "loss of contact with reality"...
. 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 histamineHistamine
Histamine is an organic nitrogen compound involved in local immune responses as well as regulating physiological function in the gut and acting as a neurotransmitter. Histamine triggers the inflammatory response. As part of an immune response to foreign pathogens, histamine is produced by...
and basophils, which he says can be treated with methionine
Methionine
Methionine is an α-amino acid with the chemical formula HO2CCHCH2CH2SCH3. This essential amino acid is classified as nonpolar. This amino-acid is coded by the codon AUG, also known as the initiation codon, since it indicates mRNA's coding region where translation into protein...
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 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.
Studies since then have tended to confirm that while other medical conditions may respond to diet and/or vitamin treatments, psychiatric conditions do not respond to them at all.