Niacin and Schizophrenia

Wednesday, January 18, 2012

Schizophrenia is a rare disorder that strikes young adults who are about to enter the prime of their lives. The average onset occurs in the early to mid-20s for males and the late 20s for females. While it is rare, since it strikes at such a tender age, schizophrenia is actually one of the 10 leading causes of disability among people 15-44 years old.

In conventional (allopathic) medicine, the standard treatment of schizophrenia involves the use of anti-seizure and antipsychotic pharmaceuticals such as haloperidol, chlorpromazine, clozapine and fluphenazine. Benzodiazepines can also be used adjunctively during the acute phase of illness with some success. Overall, the treatment of schizophrenia using pharmaceutical interventions can cause significant side effects and provides heterogeneous outcomes. Anecdotally, it has been observed that approximately one-third of patients will have a relatively good outcome; one-third will have a poor outcome with significant psychosocial impairment and persistent psychotic symptoms while the remaining one-third will have an outcome somewhere in the middle of the two extremes. This observation is known as the ‘rule of thirds.’ Fortunately, there is a promising naturopathic treatment that could lead to better patient outcomes.

Dr. Abram Hoffer has been studying the effects of supplemental niacin in schizophrenic patients for over 50 years. In 1952, Dr. Hoffer postulated the adrenochrome theory of schizophrenia. Adrenochrome is a derivative of oxidized adrenaline. A methyl group is required in order to produce adrenaline from noradrenaline. Vitamin B3 is a methyl acceptor which can reduce the methylation of noradrenaline to adrenalin and therefore decrease the production of adrenochrome. Vitamin B3 is also a precursor to NAD/NADH which can reverse the oxidation of adrenaline. By decreasing the oxidation of adrenaline, the production of neurotoxic adrenochrome also decreases.

To prove his hypothesis, Dr. Hoffer designed and commenced intervention trials. His first study, published in 1957, randomized 30 schizophrenic patients to niacin, niacinamide or placebo. The participants were given standard pharmacologic therapy plus 1 gram of the intervention three times a day for 30 days and then followed for a year. After one year, the participants supplemented with Vitamin B3 had an 80% recovery rate as compared to the placebo group which had a 33% recovery rate. ‘Hoffer followed patients from 1953 to 1960, publishing a total of six double-blind, randomized controlled clinical trials. All trials confirmed the positive effects that vitamin B3 had on the recovery of acute schizophrenic patients, and that the use of this vitamin substantially reduced patients’ reliance on the health care system.⁽²⁾’ In an ‘analysis of 27 chronic schizophrenic patients who had been under treatment for at least 10 years, consistent treatment with vitamin B3 produced the following results: 11 patients were able to work; two patients were able to marry and look after their families and homes; two patients were single mothers able to care for their children; and three patients were able to manage their own businesses.⁽²⁾’ Based on this analysis, long-term niacin therapy has significantly better outcomes when compared to the ‘rule of thirds’ seen with purely pharmacologic interventions. Optimal doses of niacin also have less devastating side effects when compared to the pharmaceuticals typically prescribed to schizophrenic patients.

While this treatment has yet to be universally accepted by conventional medicine, a relevant study that involved collaboration between The University of Pittsburgh, the Portland VA Medical Center and the VA Pittsburgh Healthcare System was published in September of 2010. The study concluded that there is in fact a schizophrenia-associated niacin response abnormality and attempted to determine a potential cause for the reduced niacin skin flush. Hopefully over time, more studies that investigate the connection between niacin and schizophrenia will provide concrete answers and a treatment regimen that is accepted by conventional medicine. Until then, Dr. Abram Hoffer recommends that schizophrenic adults begin with one gram of niacin three times a day and slowly increase to 4,500-18,000 mg per day to achieve the best possible outcome. Dr. Hoffer also recommends other nutrients in addition to niacin such as Vitamin C. Please consult the references below, especially the Alternative Medicine Review, and your naturopathic physician before attempting to implement this nutrient protocol.

Laura Firetag ND Student Bastyr University

References:

1) Hoffer, A, and J Prousky. "Successful Treatment of Schizophrenia Requires Optimal Daily Doses of Vitamin B3." Alternative Medicine Review. 13.4 (2008): 287-91. http://www.altmedrev.com/publications/13/4/287.pdf

2) Andreasen, Nancy, and Donald Black. Introductory Textbook of Psychiatry. 4th. Washington, DC: American Psychiatric Publishing, Inc., 2006. Print.

3) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2947210/pdf/nihms199528.pdf

Labels: niacin, supplementation

posted by Innate Response at

11:37 AM

1 Comments :

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Niacin and Schizophrenia

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