Abram Hoffer

Abram Hoffer (b. 1917) is a controversial Canadian psychiatrist known for his early development of biochemically based therapies including the use of nutrition and vitamins in the treatment of schizophrenia, known as orthomolecular psychiatry, as well as other diseases. This general approach, known as orthomolecular medicine, includes the use of megavitamins.

Background
Hoffer graduated with a Bachelor of Science in Agriculture (Great Distinction) from the University of Saskatchewan in 1938, followed by a Masters Degree in Agriculture (agricultural chemistry) in 1940. He received a Ph.D. in biochemistry from the University of Minnesota in 1944 with research into vitamin content in cereals. Gaining an interest in human nutrition, Hoffer entered medical school, graduating with an MD from the University of Toronto in 1949 and completing his psychiatric training in 1954. Hoffer was a faculty member of the College of Medicine at the University of Saskatchewan from 1955-67. Hoffer also served as the Director of Psychiatric Research for the Saskatchewan Department of Public Health in Regina from 1950-67. As he noted that half the patients housed in the mental hospital were diagnosed as schizophrenics and that the conditions in the mental hospital and the treatment of these patients were poor, he looked for better answers to treat the mentally ill. He used biochemistry and human physiology as an emergent psychiatric research paradigm, and was critical of psychosomatic psychoanalysis and the lack of adequate definition and measurement in psychiatric methodology.

By the mid-1960’s the psychiatric establishment, moving heavily towards neuroleptic drugs, began to snub Hoffer’s orthomolecular theories and treatments, and refused to publish works favorable to orthomolecular medicine. Subsequently, in 1967 Hoffer resigned his academic and Director positions, entered into private psychiatric practice in Saskatoon, Saskatchewan and created the Journal of Schizophrenia as a means of publishing articles related to orthomolecular psychiatry. After a few name changes over a number of years, this journal eventually became the Journal of Orthomolecular Medicine in 1986. In 1976, Hoffer relocated to Victoria, British Columbia and continued with his private psychiatric practice until his retirement in 2005. Hoffer continues to provide nutritional consultations and also continues as the editor of the Journal of Orthomolecular Medicine.

Research
Working with Humphry Osmond, MD and their scientific teams, Hoffer and Osmond developed the oxidized adrenaline - adrenochrome model of schizophrenia, the Hoffer-Osmond Diagnostic Test (HOD), niacin therapy for schizophrenia, and tests for hallucinogenic indole metabolites.

In attempting to devise a treatment for alcoholism, Hoffer and Osmond did studies with LSD. Theorizing that alcoholics needed to hit bottom before they were willing to stop drinking, Hoffer and Osmond attempted to use LSD to simulate delirium tremens (i.e.: hitting bottom) in alcoholics. Hoffer claimed a 50% success rate with 2000 alcoholics, although he noted that it was more likely the psychedelic experience of LSD rather than simulated delirium tremens that convinced the alcoholics to stop drinking.

Incidental to Hoffer's psychiatric work with niacin, he discovered the first successful anticholesterol treatment. Niacin treatment remains the cholesterol treatment best proven to actually extend life with highly beneficial improvements to HDL, Lp(a) and triglycerides as well as lowering LDL for several major types of hyperlipidemia, although the time release forms, particularly some of the slower pre-1994 formulations over 2 grams per day, can have potentially serious side effects.

Taking note of biochemical abnormalities and serendipitous cancer recoveries among his psychiatric patients, Hoffer worked for several years on the anticancer effects of vitamins particularly the B vitamins and ascorbate. This work includes treating many hundreds of cancer patients with nutrients with reported success. Hoffer collaborated with Linus Pauling on several aspects of orthomolecular medicine but especially the anticancer actions of vitamin C.

Controversy
Hoffer's treatment for schizophrenia and theories of orthomolecular medicine remain controversial as they have not been generally accepted by the mainstream medical community as of 2006. An American Psychiatric Association Task Force Report of July 1973 on using niacin in treating schizophrenia claimed both methodological flaws in Hoffer’s early work and other studies which failed to show clear benefit of this therapy. Hoffer and Osmond wrote a lengthy rebuttal to this report, citing many errors, misrepresentations, and biases. However niacin, B6, and ascorbates are still not widely used or recommended in the conventional treatments of schizophrenia. Some other limited studies that did not meet Hoffer's original conditions have also failed to find benefits in use of megavitamin therapy to treat schizophrenia.

As of 2005, orthomolecular psychiatry remains to be adequately tested and independently verified by conventional authoritative bodies. "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..."

Hoffer stated in the 1950s that such controversy would exist regarding his treatments and that he felt that it would take at least forty years for his methods to become accepted. In a 2006 interview, Hoffer stated that while he felt that current mainstream psychiatric care was “terrible”, he felt that his theories and treatments were starting to become more accepted. “[W]e’re at a transition point. If I live another four or five years, I’ll see it.”