Conditions > Schizophrenia

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Definition

Schizophrenia is a severe mental disorder characterized by retreat from reality (psychosis), hallucinations, delusions, abnormal thought processes and disrupted social functioning. Schizophrenia subtypes include:

Symptoms of schizophrenia fall into two major categories:

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Issues

One of the world’s most well known researchers on the nutritional treatment of schizophrenia is Abram Hoffer, MD, PhD, a psychiatrist with a PhD in biochemistry. He is said to have published 550 scientific documents and written 17 books beginning over half a century ago in 1952. Andrew Saul, PhD has made Hoffer's biography and a bibliography of his publications available online. Hoffer’s Curriculum Vitae is also available online. Now 87 years old, Hoffer is currently Editor-in-Chief of the Journal of Orthomolecular Medicine, President of The Huxley Institute (a non-profit schizophrenia research organization), and is still in private practice.

In 1999 Hoffer published Orthomolecular Treatment for Schizophrenia, which details the nutritional program he developed along with the results achieved after personally working with 4000 schizophrenic patients. His treatment program, as summarized online HERE, claims significant long-term success in treating schizophrenia. His program includes supplementing specific vitamins, minerals & fatty acids, as well as elimination of processed foods, additives and food sensitivities.

Other related books by Hoffer:

Hoffer has a detailed article available online (~21,000 words) in which he describes the development of his program. Hoffer and colleagues where the first to conduct double-blind, controlled experiments in the history of psychiatry, which they did from 1952 to 1960 on the relationship between vitamin B3 (niacin) and schizophrenia. Hoffer went on to co-author papers with the well known researcher Linus Pauling. Pauling and Hoffer co-founded what is referred to as 'Orthomolecular Medicine'. In 1975 Hoffer, and his colleague Dr. Humphry Osmond, published a schizophrenia diagnostic system called 'The Hoffer-Osmond Diagnostic (HOD) Test' Hoffer also features in a documentary describing the orthomolecular treatment of schizophrenia entitled 'Masks of Madness: Science of Healing'.

Online articles by Hoffer relating to schizophrenia:

Carl Pfeiffer, MD, PhD, another prominent figure in the development nutritional treatments of schizophrenia, worked with 20,000 schizophrenia patients over the span of his career. His research on schizophrenia spanned from 1965 until his death in 1988. His publication bibliography is available online.

In 1988 he published Nutrition and Mental Illness: An Orthomolecular Approach to Balancing Body Chemistry, in which he describes nutritional treatment for such psychiatric disorders as schizophrenia and depression.

In 1988 he also published:

An online excerpt from 'Nutrition and Mental Illness'describes 29 medical causes of schizophrenia and their treatment. In this book (page 10) Pfeiffer describes the biochemical classification system he created for schizophrenia. He lists the ‘five main biotypes of schizophrenias’ as follows:

*He notes the percentages do not add up to 100 because some schizophrenics have more than one disorder.

He identified the need for individualized treatment based on the patients individual chemical characteristics. Also described in his book are nutritional guidelines for each biotype. After his death, the Pfeiffer Treatment Center (PTC) was formed where they have carried his research and offer nutritionally based treatments for such illnesses as schizophrenia, depression and autism. They have continued to refine the ideas created by such people as Dr. Pfeiffer and Dr. Hoffer and are one of the top treatment facilities in the world for individualized, biochemical treatment of mental illnesses.

Table 1: Schizophrenia biotype characteristics.

Histadelia/High Histamine
(under-methylated)
Histapenia/Low Histamine
(over-methylated)
Pyroluria
Common nutritional
imbalances
Depressed calcium, methionine, B6 and excess folic acid Depressed folate, B3, B12 and excess copper Depressed zinc, B6 and arachidonic acid (an omega-6 fat)
Common neuro-transmitter imbalances High histamine and low serotonin, dopamine and norepinephrine Low histamine and elevated serotonin, dopamine and norepinephrine Low serotonin
Beneficial supplements Calcium, methionine, SAMe,
magnesium, zinc, TMG,
omega-3 essential oils, B6, inositol, A, C and E
B3, B6, B12, DMAE, folate,
choline, manganese, zinc, omega-3 essential oils, C and E
B6, zinc, evening primrose oil, C, E and manganese
Potentially harmful
supplements
Folate, choline, DMAE, copper and histidine Methionine, SAMe, inositol, tryptophan, phenylalanine, St. John’s wort, tyrosine, copper, TMG and DMG Histidine, copper and omega-3 fatty acids.
Typical dominant
schizophrenia symptoms
Delusional thinking or
catatonia
Paranoia or auditory
hallucinations
Mixed

* SAM-e = s-adenosyl-methionine, DMAE = di-methyl-amino-ethanol, TMG = tri-methyl-glycine (betaine), DMG = di-methyl-glycine.

Table 2: The Pfeiffer Treatment Center’s updated biochemical subtypes list for schizophrenia.

Histapenia (over-methylation) 45%
Histadelia (under-methylation) 18%
Pyroluria 27%
Gluten intolerance 4%
Other (includes psychomotor epilepsy, hyperprolactinemia, homocystinuria, drug-induced psychosis, polydipsia & thyroid disorders) 6%

The following on site link is a tabulated catalog of typical characteristics of these subtypes, which may be used to determine subtype in many cases, although laboratory tests are required to be certain:

The Pfeiffer Treatment Center claims that due to the diverse chemical nature of the different biochemical subgroups for schizophrenia, some nutritional supplements for each group can exacerbate biochemical imbalances and be harmful for the individual. Biochemical sub-groupings must be determined with the help of a health professional before taking any of the listed supplements for this condition.

Omega-3 fatty acids and schizophrenia

Omega-3 fatty acids are essential components of brain cell membranes, including those of neurotransmitter receptors. Omega-3 fatty acids also regulates signal transduction and electrical activity in brain cells, and control the synthesis of chemicals such as eicosanoids and cytokines, which may have a direct effect on mental health. Abnormalities in cell membrane fatty acid composition are related to the symptoms of schizophrenia, especially negative symptoms (e.g. social withdrawal, cognitive decline, apathy). Research, as summarized below, generally points to omega-3 fatty acid supplementation having a therapeutic effect on schizophrenic symptoms and correcting cell membrane abnormalities. Research focuses on the omega-3 fatty acid EPA (eicosapentaenoic acid). People with schizophrenic biotype, pyroluria, are often deficient in arachidonic acid, an omega-6 fatty acid. The Pfeiffer Treatment Center generally advises the use of evening primrose oil (rich in the direct precursor of arachidonic acid) for people with pyroluria. Fatty acid profiles by schizophrenic biotype are discussed in the following research article by the Pfeiffer Treatment Center:

Table 3: Research on omega-3 fatty acid supplementation for Schizophrenia:

Subjects Supplement General Outcome Reference
115 EPA Reduction of symptoms J Psychiatr Res. 2002 Jan-Feb;36(1):7-18
44 EPA + DHA Reduction in psychopathology Schizophr Res. 2003 Aug 1;62(3):195-204
40 EPA Reduction of symptoms Am J Psychiatry 2002 Sep;159(9):1596-8
1 EPA Reversal of cerebral atrophy Int J Clin Pract 2000 Jan-Feb;54(1):57-63
1 EPA Reduction in symptoms Int J Psychophysiol 1999 Dec;34(3):333-9
87 EPA Effects no greater than placebo Am J Psychiatry. 2001 Dec;158(12):2071-4
1 EPA Reduction of symptoms Eur Neuropsychpharm 2000 May;10(3):189-93
45 DHA or EPA EPA superior to DHA and placebo Schizophr Res 2001 Apr 30;49(3):243-51
26 EPA Reduction of symptoms Schizophr Res 2001 Apr 30;49(3):243-51
6 EFA's Therapeutic effect Prostaglandins Med 1979 Jan;2(1):77-80

DHA = Omega-3 fatty acid docosahexaenoic acid

Related link:

Minerals, vitamins and schizophrenia:

Food/chemical sensitivities and schizophrenia

'Cerebral allergies' (those which affect mental health in some way) can contribute to irritability, depression and psychosis. Carl Pfeiffer, MD, PhD reported that for 10% of schizophrenics, cerebral allergy is the primary factor. William Philpott, MD (author of Brain Allergies: The Psycho-Nutrient Connection, 1980) claims that more than 50% of schizophrenics display some form of cerebral allergy which contributes to symptoms. Common sensitivities in schizophrenia include:

Related article:

Amino acids and schizophrenia

Research exists on the therapeutic effect of amino acids (mainly glycine) for schizophrenia. Glycine is essential for the central nervous system and also functions as an inhibitory neurotransmitter.

Table 4: Research on glycine supplementation for Schizophrenia

Subjects Supplement General Outcome Reference
17 High-dose glycine Reduction in negative symptoms & improvement in cognitive and positive symptoms Biological Psychiatry 2003
12 High-dose glycine Reduction in negative symptoms Int J Neuropsychopharmacol 2001 Dec;4(4):385-91
14 High dose glycine Reduction in negative symptoms Am J Psychiatry 1994 Aug;151(8):1234-6
22 (treatment resistant) High dose glycine Reduction in negative symptoms and improvement in psychiatric rating Arch Gen Psychiatry 1999 Jan;56(1):29-36
11 (treatment resistant) High dose glycine Reduction in negative symptoms
Br J Psychiatry 1996 Nov;169(5):610-7

Table 5: Amino acid supplements by schizophrenic subtype

Histapenia/Low Histamine
(over-methylated)
Histadelia/High Histamine
(under-methylated)
Pyroluria
Potentially harmful
amino acid supplements
Methionine, phenylalanine,
tryptophan & tyrosine
Histidine Histidine
Potentially beneficial
amino acid supplements
Histidine & glycine* Methionine, glycine*,
tryptophan & tyrosine
Glycine* & tryptophan

*Glycine is potentially beneficial in subtypes where negative symptoms are present.
**Pyroluria may overlap with methylation/histamine imbalances.

Amino acids are the basic building blocks of proteins, including neurotransmitters which have important mental health regulating properties. Supplementing these amino acids in people displaying evidence of neurotransmitter deficiency has been shown to reduce psychiatric symptoms in many people. Regarding schizophrenia, these amino acid supplements should only be taken with great caution and based of individual biochemistry, as many schizophrenics display excess levels of dopamine, norepinephrine, serotonin and histamine. Neurotransmitter synthesis pathways:

Phenylalanine --> Tyrosine --> L-Dopa --> Dopamine --> Norepinephrine

Histidine --> Histamine

Tryptophan --> 5-Hydroxytryptophan (5-HTP) --> Serotonin (5-Hydroxytryptamine)

Related article:

Nutritional prevention and treatment of drug-induced movement disorders

Several clinical trials suggest that manganese and vitamins B6, C and E can help prevent and alleviate movement disorders such as parkinsonism and tardive dyskinesia induced by anti-psychotic drugs. Parkinsonism features impaired motor control including muscle rigidity, tremors and postural instability while dyskinesia is characterized by abnormal involuntary movements. Tardive dyskinesia is common in schizophrenics receiving drug treatments. The following articles outline the nutritional approach to this issue:

"A study of the practices of 80 physicians over a 10 year caseload of 58,000 patients treated with antipsychotic drugs plus high dosage vitamins, reveals a total of only 26 patients developing Tardive Dyskinesia, this is an incidence of less than 0.05%. This is a remarkable finding in view of currently reported rates of 10% to as high as 60%."

Table 6: Research on nutrient supplementation in the treatment of tardive dyskinesia

Subjects Supplement General Outcome Reference
15 schizophrenics with TD High dose Vitamin B6 Parkinsonism and dyskinetic movement decreased significantly Am J Psychiatry 2001 Sep;158(9):1511-4
5 patients with TD High dose Vitamin B6 Reduced frequency and severity of involuntary movements J Clin Psychiatry 1978 Jun;39(6):573-5
5 patients with TD High dose Vitamin B6 4 improvement on the measures of involuntary movement & 3 improved psychiatric rating Clin Neuropharmacol 1999 Jul-Aug;22(4):241-3
6 schizophrenics with TD Vitamin C & E Reduction of tardive symptomatology Neuropsychobiology 2002;46 Suppl 1:28-30

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Publications

Natural Healing for Schizophrenia & Other Common Mental Disorders
by Eva Edelman, 1998

This excellent book embraces the approaches used by both Pfeiffer and Hoffer. A quote from William Walsh PhD, (co-founder and chief-scientist at the Pfeiffer Treatment Center), on the back cover states:

"This is the most useful volume on nutritional methods for mental illness written in the past 20 years. I believe that it will be a valuable resource for researchers, clinicians, and families alike. It is required reading for our research and medical staff."

The forward of this book was written by Abram Hoffer MD, PhD. This book goes into considerably more detail than Hoffer’s and Pfeiffer’s books mentioned above and embraces the ideas concerning individuality and nutritional therapy currently used at the Pfeiffer Treatment Center. The book also contains a detailed description of medical conditions known to contribute to mental illness. For anyone looking for alternatives for mental conditions, this is a must read!

A Dose of Sanity: Mind, Medicine, and Misdiagnosis
by Sydney Walker, MD (psychiatrist and neurologist), 1997

This brilliant book discusses in detail why underlying medical conditions which contribute to mental symptoms must be carefully identified rather than simply treating the symptoms with medication, psychotherapy or even nutritional therapies. Case studies illustrate how brain tumors, hypothyroidism, heart conditions and sleep deprivation often produce symptoms mistaken for conditions such as depression, AD(H)D and schizophrenia. Every psychiatrist and psychologist should read this ground-breaking book! The following article discusses Sydney Walker's treatment protocol - Finding the Medical Causes of Severe Mental Symptoms: The Extraordinary Walker Exam

Nutritional Influences on Mental Illness: A Sourcebook of Clinical Research (second edition)
by psychiatrist Melvyn Werbach, MD, 1999

This book has an excellent chapter on schizophrenia.

The Madness of Adam and Eve: How Schizophrenia Shaped Humanity
by Dr. David Horrobin (MD, neuroscientist and fatty acid researcher), 2002

Dr. David Horrobin is a pioneering figure in the area of fatty acid metabolism and schizophrenia. He created the membrane phospholipid concept of schizophrenia. Unfortunately Dr. Horrobin passed away in April 2003.

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