Orthomolecular psychiatry

Orthomolecular psychiatry is a branch of orthomolecular medicine that believes that specific dietary supplements and measures may be effective in treating mental illness. Specific techniques commonly employed include individual biochemical workup, dietary measures, juice fasting, supplementation of essential nutrients especially vitamins C and B-3, minerals and identifying allergies.

It has used such techniques, including megadoses of vitamins, in the treatment of alcoholism, drug addiction, anxiety, autism, depression, hyperactivity, ADHD, Alzheimer's Disease, retardation, senility, bipolar disorder and schizophrenia. Pioneered in the 1950s by psychiatric physician-biochemists, Abram Hoffer and Humphry Osmond in Canada, the embryonic field of orthomolecular psychiatry was further advanced by the efforts and support of Carl Pfeiffer, David Horrobin and Linus Pauling.

Potentially impacting (then) conventional psychiatric markets and methodologies such as extended analysis, indefinite hospitalization, invasive procedures (e.g. electroshock) and neuroleptics, orthomolecular psychiatry is controversial. Some studies claim to it to be of no use. Mark Vonnegut discusses this regimen in his memoir The Eden Express. Vonnegut, a Harvard-trained pediatrician who practices in Boston, Massachusetts, once advocated the use of orthomolecular psychiatry but later disavowed such certainty after medical school.

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..."; compared with a basic, modern orthomolecular regimen.

Previous critics have noted that the claims of proponents are considered unsubstantiated by conventional psychiatry. Conventional authoritative bodies such as the National Institute of Mental Health and American Academy of Pediatrics have historically criticized orthomolecular treatments as ineffective and potentially toxic. A 1973 task force of the American Psychiatric Association charged with investigating orthomolecular claims, but instead focused on niacin monotherapeutically, 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.

Proponents consider the APA task force report error laden with sweeping, scientifically unfounded conclusions, highly politicized, and that its studies failed to use similar methods, materials and subjects as the orginal work. The APA report's criticism alleges inadequate controlled trials because Hoffer 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. 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 and an extensive biochemical research program. One of the APA report's six authors, psychologist JR Wittenborn, reacting to Hoffer's specific criticisms, later re-analyzed his original double blind study favorably with respect to orthomolecular psychiatry, obtaining the same result as Hoffer, and never received NIMH or APA support again. Wittenborn's latter report also goes unquoted by critics. Another of the APA report's authors, then NIMH member Loren Mosher, later resigned from the American Psychiatric Association in total disgust, which he also called a "drug company patsy."

Many orthomolecular physicians still prescribe neuroleptics, initially. However, the long term avoidance of neuroleptics is the main goal. Pfeiffer's Law, actually a dictum, states, "For every drug that benefits a patient, there is a natural substance that can achieve the same effect."