Transcript Schizophrenia: Alternative Treatments

Schizophrenia:
Alternative Treatments
By Rachel Martinez
and
Holley Williamson
Overview of Schizophrenia






Symptoms: Positive, Negative
Diagnostic Criterion
Phases: Prodromal, Active, Residual
Types: Catatonic, Disorganized, Paranoid,
Undifferentiated, Residual
Related disorders: Schizoaffective Disorder,
Delusional Disorder, Brief Psychotic Disorder
Alternative treatments we will investigate:
– Orthomolecular Psychiatry
– Acupuncture treatment
Orthomolecular Psychiatry as
Treatment for Schizophrenia



Orthomolecular psychiatry claims to use dietary supplements and other
treatments to effectively treat mental illness, including schizophrenia, mood
disorders, and other mental illnesses.
Orthomolecular psychiatric treatments have been around since the 1920’s.
Abram Hoffer established the orthodoxy of the field in the 1950s. In 1973,
the APA rejected the practice of orthomolecular psychiatry, which is why it
is now considered an alternative therapy. The APA’s conclusions have been
criticized strongly based on political motivations. Current scientific
research is consistent with some of the hypotheses advanced by
orthomolecular psychiatrists, but most orthomolecular practices have not
been extensively tested by conventional clinical trials. Instead practitioners
rely on their interpretations of biochemical research and case reports.
Recent efforts to rigorously establish the efficacy of some concepts
associated with orthomolecular psychiatry have been recognized in
mainstream sources.
Subcategories to be examined: B Vitamins (Folic Acid and Niacin)
Folic Acid Treatment



Folic acid deficiency occurs in 10 to 30% of hospitalized psychiatric
patients. In addition to psychosis, the deficiency is associated with
depression, confusion, disorientation and dementia as well as with
neurological symptoms such as numbness, stiffness, spasticity and
weakness, both with and without muscular atrophy. (Hoffer notes that
niacin is primarily effective for early and acute schizophrenics, while it is
ineffective -- especially when given alone -- for the chronic schizophrenics
who were included in the negative trials. )
Though we aren’t sure about the specific mechanisms that associate folic
acid deficiencies with schizophrenia, they are starting to be identified in
research. Folic acid may be an essential cofactor in the conversion of the
omega-6 fatty acids to prostaglandins, and early evidence suggests that
impaired prostaglandin metabolism may provoke a schizophrenic picture.
However, elevated levels of blood folate are also associated with increase
in psychotic episodes– there must be a balance.
Niacin Treatment

In 1952, Abram Hoffer, PhD, MD, had just completed his psychiatry
residency. What’s more, he had proven, with the very first double-blind,
placebo-controlled studies in the history of psychiatry, that vitamin B-3
(Niacin) could “cure” schizophrenia. You would think that psychiatrists
everywhere would have beaten down a path to Saskatchewan to replicate the
findings of this young Director of Psychiatric Research and his colleague,
Humphrey Osmond, MD.
 The way it is thought to work is that Niacin and ascorbate are antagonistic to
copper. Many schizophrenics have an excess of copper, which is a cofactor in
dopamine production. When there is too much copper, dopamine may be
overproduced causing the downregulation of serotonin, accounting for some of
the negative symptoms. Since Niacin and ascorbate antagonize copper, adding
Niacin to a schizophrenic’s diet could help combat some of the negative
symptoms.
 An excess of copper can be toxic, causing a hallucinogenic endproduct. Niacin
and ascorbate could also theoretically help with some of the positive
symptoms of schizophrenia if they are exascerbated by elevated levels of
copper.
Acupuncture for
Treating Schizophrenia



Acupuncture has been used for 2000 years to treat physical
and mental ailments in Traditional Chinese Medicine
(TCM)
Some studies have indicated that the treatment of
Schizophrenia with acupuncture is safe and effective.
(These were mainly small studies with limited participants,
more like case studies than clinical trials.)
However, other clinical trials have been inconclusive in
determining the efficacy of acupuncture for treating
schizophrenia.
Acupuncture Research




One study examined the efficacy of acupuncture combined with
chlorpromazine against a control of just chlorpromazine.
The results were inconclusive, neither was determined to be more
effective than the other on treating the schizophrenic symptoms of
the patient.
However, the acupuncture group was able to take a reduced dosage
of the antipsychotic, reducing negative side effects from the drugs.
The conclusion from this study was that acupuncture itself may not
be effective in treating schizophrenia, but may be helpful alongside
traditional treatments to reduce negative side effects.
Acupuncture Research




Other studies indicated a marked improvement of
certain symptoms for schizophrenic patients.
Patients treated with acupuncture showed a
decrease in auditory hallucinations, an
improvement in patients with catatonic stupor,
and a reduction in medication levels.
However, delusions were unaffected by the
acupuncture treatments.
Again, the results are not conclusive, though they
point in a positive direction for the use of
acupuncture at least to relieve some of the
negative symptoms and side effects of drugs.
Possible Mechanism for
Acupuncture Efficacy

One hypothesis behind utilizing acupuncture for
treating schizophrenia is the release of serotonin
due to acupuncture stimulation
 Research on mice has shown that acupuncture
stimulates the release of serotonin in the brain, but
not dopamine. If there is an excess of dopamine
causing negative symptoms of schizophrenia, the
acupuncture may help in combating those
symptoms.
 Cultural differences– Helping the patient feel
better or conforming to social norms?