View source for Medicine:Orthomolecular psychiatry

'''Orthomolecular psychiatry''' is the use of [[Medicine:Orthomolecular medicine|orthomolecular medicine]] for mental illness. The approach uses unorthodox forms of individualized testing and diagnosis to attempt to establish an [[Philosophy:Etiology|etiology]] for each patient's specific [[Medicine:Symptom|symptom]]s, and claims to tailor the treatment accordingly, using a combination of nutrients, dietary changes and [[Chemistry:Medication|medication]]s that are claimed to enhance quality of life and functionality as well as to reduce or eliminate symptoms and the use of [[Biology:Xenobiotic|xenobiotic]] drugs. Scientific studies have shown the orthomolecular psychiatry is ineffective. Orthomolecular psychiatry has been rejected by the mainstream medical community.

==History==
Orthomolecular psychiatry began with [[Biography:Abram Hoffer|Abram Hoffer]] and Humphry Osmond in the 1950s and was continued by Carl Pfeiffer,<ref name=CarlPheifferBio>{{cite web |last=Saul |first=AW |author2=Jolliffe M |author3=Hoffer A  |title=Bibliography of the Publications of Carl Pfeiffer, MD, PhD |url= http://www.doctoryourself.com/biblio_pfeiffer_ed.html |publisher=doctoryourself.com |access-date=2007-04-19}}</ref> although proponents of orthomolecular psychiatry say that the ideas behind their approach can be traced back to the 1920s and '30s.<ref>{{cite journal |last=Reiter |first=PJ |title=Behandlung von Dementia Praecox mit metallsalzen. Mangan. Z |journal= Neur |volume=108 |pages=464–80 |year=1927 |doi=10.1007/bf02863975}} as cited in {{cite journal |last1=Pfeiffer |first1=C |last2=LaMola |first2=S |title=Zinc and Manganese in the Schizophrenias |journal= Journal of Orthomolecular Psychiatry |volume=12 |issue=3 |year=1983}}</ref><ref>{{cite book |author=Kay Lily E |title=The molecular vision of life: Caltech, the Rockefeller Foundation, and the rise of the new biology |publisher=Oxford University Press |location=Oxford |year=1993 |isbn=978-0-19-511143-9}}</ref> Orthomolecular psychiatry's goal of weaning patients from conventional neuroleptic drugs<ref name=Edelman/> follows "Pfeiffer's Law", "For every drug that benefits a patient, there is a natural substance that can achieve the same effect".<ref>{{cite book |last=Barney |first=Paul |title=Doctor's guide to natural medicine |publisher=Woodland |location=Pleasant Grove, Utah |year=1998 |isbn=978-1-885670-84-7}}</ref> In 1968, [[Biography:Linus Pauling|Linus Pauling]] first used the term ''orthomolecular''.<ref>{{cite journal |author=Pauling L |title=Orthomolecular psychiatry. Varying the concentrations of substances normally present in the human body may control mental disease |journal=Science |volume=160 |issue=3825 |pages=265–71 |year=1968 |pmid=5641253 |url=http://profiles.nlm.nih.gov/MM/B/B/J/Q/_/mmbbjq.pdf |doi=10.1126/science.160.3825.265 |bibcode=1968Sci...160..265P|s2cid=20153555 }}</ref><ref name=Pauling2>{{cite book |author2=Hawkins, D |last=Pauling |first=Linus |title=Orthomolecular psychiatry: treatment of schizophrenia |publisher=W.H. Freeman |location=San Francisco |year= 1973 |isbn=978-0-7167-0898-8 |page=697}}</ref>

Hoffer's therapies focused on using [[Chemistry:Niacin|niacin]], among other nutrients, to treat what he diagnosed as acute [[Medicine:Schizophrenia|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 [[Medicine:Bipolar disorder|bipolar disorder]] and rejected the practice along with the reliability of Hoffer's diagnostic approach.<ref name=Menolascino>{{cite journal |vauthors=Menolascino FJ, Donaldson JY, Gallagher TF, Golden CJ, Wilson JE |title=Orthomolecular therapy: its history and applicability to psychiatric disorders |journal=Child Psychiatry Hum Dev |volume= 18 |issue=3 |pages=133–50 |year=1988 |pmid=2898324 |doi=10.1007/BF00709727|s2cid=38354755 }}</ref>

The assertions by proponents of orthomolecular psychiatry were rejected in 1973 by a panel of the American Psychiatric Association.<ref name=Menolascino/><ref name=Pauling>{{cite journal |vauthors=Pauling L, Wyatt RJ, Klein DF, Lipton MA |title=On the orthomolecular environment of the mind: orthomolecular theory |journal=American Journal of Psychiatry |volume= 131 |issue=11 |pages=1251–67 |year=1974 |pmid=4608217|doi=10.1176/ajp.131.11.1251|doi-broken-date=31 May 2021 |url=https://ajp.psychiatryonline.org/doi/abs/10.1176/ajp.131.11.1251}}</ref><ref name=NIMHtrial>{{cite web |title=Treatment of acute schizophrenia with vitamin therapy |url=http://clinicaltrials.gov/ct2/show/NCT00140166?show_desc=Y#desc |publisher=Clinicaltrials.gov |date=2005-08-31 |last=Lerner |first=V |access-date=2008-01-15}}</ref> However, the underpinning ideas of orthomolecular psychiatry have become popular in alternative medical circles as a means to explain conditions such as [[Medicine:Autism|autism]], heavy metal toxicity, and chronic inflammatory disease. After 1975, orthomolecular psychiatry research was primarily reported in ''Orthomolecular Psychiatry'', now the ''Journal of Orthomolecular Medicine'', a publication founded by Hoffer to counter what he considered to be a medical conspiracy against his ideas.<ref name=history>{{cite journal |author=Hoffer, Abram |title=The History of the Journal of Orthomolecular Medicine |journal=J Orthomol Med |url=http://www.orthomed.org/jom/jomhistory.html |access-date=2011-06-18 |archive-url=https://web.archive.org/web/20110520122017/http://orthomed.org/jom/jomhistory.html |archive-date=2011-05-20 |url-status=dead }}</ref>

==Diagnosis==
Proponents of orthomolecular psychiatry claim to have identified the causes of some psychiatric syndromes, in particular those that cause [[Medicine:Psychosis|psychosis]]; according to orthomolecular proponents, testing for these causes guides diagnosis and treatment. Diagnostic measures and therapies commonly employed include "individual biochemical workup", [[Philosophy:Fasting|fasting]], identifying suggested allergies, dietary changes, [[Chemistry:Megavitamin therapy|megavitamin therapy]], [[Chemistry:Amino acid|amino acid]]s, and other so-called "pharmacologic nutrients".<ref name=Edelman>{{cite book |author= Edelman Eva |title=Natural Healing for Schizophrenia: And Other Common Mental Disorders |publisher=Borage Books |year=2001 |isbn=978-0-9650976-7-3}}</ref> These diagnoses have not been accepted by mainstream medicine.<ref name=QW/>

==Specific conditions==
Orthomolecularists claim that the causes of psychotic disorders include [[Medicine:Food allergy|food allergy]], [[Medicine:Hypoglycemia|hypoglycemia]], [[Medicine:Hypothyroidism|hypothyroidism]] in the presence of normal thyroid values, heavy metal intoxications including those allegedly due to [[Chemistry:Dental amalgam controversy|dental fillings]], as well as several hypothesised conditions they call ''pyroluria'', ''histadelia'' and ''histapenia''.<ref name=Edelman/> These conditions are said to be not recognized by the conventional medical community though over 400 medical practitioners are said to have attended practitioner education workshops worldwide.

===Pyroluria===
''Pyroluria'' (or ''malvaria'' from the term ''mauve factor'') involves hypothetical excessive levels of [[Chemistry:Pyrrole|pyrrole]]s in the body resulting from improper hemoglobin synthesis.<ref name=LaPerchia>{{Cite journal| pmid = 2963502| year = 1987| last1 = Laperchia | first1 = P.| title = Behavioral disorders, learning disabilities and megavitamin therapy| volume = 22| issue = 87| pages = 729–738| journal = Adolescence}}</ref> Carl Pfeiffer believed that pyroluria is a form of [[Medicine:Schizophrenia|schizophrenic]] [[Medicine:Porphyria|porphyria]], similar to acute intermittent porphyria where both [[Chemistry:Pyrrole|pyrrole]]s and [[Biology:Porphyrin|porphyrin]]s are excreted in the human urine to an excessive degree.<ref name=NH>{{cite web |title=Pyroluria |publisher=nutritional-healing.com |url=http://www.nutritional-healing.com.au/content/articles-content.php?heading=Pyroluria |access-date=2008-02-17 |url-status=dead |archive-url=https://web.archive.org/web/20080226083527/http://www.nutritional-healing.com.au/content/articles-content.php?heading=Pyroluria |archive-date=2008-02-26 }}</ref> and orthomolecular psychiatrists have alleged that pyroluria is related to diagnoses of ADHD, [[Medicine:Alcoholism|alcoholism]], [[Medicine:Autism|autism]], depression, [[Medicine:Down syndrome|down syndrome]], [[Medicine:Bipolar disorder|manic-depression]], [[Medicine:Schizophrenia|schizophrenia]], celiac disease, [[Medicine:Epilepsy|epilepsy]], and [[Medicine:Psychosis|psychosis]].<ref name="Urinary Pyrrole">{{cite journal |author1=Jackson James A |author2=Riordan Hugh D |author3=Neathery Sharon |author4=Riordan Neil H |url=http://www.orthomolecular.org/library/jom/1997/pdf/1997-v12n02-p096.pdf |title=Urinary pyrrole in health and disease |journal=The Journal of Orthomolecular Medicine |volume=12 |issue=2nd Quarter |year=1997 |pages=96–8 |access-date=2008-02-17}}</ref>  Pfeiffer's methods have not been rigorously tested,<ref name=Skertic>{{cite news |first=Mark |last=Skertic |title=For some, a question of balancing nutrients |publisher=SunTimes.com |date=April 21, 2002}} Available at [https://web.archive.org/web/20040422065311/http://www.suntimes.com/special_sections/ritalin/cst-nws-ritalt21.html the internet archive.] Retrieved on 2008-02-17</ref> 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.<ref>{{cite journal |author=Holman, Paul |url=http://www.acnem.org/journal/pdf_files/14-1_july_1995/14-1_pyridoxine-vitamin_b6.pdf  |title=Pyridoxine - Vitamin B-6 |journal=Journal of Australian College of Nutritional & Environmental Medicine |volume=14 |issue=1 |date=July 1995 |pages=5–16 |access-date=2007-04-19 |archive-url = https://web.archive.org/web/20070508011442/http://www.acnem.org/journal/pdf_files/14-1_july_1995/14-1_pyridoxine-vitamin_b6.pdf |archive-date = 2007-05-08}}</ref><ref>{{Cite journal| pmid = 696910| year = 1978| last1 = Cruz| first1 = R| last2 = Vogel| first2 = WH| title = Pyroluria: a poor marker in chronic schizophrenia| volume = 135| issue = 10| pages = 1239–40| journal = The American Journal of Psychiatry| doi = 10.1176/ajp.135.10.1239 }}</ref><ref>{{Cite journal| pmid = 627053| year = 1978| last1 = Gendler| first1 = PL| last2 = Duhan| first2 = HA| last3 = Rapoport| first3 = H| title = Hemopyrrole and kryptopyrrole are absent from the urine of schizophrenics and normal persons| volume = 24| issue = 2| pages = 230–3| journal = Clinical Chemistry| doi = 10.1093/clinchem/24.2.230}}</ref><ref>{{Cite journal| pmid = 1120177| year = 1975| last1 = Jacobson| first1 = SJ| last2 = Rapoport| first2 = H| last3 = Ellman| first3 = GL| title = The nonoccurrence of hemo- and kryptopyrrole in urine of schizophrenics| volume = 10| issue = 1| pages = 91–3| journal = Biological Psychiatry}}</ref><ref>{{Cite journal| pmid = 7428279| year = 1980| last1 = Gorchein| first1 = A| title = Urine concentration of 3-ethyl-5-hydroxy-4,5-dimethyl-delta 3-pyrrolin-2-one ('mauve factor') is not causally related to schizophrenia or to acute intermittent porphyria| volume = 58| issue = 6| pages = 469–76| journal = Clinical Science| doi=10.1042/cs0580469}}</ref><ref name="pmid10197889">{{Cite journal| pmid = 10197889| year = 1999| last1 = Vaughan | first1 = K.| last2 = McConaghy | first2 = N.| title = Megavitamin and dietary treatment in schizophrenia: a randomised, controlled trial| volume = 33| issue = 1| pages = 84–88| journal = The Australian and New Zealand Journal of Psychiatry| doi = 10.1046/j.1440-1614.1999.00527.x| s2cid = 38857700}}</ref> Few, if any, medical experts regard the condition as genuine, and few or no articles on pyroluria are found in modern medical literature;<ref>{{cite web |last=National Library for Health |title=What is pyroluria, is it an accepted clinical entity and what are the treatment? |date=2005-10-05 |url=http://www.clinicalanswers.nhs.uk/index.cfm?question=1208 |archive-url = https://web.archive.org/web/20070211000315/http://www.clinicalanswers.nhs.uk/index.cfm?question=1208 |archive-date = 2007-02-11}}</ref> the approach is described as "snake oil" by pediatrician and author Julian Haber.<ref name=Skertic/>

===Histadelia===
''Histadelia'' is a condition hypothesised by Carl Pfeiffer<ref name=pfeiffer>{{cite journal  |vauthors=Pfeiffer Carl C, etal |title=Blood histamine levels, basophil counts, and trace metals in the schizophrenias |journal=Psychopharmacol Bull |date=July 1971 |volume=7 |issue=3 |pages=37 |pmid=5117854}}</ref><ref name=pfeiffer2>{{cite journal |author=Pfeiffer Carl C |title=Extreme basophil counts and blood histamine levels in schizophrenic outpatients as compared to normals |journal=Res Commun Chem Pathol Pharmacol |date=July 1972 |pages= 51–9 |volume=4 |issue=1 |pmid=4671910 |last2=Smyrl |first2=EG |last3=Iliev |first3=V}}</ref> to involve elevated serum levels of [[Chemistry:Histamine|histamine]] and basophils,<ref name=Edelman/> which he says can be treated with [[Chemistry:Methionine|methionine]] and vitamin B<sub>6</sub> megadoses.<ref name=nutrition>{{cite book |author=Pfeiffer Carl C |title=Nutrition and Mental Illness: An Orthomolecular Approach to Balancing Body Chemistry |publisher=Healing Arts Press |year=1988 |isbn=978-0-89281-226-4 |url=https://archive.org/details/nutritionmentali00pfei }}</ref> Pfeiffer claims that "histadelia" can cause depression with or without psychosis, but no published clinical trials have tested the effectiveness of this therapy.<ref name=Pfeiffer>{{cite book |author=Pfeiffer, Carl C |title=Nutrition and Mental Illness: An Orthomolecular Approach to Balancing Body Chemistry |publisher=Healing Art Press |year=1987 |isbn=978-0-89281-226-4 |url=https://archive.org/details/nutritionmentali00pfei }}</ref>

===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.<ref>{{cite journal |author=Miller M |title=Diet and psychological health |journal=Altern Ther Health Med |volume=2 |issue=5 |pages=40–8 |year=1996 |pmid=8795935}}</ref> Critics have noted that the claims advanced by its proponents are unsubstantiated, and even false. Authoritative bodies such as the [[Organization:National Institute of Mental Health|National Institute of Mental Health]]<ref name=QW>{{cite web |url=http://www.quackwatch.org/01QuackeryRelatedTopics/ortho.html |title=Orthomolecular Therapy |last= Barrett MD |first=Stephen |publisher=[[Organization:Quackwatch|Quackwatch]] |date=2000-07-12 |access-date=2008-01-02}}</ref> and American Academy of Pediatrics<ref>{{cite journal |url=http://pediatrics.aappublications.org/cgi/content/abstract/72/5/707 |title=Vitamin and mineral supplementation in Down's syndrome |first=Forrest C |last=Bennett|journal=Pediatrics |date=November 1983 |volume=72 |issue=5 |pages=707–713 |pmid=6226926 }}</ref> have criticized orthomolecular treatments as ineffective and toxic.

A 1973 task force of the American Psychiatric Association charged with investigating orthomolecular claims concluded:
<blockquote>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.<ref>{{Cite book  |vauthors=Lipton M, etal |title=Task force report on megavitamin and orthomolecular Therapy in psychiatry |location=Washington DC |year=1973 |publisher=American Psychiatric Association}}; as cited in {{cite web |url=http://www.quackwatch.org/01QuackeryRelatedTopics/ortho.html |title=Orthomolecular Therapy |last=Barrett MD |first=Stephen |publisher=[[Organization:Quackwatch|Quackwatch]] |date=2000-07-12 |access-date=2008-01-02}}</ref></blockquote>

One review suggested the APA statement was "well-intentioned" but biased, and called for further research in this field.<ref>{{Cite journal | last1 = Hoffer | first1 = L. J. | title = Vitamin therapy in schizophrenia | journal = The Israel Journal of Psychiatry and Related Sciences | volume = 45 | issue = 1 | pages = 3–10 | year = 2008 | pmid = 18587164}}</ref>

==References==
{{Reflist|3}}

==Bibliography==
* {{cite book |last1=Braverman |first1=Eric R |first2=Carl Curt |last2=Pfeiffer |first3=Kenneth |last3=Blum |first4=Richard |last4=Smayda |title=The healing nutrients within: facts, findings, and new research on amino acids |edition=3rd |publisher=Basic Health |location=North Bergen, New Jersey |year=2003 |isbn=978-1-59120-037-6}}
* {{cite book |last1=Pauling |first1=Linus |last2=Hawkins |first2=D. |title=Orthomolecular psychiatry: treatment of schizophrenia |publisher=W.H. Freeman |location=San Francisco |year=1973 |page=697 |isbn=978-0-7167-0898-8}}
* {{cite book |last=Pfeiffer |first=Carl J |title=Nutrition and mental illness: An orthomolecular approach to balancing body chemistry |publisher=Healing Arts |year=1987 |isbn=978-0-89281-226-4 |url=https://archive.org/details/nutritionmentali00pfei }}
* {{cite book |last=Werbach |first=Melvyn R |title=Nutritional influences on mental illness: a sourcebook of clinical research |publisher=Third Line |location=Tarzana, California |year=1999 |isbn=978-0-9618550-8-6}}

==External links==
* [https://www.webcitation.org/60urFV2Ig?url=http://www.orthomed.org/ Orthomolecular Medicine Online]

[[Category:Psychiatric treatments]]

{{Sourceattribution|Orthomolecular psychiatry|1}}