Orthomolecular psychiatry is the use of

orthomolecular medicine Orthomolecular medicine is a form of alternative medicine that aims to maintain human health through nutritional supplementation. The concept builds on the idea of an optimal nutritional environment in the body and suggests that diseases reflect ...

for

mental illness A mental disorder, also referred to as a mental illness or psychiatric disorder, is a behavioral or mental pattern that causes significant distress or impairment of personal functioning. Such features may be persistent, relapsing and remitti ...

. The approach uses unorthodox forms of individualized testing and diagnosis to attempt to establish an

etiology Etiology (pronounced ; alternatively: aetiology or ætiology) is the study of causation or origination. The word is derived from the Greek (''aitiología'') "giving a reason for" (, ''aitía'', "cause"); and ('' -logía''). More completely, e ...

for each patient's specific

symptom Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or condition. A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormality showin ...

s, and claims to tailor the treatment accordingly, using a combination of nutrients, dietary changes and

medication A medication (also called medicament, medicine, pharmaceutical drug, medicinal drug or simply drug) is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy (pharmacotherapy) is an important part of the medical field and re ...

s that are claimed to enhance quality of life and functionality as well as to reduce or eliminate symptoms and the use of

xenobiotic A xenobiotic is a chemical substance found within an organism that is not naturally produced or expected to be present within the organism. It can also cover substances that are present in much higher concentrations than are usual. Natural compo ...

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

Abram Hoffer Abram Hoffer (November 11, 1917 – May 27, 2009) was a Canadian biochemist, physician, and psychiatrist known for his "adrenochrome hypothesis" of schizoaffective disorders. According to Hoffer, megavitamin therapy and other nutritional interven ...

and

Humphry Osmond Humphry Fortescue Osmond (1 July 1917 – 6 February 2004) was an English psychiatrist who expatriated to Canada, then moved to work in the United States. He is known for inventing the word ''psychedelic'' and for his research into interesting a ...

in the 1950s and was continued by Carl Pfeiffer, although proponents of orthomolecular psychiatry say that the ideas behind their approach can be traced back to the 1920s and '30s. Orthomolecular psychiatry's goal of weaning patients from conventional neuroleptic drugs follows "Pfeiffer's Law", "For every drug that benefits a patient, there is a natural substance that can achieve the same effect". In 1968,

Linus Pauling Linus Carl Pauling (; February 28, 1901August 19, 1994) was an American chemist, biochemist, chemical engineer, peace activist, author, and educator. He published more than 1,200 papers and books, of which about 850 dealt with scientific top ...

first used the term ''orthomolecular''. Hoffer's therapies focused on using

niacin Niacin, also known as nicotinic acid, is an organic compound and a form of vitamin B3, an essential human nutrient. It can be manufactured by plants and animals from the amino acid tryptophan. Niacin is obtained in the diet from a variet ...

, among other nutrients, to treat what he diagnosed as acute

schizophrenia Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social withdra ...

based on an unaccepted test. In 1973, a task force of the

American Psychiatric Association The American Psychiatric Association (APA) is the main professional organization of psychiatrists and trainee psychiatrists in the United States, and the largest psychiatric organization in the world. It has more than 37,000 members are involve ...

examined niacin monotherapy of patient populations with chronic schizophrenia and

bipolar disorder Bipolar disorder, previously known as manic depression, is a mental disorder characterized by periods of depression and periods of abnormally elevated mood that last from days to weeks each. If the elevated mood is severe or associated with ...

and rejected the practice along with the reliability of Hoffer's diagnostic approach. The assertions by proponents of orthomolecular psychiatry were rejected in 1973 by a panel of the

. However, the underpinning ideas of orthomolecular psychiatry have become popular in alternative medical circles as a means to explain conditions such as

autism The autism spectrum, often referred to as just autism or in the context of a professional diagnosis autism spectrum disorder (ASD) or autism spectrum condition (ASC), is a neurodevelopmental condition (or conditions) characterized by difficulti ...

heavy metal toxicity A toxic heavy metal is any relatively dense metal or metalloid that is noted for its potential toxicity, especially in environmental contexts. The term has particular application to cadmium, Mercury (element), mercury and lead, all of which app ...

, and chronic inflammatory disease. After 1975, orthomolecular psychiatry research was primarily reported in ''Orthomolecular Psychiatry'', now the ''

Journal of Orthomolecular Medicine The ''Journal of Orthomolecular Medicine'' was established in 1967 by Abram Hoffer. It publishes studies in nutritional and orthomolecular medicine. There is controversy surrounding the journal, as the validity of the field of orthomolecular medi ...

'', a publication founded by Hoffer to counter what he considered to be a medical conspiracy against his ideas.

Diagnosis

Proponents of orthomolecular psychiatry claim to have identified the causes of some psychiatric syndromes, in particular those that cause

psychosis Psychosis is a condition of the mind that results in difficulties determining what is real and what is not real. Symptoms may include delusions and hallucinations, among other features. Additional symptoms are incoherent speech and behavior ...

; according to orthomolecular proponents, testing for these causes guides diagnosis and treatment. Diagnostic measures and therapies commonly employed include "individual biochemical workup",

fasting Fasting is the abstention from eating and sometimes drinking. From a purely physiological context, "fasting" may refer to the metabolic status of a person who has not eaten overnight (see " Breakfast"), or to the metabolic state achieved after ...

, identifying suggested

allergies Allergies, also known as allergic diseases, refer a number of conditions caused by the hypersensitivity of the immune system to typically harmless substances in the environment. These diseases include hay fever, food allergies, atopic derma ...

, dietary changes,

megavitamin therapy Megavitamin therapy is the use of large doses of vitamins, often many times greater than the recommended dietary allowance (RDA) in the attempt to prevent or treat diseases. Megavitamin therapy is typically used in alternative medicine by practit ...

amino acid Amino acids are organic compounds that contain both amino and carboxylic acid functional groups. Although hundreds of amino acids exist in nature, by far the most important are the alpha-amino acids, which comprise proteins. Only 22 alpha am ...

s, and other so-called "pharmacologic nutrients". These diagnoses have not been accepted by mainstream medicine.

Specific conditions

Orthomolecularists claim that the causes of psychotic disorders include

food allergy A food allergy is an abnormal immune response to food. The symptoms of the allergic reaction may range from mild to severe. They may include itchiness, swelling of the tongue, vomiting, diarrhea, hives, trouble breathing, or low blood pressure ...

hypoglycemia Hypoglycemia, also called low blood sugar, is a fall in blood sugar to levels below normal, typically below 70 mg/dL (3.9 mmol/L). Whipple's triad is used to properly identify hypoglycemic episodes. It is defined as blood glucose belo ...

, hypothyroidism in the presence of normal thyroid values, heavy metal intoxications including those allegedly due to

dental fillings Dental restoration, dental fillings, or simply fillings are treatments used to restore the function, integrity, and morphology of missing tooth structure resulting from caries or external trauma as well as to the replacement of such structure su ...

, as well as several hypothesised conditions they call ''pyroluria'', ''histadelia'' and ''histapenia''.

Pyroluria

''Pyroluria'' (or ''malvaria'' from the term ''mauve factor'') involves hypothetical excessive levels of

pyrrole Pyrrole is a heterocyclic aromatic organic compound, a five-membered ring with the formula C4 H4 NH. It is a colorless volatile liquid that darkens readily upon exposure to air. Substituted derivatives are also called pyrroles, e.g., ''N''-meth ...

s in the body resulting from improper hemoglobin synthesis. Carl Pfeiffer believed that pyroluria is a form of

schizophrenic Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social withdra ...

porphyria Porphyria is a group of liver disorders in which substances called porphyrins build up in the body, negatively affecting the skin or nervous system. The types that affect the nervous system are also known as acute porphyria, as symptoms are ra ...

, similar to

acute intermittent porphyria Acute intermittent porphyria (AIP) is a rare metabolic disorder affecting the production of heme resulting from a deficiency of the enzyme porphobilinogen deaminase. It is the most common of the acute porphyrias. Signs and symptoms The clinical ...

where both

s and

porphyrin Porphyrins ( ) are a group of heterocyclic macrocycle organic compounds, composed of four modified pyrrole subunits interconnected at their α carbon atoms via methine bridges (=CH−). The parent of porphyrin is porphine, a rare chemical com ...

s are excreted in the

human urine Urine is a liquid by-product of metabolism in humans and in many other animals. Urine flows from the kidneys through the ureters to the urinary bladder. Urination results in urine being excreted from the body through the urethra. Cellular me ...

to an excessive degree. and orthomolecular psychiatrists have alleged that pyroluria is related to diagnoses of

ADHD Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterised by excessive amounts of inattention, hyperactivity, and impulsivity that are pervasive, impairing in multiple contexts, and otherwise age-inapp ...

alcoholism Alcoholism is, broadly, any drinking of alcohol (drug), alcohol that results in significant Mental health, mental or physical health problems. Because there is disagreement on the definition of the word ''alcoholism'', it is not a recognize ...

, depression,

down syndrome Down syndrome or Down's syndrome, also known as trisomy 21, is a genetic disorder caused by the presence of all or part of a third copy of chromosome 21. It is usually associated with physical growth delays, mild to moderate intellectual dis ...

, manic-depression,

celiac disease Coeliac disease (British English) or celiac disease (American English) is a long-term autoimmune disorder, primarily affecting the small intestine, where individuals develop intolerance to gluten, present in foods such as wheat, rye and barle ...

epilepsy Epilepsy is a group of non-communicable neurological disorders characterized by recurrent epileptic seizures. Epileptic seizures can vary from brief and nearly undetectable periods to long periods of vigorous shaking due to abnormal electrical ...

, and

. Pfeiffer's methods have not been rigorously tested, Available a
the internet archive.
Retrieved on 2008-02-17 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. Few, if any, medical experts regard the condition as genuine, and few or no articles on pyroluria are found in modern medical literature; the approach is described as "snake oil" by pediatrician and author Julian Haber.

Histadelia

''Histadelia'' is a condition hypothesised by Carl Pfeiffer to involve elevated serum levels of

histamine Histamine is an organic nitrogenous compound involved in local immune responses, as well as regulating physiological functions in the gut and acting as a neurotransmitter for the brain, spinal cord, and uterus. Since histamine was discovered ...

and

basophils Basophils are a type of white blood cell. Basophils are the least common type of granulocyte, representing about 0.5% to 1% of circulating white blood cells. However, they are the largest type of granulocyte. They are responsible for inflammator ...

, which he says can be treated with

methionine Methionine (symbol Met or M) () is an essential amino acid in humans. As the precursor of other amino acids such as cysteine and taurine, versatile compounds such as SAM-e, and the important antioxidant glutathione, methionine plays a critical ro ...

and vitamin B₆ megadoses. Pfeiffer claims that "histadelia" can cause depression with or without psychosis, but no published clinical trials have tested the effectiveness of this therapy.

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. Critics have noted that the claims advanced by its proponents are unsubstantiated, and even false. Authoritative bodies such as the

National Institute of Mental Health The National Institute of Mental Health (NIMH) is one of 27 institutes and centers that make up the National Institutes of Health (NIH). The NIH, in turn, is an agency of the United States Department of Health and Human Services and is the prima ...

and

American Academy of Pediatrics The American Academy of Pediatrics (AAP) is an American professional association of pediatricians, headquartered in Itasca, Illinois. It maintains its Department of Federal Affairs office in Washington, D.C. Background The Academy was founded ...

have criticized orthomolecular treatments as ineffective and toxic. A 1973 task force of the American Psychiatric Association charged with investigating orthomolecular claims 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.

One review suggested the APA statement was "well-intentioned" but biased, and called for further research in this field. Use of the word "deplorable" highlights the fact that criticisms of Orthomolecular Psychiatry are often political in nature rather than scientifically based. Linus Pauling was a Nobel Laureate in his field long before the current political landscape in America existed.Samuels, Robert (2017). Psychoanalyzing the Politics of the New Brain Science. Springer. https://doi.org/10.1007/978-3-319-71891-0_1

References

Bibliography

* * * * {{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

Orthomolecular Medicine Online
Orthomolecular medicine Treatment of mental disorders Treatment of bipolar disorder