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Psychiatry

Yesterday (1950)
and Today (2007):

From Despair to Hope with


Orthomolecular Psychiatry

Abram Hoffer MD PhD FRCP(C)


1

Schizophrenia, Yesterday (1950) and loday (2007),


From Despair to Hope
With Orthomolecular Psychiatry by Abram Hoffer

Acknowledgments
Onfor this book unlUxr at #ww.ituTon!xiMn/07-2!:fl1
or cm ml unli.'iSgir tiffLild-L-Liffl

Mmq Treffoid cJilks ate aJjo avaiLabtc ar major online book retalforv,

© Copyright 20OB Abram Holfcr


To my daughter Miriam Hoffer for her skillful careful editing,
AH rights merved. No pan of chii pubhratfon maty b* rcpnxlnujJ. ltutul in a retrieval fact checking and typing of the manuscript
system, or tramsmcrtwl. in any form or by am- tnemi*. dectftmk, mechanical, phtKocopyLnf,
rvnwilcng-orwlwwi)*;, wiiluiu die wrkica prior peamsiion of she author,
Kenneth Whyte', publisher and editor-in-chief of
Nf*ie firf Ubfiitlans: A tataloguijig rceotd for this book Ls avai lable from Library
and Archives Canada at www.collmfonranad».u-aJimiUi*foiLWi-c.luin] Macleans Magazine in Canada, defended a cover story from
the previous week. In that story Professor Philip Slayton, a
isbn: ^78-1-4251-55S3-4 former dean of law at the University of Western Ontario,
accused his profession of failing to live up to its cherished
We tJi Trafford btlitvt that ir B fhr respo nubility of mi aU, us hath irith viduali
.sad litrptiftitiiiit!' to make choices that are nsttirortmenHilly artdstwialiy nwitrf, ideals and instead working to the detriment of society,
Y»u. in turn. jot suppor/itip this mpmnlbfo rendu ft rm:h Haw you pay a hum a
Ttajftird bant, at rnakt uir efatt r publishing service. To find cut how ye a tirr
Whyte commented, "Mr, Slayton has done the Canadian
helping. pif St sc vim ttm/ar. ttttjfiard.rsrmt'rr,pamihIff!itb fit hitig.himt legal profession a service by going public with his concerns
Our mission is so ejfisitruly provide iht world's finest* most comprehend rr that one of the problems ot the Canadian legat profession is
i/itoi- fiMsbirtZ lerrire, enabling rjvery aniline in experience success.
To find out bew to publish vokt bock, your it'ay, end hew if &wlh$l»tr that legal professionals are more interested in maintaining a
worldwide, visit m ontirse at 1 vw w; trafford ttm/l05l0
lucrative status quo than in confronting the need to reform."
Replace the word legal by the word psychiatric and you will
www. trafford .com
anticipate the contents of this book.
Norfb Amcrina fli tiitirriidliDiul
tLdl-fcet- I &HK 232 4444 {USA fit Canada!
plume: 250 303 Wi(H 1 fa*: 250 38i5 fj8(K 1 entail: infogtuaffhfd.com Slayton-' wrote, "in Canada, lawyers are allowed to run the
lhe Untied Kingdom di Europe legal profession as they see fit The only possible [ustification
phone: +44 (0) 16(55 487 &S * t«*l rate: 0845 230 96QI
facsimile: +44 {0)1865481 W7 ■ email inftt.u

10 9 tt 7 ft 5 1 Whyte K. Counterpoint Lawyers Behaving Badly. The National


Post, Toronto, August 2,2007
2 Slayton R Why Should Lawyers be Allowed to Regulate
Themselves? The Globe and Mail, Toronto, August 3, 2007
2 3

for this legislative gift is that it is in the public interest. But is


it?" Then after listing the detects in the present legal system
he points out that other countries including Great Britain
are developing a better system which is focused on placing
the interests of the consumers at its centre. The two key
changes are that the legal profession will be overseen by a
new board with a lay majority and secondly that complaints
will be investigated by an independent office. "Law and (he
legal system belong to all Canadians." Slayton's views are
elaborated in his book.3

I raise the same questions with respect to the medical


profession. Et is also self- regulated, through its medical
colleges, a legislative gift from the provinces, with the aim of
protecting the public. This it does to a limited degree, but in
Section One
my opinion the medical profession is much more interested
in protecting its own turf. I think that when you have read
this book you will come to the same conclusion. The medical
profession has devoted itself too much to protecting itself and
has been so conservative that il has been one of the mam
hindrances to research and new developments m medicine
and in psychiatry. As Mr. Slayton suggests for the legal
profession, medicine belongs to all Canadians, not to t he
medical profession.

i Slayton P, Lawyers Gone Bad. Money, 5cx and Madness in


Canada's Legal Profession, Viking, Canada, 200Z
/
4 5

After reviewing her history and mental state I concluded


that she was right. She suffered from hallucinations (voices
and visions), was very paranoid, found it difficult to think and
to concentrate and she was very depressed. She said to me
Chapter One
very emphatically, "1 am not a borderline personality disorder.
I am schizophrenic," And she was.
Introduction to Psychiatry
Borderline personality disorder is often a euphemism
used by modem psychiatrists when they are reluctant to
diagnose schizophrenia. Often it is the last diagnosis in a
My 57 years of psychiatry have convinced me that the series of readmissions if their patients do not respond to
four most important elements of any good medical and treatment. True personality disorders who have no underlying
psychiatric treatment must include shelter, food, civility and schizophrenia do not respond to orthomolecular therapy. But
orthomolecular therapy. As t review these years I will refer she was indeed schizophrenic and I started her on a program
to these important aspects of treatment, asking if they have of proper food and vitamins. After three months she was
changed and if so, have these changes been for the worse or much better and after a few more months she was normal.
for the teller. When l last saw her she was still normal and planning on
writing about her experience In the psychiatric hospital. She
Several years ago a very angry young woman stormed into was very frustrated and as I listened to her story so was I as
my office eager to tell me her story. She had been discharged I could visualize her future if she had accepted the incorrect
from a psychiatric ward after three days by a psychiatrist diagnosis. Her schizophrenia would have undoubtedly
who told her that she was no! schizophrenic. Since she was gotten much worse and eventually the steady progression
a borderline personality disorder, he told her, they would not of the illness would have forced her back into hospital. She
treat her, as they had no treatment for personality disorders. would then have received the correct diagnosis and placed
She had been taken to the hospital by the police after on modern powerful drugs which control symptoms, do not
living on the streets for about Iwo weeks. She fled from her lead to recovery, and cause brain damage it maintained long
apartment and husband when during a rage she trashed her enough. On the other hand, I could see what happened to her
apartment. She realized what she had done, became very after receiving proper treatment for schizophrenia. The correct
fearful that her rage would return and fled to prevent any diagnosis and the correct treatment brought this intelligent
further damage. After she was given that dismal diagnosis and young woman back to normal to become a useful member of
prognosis she looked up the definitions of schizophrenia and society. 1 have heard many similar histories over the years as
of borderline personality disorder in the American Psychiatric most of the schizophrenic patients I have seen were referred
Association Diagnostic DSM IV. She identified herself with the to me after failing to respond to the usual psychiatric therapy.
description of schizophrenia.
6
7

During August 2005, I saw two patients whose diagnosis Shannon's mistreatment or lack of I real men! is the result of
gradually changed from bipolar to schizophrenia, to a hypothesis that was forced upon the public many years ago
schizoaffective, to border fine personality disorder {BFDl In which w'as that the mentally ill were better off on the streets
each case they had not shown any response to a large variety no matter how terrible the situation was compared to the
ol drugs, i he BPD diagnosis allows the treating doctors to mental hospitals no matter how good they were. The mental
understand why the drugs failed. They could not imagine that hospitals were terrible but even then were probably better
they were using the wrong treatment. One of these patients for patients than are the streets of modern cities. Shannon's
had been sick 12 years, had been admitted to hospital 19 life-lime career trying to get help for her illness represents
Ifrnes, and had cost the province nearly one third of a million what would have happened to my angry patient who came
dollars m hospital and drug costs. She stopped all drugs a to see me and is now well Shannon never had the chance
year before 1 saw her and, after a horrible period of severe to become well because orthomolecular treatment was not
withdrawal, stabilized, stili paranoid and hallucinating. After provided for her.
Ihree months on the vitamin program she was on the way to
recovery and both she and her husband were ecstatic at her The reporter wrote/ '"She is one of a growing number
newly regained ability to think and reason and to feel almost of people with mental problems who end up in the criminal
normal again. Her hallucinations had receded, and were less justice system,* One of the prosecuting lawyers who tried to
intense and less frequent.
find some help for her said, "1 don't think the criminal justice
system is designed to deal with people suffering from mental
The December 2, 2001 issue of the Times Colonist in disabilities or disorders, but unfortunately we've become the
Victoria, British Columbia described rhe tragic history of depository for it because there is no appropriate alternative/'
Shannon Hollingworth. The title of the article, "Lost in rhe ]udge Ernie Quance said, "In a society as wealthy as ours
Cracks is very apt and the subtitle succinctly tells us what is I here has to be a place for her," A probation officer said she
happening in Victoria: "Shannon Hollingworth is desperate had "overtaxed police, hospitals, mental health care homes
so desperate she has tried to kill herself numerous times in and other services, often in an attempt to get things her
order to gam attention. She wants 24 hour protection in a safe way," What did she want? She wanted treatmenl in a 24 hour
facility where she can battle the problems that send her out secure institution. Everyone working with her recognized
* CLontr°r BlJt thesQ days there's no place for the Shannons that she was very Ell and needed help. No one raised the
of the world/' Shannon is well known to the community most important queslion of all. With all the techniques
that pari of the community which deals with the mentally ill, available to modern psychiatry why was she not getting the
the police, social workers, psychiatrists, courts and more. In help she needed? The answer will be dear later on. She was
the past tew years she has been in the emergency ward 120 getting some treatment. She was not getting orthomolecular
times, has tried to kill herself frequently and in order to be treatment.
admitted has behaved very inappropriately.

1 Wested K. Lost in the cracks. Times Colonist, Victoria, British


Columbia, December 2, 2001
8
9

treatment possible. This is orthomolecular treatment and


This is a universal problem, not only in British Columbia or means public legislation like the bill passed in 2000 by King
in C anada. The newsletter of The Schizophrenia Association (bounty which may introduce better treatment into their state
of Great Britain (SAGBi reports in the 200!) summer issue that hospital system.
nine out of ten prisoners are mentally ill and/or affected by
drugs or alcohol on entering prisons. This is the conclusion
of the director general, Mrs. Gwynneth Hemmings, Mrs.
Hemmings organized SAGS many years ago and has been a
careful observer and dedicated worker in this field. Similar
observations have been reported from the United States,

My frustration arising from the many patients I have seen


over the years has at last compelled me to record my views
ot what has happened to psychiatry since 1950 when i first
became a resident in psychiatry at the Munro Wing of the
Regina General Hospital in Regina, Saskatchewan. There was
no effective treatment at that time.

The percentage of schizophrenic patients who recover


today is no better than it was in 1950, even though the
symptoms can be controlled more quickly and effectively, in
1850 the English doctor John Conoffy reported a fifty percent
recovery rate. Recovery to me means patients are free of
symptoms and signs, are getting on well in the community
and with their families and are paying income tax and
working in produclive roles. At a hearing in King County
Washington, in 2000, a psychiatrist testified that of the 10,000
patients he had treated, none had recovered. This is a tragedy.

We are never going to get better treatment for these


patients until the public demand is so strong that it can no
longer be ignored by the psychiatric profession. The change
will not come from the drug companies. It will come when
the pubic realizes what is going on, and demands that the
conditions of treatment be vastly improved by using the best
ID 11

introduced by the Quakers over 150 years ago consisted of


I he first Ihree components of the ideal program.

Chapter Two
1. SHELTER
The Basic Treatment Elements The Mental Hospitals

! was appalled at what I saw when I first studied the


mental hospital in Weyburn, Saskatchewan in 1950. It would
turn one's stomach until hardened by daily exposure to it.
INTRODUCTION
Shelter is obviously absolutely essential for every
Treating schizophrenic patients to recovery can be as easy
person, and Ihe amount of attention that must be given lo
as giving them one vitamin for a few months, or as difficult
shelter depends upon the conditions of the environment.
as spending 25 years using a total comprehensive program
It varies from the homes in easy climates in which many
which includes orthomolecular treatment, shelter, nutrition,
of us live, such as my home in Victoria, British Columbia,
and tender and loving care by family or by others equally
to the rigid environment carried around the bodies of our
motivated to do so. To make a valid comparison between
astronauts when they' travel in space. People are prepared
psychiatry in 1950 and psychiatry in 2007 I will examine each
to pay enormous sums of money for what they consider
of these four important modalities.
to be the correct shelter, traveling first class, living in very
expensive homes, staying in first class hotels, living in areas
The ideal treatment components of a total program
surrounded by many other people who help them look after
include: (1) Shelter (2) Optimum nutrition (3) Civility which
their interests, and in geographical areas surrounded by light
means Decency, Understanding, Support, Safety and
borders guarded by their best military means.
Privacy1 and (4) Orthomolecular treatment. These are not
listed in the order of their importance as they are equally
Only our psychiatric patients have been denied the
important. The effect of each variable on the response to
absolute needs of shelter from times when they were
treatment varies with the adequacy of these factors. Thus
banished from their communities, in places where they were
treating schizophrenic patients in a very good home will
handcuffed to trees in the forest, when they were forced to
be more successful than treating them on the grates of the
wander about on the streets (even now), when they were
streets of Toronto or New York. Moral treatment of the insane
incarcerated in foul dungeons and herded into inhuman wards
given less attention than farmers give their prized animals.
About 150 years ago the first good mental hospitals were
1 Hoffer A. The importance of privacy in building human values built. Dr Conolly in England was superintendent of a hospital
into the community. Community Planning Review 1969; 19:13-16
12 13

that provided proper shelter, This was when he reported the In 1950, the Psychiatric Services Branch in Saskatchewan
fifty percent recovery rale. The Dorothea Lynd Dix hospitals, operated two large mental hospitals, one in North Battleford,
built mainly in the United Slates with one in Toronto, were about 100 miles northwest of Saskatoon, and one in
substantial struclures providing l he better elements of Weyburn, about 70 miles south of Regina. A tew years later
shelter. But as the era of profound pessimism spread into it opened the Training School for the mentally retarded in
our psychiatric system these hospitals had been allowed Moose Jaw. The one psychiatric ward in a general hospital
to degenerate into foul prisons by 1900. They were called was the Munro Wing, in the Regina General Hospital. The
asylums but they did not offer any asylum, or proper shelter. hospital in North Battleford was built about 1913 and the one
In Weyburn a few years later. Each hospital was designed
The mental hospitals that I remember before 1950 were to house 1200 patients. Before the hospital was built in
hased upon deceit. They were impressive structures and it North Battleford, the government of Saskatchewan sought
would naturally be assumed that the care and treatment would and received advice from doctors from New York who must
be equally imposing. But the public facade hid institutions have been very progressive in their view of hospital design.
that did not know' how to care for patients, did not have any They recommended that it should consist of separate units,
useful treatment, and were fearful that the community would each one to be no larger than needed to house 300 patients.
understand what was happening. They were not asylums or This was based upon experience in New York State. They
shelters. The word asylum by then was such a fearful word believed that larger buildings that housed more than 300 were
that it had become customary for these mental hospitals to be too difficult to administer and that the distance between the
given innocuous names such as the Saskatchewan Hospital patients and administration would be too great However
in Weyburn. U was hoped that the stigma of the word asylum the architects retained to build these buildings advised the
would be avoided but it was not and the stigma carried on government that it would be too difficult to heat separate
no matter what these institutions were called. They were buildings and instead recommended one building. By the
custodial, designed more to protect the public than to treat time I arrived each building was terribly overcrowded, each
and recover patients. hospital housing about double the recommended number of
patients.
But I did not know what these hospitals were really like
until I joined the Department of Public Health, Psychiatric The Training School in Moose law was built to remove
Services Branch, on July 1, 1950 and began to visit these the overflow from Weyburn. it was called Training School
hospitals. My contact with the hospitals became closer when because the philosophy of that day was that the mentally
Dr. Humphry Osmond arrived from England in the fall of 1951 retarded needed special education much more than they
and we began to meet frequently either at the psychiatric needed medical attention. Mental retardation was judged
hospital in Weyburn, where he was clinical director, or In by the intelligence quotient, the IQ. There were three main
Regina where I was working at the Munno Wing. categories, using terms such as idiots, morons and imbeciles.
Intelligence quotients were given a lot of attention and
palients with an IQ under 70 were candidates for the Training
14 15

School In the United States some of these schools for the was for the best for the family to try to forget that one of their
mentally deficient were called campuses. When the Training members was in hospital
School En Moose Jaw was completed many hundreds of
patients were moved there from Weyburn. North Battleford The grounds were spacious and contained several
was in somewhat better condition than Weyburn because it buildings, the main building, service buildings, houses for the
was not quite as badly overcrowded. medical staff and barns for the horses and cattle. The hospital
operated a farm with patients as the wrorkers. The main
My sister F.H. Kahan provided an excellent description building was about three stories high, a bng rambling building
of the history of mental health treatment in Saskatchewan.2 with an imposing entrance. From the outside it looked like a
I recommend that this important document be read by very attractive building and one could hope that the treatment
everyone Interested in the fate of the mentally ill. and care given inside was equally attractive. But it was not,
I he top floor was the nurses' residence. After one parked the
The two mental hospitals were located well away from i ar and walked to the front door the first thing that greeted
the main centres of population perhaps for security reasons you was the shouting and noise coming from the open
following the general belief thal these patients were very windows of the building. These were psychotic patients crying
dangerous. Also there would be fewer relatives who would their frustration, their delusions and fears to the world. After
visit, those who might protest at the kind of treatment their tranquilizers were introduced one enterprising United States
relatives were getting. Visiting was actively discouraged. You mental hospital installed a noise meter in one of their wards
had to be a relative in order to be allowed in. The hospital and recorded the amazing decrease in noise as the ward
in Weyburn was located one mile away from the town. became fully tranquil!zed.
This hospital was the town's main industry. The hospital in
North Battleford was in the northwest part of the province. The front hall was very large and grand with an imposing
Saskatchewan is a large province about 30 Q miles from west staircase straight ahead going to the wards. On the left hand
to east and the Inhabited area runs about 300 miles north of side was the superintendent's office and other administration
the United States border. |j a patient was admitted from the offices, and to the right was a private dining room for the use
southeastern part of the province his family would have to of the superintendent and his guests. I had several meals there
travel 250 miles to see him and with I he usual poor dirt roads with the superintendent. As soon as one went through the
and very poor train connections it was extremely difficult locked doors the environment was totally different. The whole
to visit. As a result there were few visits and gradually there hospital was divided into large moms with a nurse's station
was complete alienation of the patients from their families. and immense numbers of patients of various types. There may
However they were not discharged anyway and it probably have been a few single rooms but I can noi remember ever
seeing any. The dining rooms were large and communal. The
basement rooms were the worst and had holes in the concrete
floors. One ward had BO women of all ages and most of them
2 Kah*m F.H, Brains and Bricks. The History of the Yorkton
Psychiatric Centre. White Cross Publications, Saskatchewan Division, refused to keep their clothes on.
Canadian Mental Health Association, Regina, 1965
16 17

Branch of the Deparlment of Public Health, he started


In 1954, Dr. John Weir, the Medical Director of the a 1 raining program eventually leading to the degree ot
Rockefeller Foundation, visited us in Regina after we had Psychiatric Nurse. It was different from the training received
requested a research grant. I drove him to Weyburn and with by RNs, There were too few doctors, none who had had
Dr. Osmond we showed him I he entire hospital. On the way psychiatric training. What they knew they had to learn
back he was very quiet for a long time. Eventually I asked him from experience. The superintendent had been a patient in
what he thought about the hospital. He replied very quietly the hospital because of his drug addiction. This addiction
that he had seen only two worse in the whole world. Out of apparently came under control, and he began to work with
curiosity I asked him where and he replied, "One in Egypt and the medical staff, eventually being promoted to the senior
one in Jamaica. * According to him our hospital in Weyburn administrative position. This was really the case where an
was among the three worst in the world of the many that he inmate eventually ran the entire institution.
had seen. Apparently he had not visited any mental hospitals
in Japan. A recent report describes I heir hospitals today in There was a remarkable failure to get the patients to
terms reminiscent of what we had in 1950A interact with each other. On several occasions i watched the
nurses take a ward of patients out to an enclosed field for
The Psychosocial Environment exercise and attempt to foster some interaction between staff
and patients and between patients. Normally when you place
After admitting us, one or two nurses, usually female, 50 people in an enclosed area they do not separate from
would escort us through the ward. We would immediately each other so that there is an even distribution of patients, like
be surrounded by patients clamoring for attention. They were molecules in a gas. After a tew moments groups will form and
no! aggressive. They were supplicants demanding one thing one will find singles, but also doubles, triples and even larger
or another. The fact that one or two nurses could command groups and the distribution of these groups is uneven. The
control over such large crowds indicated that these patients groups will be actively interacting with each other. However,
were not dangerous and were probably less aggressive than when these patients were placed in the enclosed area they
a similar crowd on the streets. Some of the crowd would drift did not interact. The whole field was occupied by solitary
away as we continued our walk but many would be with individuals equally distant from each other. I could only
us uni II we left the ward. We were probably one of the tew marvel at the striking impact of this chronic disease which
exciting events of that day for these unfortunate patients. removed from the patients I he need or ability to interact. I
think it is because they are so sick they are overwhelmed and
The nursing staff had not been I rained to deal with can only live in their inner world of fantasy and psychosis.
psychiatric patients but soon after Dr. D.G. McKerracher
arrived in 1946 as the director of the Psychiatric Services This was shown several years later when one of the
more optimistic psychiatrists on staff began to conduct
group psychotherapy sessions with a number of chronic
3 Tokyo, Hospitals lor the Mentally Ill Badly Need To Reform. The schizophrenic patients. He was convinced at the beginning of
Economist, November 24th, 2001
18 19

this experiment that palients would eventually learn to behave Between 1932 and 1940 the province experienced great
like normal people in these groups. But after two years of plagues of grasshoppers, destruction of wheat by the disease
regular meetings I he degree of interaction at the end of (he rust, terrible drought, low world prices for all their produce
study was no better than it had been at the beginning. The and huge unemployment. With the war in 1939 the situation
patients still did not talk to each other or to the psychiatrists began to improve. The weather got better, the drought was
running the groups. His hypothesis was derived from a current over and farmers learned how lo deal with the other natural
view being examined by many psychiatrists that fostering disasters. As welt, the province was starting to recover under
interaction would cure these patients. The nurses also tried to the direction of the socialist government led by T.C Douglas.
foster interaction between patients and staff by playing games Fortunately for the mentally ill in Saskatchewan Premier
with them. They used large balls and would throw them for Tommy Douglas had been a student minister intern for a few
the patients to catch and to return to them. This did not work Of months at the hospital in Weyburn and never forgot what
very well either. It may be that the patients' spreading as he had seen. When he became premier he also made himself
far from each other as possible was a reaction to the forced Minister of Health and took a special interest in psychiatry.
proximity within the wards of the hospital where they were He would joke about his experience in the hospital especially
always in each other's faces. For this reason they could not after becoming premier. The Joke had to do with a patient he
join in a group protest or rebel against their incarceration by met on the ward. The patient asked him "And who are you?"
staging riots. Dr. Osmond used to marvel at the fact that there Douglas replied, "I am the Premier of Saskatchewan/' The
had been no recorded episodes of schizophrenic patients patient replied, "You too!"
staging a break out as would be the case with prisoners of
war, or with psychiatric patients who were not schizophrenic Conditions Within The Hospital
such as psychopaths, as they were known then (personality
disorders is what they would be called today). I do not suggest Our hospitals lhat Dr. Weir considered among the worst
that this is a general symptom of being schizophrenic. I think three he had ever seen were overly crowded, with poorly
it is a product of the disease and incompetent treatment over trained medical and nursing staff. They provided custodial
many years. care for palients from all over a very large province so that
most families lost contact with them. It was a system which
These huge hospitals were designed to hold 1200 patients had grown with little planning, had stopped growing during
and yet contained double that number with no provision for the great depression between 1932 and 1950 and which did
privacy of any sort, t he inmates, as they were called, were not take into account the needs of the people of the province.
managed by a gradually improving standard of nursing care, The public was not aware of what went on in the mental
medically supervised by doctors who gained experience while hospitals and probably, except for a few very quiet families,
working there and administrated by bean counters whose did not care.
main concern was saving money. This is understandable
since Saskatchewan had just begun to recover from the Great Mentally ill palients face the stigma of being mentally ill as
Depression and a series of disasters that had hit the province* also happens with some physical diseases. Diseases which are
20 21

not understood and for which we have no effective treatment The earliest term for the old mental hospitals was asylum.
tend to be stigmatized. So it was with tuberculosis many years I am sure that Dr. Con oily back in 1850 was happy with the
ago. Families were very fearful of this condition because there term asylum being applied to his hospital where he was able
was no effective treatment and patients had to be taken to to get a 50 percent recovery rate. But as the character of the
sanitariums for many months or years of treatment. Today hospitals deteriorated until 1900 the stigma of unrecovering
even though there is reason to be fearful of the resurgence patients became so bad that the term asylum was dropped. It
of this dreadful disease there is no stigma attached as we meant that anyone in an asylum was mentally ill. The Oxford
have effective treatment for it. Syphilis is another example of International Dictionary of The English Language defines
a disease which was abhorred and stigmatized- But with the asylum as follows: (1) A sanctuary for criminals and debtors
introduction of the proper antibiotics and with a change in from which they can not be forcibly taken without sacrilege
moral sexual standards it appears to have no stigma attached (2) A secure place of refuge or shelter (3) A benevolent
to it Special treatment centres were created in hospitals for institution affording shelter to some class of the afflicted,
the diagnosis and treatment of this disease although there the unfortunate or destitute (5) Lunatic asylums. I think the
were separate entrances away from the front entrance of the word is a good word and ought to be resurrected and asylum
hospital. A very recent example is HIV/AEDS which carried should be given, if necessary for life, for patients who have
the same severe stigma 20 years ago, most of w hich has been so badly damaged that they will never be able to live an
dissipated. independent existence. Meaning #5 is the proper use of this
word but without the adjective lunatic.
For the same reasons the mentally ill, especially those who
did not recover were stigmatized and schizophrenia still is. To counter the stigmatized word asylum it was
Schizophrenics were said to have nervous breakdowns and dropped and an innocuous term was used instead such as
these were discussed in hushed tones hy families and friends Saskatchewan Hospital in Weyburn or Spring Grove State
and whispered ahout to each other even though no one knew Hospital in Maryland. This did not help for the stigma which
what having a nervous breakdown meant. And the institutions had enveloped the original structure would not leave no
where these patients went for help soon were enveloped by matter how hard any one tried to blow It away. By 1950
the same stigma. Strenuous efforts have been made over the another attempt was made by simply describing the location
past 100 years to remove the stigma first by changing the of the psychiatric wards within the hospital. At the University
name of the institution and over the past 50 years by trying Hospital in Saskatoon it was called 5DL, an accurate
to educate I he public that this is a disease just like others. But description of the location of our wards on the fifth floor in
in fact it is not and the public was not fooled. Schizophrenia wings D and E. It soon became obvious that patients from
would be a disease just like other diseases if it were generally the rest of the hospital did not want to go to SDL and it, too,
recognized as an easily treatable biochemical disorder with an carried the same stigma, \ believe most psychiatric wards are
excellent high recovery rate when treated by orthomolecular still called psychiatric wards and a few places have names of
methods. their own to honour certain political persons such as the Eric
Martin Pavilion in Victoria named after Eric Martin, it has the
22 23

same reputation that any other psychiatric hospital has. It is there is a very low level of interest. The new doctors had no
not very good and patients resent and fear going there. There preconceptions and quickly adopted the new ideas of cause
h only one way to remove the stigma and that is to show the and treatment which were predominately psychological. Bui
public that patients with schizophrenia recover and become when drugs were introduced in 1955 they were adopted even
useful members of society, that it is not an unbeatable more quickly because their effect was so dramatic.
disease.
The Saskatchewan plan was conceived and developed by
The orientation of the staff after Dr. McKerracher Dr. McKerracher. The original plan envisaged small regional
arrived was quite different The earlier staff had worked hospitals across Saskatchewan. Seven were to be built and
almost entirely in the mental hospital and tended to be very the large mental hospitals were to be replaced. With three
conservative about the nature of schizophrenia although not large hospitals it was very difficult for families to keep in
so conservative about introducing new treatments into the contact with their relatives especially during the long winters
system. They were general practitioners. As there was no when most roads were closed to motor vehicle traffic. It
efiective treatment they were not restricted by any ideology was much more difficult to make realistic plans for patients
and tried new treatments as they were developed. Within a to be discharged. As I've said, Saskatchewan is a very large
few years of the development of electroconvulsive therapy province, with a very small population and only a few large
(ECO it was being used in Saskatchewan. Within a few years cities. The large distances plus poor roads meant that visiting
of the development of insulin coma therapy it, too, was being relatives was a two day excursion for many people. Neither
used. These treatments were not very effective but they did Regina, the capital, nor Saskatoon, the first city to have a
provide some hope that biochemical biophysical treatment university had any psychiatric facilities. According to the
might have some value and needed only to be perfected. Saskatchewan plan the seven smaller hospitals would be
scattered across the province so that patients were no more
It is much more difficult to introduce new therapies today, than 60 miles, one hour driving time, from their home. The
unless It is a new drug, since modern psychiatry adopted second main reason was that it would be easier to administer
the stance that only drugs have any value. Psychiatry has small units and management would be less alienated from the
gradually gone through a phase of psychotherapy (especially patients. Two of these hospitals were built eventually, one in
analysis) as the only valid treatment, has forsaken that and York ton, in the eastern central part of the province and the
now considers that drugs are sufficient while paying lip other in Prince Albert in the north east part of the province.
service to psychotherapy in conjunction with drugs. Keith* in This Saskatchewan plan was the forerunner of the massive
an editorial in the American Journal of Psychiatry asks, 'Are program of deinstitutionalization which was a corruption of
We Still Talking to Our Patients With Schizophrenia?" And the original Saskatchewan plan. Deinstilutionalization swept
he answers his own question, "1 hope so." But he points out

* Keith 5. j. Are We Still Talking Lo Our Patients With


Schizophrenia? American journal of Psychiatry 2006; 163:361-364
24 2.^

across North America leading in Jarge part to the terrible


shelter situation we have todays Dr, Osmond as clinical director of the hospital In
Weyburn had as his main mission to bring into being a
The New York rimes" featured the condition of the modern administrative structure which could cope with the
mentally ill in their city. In their reports the main emphasis vast problems of this old inadequate hospital. But he laced
is on inadequate housing and inadequate care. None of the resistance from Ihe start by members of the psychiatric staff
ihree basic principles of humane and effective treatment are and by the superintendent of the hospital. He could not
followed; Patients are given inadequate shelter, Inadequate introduce changes that he fell should be Introduced and thus
food and are not treated with dignity and respect, but we for several years he concentrated on studying the problems.
now need another journalistic investigation to examine the On Ihe positive side it left him much more time Io work with
inadequacy of modern psychiatric treatment which depends me on our joint research.
only on medication. The situation is no better In Canada.
Recently Nunes and Simmie7 described the plight of the Dr, Osmund became interested in the impact of the
mentally til in Toronto and used primarily the histories of environment on patients. He had taken mescaline and LSD
patients who had done fairly well or had recovered. Most several times and was aware of the perceptual changes
of these survivors of the mental health system suffered from induced by these hallucinogenic compounds. The drugs
depression or from bipolar conditions. The same patients induced temporary changes in the experiential world. But
who also had schizophrenic symptoms did not do nearly schizophrenic patients had to live with these perceptual
as well and most remained impaired and damaged hv their changes for years if not forever. Osmond wondered whether
experiences. one could design wards thal would minimize these perceptual
abnormalities. The typical hospital consisted of large wards
Or. McKerracher was facing very severe problems with and long corridors. What is the impact of walking down a
the administration of these institutions. The patients were long corridor when there are no symbols on the floor or walls
warehoused, not receiving any useful treatment and usually that indicate that one is making some headway? Modern
stayed in hospital forever. But the administration appeared buildings are aware of this and corridors which lake this into
to have accepted this as one of the symptoms of chronic account are much more pleasant for walking and are not
schizophrenia and hefieved that there was nothing that could nearly so monotonous. Ideally patients would be asked lo
be done.
describe the impact of Ihe rooms they were living in but very
lew patients were either well enough or verbal enough or
sophisticated enough to describe the impact of any changes in
5 Hotter A The Current Mental Health System for Schizophrenic
E-Yiiients Canadian Journal oi Community Mental Health 2000 19144- their environment.
146

6 Levy t J. For Mentally III, Death and Misery, New York Times By this time joe Iztmni, a bright young architect known for
April 28, April 29, April 3U and May 5,2002 some of the buildings he had designed, was retained to carry
7 Nunes J. & Simula S, Beyond Crazy. Met.elland and Stewart out some remodeling of the wards at the Weyburn hospital.
I Id., Toronto, 2002
26
27

He knew about our research with LSD and he was intensely aides and doctors) to patients. Our budget was al least four
interested. He volunteered to take LSD so that during the limes the budget per patient for our two mental hospitals,
experience he could walk through i he wards of the hospital, about 80 dollars per day. (Remember that this was between
spending time in the various rooms to see what the impact 1955 and 1967.) A research study by my assistant director ot
would be on him during this experience. We agreed that psychiatric research, Dr. C Smith1" in cooperation with Dr,
this would be interesting and could be valuable. Humphry McKerracher, of the treatment results of our ward in Saskatoon
gave him LSD at the hospital in Weyburn and later I gave' and the nearest mental hospital in North Battleford showed
It to him in Saskatoon at the University Hospital, l or the that the results of treatment were about the same.
following month he studied the impact LSD had on him and
following that he designed a hospital that he thought would Between those heady years when tranquilizers became
minimize the impact of perceptual symptoms on patients. available and 1987, the race was on ail across North America
The building" he built in Yorkton won a silver medal from to see which hospital could empty itself the quickest. This
t e American Psychiatric Association. A second building was process was called ddnstitulionalization and was supported
built jn Prince Albert. No more were constructed because by every group or agency interested in the welfare of the
I he newly introduced tranquilizers filled the psychiatric mentally ill A rallying cry was used: The worst home in
community with the expectation that a cure for schizophrenia the community is better than the best psychiatric ward.
Pact at last been found and no more hospitals would be Governments loved it because they were promised that
needed. The Saskatchewan plan was shelved but moved total cosl would go down. It was assumed that the dramatic
south into the United States in a corrupted form that led to response to these drugs was in fact a cure and that the
deinstuutotalization which has been so harmful to patients patients would not ever have to come back again. Our
ramifies and their communities.
superintendent in North Battleford proudly showed us a chart
showing the dramatic decrease in the total population of his
Between 1955 and 1967 I trealed my patients in the hospital year by year.
University Hospital, now called Royal University Hospital in
Saskatoon, Saskatchewan. I had been one of the advisors to The communities had become aware of the desperate
Dr. McKerracher, Chair of the Department of Psychiatry at condition of the patients in mental hospitals and demanded
the University ot Saskatchewan, before I he wards were built that the psychiatrists do a better job. The invariable response
We were given the outside dimensions and had to design the of every superintendent tn every hospital wras that they were
interior This was the best psychiatric facility in the province short of money and if the community would give them more
with a large ratio of staff (nurses, psychologists, social workers. staff, more doctors, more nurses, more social workers and
aides then they would do a much better job, I became very
dubious about this automatic response especially after the
s Izumi K- & H. Osmond. Community Mental Health Center/
research-oriented situation 34-61, In Architecture for the Community
MasmTVv1 “ «-“« Materials Center, In^ 9 Smith CM., McKerracher D-G-, McIntyre S. Care of the Certified
SSKSSg 1967 Y°fk l0°10' ^-sCatsfoguc Psychiatric Patient in the General Hospital. The Saskatoon Project.
Can Med Assoc] 1963; 88:67-74
26 29

results of the Colin Smith study became known, I decided to medical and orthomolecular methods as needed. My patients
test it En a crude way on my own. in the University Hospital received the same four components
of the ideal treatment. 1 was able to treat about 100 patients
In 1967 I resigned my two positions from the university Over the next eight years.
and governmem and entered private practice with admitting
privileges to the local general hospital, City Hospital, in I then compared the outcome of my treatment at the
Saskatoon, A nursing home company announced they were hospital and at the nursing home and found that it was the
building a new nursing home in the city for the physically same. The shelter and additional care given at the hospital
handicapped. I approached a friend involved with this which cost four limes as much did not improve the efficacy
company and asked whether I would be allowed to admit of my orthomolecular treatment. I found to my surprise that
patients to his nursing home. They would be chronic the mix of young schizophrenic men and women in a nursing
schizophrenic patients from the United States and Canada home with chronic invalids, who were mentally normal or
who had failed to respond to any previous treatment. \ had senile, was very good. My young patients added life to the
been treating these patients at the University Hospital with institution. They volunteered to help in pushing wheelchairs,
some success. The nursing home was to he built following the talking to the mentally normal but physically infirm patients,
model of motels then very popular. Each patient would have serving etc. Only one patient left and he was promptly
his/her own room. There would be one nurse in charge, no discharged. He went back to his parents in the United States.
other professional workers, but the usual amenities of nursing Only one chronic schizophrenic patient who was also an
homes would be provided. The place was bright and dean alcoholic would not cooperate. Nor would his father support
with a large central living area where patients could meet. what I was trying to do, even though his mother tried very
They all ate together in a large dining room. The cost was 20 hard to get him to stop drinking. His father did not support
dollars per day, i.e. 25 percent of the cos! at the University my advice that he must not drink. From this I concluded
Hospital. I would be in charge of treatment and would give that although shelter was very important one did not need
ECT if needed. There was no compulsion; patients were there to go to extremes to provide adequate shelter and that more
voluntarily and could leave at any time. The difference in cost important than shelter alone was the addition of the correct
represented the difference In the number of staff. The quality orthomolecular treatment.
ot the food was the same but my patients at the nursing home
did not receive any psychotherapy from nurses or other staff. No one will disagree that shelter is vital but society
But the staff were friendly and kind to them and they got appears not to understand that it is also vital for psychotic
along very well with the physically ill patients. The nursing patients. One can judge l he overall sense of decency and
home agreed to admit my patients, whom I saw several limes humanity of any society by the kind of shelter it provides lor
a week. I was using the moral treatment introduced by the its mentally ill population, A decent and humane society will
Quakers m 1650 without knowing about I heir work. These treat their people in hospitals and other shelters that live up
patients were given good shelter, were treated with respect, to the standards established in 1650 by (he moral treatment
and received good food and proper medical treatment with introduced by the Quakers. A less decent and less humane
30 31

society will treat them rn prisons as is happening today or psychiatric hospitals have been shutting down their beds the
wiff allow them to languish on the streets. This has little to do number of patients who need the kind of care they could
with industrialization but everything to do with attitude and offer is going up and will have lo be supplied by the prison
belief. Psychiatry has not convinced society that it can treat system. A survey ten years ago showed that provincial jails
schizophrenic patients successfully in spite of the protestations in Ontario had 350 mentally ill prisoners and of those 130
of the remarkable effect of modern drugs. I believe that only were certifiable. The same survey last year showed that there
when society is convinced that these patients can be treated were 600 mentally ill prisoners. The reason is that the mental
successfully and restored to the community as normal people hospitals have the power not to admit patients and in this they
will it take seriously the need to provide proper shelter. It can are assisted by the state mental health laws while the prisons
be done now and modem hospitals are fully equipped and do not have the luxury of denying admission to people sent
know what to do but it is not available to these patients due there by I he judicial system. There is a gradual swing over
to policies that have been developed over the past sixty years and care is forced onto the prison system while liberating the
all arising from the deinstitutionalization fiasco that started health system outside of the prisons from having to deal with
in Saskatchewan in 1955. Had the Saskatchewan plan not it. I can not think of a worse place to treat psychiatric patients
been corrupted by the excessive enthusiasm generated by the than in a prison hospital except that since only drugs are
tranquilizers we would not have the fiasco we have today. being used in both types of hospitals the results will probably
be the same, not very good.
In the United States™ a report by the U.S Justice
Department showed that 280,000 or 15 percent of the entire The television program. Sixty Minutes, on July 22, 2007
jail population was mentally ill. The total in 2007 is 300.000, devoted one-third of its program to the condition of the
A news report proclaimed that, "Jails Become Nation's New mentally ill in the prison menial wards in the United States.
Mental Hospitals." Another 200,000 people are homeless. Timothy Souder, age 21, was a manic depressive in one of
An even larger group is probably just on the edge of entering these prisons. He had become different in his late teens, with
these two populations il their circumstances deteriorate strange behaviour, anxiety and depression and in prison he
more^ About 60 percent of the psychotic population of tried to kill himself three Limes. In his cell he was chained
over 5 million is not receiving any treatment whatsoever. to the cement floor for up to 17 hours with only the video
However this may be an advantage for some considering camera recording his torture. He died alone lying on the floor
the high natural recovery rate when It is allowed to operate, of his cell from dehydration.
I he situation is not any better in Canada. Philip1 reported
that there was a problem in organizing a mental hospital for All elements of the ideal treatment are essential to build
the inmates in the prison system. At the same time as the and maintain self respect and morale. There can he no
argument about these being important Patients are sick
people, and they must be treated with decency and respect it
we want them to recover. All (he elements of civility improve
11 M hospital-jail Offers Hope for the Merit nil v III, GJobe the patient's natural recovery possibilities. The best example
and Mail, Toronto, Nov. 4, 2002
32
33

was the hospital in England supervised by Dr. Conolly and the 2. OPTIMUM NUTRITION
Dorothea Dix hospitals in New York State, Connecticut and
Pennsylvania. I read (he first annual report of these hospitals. The food served in 1950 in these hospitals was not much
This annual report fater became the present day American different from the food the general population ate. But like
journal of Psychiatry. They reported a 50 percent recovery most institutional food it was too rich in refined carbohydrates
rate of these insane patients. They had no medication, no and did not provide enough vegetables and protein. During
psychiatric drugs, I assume they provided good food not yet the previous years of economic depression the die! in
• t>Y modern technology. They provided shelter and institutions was probably better than I hal of many people
treated (heir patients with civility. EE was common in these who were living at home. Costs were kept as low as possible
hospitals to have Saturday night parties attended by palients but the hospitals had their own kitchens and cooked their
and staff together, just these three elements of the treatment own food. The large hospitals also grew some of their own
process alone aEfowed half the patients to recover. I think that vegetables. This food was probably similar to the food that
schizophrenia has a high natural recovery rate if patients are was served in 1850. By 1900 in the northeastern United States
allowed to use their natural recovery processes by providing the food budget of mental hospitals had become abysmally
the elements of good treatment. The best recovery rate today low. One superintendent prided himself on the fact that he
with the most modern tranquilizers and other drugs is under could feed his patients on 19 cents a day. Not surprisingly the
10 percent. By recovery I mean patients are well enough to discharge rate decreased from 50 percent in 1850 to almost
earn a living, to engage in normal activities and to pay income zero in 1900. The mental hospitals always served enough
tax. On modern drugs it becomes impossible to pay income calories. No one starved in hospital and many got fat.
tax unfess the wealth has been inherited.
The commercialization or deterioration of our food started
The erticacy of any treatment regimen is directly related to after the last war. In 1950 in Canada 15 percent of the food
the adequacy of shelter, but I do not think the relationship is ' was processed. In 2007 it is closer to 85 percent. Only In
linear. The optimum level is reached when it is approximately the past decade has much, if not all, of the food given to
what an average family has, excluding those families that are patients been prepared outside the institution and brought in
on welfare or on very low incomes, increasing the standard precooked. Kitchens are absent from modern hospitals. This
above that will not increase the efficacy of treatment very was alt done to save money. In some hospitals less money is
much. The relationship is curvilinear. When one pfots level spent on food than on bandages and casts. Not only has the
of shelter against efficiency of treatment the curve will rise nutritional quality of modern foods deteriorated it has also lost
sharply from zero (on the streets, chained to trees) to the
much of its flavour.
average level and after that it will rise slowly, slowly reaching
its maximum. In 1950 most psychiatric institutions did not But the deterioration of the food served to patients is no
provided adequate shelter. Today most institutions do not longer a major factor since they are seldom kept in hospital
provide adequate shelter long enough to do any good. long enough. They would be much healthier on a good diet
but a good diet for a few days does not do much for a street
34
35

person who spends [he rest of their time on the streets. Food important in the relationships between dominant and less
not considered an important factor in modern psychiatric dominant people e.g. doctors and their patients. The doctor
theory and practice. And the reason is simple. In Canada patient relationship especially must be described by the
most medical colleges give their students about one hour of adjectives that make up the term civility. I have seen many
nutrition over four years with the exception of the University palients who complained about the way they were treated
ot Toronto and McGill. But chronic patients who cannot be by their doctors, their psychiatrists and hospitals. Had the
discharged will si ill suffer from the deteriorated diei of modem physicians respected these principles of civility there would
institutions.
have been no complaints from their patients. The five
adjectives describe the doctor patient relationship as I think
In 1950 staff running the mental hospitals knew little about it should be practiced. I will use the term civility hereafter to
nutrition and the importance of food, and they were forced to cover these essential values.
consider cost as a major factor in preparing their meals, but in
t is t ey were not much different from the general population Diagnosis
outside of the institutions. In 2007 much more is known about
the vast importance of proper diet and food in treating the Civility must include being scrupulously honest with
mentally ill, but the staff of psychiatric hospitals are equally patients in telling them what is wrong with them, what the
ignorant and I hey are generally providing food to their palients treatment plan is and the anticipated outcome or prognosis.
which is less nutritious than that of the general population. Patients should aEso understand the reasons why Ehey have
And when there are rare hospitals that do recognise these been admitted into hospital. This depends upon the symptoms
tacts the patients are not in hospital long enough to benefit anti signs of the disease. They must be given the information
from this knowledge. In terms of feeding patients the mental they will need for true informed consent. Today in mental
hospitals of 1<J50 did a better job than the psychiatric hospitals hospitals informed consent does not exist for certified patients.
do in 2007.

Schizophrenic symptoms can be divided into two sets: (1)


those that force patients into hospital, (21 those that permit
3. CIVILITY
patients to live in the community. The first set of symptoms
is what 1 call I JOT symptoms and the second set is COOL
Many adjectives can be used to describe the desirable symptoms. Hot symptoms include severely abnormal or
relationship between people. Five adjectives in particular - criminal behaviour such as shooting people at random,
decency, understanding, support, safety and privacy can be burning down buildings, shouting at people in the streets,
combined into the term civility,1' And inasmuch as cjvilfty running around nude, talking about severe paranoid ideas,
is desirable for relationships between equals it is even more or severe depression or mania, these are symptoms which
normal society cannot tolerate. Cool symptoms are equally
devastating to the patients but are much more tolerable to
l* A The of privacy in building human values the community. They include moderate depression, paranoid
o me community. Lominunily Planning Review 1969; 19:13-16
36
37

ideas that are not shared, and hallucinations that are kept Association specializes in turning human frailty into disease.
secret. An example is the man who had been sick in his In Ihe last year ads have been appearing in psychiatric
parent s farm home for two years. He sat quietly in the kitchen journals ahout possible treatment of shyness, a syndrome
and did not say a word for the whole time. His family was nut yet officially recognized as a disease You can bet the
able to tolerate this abnormal behaviour. However one day association will include it in the next edition of the Diagnostic
he began to hop on one foot and did so for three days. On and Statistical Treatment Manual of Mental Disorder. As it
the fourth day he was admitted to ihe psychiatric hospital. turns out the Association has been inventing mental illness
Tranquilizer drugs decrease the intensity of the hot symptoms for the fast 50 years or so. The original diagnostic manual
and convert them into cool symptoms but they in essence appeared in 1952 and contained 107 diagnoses in 132 pages,
do not cure the basic biochemical process which keeps on f>y my count. The second edition burst forth in 1968 with 180
burn mg as intensely if more quietly than before. They convert diagnoses in 119 pages. In 1980, the association produced a
the one-foot-hopping-patlent back to his original quiet non¬ 494 page tome with 226 conditions. Then in 1994 the manual
talking patient state.
exploded to 886 pages and 365 conditions, representing
a 240 percent increase in the number of diseases over 42
Diagnostic criteria have changed over the past fifty years. years." Does this mean that in fifty years there has been a
In 1950 it was relatively simple. The vast majority of patients real prof iteration in the number of psychiatric diseases from
were divided into psychoses, neuroses, and behavioural several handfuls to many hundreds? It does not. It does mean
disorders or psychopathy and intelligence levels were that the system of diagnosing has become manic, has run
determined by paper and pencil tests. There were three main out of control has very little meaning except legally and for
types of psychoses: schizophrenia, manic depression and the insurance company purposes, it means that the minutiae of
organic psychoses. There were four types of neuroses and human differences has been coded with diagnostic numbers
several types of behavioural disorders. All these diagnostic so that even the slightest variation means a new diagnostic
groups were based on clinical descriptions of the patients, number must be assigned. It means that one of the rare
not upon cause or outcome of treatment and there were no delusional systems believed by schizophrenic patients is
specific treatments so that ft did not matter that much except dignified by a special name called Capgras syndrome which
that the psychotic patients were much more apt to wind up is dealt with as if it were a special disease, when aEl it is, is a
incarcerated in hospital or prison. description of this rare type of delusional thinking.

Today the fourth edition of The Diagnostic and Statistical In my opinion, modern diagnosis is no better than it
Manual of Mental Disorder (DSM-IV) lists hundreds of distinct was but much more complicated. Please read Making Us
diagnostic mental conditions.1' In a hard hitting editorial Crazy by Herb Kutchins and Stuart A Kirk11. Herb Kutchins
opinion piece in the Los Angeles Times, January ]f 2006, Drr
I Savodnik, psychiatrist and philosopher at UCLA writes, ''The
14 Kutchins H. and Kirk A K. Making Us Crazy, D5M: the
Psychiatric Bible and the Creation of Mental Disorders. The Free
Press, New York, 1997. Also, The Belling of D5M. The Rhetoric of
13 American Psychiatric Diagnostic Manual DSM IV Science in Psychiatry. Hawthorne, New York, 1992
.38 39

is professor in the School of Health and Human Services at 1 also became aware that the diagnosis of schizophrenia
California State University, Sacramento and Stuarl Kirk holds was not always the first one tagged onto a patient. Either the
the Marjorie Crump Chair in the School of Public Policy and symptoms were not very clear, or the diagnostician failed
Social Research at UCLA. See Also Walker1' and Hobson & to look at them closely enough. The diagnosis was very
Leonard.1 & The creation of so many diagnostic categories has unstable with recurrent admissions. Patients were diagnosed
not improved the lot of the mentally ill and for many it has as depression, or manic-depressive, or personality disorder on
been catastrophic as it could have been for the young woman first admission; later this was changed and finally, often after
who was wrongly called borderline personality disorder when several admissions, they were clearly recognized as having
she was in fact schizophrenic, if they happen to be pigeon¬ schizophrenia. Many years ago it was rare for the diagnosis,
holed in the wrong category DSM-IV is included in the list of once it had been established, to he changed to something
things that drive psychiatrists to distraction. This is based upon else but in modern psychiatry this has become very common.
a poll ol 200 psychiatrists from around the globe. Containing The same patient may see several different diagnosticians and
every psychiatric diagnosis, it h criticized for reducing receive a different diagnosis from every one of them. Too
psychiatry to a checklist, "If you are not in DSM-IV, you are often bias against the term schizophrenia or fear of the disease
not ill. It has become a monster, out of control."17 will make It very difficult lo diagnose patients. 1 have seen too
many unfortunate patients who, after repeated admissions,
In general, early treatment of disease is much more have finally been diagnosed as personality disorder simply
effective than later treatment when the disease has been because they behaved in a way that was not acceptable or
well established with resulting impairment of function. That because they had not responded to the current anti-psychotic
was why Dr. Osmond and I concentrated on early cases, treatment,
called acute. These were patients who had been sick for a
short time, or who had responded lo earlier treatment and in our book How to Live with Schizophrenia™ Hotter and
had subsequently relapsed. They were not mild cases. All Osmond described the early and developed stages of this
the first 8 patients we treated were very psychotic and had disease so that it would be easier to diagnose. Practically in
not responded to the treatment of that day including ECT. All modern psychiatry il doesn't matter since no matter what the
our controlled trials were with early onset patients. We soon diagnosis Is the same drugs are used one after the other in an
discovered that schizophrenic patients who had been sick for altempi to find that combination which will help. But many
a long time also responded but much more slowly. years ago the diagnosis did matter and helped decide the
treatment as is the case for all of medicine.

York '?9%er IIJ 5 A °0Se ”fSanity' J°hn Wiley ,ind Sons ^ Neu
18 Hoffer A & Osmond H, How To Live With Schizophrenia.
Hobson |-Allan and Leonard, Jonathan A. Out of Its Mind,
University Books, New York, NY, 1966 Also published by Johnson,
svl i a try in Crisis, Perseus Publishing, Cambridge, Mass., 2U01
London, 1966. Written by Fannie Kahan, New and Revised Ed, Citadel
I7 tThe Independent. March 19,2001. Ten Things that Drive Press, New York, NY", 1992, Revised Quarry Press, Kingston. ON 1999.
Psychiatrists to Distraction".
I loffer A. Healing Schizophrenia. CCNM Press Toronto, 2004
40
41

Etirly in our research in Saskatchewan we were aware of are on medication but some are apparently well white still
the need to have accurate diagnosis and we were (coking hearing their voices. This group has many ideas with which i
for objective methods of diagnosis. Our studies of the can not agree but their basic philosophy is correct. They need
hallucinogenic experience produced by LSD, mescaline, an organization in which they can freely talk about these
adrenochmme and other substances made us familiar with phenomena. This undoubtedly eases a lot of pressure. The
the experiential world of the patients without us needing to tragedy is that the members are totally unaware that many
become schizophrenic fora long period of time. We realized of them could be relieved of their voices if they were treated
that the experiential world of our patients was similar to what with orthomolecular methods.
we and many others had experienced from the use of these
drugs and we were able to formulate a series of questions We developed the Hoffer Osmond Diagnostic Test
designed to test this similarity. (HGD)7fU1-2Jn This is a very simple card sorting test which
I have found very valuable in diagnosing schizophrenia. It
John Conolly1 in his remarkable book defined insanity is based upon examining the perceptual world of patients
{the term schizophrenia was invented 70 years later) as a by having them answer True or False to a number of
disease of perception combined with the inability to tell specially targeted questions. But the test has not caught
whether these perceptual changes were real or not. The on. It never became popular except among chiropractors
presence of both conditions is essential for the diagnosis to in the soulhwesEern United States. In my opinion it is one
be made. Perceptual changes such as visual hallucinations of the best, simple and accurate diagnostic tests and ought
{visions) or auditory hallucinations (voices) when present to be used for assisting in deciding whether schizophrenia
alone do not establish the diagnosis. Normal people may is really present or not. Since schizophrenia is a perceptual
have these phenomena but as long as their judgment about disease every diagnostic test ought to include these kinds of
Ihe reality of these events is intact they are not psychotic. perceptual questions.
Patients can be taught not to accept (he phenomena as
real. In the Schizophrenics Anonymous group I started in At the same time we had discovered a new compound
Saskatoon in the late 1960s, members learned to discuss Ihese in the urine of the majority of schizophrenic patienis that
hallucinations. Often they would greet each other, ‘Greetings was not present in normal people and which was present to
and Hallucinations. And who are you today?" and laugh.
In England and in a few other countries the Hearing Voices
Network for people who hear voices was created From (he 20 Holler A & Osmond H, A card sorting test helpful In making
account reported in the New York Times, menders of this psychiatric diagnosis. J Neuropsychiatry l%i;2:306- 330
group do not consider that the voices are symptoms of mental 21 t loffer A fit Osmond H. The relationship between an unknown
illness. Many ol the members were psychotic at one time and factor (US) in the urine of subjects and HOD test results, J
Neuropsychiatry I96I;2:36S-368
22 Hotter A. Maivaria, schizophrenia and the HOD test. Int ]
Neuropsychiatry 1965^2:175- 177
Conolly J, An inquiry Concerning the Indications of Insanity, 23 Hotter A, Kdm I I fit Osmond H. The Hoffer-Qsmond Diagnostic
1830, 1964 London, Dawsons of Fall Mail
test, RE Krieger Fub Co. Huntington, New York, 1975
42 43

a much lower degree in mentally III patients who were not disturbances will become the basis of the developing
schrzpjphrenic. We called it the mauve factor and it was later delusional system."
identified as kryptopyrrofe* This strange compound is being
examined worldwide. According to Dr. W. McGinnis24, 25 it Until 1960, and perhaps much later, psychiatrists rarely
is an indicator of oxidative stress. As we suspected in 1952, it tkl their patients their diagnosis if they were schizophrenic, in
schizophrenia is characterized by excessive oxidation. We il occurred to me that psychiatric patients had as much
examined many patients for the presence of this factor Its right to know their diagnosis as did patients on the physical
presence correlated very highly with the scores of the HOD side of medicine. I could not think of a single good reason
test. This increased the potential validity of both these tests. why not, even though Dr. Karl Menninger had published a
This test for the mauve factor also is not used widely but a few paper in which he demanded that psychiatrists not tell their
laboratories are using it with success. patients that they were schizophrenic Dr. Menninger was
convinced that telling patients would make the situation
Recently Bota et al^ examined 24 schizophrenic much worse. In 1960 I began to tell every patient what I had
patients" history of interaction with psychiatrists. They found concluded was their diagnosis but if they were schizophrenic
substantially what I had observed fifty years ago. Frequent I would immediately follow that with the statement that it was
diagnoses before the final diagnosis were impulse disorders, a biochemical disease, and that it had not been caused by
ADHD, and bipolar disorder Patients showed evidence their mother. The bad mother or schizophrenogenic mother
of illness 44 months before final diagnosis. They write, hypothesis was very powerful at that time. I was not surprised
"The incipient experiential changes were described by the and was delighted when my patients accepted their diagnosis
patients as ill defined dissociation phenomena, feelings and appreciated knowing it. I remember two cases. One
of unreality, ambivalence regarding day-to-day decisions, was a teen-aged boy who came with his mother, I told them
decreased tolerance to normal stress, increased emotional both (at I hat time this was another psychiatric no-no since
reactivity leading to conflicts, and decreased ability to initiate no one but the patient was supposed to be in the room with
and maintain social contacts... fcVentually their perceptual the psychiatrist) what the boy had and then told his mother,
"And you did not make him sick." She immediately burst into
tears. Then she told me that I was the first doctor who had not
24 McGin n is W R Uri na rv pyrrole (Mauve Fa rtor): m etric for
blamed her for making her son psychotic. I he second case
oxidative stress in behavioral disorders. Poster presentation at was a man in his early twenties who was both schizophrenic
the Diet and Optimal Health Conference, Linus Pauline Institute and alcoholic. He came with his priest who waited in I he
Portland, May 21,2003
waiting room. I told the patient what I thought. The next visit
25 McGinnis WR, Audhya I, Walsh W). Jackson JA, McUron- the priest came in with him. He sold me that when the patlenl
Hisward |, Lewis A, Lauda P Bitnis DM, Jurnak Fr Lietha R, Floffer A
had gone back to the waiting room after the first visit he asked
Discerning the Mauve Factor. Alternative Therapies in I teaith and
Disease. Part One 200B;14:40-5L Part Two 2tK)S;14r5F-63 him what Dr. Hoffer had said. The patient replied, "He said I
Bota RG. Sagduyu K and Munro JS. Factors Associated in the have schizophrenia, I do not know what that means but 1 sure
Prodromal regression of Schizophrenia that Influence the Course of
the Illness. CN5 Spectra ms. 2005; 19:937-942
44 45

feel better" Alter seeing ever 5000 patients since then I have have seen 10 who developed cancer, but everyone made a
had only one complaint complete recovery with standard Ireatment and of course the
orthomolecular program they were on as well. I am not aware
But just giving patients the diagnosis is not good enough of a single schizophrenic patient under my care thal died from
because most people either know nothing about that strange cancer. The inverse connection between schizophrenia and
term or disease nr if they have heard anything it is usually cancer is confirmed by a major study in Finland.-5
ali bad, I tell my patients that schizophrenia is not a mental
disease, meaning that it has not been caused by mental Decency
stresses, evil mothers, or evil societies, but that it is caused
by biochemical abnormalities with a genetic basis and that According to the Oxford International Dictionary of the
it can be treated successfully by biochemical means. Most English l anguage, decency is defined: fitness, seemliness,
psychiatrists today agree that schizophrenia is biochemical but propriety, what is appropriate, orderly condition of civil or
they don't realiy understand it because their only treatment social life.
is with xenobiotic drugs. {Xenobiotic means strange and
therefore is opposite to orthomolecular which means natural These descriptions of decency are all culturally based.
Although they don't have to be, xenobiotrc substances are What I mean is that one cannot judge whether an idea is
usually toxic.) paranoid unless one knows the culture from which the patient
has come. In some countries some ideas are normal without
For the past five years I give additional information. I tell being paranoid but when transposed inlo Canada might be
my patients that I wish I had schizophrenic genes but hastily considered paranoid. One can only judge the appropriateness
go on to explain. It's not that I wish to be sick but thal I of ideas from knowing the basic culture and whether the
believe that schizophrenic genes or some of the schizophrenic patient has adapted to the new culture in which he is now
configuration of genes in healthy individuals have great living. Doctors practicing in cultures foreign to the one they
value. This applies to their first order relatives and even to were raised in must be aware of these differences.
themselves once they have fully recovered, Huxley el aLa*
Invariably I see a sense of relief and even an increase in Decency means being respectful, honest, polile,
self-respect in the patient and in the relatives who are there courteous, ethical, non-judgmenlal and concerned. The main
with them. The physical benefits include a more youihlul consideration is to do no harm. During interviews all attention
appearance with aging with less gray hair, more tolerance to must be given to the patients, to their history or anecdote
pain, more resistance to bacterial infections, fewer somatic which is all important to the patient and during that interview
allergic manifestations and, most important, a major decrease must be all important to the physician. Decency does not
in the incidence of cancer. Out of over 5000 patients, 1 include being rude, shouting at the patient, making them feel

28 Lidhermann D, ] Ekclund, E Pukkala, A Tanskanen & J


27 Huxley J, Mayr E, Osmond H & Hoffer A, Schizophrenia as a Lonnqvist. Incidence of Cancer Among Persons With Schizophrenia
genetic morphism. Nature, 1%4; 204:220-221 and Their Relatives. Arch Gen Psychiatry 2001; 58:573-578
46 47

demeaned or inferior. Decency means (hat (he doctor must asked. If voices are a main symptom and the doctor does not
nol discriminate by gender, sexual orientation, or age, or on ask if they are present, the patient will lose confidence in the
any other grounds. doctor or conclude that hearing voices is so awful that even
I he psychiatrist will not talk about It* From a diagnostic point
I am appalled at the way many doctors treat their patients. ! T view these patients are often misdiagnosed as bipolar since
The stories my patients tell me are spontaneous as I never ask all the emphasis has been on their moods and mood disorder
diem how their psychiatrists treated them, in August 2007 I ,md the perceptual or experiential world has been ignored.
received this brief message from a client I had seen. She had Psychiatrists and nurses who have experienced the effect of
had a three day relapse into manic behaviour and had to LSD under a proper setting are in my opinion much better
be admitted to hospital. After discharge she wrote, "He had doctors and nurses thereafter when they are working with
me repeat after him, I have bipolar affective disorder I have schizophrenic patients.
bipolar affective disorder He did not make me count to ten
or spell my own nameT It ts obvious she did not appreciate Understanding depends upon the ability to empathize and
being treated like a child. even more on knowledge, on training, and on experience
in working with patients. It helps to read books written by
Understanding recovered patients who describe in detail what was the
impact on them of these phenomena.
Understanding is defined as being capable of judging with
knowledge. Support

T he doctor has two functions during the anecdotal part The Oxford Internationa! Dictionary of the English
of the interview. The first is to come to a tentative conclusion Language, 1957, defines support: the act of backing up or
about the diagnosis, caffed the differential diagnosis. Bui taking a person's part, assistance.
equally important is the ability to empathize, to put yourself
into the shoes of the patient, trying to understand what is Very often schizophrenic patients are on pensions or
happening and the impact it is having on the patient and welfare because they have not been treated early enough
hrs family. Most doctors can empathize with depression and well enough to continue without this type of support.
or anxiety because they have almost all experienced these Often they are at the mercy of bureaucrats working lor
symptoms. However very few are able to empathize with government or some agency. Too often my patients have nol
hallucinations. How many doctors know what it is like to been treated with dignity and respect and when this was
see visions or to hear voices? This is why in so many cases brought to my attention I did what l could to help, even if
psychiatric histories do not contain descriptions of these it meant writing letters on their behalf. One of my patients
symptoms. I have often asked my patients if they have ever saw me every two to three months but he lived En Vancouver
told anyone else about (heir voices and if they reply they and it takes a day to come to Victoria by ferry and bus.
have not and I ask them why, (hey reply that they were not This is expensive. We had a good relationship and over the
48 49

years he slowly improved. Although he did not get well lie violence traumatized mentally ill patients and made recovery
had not had to go back to hospital over this period. I or the more difficult.
first few years Social Services provided him with travel fare
but latterly they began to resist and to question him every Privacy
time he came. They became very unpleasant to him and he
in turn often frightened them. This was making him more Privacy is defined: a sEate or condition of being withdrawn
paranoid. Eventually 1 wrote to the Minister of Social Services from public interest, secrets.
demanding that this practice of demeaning him cease,
pointing out to the Minister that the word "civil" ought to have Normal people value their privacy and are willing to pay
some meaning and that people working for the government lor it. That is why people pay to travel first class in a plane
must be civil to their clients even if they are paranoid and wen though it costs much more to go exactly the same
schizophrenic. The worker mainly responsible was moved to distance. It is why private dubs charge a fee. Privacy must not
another position and that problem was solved. This does not be confused with enforced privacy as it would be for a person
happen often but is something I think all psychiatrists should in prison or under house arrest
do to support their patients. ! was often told by civil servants
who came to me as patients that they had been advised by Patients want their freedom and to be treated with respect
the department not to see me. J am not popular with the but they equally need to have and deserve privacy. In any
government which is an indication to me that I am doing my hospital unless you pay for a private room, privacy is limited,
job well. but the physically ill never have to surrender as much of their
privacy as do psychiatric patients. The term Intensive Care
Safety Unit of psychiatric wards does not convey the real meaning
of what it means to throw a patient into these rooms with no
Safety is defined: the freedom from danger, exemption bathrooms, no beds and no comfort and to be kept there until
from hurt or injury. the powerful anti-psycholies they have been given by force
have begun to work. Privacy is absolutely essential to respect
This applies mainly to patients in nursing homes, I would every patient.
visit my patients, especially elderly patients in nursing homes,
frequently, to make sure they were not being mistreated and The Doctor Patient Relationship
that they were safe. Since 1999, hospitals have recorded
a major increase in patient attacks on workers. These are The impact of a positive doctor patient relationship cannot
usually dealt with by seclusion and excessive medication. The be emphasized enough, it is important in a doctor's office and
United States government has recently ordered every mental should be present in a research setting. However, in double
institution to eliminate most restraints and seclusion or risk blind controlled experiments all human factors of the doctor
losing federal funding. Mental heallh officials agreed that such patient relationship are eliminated because of the use of
placebo. Placebo is a dud that cannot have any biochemical
50 51

effect on the body. It is given to research subjects to test a 4* ORTHOMOLECULAR TREATMENT. THE FOURTH
hypothesis that a test substance has some effect compared COMPONENT
to an inert compound. One of my main criticisms of the
double blind technique is that it removes the human factor The pellagrologists in the United States were the first to
and therefore removes one of the most important therapeutic- use vitamin B-3 supplements when they got access to the anti-
aspects of treatment, ft is impossible to treat anyone in the pellagra vitamin. One hundred years ago up to one-quarter of
absence of the doctor patient relationship which instills hope, the admissions to the southern United States mental hospitals
expectation and trust. This relationship is a very important were pellagrins but I he doctors could not distinguish many
aspect to healing and if it does not exist then the physician of them from schizophrenic patients until the pure vitamin
ts derelict in his or her duties. The relationship is more than was made available. If a patient recovered in a few weeks
simply handing out pills while lying to the patient about on vitamin B-l he was labeled as having pellagra. If not, he
their value. Giving placebo pilfs in fact destroys the doctor was labeled schizophrenic. This prevented the doctors from
palient relationship as it creates doubt in both patient and realizing they had a very valuable treatment for schizophrenia.
doctor. The patient can no longer trust that doctor to place
his interests first, and the doctor can not forget that he is lying Under my direction in Saskatchewan we were the first
to his patients by not telling them they are getting placebo. research group to study the therapeutic effect of niacin and
Truly double blind experiments are fraudulent since the niacinamide on early and, later on, chronic schizophrenic
patient is not aware that what they are taking cannot have patients. By I960 we had completed six double blind
any therapeutic value. The placebo has been given altogether controlled trials, the first in psychiatric history. Since then
too much value. But this practice is being questioned. Thus every investigator who repeated our work using our method
Hrobjartsson and Gotsche-' concluded that there was little tor treatment found the same recovery rates. This vitamin is
evidence that placebos had powerful clinical effects and that now one of the standard vitamins used by orthomolecular
outside of the setting of clinical trials there Is no justification physicians to treat their schizophrenic patients. Bui other
for using them.
nutrients have been found to be very useful including
pyridoxine, vitamin C and, for many, zinc.'0,J1,12 Medical
fo summarize, the therapeutic response is directly related treatment also includes the optimum and skillful use of drugs
Eo the optimum use of civilify. I have defined and explained as described for psychiatric treatment.
the elements of civility as decency understanding, support,
safety and privacy when the doctor patient relationship is sef
at its optimum level.

3Q Pfeiffer CC Zinc and other micro-nutrients. Keats Publishing,


New Can£«n,Conn 197&
3J Pfeiffer CC Menta l and c lementai nu t rients. Keats Publish iJig,
23 Hrobfartsson A and Gotsche PC. Is the Placebo Powerless? An New Canaan, Conn. 1975
Analysis of Clinical t rials Comparing Placebo with No Treatment 32 Pfeiffer CC & UMola, 5. Zinc and manganese in the
New kngland J of Medicine 2001, 344: 1594 1602 schizophrenias, J. Orlho. Psychiatry 1983: 12:215-234
52 53

The following table summarizes my views of the efficacy (>utcome of Treatment


of the four treatment modalities.
1950
Response to Treatment, Improved and recovered
Between 1900 and 1950 the first three components of
Shelter, Food, Civility About 507« (he ideal treatment were almost totally neglected. Recovery
was so rare that if one did recover it might lead to a book
Drugs alone Less than 10% describing that recovery. Admission to one of the two mental
hospitals in Saskatchewan by 1950 was almosi a life sentence
Shelter, Food, Civility and Drugs Not tested since so few were ever discharged. These hospitals provided
very crude shelter, very low quality starchy food designed to
Orthomolecular and Shelter, Food, Civility save money and very little personal care and respect. These
hospitals wiped out the natural remission rate of about 50
(a) Early cases About 90% percent which would have occurred had these three essential
(b) Late chronic cases About 75% principles been followed as they were in the 1850s in a few
places.
Prodromal i.e. pellagra About 100%.
At the Munro Wing, a part of the General Hospital in
Pellagra almost vanished over 60 years ago with the Regina, the results were better. Shelter was belter, the food
fortification of flour with niacinamide introduced by the was the same as that provided by the rest of the hospital
United State government. This is one of the greatest public and in 1950 it had not yet been corrupted by modern food
health measures ever taken and follows Dr. Gotdberger's technology. I would often have lunch in the hospital cafeteria
extremely important research into the cause, prevention and and can recall that the food was pretty good and nutritious.
cure of pellagra. There is no doubt that modern psychiatrists The Munro Wing patients were given a lot more respect
it confronted with a psychotic patient with pellagra would and dignity, following Dr. McKerracheds lead of believing
diagnose that patient as schizophrenic or bipolar. This public in the Moral treatment of the insane. And our recovery rate
health measure is comparable to the British Navy introducing was much better even before I began to use orthomolecular
lemon juice into their daily rations around 1790 to prevent treatment. After Humphry Osmond became clinical director
scurvy. Napoleon could not invade England because his of the Saskatchewan Hospital the results of treatment also
sailors were not similarly protected. improved in his hospital.

Before the introduction of tranquilizers the discharge rate


was a good measure of response to treatment in hospital
because if patients were discharged before they were ready
they were soon re-admitted. But after the introduction of
drugs which apparently "cured" the patients, they were 2007
discharged before they were ready and it was not recognized
that drugged patients now had to contend with two major There are no mental hospitals in Canada or the United
p rob ferns, the original psychosis still burning internally and Slates that provide all four components of the idea! program,
the superimposed tranquilizer psychosis. This soon led to the with the exception of one psychiatric ward headed by an
revolving door common to all modern institutions and to the orthomolecular psychiatrist and a private institution in New
iact that hospital discharges have no connection to whether jersey called Earth House, which was started by Carl Pfeiffer
the patient is better or not. They are used primarily as first aid many years ago and is still functioning. The treatment resulls
or filling stations, to fill the patient with the drugs designed for chronic patients are very good.14 I predict that if there
to keep them from getting back into the hospital. I think our is any institution that yields lhe fifty percent recovery rate
hospitals in Saskatchewan represented the mean of all North achieved by lhe Moral treatment of 1850, they are using the
American hospitals, some much worse, a few better but even first three modalities of the idea! treatment and pay much less
the psychiatric wards al university hospitals do no better than attention to the use of drugs.
the mental hospitals.
Orthomolecular medicine developed over the past fifty
A research study by my assistant director of psychiatric years has been enveloped in conflict from its beginning. This
research, Dr. C Smith33 compared the results of treatment at cannot be understood if the context of discovery in medicine
the University Hospital in Saskatoon and the nearest mental is ignored. Progress in medicine does not follow a smoolh
hospital in North Battleford and found that they were ihe curve with one finding leading to another. It is more like
same. The major difference was that the staff to patient ratio quantum leaps with each quantum a major reconstruction
was much higher at the University Hospital. Shelter, food of the previous quantum. These states of hypotheses and
and civility were much better at the University Hospital but data are called paradigms. A paradigm is a system of ideas,
patients not under my care were getting the same xenobiotic often derived from previous ideas and facts which has gained
treatment * major acceptance from the theoreticists and practitioners of
that science and which remains the main faith, almost like
lhe response of chronic schizophrenic patients treated in the dogma and doctrines of any church, until it is in turn
the nursing home were the same as the University Hospital overthrown by the new paradigm-
where dally costs were four times as high, The major
difference was that the staff to patient ratio was much higher
at the University Hospital. Ail the other components of ihe
ideal program were the same.

3.3 Smith CM, McKerracher DC. McIntyre 5, Care of the Certified 34 Fitch L & La Roche R. Earth House: an alternative for persons
Psychiatric Patient in the tieneral Hospital. The Saskatoon Project suffering from the schizophrenias. Journal of Orthomolecu lar
Can Med Assoc J 1963:88:67-74 Psych iatry 19H5;l4:136 -142
56 57

children. The Agency advised parents to watch their children


for this effect. Ben Felngold, at last, has been vindicated- This
recommendation wilt probably be ignored since it was not
Chapter Three a double blind study. This is a good example of the massive
cost to society of waiting for double blinds and ignoring good
observations labeled anecdotal.
Orthomolecular treatment for
schizophrenia. Frofessor Roger Williams-, 3, 4 demonstrated the physical
and biochemical uniqueness of individuals thereby explaining
their need for a food supply to which their bodies have
been adapted. Thus a vegetarian diet that is ideal for many
may make others sick, and conversely a diet rich in animal
1. THE DIET products may be optimum for some but not all. There is no
panacea diet. Beware anyone claiming that one diet is optimal
Before recommending supplements it is essential to for everyone. One can better assess a person's optimal diet
analyze the dietary program in order to get dues as to by determining their nutritional and ethnic background and
whether the illness might be the product of a nutrient seeing whether they have deviated from it. Thus if the person
deficiency or dependency. Physicians specializing in allergic comes from a group which has traditionally used fish as half
reactions caused by the environment are called clinical their diet while they consume a diet overly rich in sugar and
ecologists. 1 his idea has not been well received and the food refined foods, it should not be surprising if they are not well.
industry has stoutly resisted this concept. October 2002 saw One may also have to consider the principle of adaptation.
the report by Evenson in England entitled "Food Additives 1 mean by this the process which has gone on since liie
Cause Tantrums,'' The lead paragraph saidr "Food additives started whereby l iving organisms have had to adapt to I heir
used to colour many popular children's foods can cause food supply over many thousands of years. A huge change
temper tantrums and disruptive behaviour in up to 25 percent in our diet occurred about ten thousand years ago with the
of toddlers, a British government study has found/' Food introduction of agriculture and it is possible that there are
colourings were used in 78 percent of children's desserts, some people whose digestion never completely adapted.
93 percent of candies, 24 percent in cheese marketed for
children and 41 percent of children's drinks. More recently, on I use three simple food rules:
September 6, 2007, The New York Times reported on research
financed by Britain's Food Standards Agency that showed
2 Williams RJ. Nutrition Against Disease, FLiman Publishing Co.
that food additives and colours increased hyperactivity in
New York, 1971
.1 Williams RJ. You Are Extraordinary. Random House, Inc, New
York, 1967
I Evenson B, Food additives cause tantrums. The National Post, 4 Williams Kj Physicians Handbook of Nutritional Medivine,
Toronto. October 26, 2002 C.C .Thomas, Springfield, IL, 1975
SB 59

treatment paradigm. In biological matter niacin is present


1. Avoid all foods containing added sugar when this is t briefly as nicotinamide adenine dinucleotide (NAD), the
possible. About 125 pounds of all sugars per person active anti-pellagra vitamin. The usual dose of niacin (also
per year are consumed in the United States and called nicotinic acid) is 1.5 to 6,0 grams daily, best given in
Canada* The same foods which contain added sugar three divided doses. But many patients have required much
also contain other food additives* Eliminating sugars more. In November 200.5 a female patient was referred
improves the nutritional quality of the food, to me. She had had two major episodes of psychosis over
2* Remove all foods to which the person is allergic. the previous Swo years. The first one was diagnosed as
3. Take individuality into account. schizophrenic and the second bipolar. She was determined
she would not take drugs and after her second discharge
she started to take niacin. When I saw her she was taking
2* VITAMIN SUPPLEMENTS 50 grams of the vitamin in the morning and 30 grams in the
evening* I was astonished thal she was able to take that much.
The problem is to determine which vitamins are going to She told me she preferred to swallow 120 of the 500 milligram
be needed and in what amount. pills each day of niacin rather than remain on medical ion*
She was normal. I advised her physician to work with her
{a) Niacin and niacinamide,6/;*9,10 (vitamin B J). This and see if they could gradually decrease the dose to a more
vitamin is a major player in orthomolecular psychiatry and has common level. She had no side effects. Carlson11 showed
a historically important mle for i| was the first vitamin to be that for the treatment of pancreatitis associated with type V
approved by the United States Food and Drug Agency (FDA) hyperlipidemia, 10 to 20 grams of niacin per day are needed.
tor a non-deficiency condition i.e, for lowering cholesterol With this treatment the triglyceride levels become normal
levels. It is also credited with opening up the vitamin-as- and the attacks of pancreatitis disappear The largest dose
I am aware of was that taken by a leen-aged girl. After her
5 differ A, Osmond H, Cdlbeck MJ & Kahan I. Treatment of psychiatrist told her she had been made sick by her mother
Schizophrenia with Nicotinic Acid and Nicotinamide, J Clin Exper (the old delusion about schizophrenogenic mothers) she fled
Psychopath#] 1957:1&13M58 from home and joined a group of wandering hippies. One
6 Hotter A Niacin Therapy in Psychiatry. C, C- Thomas, day in a drug store she ran across the book Megavitamin
Springfield, 1L, 1962
Therapy; She read about the connection to niacin. With a
/ Osmond 11 & Hof far A, Massive Niacin Treatment in sudden flash of insight she went home to her mother and they
Schizophrenia. Review of a Nine- Year Study, Lancet 1963; 1:316-320
both began to look for a physician who would monitor her
8 A &■ Osmund H. Treatment of Sehizophren ia with
Nicotinic Acid- A Ten Year Follow-Up. Acta Psychiat Stand treatment. They could not find one. She began to take the
1964:40:171-189 vitamin herself* She did not become nauseated and when she
9 Hotter A. Vitamin Hi-3 and Schizophrenia: Discovery, Recovery,
Controversy Quarry Press, Kingston, ON, 2000
10 Hoffer A. Orthomolecular Treatment For Sthizophren ia. Keats 11 Carlson LA, Nkotinic Acid: the flroad Spectrum Lipid Drug. A
Lincoln wood, H, 1999 50th Anniversary Review, J. Internal Medicine 2005:258:94-114
60 61

eventually reached 60 grams daily her hallucinations suddenly the vitamin were needed. Within the past few months three
vanished. E saw her at a meeting i addressed in the United patients consulted me. They had been treated for up to
States two years later. She wfas normal and had reduced the ten months by competent orthomolecular psychiatrists and
dose to the usual three grams daily. I think I have erred in not had not responded to treatment. But on looking over the
going high enough for many of my chronic patients. treatment they were on I was astonished that I could not find
any vitamin B-3 En that list. They were taking large numbers
Schizophrenia is not a multivitamin deficiency disorder. of pills containing nearly every known nutrient but as they
VVe suspected in 1952 that we would have to use large doses were schizophrenic and not suffering from a multivitamin
of vitamin B-3. From our first publications in 1954 Osmond deficiency disease they were not healed. In one case a young
and I emphasized that large doses are needed. Unfortunately man who was making substantia! and steady progress was
the vasodilatation caused by niacin when it is first taken taken off the B-3 and started on some other natural products
causes a flushing reaction. This is a minor problem when used whereupon he promptly relapsed. On resuming his vitamin
by doctors who know what they are doing, bur it has given B-3 intake, he continued to recover arid has now been well
niacin a bad name and even today most doctors are more several years.
fearful of this vitamin, which kills no one, than of the major
atypical anti-psychotics which kill many. I had hoped that the I can not believe that doctors could have failed so
results I have published with hundreds of case histories and miserably to realize that while all the vitamins are helpful in
which have been confirmed by every physician who used the restoring health, this will not occur if the schizophrenic patient
same protocols that I published would by now be comfortable is not given the B-3 they must have. Give a patient with
with niacin. But unfortunately this has not happened. pellagra tons of vitamins and she will not recover until the
right amount of B-3 is added. If the patient is schizophrenic
SCHIZOPHRLNIA 15 NOT A MULTIVITAMIN give him vitamin B-3, but in the right doses. In mosl of those
DEFICIENCY DISEASE. IT IS IN FACT THE DISEASE cases of patients failing Eo get well, they were taking an
PELLAGRA, A VITAMIN B-3 DEPENDENCY DISEASE, IT exorbitant number of pills containing amounts of vitamins
WELL NOT BE TREATED SUCCESSFULLY NO MATTER HOW that can he found in food. Not only do patients not recover,
MANY DOZENS OF VIT AMIN PILLS ARF GIVEN IF THESE but if treated with multivitamins, and not enough B-3, the
PATIENTS ARE NOT GIVEN THE CORRECT DOSES OF THES establishment will be correct in its conclusion that there is no
VITAMIN. YOU CAN GIVE PELLAGRINS EVERY KNOWN connection between niacin and schizophrenia and the use
NUTRIENT BUT IF YOU DO NOT GIVE THEM B-3, THEY of this valuable treatment will be set back another fifty years.
WILL STILL REMAIN PELLACRiN. For a complete review of the benefits of niacin see Hoffer and
Foster,1*
Nowhere in our reports have we suggested that
schizophrenia was a multivitamin deficiency disease. We
have always maintained that it was a vitamin B-3 dependency
disease and that large and sometimes very large doses of 12 Hoffer A & Foster HO. Feel Better, Live Longer With Vitamin B-
3. CCNM Press, Toronto, ON, 2007
62 63

Njactn is 3 strong vasodilator when it is first ingested. No and learning disorders in children. Over the past five years
one should take ft until they have learned about this reaction it has been used much more extensively for the treatment
or they will be very fearful and this aggravates the flush. The of high blood cholesterol and low high density lipoprotein
red or pink flush begins in the forehead and works its way cholesterol {HDD since it was proven to decrease mortality
down (he body, usually stopping before reaching the legs, and increase longevity.31, 1 have been using it since 1952 for
but it may involve the whole body, it is itchy and burns and all of these conditions and more.11
has been mistaken by unaware nurses for a serious rash
which it is not It is usually gone within a few hours but rarely Parsons,1* the first physician to confirm our niacin
lasts longer With each succeeding dose the intensity of the cholesterol claims, concluded that niacin was not hepatotoxic
reaction recedes until it is a very minor problem or does not (toxic to the liver). The increased levels of liver function tests
appear at all. I have been taking niacin for TO years and do did not indicate that the liver was damaged. Recent studies
not flush unless I stop taking it for several days. It should be by McCarty17 suggest that giving betaine will counteract the
taken right after eating, preferably with a cold drink. The flush increased need for methyl groups and thus prevent some of
can be inhibited by taking aspirin several days in advance or the niacin side effects. He talks about liver toxicity but l object
by using any anti-histamine. Niacinamide (nicotinamide) does to this term since it has not been shown to be hepatotoxic.
not cause flushing in 99 percent of people but about one in
one hundred will also flush with this vitamin. These people The psychiatric conditions for which niacin is indicated
must be able to convert the niacinamide very quickly into are: schizophrenia, schizoaffective disorders, some
niacin in their bodies. The flush produced by this form of B-3 depressions, learning and behavioural disorders in children,
is generally unpleasant while the niacin flush is liked by many, alcoholism, premature senility (Non Alzheimer's type), and
who will stop taking the vitamin for a few days in order to Huntington's disease.
reactivate the flush. The usual dose range is 1.5 to 3 grams
daily. The upper limit for both forms is reached when the
patient develops nausea and if this is not controlled, vomiting.
J3 Canner PL, Berge KG, Wenger N K, Stamler J, Friedman L,
As soon as nausea k felt the dose must be lowered. In these Priweas Rf & Friedewald W, Fifteen year mortality in Coronary
dose ranges this vitamin is safe and is generally considered Drug Project Patients: Long Term Benefit With Niacin. J. Am. Colb
non-toxic. Cardiology, 1986;8:1245-1255
U Hoffer A and f oster HD. Feel Better, Live Longer With Vitamin
1 he incidence of jaundice is so rare it is impossible to B-A CCNM Press, Toronto, 20U7

determine whether the vitamin was a cause or whether it was 15 Ahschnl R, Hof ter A & Stephen JD. Influence of Nicotinic Acid
on Serum Cholesterol in Mar. Arch Biochem Biophys 1955;54:558-559,
coincidental. Over the past fifty years there has been one
16 Parsons Jr WB, Cholesterol Control without Diet. The Niacin
death attributed to niacin out of hundreds of thousands of
Solution- William B- Parsons Jr. Lilac Press, Box 1356 Scottsdale,
people who have taken it. Nicotinic acid was originally used Arizona, 1998
by orthomolecular physicians for the treatment of psychiatric J7 McCarty MR Co-administration of Lquimolar Doses of Betaine
diseases such as schizophrenia, alcoholism, and behavioural May Alleviate the Hepatotoxic Risk Associated with Niacin Therapy.
Medical Hypothesis 20G0;55:189-194
64 65

Medically, niacin may be used for lowering total first double blind prospective controlled experiment which
cholesterol and elevating high density lipoprotein cholesterol, showed that pyridoxine was therapeutic for children who
relieving cardiovascular disease, including arrhythmias (in have infantile autism. Dr. Rimland stated/*' "There are now
combination with folio add), preventing strokes and coronary 17 published sludies—all positive-showing that high dosages
disease, healing cancer and arthritis, and preventing diabetes of vitamin B-6 and magnesium are a safe and often helpful
mellitus in susceptible children. treatment for autism. Thousands of parents are using B-6 and
magnesium to help their children. Almost 50 percent show
(b) Pyridoxine (vitamin B-6), The usual recommended worthwhile improvement and the vitamins are immeasurably
dose of pyridoxine is less than 500 milligrams daily. Almost safer than any drug/' There were behavioural improvements
all of my patients take up to 250 milligrams a day if I and positive changes in the EEC and in urinary metabolite
determine I hat they need it* Doses of over 1000 milligrams measures. These studies were done by different investigators
have been associated with peripheral neuropathy which and conducted in several countries. But there appears to be
cleared when the vitamin was discontinued. The studies in no interest in the psychiatric or pediatric establishment,
which neuropathy was shown are not very good* They were
not double blind prospective clinical studies* They found (c) Folic Add, Folic acid is a safe water soluble vitamin.
six people who were taking 2 to 6 grams daily without any It has been used in doses up to 100 milligrams daily. There
indication whether they were taking any other vitamins has been a report that this dose caused gastrointestinal
or whether they were on any peculiar diets. It is certainly disturbances, but in another study with the same dose
possible that these large doses might have some effect. But this was not seen. Most patients do not need more than 5
to claim that pyridoxine is toxic is equivalent to claiming that milligrams. Recently the idea has become acceptable that folic
wafer is toxic because many people drown in it. loxicity must acid will decrease the incidence of spina bifida and similar
always be related to the recommended doses as is the case neural tube defects (NTD) if pregnant women take 1 milligram
with every medicine used. In my experience with pyridoxine daily, I generally recommend 5 milligrams daily. But for
going back 30 years in doses below 500 milligrams I have depression and bipolar conditions I use up to 25 milligrams
seen no toxicity although I have seen a few children become daily. Many physicians are still fearful of folic add, thinking
more irritable. Dr E, Leyton similarly found no toxicity,19 that it will mask the symptoms of pernicious anemia, I have
Children should be given magnesium when taking pyridoxine never seen this, nor has it been reported in llie literature very
to prevent an increase in irritability. often. However giving any one of the B complex preparations
which contain vitamin B-12 will prevent this from occurring it
Psychiatric indications for the use of pyridoxine include in fact it is a real problem.
schizophrenia, infantile autism, premenstrual tension and
depression* Dr, Bernard Rimland was a co-worker in the

19 Rimland B, Recent Research in Infantile Autism. J. of


IS Leyton K* let ter to Editor* Fear of Large Doses of B-6 Operational Psychiatry 3: 35,1972 and Autism Research Review
Unfounded* The Medical Post fan 25, 1994 International 7: No 2, 1993
66 67

The deficiency of folic acid is clearly related to


psychopathology. Young and Chad!nan20 reviewed the I have given more attention to folic acid because it is
medical literature. They found that folic acid deficiency was only now coming into prominence in general medicine as
high in patients with depression, senility and schizophrenia, well as in orthomolecular medicine. The B vitamins already
and in epileptic patients on Dilantin. It is also low in women described have been written about In hundreds of articles in
who lake birth control pills. Medical patients with folic acid I he literature, primarily in the orthomolecular literature,
deficiency suffered more from psychiatric symptoms. The
addition of folic add to these patients produced substantia! (d) Ascorhic acid (vitamin Q. This is one of the major
improvement They recommend, "...that all patients in certain vilamtns in orthomolecular therapy and has been reviewed
diagnostic categories should receive vitamins/' However in many excellent publications. Dr. Linus Pauling's71 classic
they recommended very small doses only. In sharp contrast. report in Science gave a scientific explanation why mammals
Dr. Kotkas-1 used larger doses with success and without any stopped producing vitamin C when it was available in
evidence of toxicity. adequate quantities in their food. This report made l he world
aware of the vast importance of vitamin C. Pauling provides
□r. Paul Godfrey, from the institute of Psychiatry in an excellent description of the uses and importance of vitamin
London, reported that folic acid speeded recovery from C.
depression. One-third of his depressed patients were folate
deficient. The overall outcome was impressive. Everyone The dose range for vitamin C is enormous ranging from 1
improved to some extent. The best results were obtained to 100 grams per day. The optimum dose is highly individual
in three to six months, Abou-SaJeh and Copper^, found and depends upon a large number of factors including life
that lolic acid deficiency is common in psychiatric patients. style, level of stress, disease, age, etc. The optimum dose can
Patients given 10 milligrams daily responder! in 2 to 3 be determined by increasing the vitamin until stools become
months, but gastrointestinal and neurological symptoms were loose and too much gas develops. The dose is then decreased
improved in five months on 10 milligrams weekly. It is clear below this level. Vitamin C DOES NOT CAUSE KIDNEY
that orthomolecular therapists will have to give much more STONES, DOES NOT DESTROY VITAMIN B-12, DOES NOT
attention to this important vitamin. CAUSE PERNICIOUS ANEMIA, and DOES NOT DESTROY
KIDNEYS. These are all myths.

PM Young SN & Chadirian AM, Folk Add and Psychopathology,


^rog. Neuro-Psychopharma col and Biological Psychiatry 1989; 13:841-

2' J Kc!tka& 1 B12 and folic add in treatment of some psychiatric


AnnuaE meeting, Canadian Schizophrenia Foundation, June
Till, 19/8,

22 Abuu-Saleh Ml & Copper, A. The biology of fntale in depression:


implications tor nutritional hypotheses of the psychoses, J. Psychiatrk
Researeh 19S6^0:91-K51 J 23 Pauling L. Orthomolecular Psychiatry, Science 1968; 160:265-271
68
69

3. ESSENTIAL FATTY ACIDS


psychiatry. Eicosapentaenoic acid (ERA) may be one of the
most important essential fatty acidsP,ilJ
rhe ess*ntfel F-atty acids play a very important role in
the etiology of schizophrenia and not surprisingly in its
treatment. Dr David Horrobin and his associates were the first 4. MINERALS
to demonstrate this. Indirectly Horrobin helped Dr Donald
Rudin^ by publishing his paper in Medical Hypotheses in (a) Copper and zinc. These are best treated together since
1982 when this type of research was very unpopular. Rudin's ihey are inversely related in the body. Increasing zinc levels in
studies showed that the addition of omega 3r present in fatty the blood will decrease copper levels and vice versa.
fish and flax seed oil, was therapeutic for the psychoses
including the schizophrenias. He hypothesized that essential Zinc deficiency causes a large number of symptoms
fatty acids were needed as precursors of the prostaglandins including stria, i.e. stretch marks, in both men and women,
and that schizophrenia was a deficiency of these important white areas in the nails, and acne. It can be responsible
transient molecules In the body. Therefore a deficiency of for premenstrual tension, increased blood pressure, joint
these essential fatty adds would lead to a deficiency of the pain, retardation of wound healing, loss of taste and smell,
prostaglandins. But the conversion requires vitamins and psychiatric symptoms and acrodermatitis enteropathies. Dr.
minerals such as vitamin B-3, Therefore even if patients had C. C. Pfeiffer carried out the best research relating zinc and
adequate amounts of these fatty acids they would still suffer copper to human health and disease.271 have found the
from a deficiency if they could not be converted into the presence of zinc deficiency symptoms extremely valuable in
prostaglandins. He reasoned that there were two types of deciding whether patients should be given extra zinc.
pellagra, one caused by the deficiency of vilamin B-3 and one
caused by a deficiency of the essential fatty acids. The type Serum zinc levels tend to be very stable. In a large series
caused by a deficiency of vitamin B-3 would he a vitamin of patients 1 analyzed for the presence of copper and zinc I
or enzyme deficiency pellagra while the one caused by a saw that there was no change in zinc levels with increasing
shortage of essential fatty acids would be a substrate type of age whereas copper levels went up significantly after age
pellagra. This is a very valuable hypothesis which was already 50. Recently I saw a patient who has been coming to see
being examined by Hormbin and his associates. The value
of omega-3 essential tatty acids is sweeping into mainstream
25 Enisle y K, Myburgh CJ, Gosfemizen P, & Van Kcnsburg Sj.
Randomized, Placebo- Controlled. Study of Ethyl-Eicosapentaenoic
Acid as Supplemental Treatment in Schizophrenia. American Journal
Psychiatry 2002;159:1596-1598
26 Feet M, Horrobin DF. A dose-ranging exploratory study of
the effects of ethyl- eicosapentaenoate in patients with persistent
-4 Rodin DO. The dominant diseases of modem ized societies as schizophrenic symptoms, foumai of Psychiatric Research 2002;36:7-18
fatty acid deficiency syndrome; substrate pellagr 27 Ffeiffcr CC & LaMola, S, Zinc and manganese in the
Medical Hypothesis 1982^:17 P S
, :
schizophrenias. J. Ortho. Psychiatry 1983 12 215 - 234
70
71

me every year or two. I saw her first in 1986 when she


Patients helped them to regain weight. Vegetarians are more
complained she had lost her sense of taste, that food tasted if it to be anorexic and they are also more often low in zinc,
aSLTll ne r'd 5mdl Pr°Per,y- She found eating
almost intolerable. I suspected she hati a zinc deficiency I find the connection between zinc and vitamin B-6 very
and started her on zinc supplements using zinc sulfate 220 interesting since it originated from some of our research
milligrams daily. After two years she was no better. | replaced m Saskatchewan over 45 years ago. The mauve staining
foe tab'ets with a liquid zinc and manganese preparation substance that we found in the urine of schizophrenic patients
e ope ay Dr. Pfeiffer (10 percent zinc sulfate and 1/2 was identified as kryptopyrroie. Dr Pfeiffer50 and his group at
Lhl0ride!' Two ^ears ,a,er Ehe was much liie Brain-Bio Center in Princeton discovered that too much
better. Now over age 92 she is still mentally well although mi I his compound caused a double deficiency of vitamin
physically infirm. When I saw her last she told me that she B-6 and zinc. This condition that we had called malvaria,51
enjoyed eating. One of her new problems was she was a little they termed, more appropriately, pyrolleuria. The treatment
too heavy. She was cheerful and relaxed and was still on the included ample quantities of zinc and vitamin B-6. While
zfnc manganese preparation.
most schizophrenic patients have this factor it is also present
in a smaller proportion of non-schizophrenic patients such
Zinc deficiency is associated with eating disorders. as people with depression, anxiety states, alcoholism, and
Schaussr summarized the research since 1934 which behavioural disorders. It may well be present in patients with
established a relationship between zinc deficiency and
eating disorders as well.
ea mg disorders, obesity, pica, anorexia nervosa and bulimia
nervosa. Between 1985 and 1990 several studies showed that Copper is needed for the formation of hemoglobin. The
most eating disorder patients are low in zinc and that when body contains about 125 milligrams, On the average we
they are supplemented with liquid zinc 25 to 110 milligrams ingest 3 to 5 milligrams in our diet but we need only about 2
atly they get better. Occasionally they had nausea which
milligrams so there is some accumulation. Dr, Pfeiffer found
was controiled by pretreating them with vitamin B-6 Dr
no cases of copper deficiency in 20,000 patients. Many
Pfeiffer lound that the combination of vitamin B-6 and zinc
vitamin and mineral preparations contain copper because
was more efficacious than either one alone. A zinc deficiency of the widespread belief that copper deficiency is a serious
which oS,tPreSen‘ ll "1e ***** tlnds a sulfate solution, problem. In certain areas where copper in soil is deficient and
wh ch ought normally to taste bitter, to have little or no taste babies are ted cow's milk, a copper deficiency may develop.
at all. Rita Bakun,- a psychologist at St. Paul's Hospital in
Copper tends to accumulate if the diet is too low in zinc or
Vancouver found that adding zinc to the diet of anorexia
where there is too much copper in the drinking water, usually
due to copper plumbing and very soft water. But the danger

30 Pfeiffer CC Zinc and other micro-nutrients. Keats Publishing,


M*d “15^ diSOTderS' lnl' BiOSOdal
New CanaanConn 1978

L T™ t0 dHfic,en^ - 31 Hotter A & Usmnnd H, Malvaria: a new psychiatric disease,


Acta Psyduat Scand 1963; 39:335-366
72 73

rrom too much is greater Dr Pfeiffer considered copper to be Tranquilizers create a major loxic reaction called tardive
a toxic element. Excess copper is associated with post partum dyskinesia. This is a motor disorder which can be irreversible.
psychosis, depression from birth control pills and cancer. The About 25 percent of patients on tranquilizers long enough
best measure of copper and zinc status is the ratio of serum will gel it However it does not occur when orthomolecular
copper over zinc. regimens are used. Dr. R. Kunin 3i found manganese to be
very helpful in removing tardive dyskinesia very quickly. The
Excess copper is also associated with a schizophrenic tranquilizers bind manganese, carrying it with them as they
syndrome and with senifity. [ have found that copper levels are excreted, Ihus causing a deficiency.! have seen the same
increase substantially with age and that pre-senile and senile positive response to manganese in the few patients who have
patients have the greatest increase. Excess copper is treated by come to me with this toxic condition. Patients I have treated
increasing the intake of zinc using Pfeiffer's solution, Ziman since 1955 do not get tardive dyskinesia. Manganese also
drops (ten percent zinc sulfate and 1/2 percent manganese plays a role in seizure disorders not related to drugs.
chloride), ascorbic acid, high fibre diet, selenium and, if
necessary, copper chelators such as penicillamine and EDTA. Doses up to 30 milligrams are safe but are seldom needed.
Excess levels will be detected by dietary history, hy blood I usually use less than 50 milligram datiy doses. If drug
tests and by hair analysis. companies would put manganese into every tranquilizer tablet
tardive dyskinesia would disappear, 1 have recommended this
(b) Manganese. to one company but nothing has been done about it. Good
natural sources are tropical fruits and tea. Perhaps English
The body contains 10 to 20 milligrams of manganese. schizophrenics do not get tardive dyskinesia as often as
About 45 percent is absorbed from food and 4 milligrams American patients. They drink much more tea,
is excreted daily. The diet provides 2 to 9 milligrams.
Manganese deficiency is associated with growth impairment,
abnormalities in bone, diabetic-like carbohydrate changes, 5. DRUGS
incoordination, tardive dyskinesia and convulsions. Zinc
alone increases copper excretion in schizophrenics threefold. Chbrpromazine was first used in France and from there
Adding manganese increases the excretion even more. it swept around the globe. Since then new drugs have been
Giving zinc alone may induce a manganese deficiency. The developed and every decade new drugs are proclaimed to
nutritional importance of manganese is discussed by Dr. be better and freer of side effects. For many patients the
Free! and-Graves^. drugs are necessary but I always aim to gel them off them
as soon as possible. I call drugs essential evils because
they are essential for many patients during tine treatment

32 Freeland-Grave* JH, Manganese: an essential nutrient for 33 Kunin, RA. Manganese and niacin in the treatment of drug-
human5. Nutrition Today 13 -19, Nov/Dec 1988 induced dyskinesias. J Orthomolecular Psychiatry 4-27
75
74

process although the consequence of using them without known as the father of tranquilizers in North America; the
an orthomolecular program is so evil because they cause other doctor remains unknown.
dangerous side effects and deterioration of life. T he most
modern drugs are addicting. Patients are seldom able to work The rest of the tranquilizer story is history. The need
when on these drugs. for this type of drug was great, the potential tor profit was
immense, and the combination of need and greed soon
In 1952 I first heard about this French drug wilh propelled this and similar drugs onto the market And they
remarkable properties in treating psychotic patients. It had just were very successful in controlling psychotic behavior. It was
become available in the United States via Canada from Rhone assumed that this meant that patients were also recovering
Poulenc of France. The Canadian representative of this drug from the illness. Farsighted psychiatrists realized from the
company tried to peddle the drug to United States companies beginning that patients who took these drugs paid a major
starting with the largest and working his way down to the least price. Dr. A. Meyer-Gross, author of an impressive text on
significant. He was rejected by all the companies with the psychiatry in the late fifties, claimed that these drugs merely
exception of a one-product company whose medical director converted one psychosis into another. However necessary
had the vision to realize the importance of this compound. they were, these drugs made possible the ill-conceived
The drug, Chlorpromazine in Canada, became Thorazine in corrupted deinstitutionalization of patients because they were
the United States. That company today is one of the largest so good at coding hot symptoms, making psychotic behaviour
more tolerable to the community even if the patienls did
We had not yet formulated the ad renochrome hypothesis not get well. Thus began the revolving door process where
of schizophrenia or its offshoot that vitamin B-3 might be psychiatric hospitals became first aid stations for ref Lie ling the
therapeutic for schizophrenia and I was interested in obtaining patients with drugs-much as cars get refueled at gas stations.
this drug. But I could not obtain any until the Canadian The major difference is that cars and fuel are perfectly
subsidiary of Rhone Poulenc made it available commercially. adapted and the cars run well.
It was the first major tranquilizer, discovered by the French
surgeon Henri Laborft and tested by French psychiatrists. This first drug, Chlorpromazine, marked the new paradigm
Dr. H. Lehmann in Montreal soon confirmed the European of treatment in mental illness using powerful drugs that were
reports, as did the medical director of a United States not narcotics. But they were not curative and the race was
company. They both submitted papers at about the same on to find better compounds that would be more effective
time. Dr. Lehmann reported his din leal observation on a and less toxic. This search still continues. The modern drugs
small series of manic depressive patients (now called bipolar) are effective with fewer milligrams of chemical per day and
and I he other physician reported on a much larger series of they have different side effects. But the efficacy of the new
schizophrenic patients. Dr, Lehmann's paper was accepted class of drugs is really not much better than the efficacy of
immediately while the other paper was sent back for some
revision. Dr. Lehmann's paper appeared first and he became
76 77

She old drugs. Geddes;< analyzed fifty-two therapeutic trials Increasing number of chronic patients who are tranquilized
involving over 12,600 patients. He found that; compared with the new atypical drugs who do not get well, and 1
with conventional drugs at a moderate dose, atypical anti¬ ihudder to think what they will be like twenty years from now.
psychoties caused fewer side effects but had similar effects
on symptom reduction. In a recent report3" ii was shown that Harrow and Jobe16 published the results of a fifteen year
over a two year period schizophrenic patients treated with lollow-up study comparing drugs against no drugs. Forty
these drugs suffered a 35 percent readmission rale. It has been percent of schizophrenic patients not on drugs showed
accepted for many years and is standard psychiatric teaching periods of recovery and better functioning compared
that one-third of these patients recover, one-third do not and in only 5 percent of the patients on drugs. A study at
one-third continue to relapse. the Massachusetts Mental Health Center compared t wo
cohorts of patients treated between 1945 and 1949 before
The main advantage of the newer atypical drugs is that tranquilizers were introduced, against a cohort between 1955
one has more choice. Of course this also applies every time ~ and 1959 after these drugs were in use. The earlier cohort was
any new drug comes onto the market. There will always be better off since more of them were employed and fewer were
patients who do not respond to older drugs, who will respond dependent on welfare.
to newer ones and so on. Dr. Geddes recommended that the
conventional drugs should be used as the initial treatment, In order to prevent relapses and further need fur
i see patients who do well on Chlorpromazine and do very treatment in hospital, modern protocols call for continuing
badly on any of the new drugs. Whereas the old drugs such ihe use of medication. The American Psychiatric Association
as Haldol caused extra pyramids I side effects which were recommends prophylactic treatment for about one year after
easily controlled by other medication, the newer drugs are the first episode and for up to five years after two or more
less prone to do so, but have a major effect on obesity, episodes. These are sensible recommendations. But in my
on disturbance in blood sugar levels, and in causing brain experience very few modern psychiatrists accept these and
damage with long term use. But there is one side effect that as far as I can tell want the patients to remain on medication
worries me more and more. I am not in principle opposed to forever. Chan and Ungvari37 reviewed the studies dealing
using drugs especially as pari of orthomolecular treatment. with outcome and prophylactic treatment and concluded that
In orthomolecular therapy we use drugs to control the hot because of side effects long term medication should be re¬
symptoms of psychosis. I am very concerned about the examined.

34 tieddes Jr Freemantie Nr Harrison P, liebbington R Atypical 36 Harrow M and Jobe TH. Factors Involved in tlutcomo
Antipsychotics in the Treatment of Schizophrenia: Systematic and Recovery in Schizophrenia. Patients Not on Antipsychotic
Overview and Meta-regression Analysis RMJ 2000; 321:1371-1376 Medications: A 15-Year MultifoUow-Up Study. Journal of Nervous and
35 Rahiiiowttz J, L.ichtenberg Pr Kaplan Zet at. Re hospitalisation Mental Disease 2007;195(5):406-414
Rates of Chronically HI .'schizophrenic Patients Discharged on a 37 Chan SSM & Ungvari C5. Maintenance Therapy in
Regimen of Risperidone, Olanzapine, or Conventional Antipsyc holies. Schizophrenias: a Critical Comment, international Journal of
Amer J Psychiatry 2001;158: 266-269 Ne Liropsychopha onacology 2fl02;5:275-2R l
78
79

the same level of control. It one lakes much more than the
1 am ^ very worried about I he difficulty in taking recommended level there are major side effects and no
patients off the new drugs compared to the conventional
increase in therapeutic power.
ones, in orthomolecular therapy it is always the objective
to have patients drug tree without any relapse, and this was
Modern anti-depressants also are addicting. The company
not very difficult with the ofder drugs. As soon as the patient
that makes Paxil has been sued in the United States, with the
had shown major improvement the amount of medication
money obtained being used to set up withdrawal treatment
w'35 slowly decreased If there were any signs of recurrence
centres to help people who are having trouble getting off
or symptoms the dose was increased again for awhile and
the drug. In my opinion the early anti-depressant drugs were
then the process was repeated untif most patients were drug
not as bad. If patients went off them they usually lelt better
free or needed so little medication that there were no side
as the toxic effect wore off, and there were no withdrawal
effects. Medication which is effective and free of side effects
symptoms. However, if the depression did recur, which
is equivalent to not taking the medication. The usual response
can and does happen after several weeks, the medication
was relief as the drug effect wore away, but if the patients still
would have to be renewed. This is totally unlike the action of
needed the medication it would become more noticeable
addicting drugs such as morphine, heroin etc. and the modern
after one or more weeks. It was never noticeable the first day
anti-depressant and tranquilizer drugs. Ritalin, the most
after the medication was stopped. But with the atypical anti¬
commonly used drug for children with behavioural disorders,
psychotic* it has become an enormous problem. For example, induces changes in the brain which continue after the drug
with Risperidone it is not too difficult to reduce the dose from
is discontinued. The gene called "c-fosM is changed. It is the
high levels to more moderate levels, but when one gets down
same gene changed by amphetamines and cocaine. Perhaps
to lower levels even a 0.25 milligram decrease may cause
the modern anti-psychotics will be found to have the same
a surge of symptoms. These drugs behave as if they were
effect.
addicting drugs. With the addicting drugs, such as heroin, as
soon as the dose is decreased there is a marked relapse. So it
I would not object to these addictive properties if patients
Is with these atypical drugs. It takes much longer to reduce the on the new atypical psychotics were able to function as
medication and when it is down to 3 milligrams daily I cannot normally as they can with orthomolecular therapy. But
decrease the dose by more than 0.25 milligrams. I never saw fewer than 10 percent of patients on drugs alone are ever
this with the conventional tranquilizers. The question that able to pay income tax from earned income. I am also very
puzziesmeis whether these drugs are also attracted to the concerned about long term effects of brain damage which
addictive centres in the brain that bind morphine and heroin. according to some studies becomes progressively worse with
Haldol was conceived by splitting the morphine molecule
increases En dose and duration of treatment The older drugs
into two and preparing a structure very similar to one of
prescribed in moderate doses also increase the relative and
these components. But Haldol is not nearly as addicting. The absolute risk of sudden cardiac death. Similar results might be
atypical anti-psychotics, however, do differ from narcotics
expected from the newer drugs and this should be taken into
because one does not have to increase the dose to maintain account in patients with cardiovascular disease.
80 81

Tranquilizer drugs must be used only as crutches. If they


are made part of the permanent program they become the
problem. They produce a tranquilizer psychosis. They make
Chapter Four
schizophrenic patients sick.

In a recent report Madsen et aP6 found a significant A Comparison of Schizophrenia and


association between the amount of tranquilizers taken over the Tranquilizer Psychosis
years in grams and cerebral cortex atrophy. The estimated
risk of atrophy increased by 6.4 percent for each additional
10 grams of tranquilizer drug (In chforpromazine equivalents)
prescribed. Gur et aP reported that tranquilizers increased SympKMns/Signs Schizophrenia Tranquilizer Psychosis
subcortical volumes rn schizophrenic patients. These changes Perception Voices, Visions, Illusions Same, to a lesser
were not present in patients not on this medication. They degree
suggested the changes were In response to receptor blockade Thought Paranoid, Delusional, Not as intense
and could decrease the effect of treatment. In other words, Disorder: Content Ideas of reference
these drugs damage the brain and decrease the odds these Process Blocking Not as intense
patients can ever recover. Are we preparing the ground for Memory, Concentration Same or worse
the next major pandemic of illness with millions of chronic Mood Depression Same
schizophrenic patients becoming more and more brain Agitation Less
damaged as they are forced to remain on their tranquilizers? Anxiety Less
And when it is fully upon us what are we going to do about it? Apathy, disinterest
Behaviour Hot Cool

Physical Toxicity None Tardive dyskinesia


Nausea
Weight gain and
diabetes
Sudden death
impotence
Neural tube defects

Brain Damage None Yes, severity limited to


38 Madsen A, Keiding N, Karle A, Esbjerg S & Hemmingscji R, lifetime dose in grams
Neuroleptics in Progressive Structural Abnormalities In Psychiatric
Illness. The Lancet 1998;352r p784 only
3S Gur RE, Maany Vr Mozley PDr Swanson C Bilker W & Gur RC The diagnosis of tranquilizer psychosis Is found in the
Subcortical MR I Volumes in Neuroleptic Naive and Treated Patients American Psychiatric Diagnostic Classification. Section
With Schizophrenia. American J of Psychiatry 199S;155;1711-1717
83

J92.11 refers to sedative, hypnotic, anxiolytic psychosis with The investigator will then conclude that there has been no
delusions white section 292.12 describes sedative, hypnotic response to the vitamins. It must be stated over and over that
anxiolytic psychosis with hallucinations. The Merck Manual drugs are to be used carefully with the objective of gelling
16"' Edition, 1992, lists anti-psychotic drugs under the heading patients down to very low non-toxic levels or off I he drugs
anti-anxiety drugs or anxiolytics.
completely.

tranquilizers thus convert a natural psychosis to an This, then, is the dilemma. How can one benefit from the
iatrogenic (treatment caused] psychosis, the tranquilizer moderate improvement induced by drugs while not becoming
psychosis. They convert hot into cool symptoms which are psychotic from them? The usual way is to withdraw' the
much more tolerable and allow the patient to be cared for drug, but in most cases the original psychosis recurs and this
at home, to be discharged from hospitals too soon, and to process is repeated over and over. Or one can very slowty
make available the city streets tor their care and shelter. But decrease the amount of drug, but in most cases the same
the objective of therapy should be to cure the patient in the disease recurs. There is no escape because when the drug
sense that one cures diabetes, that is, to remove symptoms dose is so small that the side effects are gone, its therapeutic
and signs, to make it possible tor the patient to get along
effect is also gone.
reasonably well with family, to permit the patient to get on in
the community properly housed and reasonably comfortable, Orthomolecular psychiatry does provide a third pathway,
and for the patient to pay income tax. I estimate that fewer a pathway toward health. Nutrients have no side effects in
than 10 percent of all schizophrenics treated in North
their recommended doses. They gradually start the process
America ever achieve this state of well being with or without of real recovery in most cases, but they do so slowly. It takes
tranquilizers w'hen this is the only treatment.
at least two months before they kick in. But once they are
effective the disease seldom recurs as long as the nutrients
There is another serious problem. Since these drugs are taken. This means that one can combine the therapeutic
produce a different type of psychosis any improvement effect of nutrients, which is slow but enduring, with the rapid
brought about by the use of supplements and diet wifi not be therapeutic effect of the drugs, and as the patients begin to
evident. As long as the dose of drug remains high any benefit recover the amount of drug is slowly decreased until the
Irom orthomolecular treatment will be masked. Niacin does dose is nil or so dose to it that there are no side effects. I
not treat tranquilizer psychosis. Therefore any double blind have several patients on Haldol 1 milligram daily and they
study which maintains drugs at their original therapeutic remain well on this very small dose. Xen obi otic psychiatrists
level will not show improvement unless and until the provide their schizophrenic patients with two choices: remain
amount of drugs is reduced as the patients begin to recover, psychotic without drugs or became psychotic with drugs. Et
is not surprising so many patients have to he legally forced to
1 Koren Cr Cohn T, Chitayal D, Kapur B, Remington G, Reid DM, take their drugs. They do not like the tranquilizer psychosis
Zipursky RE. Uso of Atypical Antipsychotic* During Pregnancy and often will go to any lengths to be free of it.
and the Risk of Neural Tube Defects in Infants. American Journal
Psychiatry 2002; 159:136-137
84 85

Rut the psychoses in both condiI ions are identical1- . Logically


these psychoses should be called pellagra, schizophrenic type
or pellagra schizoaffective type or pellagra bipolar type.
Chapter Five
I propose that there is a continuum between manic
depression (hereafter called bipolar) and schizophrenia with
The transition from bipolar to an in-between stage called schizoaffective psychosis. I suggest
schizoaffective to schizophrenic that a bipolar patient who never has perceptual changes
psychosis even in the manic phase differs from schizophrenia in the
oxidation of adrenaline to adrenochrome, it there is excess
adrenaline this may be a causal factor for the manic state if
the adrenaline is not converted into adrenochrome. If the
Many people have asked me whether I have ever written manic state is characterized by perceptual change (sensory
about bipolar psychosis and ortho molecular treatment, illusions and hallucinations) and thought disorder, more of
f his I have not done mainly because I have focused on the adrenaline has been oxidized into adrenochrome. There
the schizophrenias (Hoffer, Osmond, CaJlbeok and Kahan, are several oxidized derivatives of the catecholamines such
1957). We started our research in Saskatchewan in 1952 as dopachrome from dopamine and noradrenocbrome from
and discovered that the results of any treatment program for noradrenalin. When 1 use the term adrenochrome I refer to
these patients was much better if one included the optimum any or all of these oxidized derivatives. There is a continuum
doses of vitamin B-3. We did nut explore the use of this from no conversion or very little conversion of adrenaline Into
vitamin tor manic deprcssives as they were then called adrenochrome in the bipolar patients, to more conversion in
because it was a different category of illness. Over the years the schizoaffective state to a lot more in the schizophrenic
ihe distinction between manic depressive and schizophrenic state.
disease gradually vanished and ! am now convinced I hey are
both forms of I he major disease pellagra. Pellagra is caused The Continuum: Bipolar to Schizoaffective to Schizophrenia
by a deficiency of vitamin B*3 in the diet of people who
have normal needs for this vitamin, whereas these major Clinical research in a non-research oriented psychiatric
psychotic diseases are deficiencies of the same vitamin clue ward is never easy* For our double blind controlled
to internal factors which generate an increased need for the therapeutic trials in 1952 we tested I he activity of the two
same vitamin. When the deficiency 3s primarily in the diet vitamin B-3 forms, niacin and niacinamide, against pLicebo,
it is called a deficiency and when the need is a result of a This study was on schizophrenic patients only. As Director
biochemical problem in the body it is called a dependency.
1 Merck Manual, 16th Edition, Merck Research Laboratories,
Merck and Co. Tnc., Rahway, N.J, 1992
2 Hoffer A & Osmond H. The Hallucinogens., Academic Press,
New York, 1967
86
87

OfPsych,„lric Research I did not make the first diagnosis


the Department of Psychiatry at Columbia University and
That was made by the treating psychiatrist but I would not
Iris research psychologist Dr Piotrowski. They followed
accept subjects into the study unless I agreed that they
70 patients and came to the same conclusion as ! had. Dr.
were schizophrenic. That meant that at least three doctors
1 ewis was one of the most distinguished psychiatrists in
were involved in the diagnosis: the treating psychiatrist, his
psychiatric history. His Interests were eclectic and ranged
penor and me. From counting the proportion of patients
from psychoanalysis lo pathology. He was even interested in
, Cn f to lh,s lvard 1 expected that it would not take very the effect of mescaline which he had taken. Dr. Lewis was
long to have enough patients. But to my surprise once the
chair of the Dementia Praecox Committee of the Scottish
study got underway the number of patients diagnosed with
Rites Masons. Dr. Osmond and I were invited to one of their
schizophrenia suddenly decreased. It was obvious the treating
meetings in 19.S2 held in the Canada Room of the Waldorf
doctors did not want their patients placed in this treatment §
Astoria Hotel where we reported for (he first time our new
hypothesis about adrenochrome and schizophrenia. Dr, Lewis
had nourished the slender efforts being made by American
I became interested in the long term stability of
psychiatrists to prevent being swamped by psychoanalysis
tagnosts. Did a manic depressive remain manic depressive
which was galloping into North America. We became
on subsequent admissions and did a schizophrenic remain
good friends and later he wrote the foreword to our first
so after many years? As Director of Psychiatric Research I
American edition of How to Live with Schizophrenia. Our
had free access to all patient files. I started to keep track of
first application for a grant from Ottawa to test our hypothesis
pahenls to study this effect. I found that manic depression
was turned down by the three Canadian professors of
was not a stable diagnosis meaning that, with subsequent
psychiatry on the committee then vetting federal grants. But
admissions, and often there were many, there was a gradual
2 ^mcdepressive to
schizoaffective to schizophrenia
diagnoses But the reverse was not true. Once a patient was
we were given a small grant after Dr. l ewis reviewed it and
recommended that we should get 20 years of support not just
for the two we had requested.
diagnosed schizophrenic he remained so on subsequent
admisstons except he would eventually be called chronic
A!! their patients had been diagnosed with manic
Schizophrema was stable but the diagnosis, manic depression
depression on (heir first admission. But by following them up
was not. The meaningless term borderline personality disorder
for several years they found that half of them eventually were
given to schizophrenic patients that are not iiked or who do
re-diagnosed as schizophrenic* This raised the question, had
not respond to treatment had not yet been invented.
the condition really changed its nature or had the diagnosis
been missed in the first admission? They found that had
i did not do a formal study but fortunately did not have
the original diagnostician taken seriously the presence of
to as it was done by Professor Nolan D.C. Lewis', Chair of
hallucinations they would have been able to predict accurately
those patients who eventually were dearly schizophrenic* The
3 Lewis NDC, Piotmwski ZA. ClinicaTdi^nosis of manic-. difficulty with this diagnosis was that these patients showed
(«* ™ H„ch„| Zubin), 1954:25- schizophrenic features, usually when they were in a manic
88 89

phase and seldom when they were depressed or normal. manual he had written describing in a logical and systematic
They analyzed the symptoms and signs present in the first way how lo do the mental state examination. During those
admission history. They found ten factors which if they had I wo weeks he was in Saskatchewan my wife Rose and I
been taken into account would have accurately predicted the played a lot of bridge with him and his wife. When he left he
manic depressive* who eventually became schizophrenic. gave me this manual which t cherished but unfortunately ! lent
Half of the factors were perceptual. This research by Lewis it to someone and, as is too often the case, it never found its
and Piotrowski must be read by every psychiatrist but most way back to me.
of them are not even aware it has been published. Here are
some of their conclusions. Dr. Menninger listed four areas of mental activity that
needed to be examined* These are perception, thinking, mood
a) I he essential psychological trait of schizophrenia and behaviour. Perception covers the senses by which we are
is a defect in the patient's criterion of reality. If this aware of the world and of our own bodies* It includes vision,
is normal the patient does not have schizophrenia. hearing, taste, touch, and smell. Examples of visual changes
(Remember Conolly's definition of schizophrenia as a include hallucinations. Examples of auditory changes include
disease of perception combined with an inability to hearing voices. Thinking may be disordered. Delusions
judge whether these changes are real or not.) would be an example of this whereby the process of thinking
as well as the content of what is heing thought about is
b) The diagnosis of manic-depressive psychosis {bipolar) compromised* Mood may be high or low' or inappropriate and
can be made only by the elimination of the diagnosis the same applies to behaviour which may be overly active,
of schizophrenia, too passive or inappropriate. These are all described in detail
in our book How to Live with Schizophrenia. Dr. Menninger
c) The practice appears to be to diagnose schizophrenia had a remarkable scheme for examining the mental state
only when the schizophrenic features are predominant and it ts one l have used ever since I read his book, but it
and to ignore the diagnosis when the schizophrenic appears to me that very few psychiatrists are aware of this
features are not prominent as in spurious manic work. Menninger's ideas of the value of perceptual changes
depress! ves. in diagnosing schizophrenia have been given short shrifi in
diagnosis while tori much weight has been given to mood.
d) Lven a trace of schizophrenia is schizophrenia. Many This is a pity as it has been known for several hundred years
patients with few and mild schizophrenic signs and that perceptual changes are the key to many of the bizarre
with a strong affective element far! to improve and changes in a patient's behaviour*
spend years m institutions.

In about 1952, Dr. Karl Menninger, pre-eminent physician


who had become a psychoanalyst (Menninger Clinic), gave us
a series of seminars in Saskatchewan, He had with him a little
90 91

Smith4 5 6 found that a substantial proportion of normal impressed the volunteers by the striking changes they felt
people bear voices and do not believe that they are sick or in their perception. This immediately drew attention to the
need treatment. And many are correct. Had he been aware perceptual symptoms in this psychosis. Osmond and I read
of l he Conolly definition of insanity he would have been many books written by patients who had recovered from their
less puzzled since hearing voices is only half of the correct illness. We read hundreds of patient charts and the more we
definition. The person hearing voices must also believe they studied this phenomenon the more convinced we were that
are real and may or may not display psychotic behaviour by perceptual changes were extremely important if we were
acting upon them. The mere act of hearing voices does not to understand what il was like to be schizophrenic* 1 his led
indicate than he person is schizophrenic, to the development of the Hoffer Osmond Diagnostic Test
(HOD) which we standardized on thousands of patients at
Osmond and Smythies" originated the hypothesis that four different hospitals in Saskatchewan. These results were
the experience induced in normal volunteer subjects by announced in the journal of Neuropsychiatry. Dr, Meduna,
mescaline, the active ingredient in Peyote, in many ways was Lditor-in-Chsef, gave us the entire August 1961 Volume 2
a model for what happened in schizophrenic patients, that issue.
there was a relationship between adrenaline, a catecholamine,
and mescaline in chemical structure. In other words this The HOD test is a simple card sorting test of 145 cards,
suggested that toxic substances which had the hallucinogenic each one containing a statement or question, Sixty-two cards
properties of mescaline (or of LSD and similar substances) test the subject's experiential world and perceptual changes,
and might be related to or derived from adrenaline could be 39 cards deal with thinking and its disorders and 44 are
found in the body of these patients. We did not know enough concerned with mood changes. It is really an examination
about transmethylation of adrenaline and its derivatives of the way subjects experience their sensory world.
to pursue this any further. It was generally accepted that Schizophrenic patients and subjects under the influence
transmethylation could not occur in the body. But the basic of hallucinogens get very high scores when doing this test.
idea was extraordinarily sound and productive leading to our There is a very close correlation between the diagnosis of
adrenochrome hypothesis*. schizophrenia and the scores. But it is not a diagnostic lest
for schizophrenia. High scores suggest that schizophrenia
The hallucinogenic experience, whether it was should be considered seriously but they can also be high in
psychotomimetic (bad) or psychedelic, almost always other conditions. We found that most schizophrenic patients
when sick scored high and as they recovered the scores
decreased. During a relapse the scores go up again. But we
4 Smith DB, Muses, Madmen and Prophets, Penguin Press 2007. also found that up to one-third of other psychiatric groups also
Reviewed in New York Times by PD Kramer, April ft, 2007
scored high. This is not surprising considering the difficulty
5 Osmond H and Smvlhies J. Schizophrenia. A New Approach. J
of clinical diagnosis. The manic depressive patients of Lewis
Ment Set 1952:98: 309-315
and Pietrowski would have scored high with this card sorting
6 Hoffer A Osmond H & Smythies J. Schizophrenia: a new
approach. U. Results of a. year's research. J Merit Science 1954; 100:29- test. It is really a very good simple test easy to give, Il does not
45
92 93

tire the patients and may be used as often as one wishes, li is


an excellent test to measure relapse before the patients even
become aware of it. It is also cross cultural It is being used
successfully in Japan. Professor Kakitani described its value in
diagnosis and in treatment.
Chapter Six

The HOD test

Following is a report on his experience with the HOD test


by Professor Masaki Kakitani1 of the School of Psychology,
“Rissho University in Japan.

"I came to know somehow the work of Dr. Hoffer when


I was a graduate student in the United States. I stayed in the
United States from 1968 through 1978. The McGovern Report
came to my notice in 1978. Through ihis report I became
interested m problems caused by hypoglycemia. Then 1
encountered with KYB (Know Your Body) Club and met Dr.
Kaneko I joined a tour sponsored by KYB Club and I mei Dr.
Hoffer in New York City. Since I had known I he existence of
HOD test, I approached Dr. Hoffer and got his permission to
translate it into Japanese. I am a clinical psychologist teaching
Choice Theory, Reality Therapy, Quality School, and Lead
Management. I train graduate students to become clinical
psychologists. 1 would [ike to share some of my experiences in
which I used HOD tesl.

1 Kakitani M, My experience with HOD test. Personal


Communication, 2007
94 95

Case 1: Thirty five years old man. Single, under medications. Case 2: A female college student, 20 years old. Single,
The client had been diagnosed as schizophrenia two She came to a school counselor before summer vacation*
years before he came to me for counseling. He was under After checking the HOD test results the school counselor
medications. He was given risperdal (risperidone), artane, asked her when she felt this way first lime. She said that she
miradol, lupox, and I exotan. I asked him to take HOD test fell like this since her grade school. The school counselor
and he agreed. He took it three limes altogether at different talked to her parents and got iheir informed consent. She
occasions. The results are shown at table 1. started taking Vitamin C and Niacin 3 grams each per day,
and some Zinc, She came back to school after summer
Table 1 vacalron and took HOD test again. She was found to be in a
April 7, lune 22, July 3Q normal state. The results are shown at table 2.

TS 69 35 13
Table 2
PerS n 5 1

PS 5 ? 1

DS a fi 0

RS 8,6 5.8 2.6

7 3 1
SF
In April he began to take 3 grams of Niacin and 3 grams
of Vitamin C per day while maintaining medications, fn May
Vitamin B complex (B1 level 150mg/day) was added. In June
Vitamin Bfi (250mg) was added. The sign of improvement was It was fortunate that she had not received any medications.
shown at the fable 1. He described his conditions saying he She was free from some possible complications from
used to function 30 percent level but now 60 - 70 percent medications.
level. He was able to ask his doctor to reduce medications.
Medications were changed to three from rive kinds and doses
were also reduced. The final medicine was risperidone which
was most difficull to secede from.
96
97

Case J: A man of 96 years old. Single. Under medications. The lest results also correlate very significantly with I he
He was referred to me by a counselor. He was under presence of the mauve factor in the urine of patients, the
medications. He took HOD test. I asked him to take the test syndrome Osmond and I called malvaria, as the mauve factor
indicating his current conditions and recall the worst time was not yet identified {Hotter and Osmond, 1963). Patients
which was two years before, and answer his worst conditions with malvaria were those who scored high on the HOD test
The results are shown at table 3,
l.e had a lot of perceptual changes, had the mauve factor in
their urine and, when treated with vitamins, responded as if
Table 3
they were schizophrenic no matter what the clinical diagnosis
His guess at worn time March 7, was. Until Cart Pfeiffer (1975) showed that the mauve factor
s caused a deficiency of pyridoxine and zinc, we treated those
47 JO
patients with the mauve factor with vitamin B-3. But the
PerS 3 0 addition of these two other nutrients greatly improved the
PS U
treatment results and decreased the need for as much vitamin
0
B-3, The dose needed for each of pyridoxine and zinc is less
05 7 3 than one gram per day. These vitamins are also useful for
RS 6J some patients with severe premenstrual tension. Pfeiffer found
3.5
that patients with pyrroleuria (what we had called malvaria)
5F 5 0 had distinguishing signs such as white areas in their fingernails,
stria, pain in their knees, changes in their skin and PMS. He
In case three I am rather confident through HOD test also found that if patients improved, the amount of the mauve
results that he should ask his psychiatrist to reduce his factor (kryptopyrrole) went down to normal or very low
medications. He would be fine if he could maintain his levels. A relapse in their condition was usually preceded by a
conditions without brain drugs. He would be starting his recurrence of the urinary factor. Very few laboratories test for
supplement and reducing his medications. this factor. I look upon these people with malvaria as having
a form of peiiagra. I have found that mentally ill patients who
These three cases show that HOD test is a useful tool for score high on the HOD test, or who have above normal levels
monitoring the progress as well as diagnosing schizophrenia in of the mauve factor in their urine or both respond best to a
Japanese culture. The HOD test has not been standardized in program which includes vitamin 6-3.
Japan yet. We have no intention to do so now since the most
of the questions on the test seem to appeal similarly to people The clinical diagnosis of schizophrenia is so imprecise
with different cultures. The counselor is able to determine the and variable that nothing can be correlated with it, Bui if
level of confusions the client is having by looking at the HOD one day by consent physicians agree to diagnose depending
test results. I can say that it is a very useful psychological test." upon the results of a laboratory tesl then the correlation will
be high. Syphilis used to be diagnosed by clinical evaluation
98 99

and as often misdiagnosed an til a blood test for diagnosis was hundred and fifty years would have been very much different
developed. and in my opinion much more positive if Conolly's diagnostic
criteria had been accepted.
When it was identified in collaboration with Carl Pfeiffer
the term mauve factor was changed to kryptopyrrole. They The Three Main Psychotic Disorders
are dose but not identical. Kryptopyrrole is closer to OHHPL
fhydroxyhemoppyrrotin-2-one). It is a member of the pyrrole Schizophrenia is characterized by the combination of
family and may be correctly referred to as "urinary pyrrole/' perceptual changes and thought disorder. The mood changes
Today this compound is being studied by many investigators. which are almost always present are due to the biochemical
Dr. Woody McGinnis heads a large study group. It appears changes in the body and the psychological reaction to this
to be a measure of oxidative stress. There is no doubt that very serious disease. The mood disorder must be secondary to
many patients who are mentally ill suffer from oxidative stress. the perceptual and thought disorder.
These include schizophrenic patients, autistic children, and a
substantial proportion of other diagnostic groups. Bipolar disorder is characterized by a series of mood
swings from mania to depression with normal in between.
Dr. Con oily described insanity as a disease of perception The cycle varies tremendously from once a month to once
combined with an inability to judge whether these changes every few years. Modern drugs will distort the typical cycle
are real or not. This is a remarkable working diagnosis and in many cases convert depression into mania. When
which I have found most helpful. Not only is this definition normal or depressed, bipolar patients do not suffer the typical
valuable but it also helps to understand why schizophrenic schizophrenic symptoms but when they are manic they may
patients have delusional symptoms or signs. For example, often hear voices and see visions which dear as the mania
if the individual lost Ns sense of taste (zinc deficiency) and clears. We therefore have at least two types of bipolars: those
everything tasted flat or bitter he might ascribe this to poison who never have any schizophrenic symptoms and those who
being put into his food. This is a very common delusion do when they are manic. What are we then to call them?
caused by a taste misperception. It is a pity that modem Psychiatry got around this. When the diagnosis is not clear
psychiatry ignored Con oily's description and definition of and it is doubtful how to name the patient, they are called
insanity in favour of the Bleulerian definition which played schizoaffective.
down perceptual changes and emphasized thought disorder.
Ironically most modern psychiatrists while paying lip service Schizoaffective disorder is present when the perceptual
to Bleuler still depend upon gross auditory and visual and t hought disorder changes are present during the manic
hallucinations before they will diagnose schizophrenia. But phase of bipolar. Bipolar disorder is present when there are no
the modern trend is to give ever more emphasis to mood perceptual or thought disorder changes. The HOD and similar
and whenever patients are depressed they are immediately perceptual tests will alert the clinician to the presence of any
called bipolar and the gross perceptual changes are missed perceptual changes.
or ignored. The history of schizophrenia over the past one
100 101

Bjpolars and schizoaffective people respond differently schizophrenia was caused by the formation of adrenochrome
Eo orthomolecular therapy. The non-schizophrenic bipolar* in the body. Adrenochrome is the oxidized derivative from
need mood stabilizing treatment while Ihe schizoaffective adrenaline. The reaction is activated by oxygen, accelerated
patients need these and also treatment for the schizophrenic by oxidizing enzymes and by copper or iron. Our research
component of their disease, I find that schizoaffective patients: division showed how to synthesize pure crystalline
are much easier lo treat than are bipolar patients and their adrenochrome, which later was identified in blood and
response is much better. other tissue and can be measured, usually by its conversion
to adrenolutin, We showed that it is an hallucinogen. And
Diagnosis can be very difficult and often this depends finally we based our vitamin 8-3 trials on the hypothesis that
more on the orientation of the diagnostician than on the anything that might inhibit the formation of adrenochrome
disease itself. The diagnosis, schizophrenia, is so dismal and from adrenaline would be therapeutic. But adrenochrome is
carries such a poor prognosis that many psychiatrists prefer only one member of a class of chrome indoles that is readily
not to even think about it and if their patients have mood made from the catecholamines: dopachrome from dopamine,
swings, minor or major, they will call them bipolar. A large noradrenochrome from noradrenalin and adrenochrome from
proportion of the schizophrenic patients who are referred to adrenaline.
me were originally called bipolar and their perceptual changes
had been either not elicited or were ignored. In a major recent The amount of adrenochrome that can be formed must
study WeiserJ found that nearly 30 percent of a schizophrenic depend upon the amount of adrenaline that the body
population had been diagnosed with depression during can make. That means that under stress when adrenaline
adolescence compared with only 7 percent in a general secretion is greatly enhanced much more is available. And
population. This contirmed what I have been seeing for the since adrenaline must be removed very quickly because of
past fifty years having seen over 5000 schizophrenic patients* its dramatic effect on blood pressure the body will convert
as much as possible to substances that do not increase
The Adrenochrome Hypothesis blood pressure, Adrenochrome is toxic to dividing cells, and
probably provides one of nature's methods for controlling
Are the three main types of psychotic patients-mood excess growth like cancer and for destroying bacteria. It
swinging bipolar*, schizoaffective* and schizophrenics related? is toxic to heart muscle and is toxic lo neurons as are all
hallucinogens. Schizophrenic patients are more prone to heart
The adrenochrome hypothesis provides an explanation. disease.
Hoffer, Osmond and Smythies hypothesized that
I suggest that bipolar patients excrete large amounts
of the catecholamines but do not convert as much into
l Weiser M, Reichenberg A, Rabmowilz J, Kaplan Z, Mark
adrenochrome. They will not suffer the usual changes induced
M, Bodmer E, Nahon D &. Davidson M. Association Between
Nonpsychotie Psychiatric Diagnoses in Adolescent Males and by this hallucinogen. Schizoaffective patients produce
Subsequent Onset of Schizophrenia. Arch Gen Psychiatry 2001 loo much catecholamines in the manic phase. They are
58^59- m
102 103

under extreme stress and that is why it is only in that phase that it takes a minimum of 5 hours of sleep to be rid of excess
that they will make enough ad renochrome to cause the ad renochrome and similar chrome indoles.
schizophrenic symptoms. Patients wilh severe heart failure
have increased amounts of adrenokitin in their blood. In There are other oxidized derivatives of adrenaline
blood, adrenodirorne is converted into adnenolutim The and other catecholamines. Adrenolutin is as toxic as
Schizophrenic group on the other hand makes too much ad renochrome. But when adrenochrome is treated with
adrenodirorne as long as they are sick whether ihey are ascorbic acid under certain conditions some of it is converted
manic or depressed. into 5, 6 dihyroxy M methyl indole that is called leuko
adrenochrome This substance has anti-tension or anti-anxiety
The main prodromal symptom of oncoming mania is lack properties.
of sleep, When the patient is getting only 4 hours of sleep or
less he is in grave danger of going manic. I advise my patients For a more elaborate discussion of the relation between
of this and discuss with them what they can do to prevent this the catecholamines and mental disease you should read Foster
from occurring. One of my patients under very good control and Hoffer145 Smythies and Smythies and Calzigna.9
wenl to Las Vegas. He got swept up in the gambling, did nol
go to bed (a very bad idea) and after 36 hours was wildly
manic and had to be shipped back to Victoria once more
psychotic. 3 Foster HD & Hoffer A, Schizophrenia and cancer: The
adrenochrome balanced morphism. Medical Hypotheses 2004; 62:415-
419
I think that one of the functions of sleep is to destroy and
4 Foster HD & Hoffer A. The two faces of L-Dopa: benefits and
to remove from the body products of metabolism that are
adverse side effects in the treatment of Encephalitis lethargies,
no longer needed or are harmful I think that the chrome Parkinsons' disease, multiple sclerosis and amytrophic Literal
indoles are examples of these harmful products. Normally, sclerosis. Medical Hypothesis 2004; 62177-181
if deprived of sleep long enough, people become psychotic 5 Foster HD and Hoffer A. Hyperoxidation ol the Two
and have hallucinations. Sleep deprivation is well known as a Catecholamines, Dopamine and Adrenaline: Implications for the
Etiologies and Treatment of Encephalitis Lethargic, Parkinson's
harbinger of bad news. And is it not interesting that visual and
[Disease, Multiple Sclerosis, Amyotrophic Lateral Sclerosis, and
auditory hallucinations during sleep are called dreams and are Schizophrenia. In Oxidative Stress and Neurodegener alive Disorders,
considered to be perfectly normal? The great psychoanalyst Ed ti All Qureshi and S Hassan Parves, Chapter 16, 363-376, 2(K]7
Dr. Karf Menninger once wrote that schizophrenia was like 6 Smythies JR. Oxidative reactions and schizophrenia: a review-
a dream, a condition from which one did not awaken. There discussion Schizophrenia Research 1997; 24:357-364

is some relation between hallucinations and dreams. 1 have 7 Smythies J. Recent advances in the neurobioJogy of
schizophrenia. German Journal of Psychiatry 1998; 1; 24-40
seen in many patients how daytime voices go away. They
recede into dreams and the voices heard while awake vanish. 8 Smythies J. Hie adrenochrome hypothesis of schizophrenia
revisited. Neurotoxicity Research 2002; 4:147-150
It is more normal to hear voices while dreaming. I suggest
9 Smythies J & Galzinga L- The oxidative metabolism of
catecholamines in the brain: a review. Bioehjjnica el Biophysics Acta
1998; 1380:159-162
104 105

Orthomolecular Treatment
1 hope this experiment will be done, for bipolar and
The orthomolecular component of treatment of schizoaffective patients might respond well to high doses of
schizophrenia is described by HofferKI and in the case niadn. The dose should be increased at the first indication
histories written by IB patients, Hoffer11. This was that they are moving into a hypomanic and later manic phase.
the treatment protocol developed on the basis of the
adrenochrome hypothesis. Bipolar disorders where
ad renochrome appears to play no role will need different
treatment with much more emphasis on dealing with the
excessive production of the catecholamines. Drugs are used
to control mania and they are very helpful, especially lithium.
These drugs are xenobfotics and difficult for the body to deaf
with. They should be used with great care, in the lowest
possible effective dose and not forever.

I think we should consider using much larger doses of


niacin to control both schizoaffective and bipolar disease
since it is one of the best antagonists to adrenaline. Certainly
niacin is much safer than lithium or any of the drugs currently
in use. II Is impossible to poison oneself with niacin because if
the dose is too high nausea and vomiting will soon persuade
anyone to cul the dose down. I have already mentioned the
2 pal tents who, on their own, took 60 grams of niacin a day
with no side effects. Saul77 reported that "over a twenty-
three year period, vitamins have been connected with the
deaths of a tolaf of ten people in the United States. Poison
control siatisties confirm that more Americans die each year
from eating soap than from taking vitaminsAbout half the
population of the United States takes vitamins.

Kt Hotter A. Treatment Manual. Internationa I Schizophrenia


Foundation, Toronto ON, 2007

Ji Hoffer A. Mental Health Regained. International Schizophrenia


Foundation, Toronto, 2007

12 Saul A. Orthomolecular Medicine News Service, Feb. 27, 2007


drsaui@doc lory oursel f. com
Section Two
109

A very recent report emphasizes this conclusion.2 The 18lh


European College of Neuropsychopharmacology Congress
j! am one of the founding members of this organization)
discussed the probability of achieving remission in the
Chapter One
treatment of schizophrenia. But nowhere in this report is there
any reference to recovery, to paying income tax. The report
Problems With Traditional Psychiatry included which symptoms to measure for assessing remissions:
delusions, conceptual disorganization, hallucinations, unusual
thought content, mannerism and posturing, blunted affect,
social withdrawal and lack of spontaneous conversation.
The problem with psychiatry is that it does not treat These are exactly the same symptoms we used to analyze
the schizophrenias successfully. This is the conclusion the disease in 1950 when we also did not think recovery was
of almost every published analysis. Thus Mafia et af\ possible.
following a very thorough examination of published studies,
conclude, "Outcome in regard to functional measures such Jobe et aP confirm the poor results. They conclude
as employment and community and social adjustment are schizophrenia is a "poor-outcome disorder" and I hey warn
predicted not only by delay in treatment but also by cognitive that more attention must be given to suicide and early death.
dysfunction, residual symptoms and adherence to medication. It does not say much for anti-psychotic drug treatment that
Pharmacological and psychological intervention show a after 50 years all psychiatrists write Is merely a rehash of what
promising effect In terms of either delaying or preventing has already been written.
conversion to a syndrome level of ultra high risk individuals,
but the evidence is not yet at a level that can be applied in But we should not be surprised. Apart from the Quakers
practice." Plainly pup Mafia and colleagues concluded that and a few dedicated psychiatrists, the general consensus
although there was some evidence that early intervention for the past 200 years has been that schizophrenia is not
might improve some of the treatment results, they presented treatable and that the best that can be done is to isolate such
no data that showed (hat early onset patients were any better patients from society in terrible mental hospitals and, in the
off with treatment. There is no mention of the number that last 50 years, to control the worst aspects of their behaviour
actually became and remained normal. And these early by using toxic chemicals which do not cure. Around 1900
onset patients are (he best prognostic group, the group that the differential diagnosis for dementia praecux (now called
responds the best to orthomolecular treatment. schizophrenia) included pellagra, scurvy and syphilis oi
the brain. Adding nicotinamide to white (lour eradicated

2 18ftl European College of Neuropsychopharmacology


Conference, Amsterdam, The Netherlands, October 22-26,2005
1 Malta AK, Norman Ross MG, and foober R. First Episode
Psychosis. Early Intervention and Outcome; What Have Wc Learned? 3 jobe TH and Harrow M- Long-Term Outcome of Patients With
Can J Psychiatry 2005; 50:881-891 Schizophrenia: A Review. Can J Psychiatry 2005; 50:892-900
no 111

Ihe pellagra psychosis. Curing scurvy cured the scorbutic remain and to grow, modern medication is very successful.
psychosis, arrd penicillin cured syphilis. As the cures for So was permanent incarceration in 1950. If your main interest
these types of psychotic reactions were found these patients is in keeping patients out of expensive hospitals, the modern
were promptly removed from psychiatry and became part of use of medication with legal sanctions, which force patients
genera! medicine, The term dementia praecox was replaced to take medication against their will, is very successful, 11 you
with the name schizophrenia, which remained unbeatable, do not care about the pain and suffering endured by patients
and so schizophrenia was left with psychiatry. The mental and their families, then modem drugs are very successful. On
hospitals became depositories for all unwanted people the other hand, if you want your patients to really become
who created problems, but not enough to have been sent normal, to take up their role in society, to be useful members
to prison. These mental hospitals developed such a well- and lo pay income tax, then modern drugs when used alone
deserved terrible reputation that governments began to shut are a dismal failure. The general fear and attitude of the
them down. Instead of converting them info asylums, real public toward the word schizophrenia is adequate proof l hat
hospitals, government officials were seduced by the opinion psychiatry has failed. Diseases which are preventable and
of a large faction of society dealing with the mentally ill, curable do not carry any major stigma. The schizophrenias
including the psychiatric profession, into thinking that these are preventable and curable but the public does not know ibis
sick patients were better off If they were left in the community since the profession refuses to use treatment that will eradicate
in which they had gotten sick in the first place. The hospitals both the disease and the stigma.
with their horrible reputation for brutality and lack of care
began to disappear Not their inmates, however, who began By my definition of wellness which is freedom from signs
to dog up the prison system. Some of the largest mental and symptoms, good relationship with family and community,
hospitals are operated hy prisons in the United States. So the and gainful employment paying income tax, fewer than 10
same patients who were warehoused In terrible institutions percent of drug-only treated patients ever achieve that state.
were dumped into prisons and their even worse mental If you doubt my conclusion ask your psychiatrist friends how
wards. The psychiatric profession which should have been many of their schizophrenic patients ever pay income tax on
fighting for better care and treatment for the mentally ill did money they have earned. Ask them how many have been
nothing. It preferred to treat non-psychotic patients as much able to become doctors, lawyers, teachers, business people,
as possible because they were usually less trouble. Mental writers, poets, painters and more. You will be surprised at
hospitals are the storage warehouses for the mentally 111 and the answers. Ask them why Big Pharma still spends billions
the psychiatrists who treat them are the wardens. The global of dollars and earns even more billions of dollars searching
idea held by psychiatrists that schizophrenia Is not treatable for profitable drugs which are not more effective, are just as
remains inviolate, and as long as they persist in not using unsafe because of serious toxic side effects and which cost a
adequate treatment they will remain correct. lot more. The life span of a drug patent is about fifteen years.
Every generation witnesses new blockbuster drugs which are
The term "successful" has to be analyzed. If all one wants touted as better and less toxic, but we have not seen this. The
Is to subdue some ot the symptoms while allowing others to
112 113

most recent drug, Zyprexa, is a good example. It is no belter referred to me. They suffered from a variety of symptoms of
than Chbrpromazine which was created fifty years ago. depression and anxiety and very often with ill defined signs
of thought disorder and paranoia. They were not sick enough
Basically psychiatrists may, in self-defense, maintain that to be readmitted and not well enough to he considered
these are totally unrealistic goals and therefore there is no well. I have therefore used much more stringent criteria for
point reaching for them. The public is not fooled and that recovery. To me a patient is recovered when he or she is free
is why the stigma of the name schizophrenia still remains of symptoms and signs, getting on well with their family and
a major problem. And the profession remains uncertain community and when they are productive, employed and
about diagnosing. They do not understand how it affects paying income tax. These criteria are so clear that one does
patients. Modern psychiatry has failed in the treatment of not have to be a physician to decide whether or not a patient
schizophrenia. That failure is not due to ignorance of better has become and is well
ways of treating. It is due to professional resistance against
using any therapy that does not keep the major drugs at the ~~ II es also necessary to define what is meant by natural
central core of the treatment program. recovery rate. A true natural recovery rate would be one
in which a patient would remain in the environment in
Recovery from schizophrenia is not considered a which he or she had become ill There would be no change
reasonable objective by psychiatry. The word cure has never in life style and no treatment given. This also applies to
occurred in any psychiatric dictionary. In 1957 when we cancer. Spontaneous recovery from cancer, at one time,
first issued our reports in the medical literature about the was considered so rare as to be non-existent, but many
results we were getting we were attacked by the Canadian such recoveries have been described. Foster1 in a study of
Mental Heafth Association led by Canadian psychiatrists spontaneous recovery from cancer found that in most cases
because, they said, we had claimed we cured our patients, the recovery was not natural at all In these patients something
in fact we never did make that claim but we did talk about had been done to or with the patients but that something was
recovery lasting one or two years. Even though recovery was not the standard treatment for cancer. The same applies to
not expected, psychiatry did accept that about one-third of schizophrenia. Many years ago a mother called to report that
patients with no treatment whatever would recover. These her son had been diagnosed schizophrenic but had ret used
were called natural recovery rates. Is this really true? to take any treatment. His mother eventually realized that
whenever he drank milk he seemed to be worse and took him
The earliest studies of natural recovery used readmission off all dairy products. He recovered. His would have been
statistics. Any patient discharged and not readmitted was considered a natural recovery but it was not. Something had
classed recovered. This led to the usually accepted 33 percent been changed.
recovery rate. But f have seen hundreds of these patients
who had been in hospital once or twice or more and who
thereafter, for a variety of reasons, never had to be readmitted. 4 Poster HD. Lifestyle Changes and the 'Spontaneous' Regression
They were not well or else they would not have been of Cancer: An Initial Computer Analysis. International |ournaJ of
Biosocial Research, 1988; 10<1):17'33
114 115

Recovery rates were nearly zero percent tor the treatment but I think these three, shelter, food and civility (SFC) are
given in the mental hospitals between 1900 and 1950. The necessary.
patients did not receive the three basic conditions (shelter,
food, civility} required for recovery. The Quakers, with I prefer to drop the term natural and to talk only about
their moral treatment of the insane, claimed in 1850 that recovery rates. The recovery rate for the schizophrenias is
fifty percent of their patients recovered. The usual quoted a function of shelter, food, respect and treatment which
recovery rate depends entirely on the figures obtained from may be drugs only, as is the standard practice today, or
patients who have been in hospital. But in my experience a orthomolecular treatment described in this report.
large number of patients have not had to be admitted. They
have been called nervous breakdowns and this also includes When the first three elements of recovery are not used the
people with depression. Since many patients do recover it is recovery rate will be very low. When they are used at their
impossible to guess what the real recovery rate is. We will optimum level the rates will be at least fifty percent. This may
never know how many are schizophrenic until we have an explain the curious finding, to North Americans, that patients
acceptable biochemical test for schizophrenia. w ho become schizophrenic in less developed countries like
Bangladesh have a better prognosis than similar patients who
Actually these essential principles of any treatment become ill in Canada or the United States,
program were used by Asklepios, Dr Erik Paterson, an
experienced orthomolecular physician wrote, "In his My conclusions of the results of orthomolecular treatment
Asklepiads, he removed the sick people from their stressful are based upon our double blind controlled trials, my own
environments (long before Parsons coined the term "Sick personal experience of treating over 5000 patients since
Role"), gave them fresh air, clean water, good food, a 1955, and on the results of numerous studies published by my
modicum of rest and exercise, a modicum of spirituality, and cot leagues over the past three decades. (Most of these studies
Time (hence "patient"}. Remarkably (not to us orthomolecular were published in the Journal of Orthomolecular Medicine
physicians) such a large proportion of patients completely because establishment journals would not take them. They
recovered ibai the Greeks made Asklepios into a god thus remain unknown to physicians who depend only on
— hence ^sculapian Authority. It is one of the most serious Medline.)
condemnations of modern (pseudo ) psychiatry that orthodox
psychiatrists cannot achieve anything remotely like the 1 conclude that the recovery rale using orthomolecular
recovery rate of what they would regard as an ignorant Greek treatment is about 90 percent for patients sick less than two
3,500 years ago!" years (or having been sick and recovered, have relapsed and
then been sick less than two years), if treated for up to two
Perhaps we should honour Asklepios by using that term years. The recovery rate for patients who have been sick
to describe the basic three elements but I prefer to list them longer than two years is not nearly as good, I have found that
separately. Many other factors can be teased out and studied about 50 percent of chronic patients sick over 7 years and
treated for at least ten years, recovered.
116 117

Psychiatrists must learn to use their dangerous drugs in a way


Table Showing Recovery Rates that benefits the patient.

Estimated Recovery Rate The Journal of the American Medical Association reported
that adverse reactions to drugs are the fourth leading cause of
death. Reactions to prescription and over-the-counter drugs
Orthomolecular Drug only
kill more people than all illegal drugs do. CohenV excellent
SFC Yes No Yes No book summarizes the massive evidence and discusses the
part played by Big Pharma in creating this terrible situation.
Percent 75-90% 35-50% No data <10 He points outthat drug companies deliberately over-estimate
the amount of drug patients should be given daily and make it
difficult to give smaller doses. Null, Dean, Feldman and Rasio*
conclude their report as follows, "When the number one kilter
Recovery rates looked at another way:
in a society Is the health care system, that system must take
responsibility for its shortcomings. It's a failed system in need
Mental hospitals 1900 to 1950 0 response
of immediate attention."

Modem psychiatry under 10%

Moral treatment insane (SFC) 50%

Orthomolecular and SFC 75-90%

Modern drugs are very toxic and dangerous. This means


that they must be used carefully and in optimum doses,
Pataracchia,1 There is really nothing more dangerous than
insulin infections since the toxic dose is only a small amount
larger than the therapeutic level. Yet insulin is used with
success for treating diabetes mellitus and children can be
taught how to inject themselves. The medical profession has
had decades in which to learn how to use this dangerous
product in a productive way. Danger is an important issue.

2 Cohen JS. Over Dose; The Case Against the Drug Companies.
Jeremy F Tarcher, Putnam, New York 2001

1 Pataractrhia RJ. Optimal Dosing for Schizophrenia. Journal 3 Nul IG, Dean C, Feldman M, Rasio D. Death by Medicine. I
Orthomolecular Medicine 2005; 20^3-99 Orthomolecular Med 2005^0:21-34
118 119

the drug could be released and no one could later hlame


the government agencies. This not only took away major
responsibility from government agencies but made them
Chapter Two careless, since no thinking was needed. I know that almost all
investigators will disagree with me but under my direction my
research group did the first double blind trials in psychiatry
Why Psychiatry Has Failed beginning in 1952 and f have been a student of the method
ever since.

Based on a very large number of double blinds costing


When governments undertook to vet the efficacy of drugs
billions of dollars a lot of evidence has accumulated which is
as well as their safety they bit off more than they could chew.
taken as gospel and has been used to prepare evidence-based
Permission to allow drugs to be advertised and sold carried
guidelines. But Is this evidence reliable? McAlister et al1 do
with it enormous responsibility. For if a wrong decision were
not think so. They reported on what they had found from a
made and the new drug killed too many patients (no one has
study of Ihe literature. "Evidence-based medicine guidelines
specified how many is too many) someone would have to
are not necessarily based on high quality evidence." How
bear the responsibility. It was much simpler when bureaucrats
reliable are these guidelines if they are based on faulty
had only to decide whether a drug was safe, as this was done
evidence?
by determining lethal doses for animals and then extrapolating
to humans. No double blinds were or are still needed to
The original double blinds that we did before 1960 will
measure how toxic a drug is. It became very important to
never be repeated. We did not use any drugs and today these
have a method that could be used to make these decisions so
are mandatory, 1 doubi I could find any psychiatrist willing to
that bureaucrats would not have to take the blame.
undertake a trial without these drugs. Secondly our controlled
trials were part of an over-all treatment program which
The double blind method came along at the right time
provided decent shelter, good food not yet corrupted by
and became the hallowed method used by all government
modern tood technology and decent and humane treatment
agencies, by all investigators, by editors of journals and by
of patients, I doubt there are any institutions today that follow
granting agencies. An arbitrary standard was selected. If
these principles. And clinical studies, which any physician
the drug being tested was better than no drug or placebo
or non-physician orthomolecular therapist can do, will not
with a probability of 0,05, It was assumed that the drug was
be accepted by standard medicine as evidence if they are
efficacious. This is based on probability hypotheses which
not double blind. The psychiatric establishment has a perfect
themselves have never been shown to be valid for human
excuse not to try to duplicate our results and need not worry
trials. Now the bureaucrats were in the clear. If a company
wanted to get approval for a new drug they would merely
1 McAlister FA, Van Djcpen S, Padwai RD, Johnson JA, M.ifiinul.u
have to run enough double blind controlled trials to find
SR. How Evidence-Based Are the Recommendations in 1 iv'idem *■
a few' where the holy 0,05 p value was exceeded. Then Based Guidelines? P!o$ Aug, 7/2007.

1
120 121

at all until they are found to be superfluous when general


practitioners take on the treatment tor schizophrenia and no
more patients are referred to psychiatry. There have been
many physicians who have already taken on the treatment
Chapter Three
of schizophrenics* One lost his medical license because this
made the local psychiatrists so angry.
How to Use Drugs Safely
Students of the history of medicine will have to examine
this issue very carefully and one day we will have on
record all the factors which have been used in suppressing
orthomolecular information from the public and the Chlorpromazine was first used in France and from there
professions. it swept around the globe. Since then other drugs have been
developed and every decade more drugs are proclaimed to
be better and freer of side effects. I call them essential evils.
For many patients they are very essential during treatment but
1 always aim to get them off as soon as possible. They are evil
because of the dangerous side effects and because the most
modern drugs are addicting and patients are seldom able to
work as long as they have to take these drugs. They are very
helpful crutches but not as safe as wooden crutches which
only become a weapon when someone threatens to use them
as such.

Are The Newer Antipsychotfcs Any Better?

A reasonable person would expect that new drugs that


have the same general therapeutic characteristics as do older
and existing drugs would have additional properties that make
it sensible to replace the older ones. They should be more
effective, they should have fewer and less serious side effects
and in my opinion should be cheaper and easier to use.
When U comes to the newer antipsychotics these reasonable
expectations fly out the window. The modern atypical
antipsychotics are not mure effective, they have the same
and even more serious side effects and they cost ten times as
much. Obviously the possibility of driving the costs up has
122 123

been the main determining factor. Big Pharma has gained, Physical Toxic Side Effects:
everyone else has lost*
The metabolic syndrome
Gardner et ah' compared the modern antipsychotic drugs
to the original drugs. Olanzapine is an example of a modem This syndrome is characterized by weight gain,
drug and Haldol is an example of one of the early drugs. hyperlipidemia, hypoglycemia, and increased risk of
They referred to 95 reports dealing with the entire spectrum diabetes. Not surprisingly there is also an increased risk
of positive and negative drug activity They concluded that, of cardiovascular disease, increased blood pressure and
"Modern antipsychotic drugs offer useful therapeutic options kidney damage. The increase in weight is not trivial for many
and the risk of some extra pyramidal symptoms is generally palients. Some have gained 60 pounds in a few months and to
lower with these drugs than with older antipsychotics. As see .300 pound patients who formerly weighed less than 150
a group, modern antipsychotic drugs vary greatly in their is not uncommon. Schizophrenic patients tend to be more
pharmacology and in their risk of specific adverse effects. susceptible to cardiovascular disease than normal people and
With I he exception of Clozapine, they do not represent the use of these toxic drugs greatly increases this vulnerability.
major gains in effectiveness or tolerability. Some present
potential important adverse effects associated with weight Neurological side effects
gain, including diabetes, hyperlipidemia and hypertension.
As a group, they are much more expensive than the older These include extra-pyramidal symptoms. When the
antipsychotic drugs, some of which are available as generic newer atypical antipsychotic* were released the major claim
drugs." But the newer drugs are rapidly replacing the was that the side effects, often troublesome with the older
older drugs simply because of the billions of dollars spent drugs, would not be as serious or frequent. This is true only
advertising them. Merit is the least important variable, to a minor degree. Orthomolecular practitioners hardly ever
Gardner et al write, "It is reasonable to consider both older had to deal with side effects from the older drugs since it was
and newer drugs for clinical use and it is important to inform possible to use lower doses that did not induce them. Modern
patients of relative benefits, risk and costs of specific choices." atypical antipsychotics do have the same side effects however.
I agree with the authors' conclusion in this thorough sludy- Other neurological side effects include restlessness and
there is no real advantage to the newer drugs, there is a major anxious agitation.
increase in cost and patients must be allowed an informed
choice. This kind of thinking is very rare in modern psychiatry. Results of Treatment

Treatment with optimum (large if necessary} d< ol


vitamin B-3 began rationally. It was not serendipitous, nor
trial and error. I do not know of any psychologic .il psyi hlalrii
treatment that originated in the same way, Prufessi >r Ugo
2 Gardner DM, Baldessarini Kj and Warskh F- Modern Cerletli in Rome got the idea of using electric shot k from I he
antipsychotic drugs: a critical: overview. CMAJ 2005; 172:1703-1711
124 125

information be received that shocking animals in abattoirs


caused a convulsion. Mussolini bad mandated this be done The Schizophrenias
because he wanted the animal's death to he painless. Insulin
coma originated from a clinical observation that there was The quality and rapidity of I he response to therapy
an incompatibility between schizophrenia and epileptic depends upon the intensity and duration of the illness. From
convulsions. Phis has not been established but it created one our research we concluded that patients who were suffering
of the early biochemical treatments that had some success. their first episode or, having recovered from one and having
Our work was based upon the adrenochrome hypothesis relapsed, responded the best. After iwo years of treatment
which when examined carefully called for the use of over 90 percent of this group was well. Chronic patients, all
substances that were anti oxidants in order to decrease the treatment failures, responded more slowly and if they had
oxidation of adrenaline to adrenochrome. Orthomolecular been ill for many years were so badly damaged by the illness,
therapy was the first treatment to be brought in following by the treatment given them, that they would never be fully
carefully controlled double blind therapeutic trials. There is normal even though they would be much happier and more
an enormous amount of literature documenting this, with a comfortable. In my practice on hundreds of these patients
large proportion of the reports coming from the Saskatchewan when treatment was continued ten years or more fully 60
Research Division of the Department of Public Health, percent were normal. But many were not able to meet my last
Psychiatric Services Branch and from my colleagues and criterion; they were not working or paying income tax. The
me. I will not list all these important papers. Had there been prolonged illness before they were placed on orthomolecular
any real interest in looking up this data it could have been treatment made it impossible for them to find employment
exposed to the usual follow-up studies and would have been and our society has not yet developed (he syslem that allows
shown to be superior to treatment with drugs used alone. them to be retrained and re-employed. Here is an example.

Our first trial used small groups, meeting Do D. In December, 2005, I received a card from a patient I
HorrobinV demand that large scale studies be discontinued first saw 20 years ago. This was in response to my telling him
and replaced by small scale targeted studies. The first account that I would no longer be able to see him as 1 was retiring.
of our early trial appeared in Hoffer, Osmond, Cal I beck He wrote, "Thank you for the wonderful 20 odd years of
and Kahan.3 4 5 A complete review of the clinical value of treatment for schizophrenia and nutrition. 1 will be reading
orthomolecular treatment is given in Hoffer,1 your latest books so I will be continuing with your program.
Long life, happy memories and the best of health to you." He
was referred 20 years earlier with the diagnosis of paranoid
3 Horrobin D. Are Large Clinical Trials in Rnpidlv lethal Diseases
schizophrenia. He was so paranoid that he had lost 12
Usually Unethical? The Lancet 2003; 36T695-697
different jobs. He had been trained as a nurse and ambulance
i Hoffer A, Osmond H, Callbeck MJ and Kahan t. Treatment of
Schizophrenia with Nicotinic Acid and Nicotinamide] Clin Exper
driver. But no one could stand his paranoid Ideas and his
psychopathol 1957; 18:131-150 hostility. He was in fact black-balled and would never be able
5 Hoffer A. Vitamin B-3, Schizophrenia, Discovery, Recovery, lo get a job in the health area. The first day I saw him his
Controversy. Quarry Health Books, Kingston ON, 1990
127

paranoid ideas and hostility were so intense he would have


frightened most people.

I started him on the orthomolecular program and in a


Chapter Four
couple of years he was well But he was not able to find a job
and when he applied he was asked to see another psychiatrist
for a second opinion. They did not tmsl my judgment that Modern treatment illustrated
he was fit to work. The psychiatrist he saw totally ignored
his present state and reported that he was not employable
on the basis of his previous record. I had been seeing him
every 3 months. He had carved out a very useful life for The following letter illustrates the modern standard
himself. He was a warm, pleasant and kind man who did a treatment program In action.
lot of volunteer work driving people about, helping them with
their shopping, eic, He established a very good relationship "July 20, 2005
with his family and was in dose contact with them. But even
though he could have been working he was not allowed to. Good Day!
Last year my daughter was diagnosed with schizophrenia.
His card reminded me of a letter I received in 1960 from She is now 17 years old. She was 16 when she experienced
Dr, Ted Robie, a psychiatrist from Boston who had been the initial "acute episode." My daughter, A, was (is) a brilliant
practicing for over forty years. In December Ted wrote that child. She excelled in academics, music, and athletics. She
he was impelled to write to me because for the first time in made A's in instructor classes, when the instructor insisted he
his career his paranoid patients had become friends. In a did not give A's* She played not only I he violin, but the flute
two-page handwritten letter he described how in the pasi he and the piccolo, as well. We are residing in ***** She ran
had never had a good relationship with his paranoid patients cross country for her high school As grueling as the race can
who remained paranoid and hostile, but after he started be, she ran with a smile on her face, loving ever minute of it.
giving them niacinamide the paranoia gradually vanished She was looking at a bright future. Then this horrible, horrible
and they became friends. He wrote to thank me. He was the ailment affected her.
first United States psychiatrist to become an orthomolecular
psychiatrist and was convinced by I he results he witnessed Our experience with the psychiatric arena has been
in his own practice. But in 1960 Big Pharma had not yet totally unacceptable* They bullied my wife and me intf i
occupied all of psychiatry. accepting treatment that was based on trial and error, with
the most powerful drugs on the market to dale, they saw
her "in passing," because they were busy with other patients,
and going on vacation. Nevertheless, they got paid bul my
daughter did not get better!
U8 129

The doctors told my wife and me that my daughter 90 percent will become norma! if treatment is continued
would never be the same, and that she would have to take long enough. This may require several years.’ A few of my
their medication for the remainder of her life. 600 dollars a patients did not respond but in those cases it was impossible
month for the rest of her life. These drugs are guaranteed to to gel the child's or the parents' cooperation in the treatment
cause pyramidal side effects. Guaranteed!! A week after I program. Most parents are determined to help their children
got A. home, she began to show signs of tardive dyskinesia. get well, I remember Dr. Alan Colt's presentation of an
I immediately got rid of the drugs. I took her to a nutritionist. interesting case at the last meeting of the Huxiey Institute of
He recommended a strict diet and vitamins. It has been three Biosocial Research held in the Roosevelt Hotel in New York.
months. My family is taking this day-by-day. Mayor Koch opened this meeting with over 500 people in
attendance. He introduced three people: a tall young man,
She shows little emotion or motivation (negative his girhriend, quite a bit shorter, and his mother who was the
symptoms). Nevertheless, when I ask her to dean the smallest. The mother told us how sick her son had been as a
kitchen, or her bedroom, she does an excellent job! seven year-old child and that he would not take the pills that
Sometimes she laughs out of place, like someone is telling Dr. Cott had recommended as part of the orthomolecular
her a silent joke (positive symptoms), but she insists that she program. At last in desperation she adopted a rather heavy-
is hearing nothing in her head. She is only remembering handed technique. Lach time he refused to take his pills, she
a past experience that caused her to laugh. She goes to a sat on him until he agreed to swallow them.
private academy where the teachers are sympathetic to her
condition. She has 6 more credits to graduate. The problem Then the young man spoke. He told us that he wanted to
is that she is very, very sensitive to what my wife and I say to publicly thank his mother for having forced him to take his
her, as well as how we say it! This is an issue! Because even vitamins and for his present state of good health. His girlfriend
though my wife and l can deal with this, someone she doesn't stood by his side smiling. This was a very dramatic scene.
know will respond differently, and that might cause her stress. The applause was deafening, Anolher mother told me that
I am coming to the realization thal perhaps I might have lo her son would not take Ills pills. She discussed this with his
consider the drugs, because that is all that is available But, teacher who weighed dose lo 200 pounds. Pretry soon he
what a loss!" was taking them without any problem. Whenever he refused
to take them the teacher wouid sit on him. When parents and
More such stories are available from the International patients were cooperative the results were almost entirely
Schizophrenia Foundation. They were written by patients or good and no one got worse. I have described many of these
by members of their families. cases in my publications.

Learning and Behavioural Problems in Children

On the basis of the two thousand children under age


14 I have treated since I960 I have concluded that over 1 Huffer A Healing Childrens Attention find Ri-hmdor I >inorilv^
CCNM Press, Toronto ON, 2004.
130 131

t find the multiple diagnostic categories developed by the


American Psychiatric Association for children totally useless If they passed that first firewall and started on treatment
and use them only for insurance or legal forms. They do not he or she and their family were on their own. If there was
in the slightest degree indicate what treatment should he used. a relapse and the patient had to be admitted to hospital
Yet this should be the main function of diagnosis. the orthomolecular treatment was promptly stopped with
comments about how ridiculous it is to think that vitamins
Any treatment not recognized by the leaders in any field could be of any use. In a California court a patient was
stands on its own. If the schizophrenic patient is placed upon being examined by the judge in order to determine whether
medication only, that is acceptable. If the patient relapses and she should be forced into hospital. The psychiatrist gave his
has to be admitted to hospital, the treatment in hospital will evidence that she should be and one of the points he made
be continued and the opinion of the specialist who started was that she was delusional. She believed that vitamins
it will be respected. The entire resources of the psychiatric could help. This to his mind made her delusional, in hospital
community will be available to help that patient. This will patients will be forced back on medication they may not like
include counselors, psychologists, welfare support, payment since informed consent does not exist in mental hospitals,
for drugs and support to the families. But it the same patient is even though this is against the law in Canada. If this law
started on orthomolecular treatment the pathway to recovery were enforced, psychiatrists who no longer had the power to
is very much different. order patients to take drugs would be forced to persuade their
patients of the value of the drugs and they would necessarily
The first problem faced by the patient and family will be be more considerate and kinder to them. If they did that most
to find physicians willing to use the treatment or even to refer patients would be cooperative.
them l.o someone who will. Often these referrals are made
grudgingly after an attempt has been made to dissuade the Patients are discharged just on medication, and if they
patient from coming. This is usually accompanied by many come back to the orthomolecular therapist they will have
comments and statements that indicate that the doctor asked to start all over again. Many patients are so determined lo
to make the referral had a very low opinion of any doctor stay with the program that they find ways of keeping on the
recommending that kind of treatment. Patients I saw who vitamins while in hospital. Parents bring them in and give
passed these hurdles told me some of the statements made them to them when they are alone. One of my patients hid
about me. They were told that l was dead, I was too old, his vitamins in his open top cowboy boots and stayed on
1 was senile, I was kicked out of the College of Physicians the program while in hospital. In some cases whenever they
and Surgeons, I charged too much, l would make them have a home visit they take them. But due to legal sanctions
immediately stop all their medication and force them to take if the psychiatrist determines that the patient, now in the
vitamins only, I was incompetent, I diagnosed everyone as community, will refuse to lake his medication or if the doctor
schizophrenic, I lost my hospital privileges, and that vitamins knows he is also taking vitamins he may order the police to
are too dangerous. When the patients learned these were all bring that patient back into hospital. This compulsory system
lies they quickly changed doctors. reminds me of dictatorships. It is totally against the spirit of
133

democracy when people have no rights whatsoever. And within a short time the stigma of the disease would be gone.
if and when the system no longer harasses the patient and The following letter illustrates the orthomolecular program In
allows them to stay on the orthomolecular program, they action,
are denied services available lo patients on drugs alone.
Their vitamin costs are not covered by any drug plans "July 20, 2005
whereas drugs are. They are denied access to counseling and
psychological services. The pressure can be so great that they Dear Dr Hoffer,
will contemplate suicide, and in one case a patient caught in 1- Since we came to see you the second time on July 5,
this web was so fearful of the system that she did kill herself. Z has been taking his vitamins regularly including the
She was afraid to see me as the psychiatrist who had last 1,000 mg niacinamide and 1,000 mg vitamin c, three
treated her in hospital had told her that if she did, she would times a day.
be forced back into hospital under his care again.
2* 1 have been noticing improvements but over the past
Doctors who might be interested are denied access to the two days, (in fact exactly one year since he had his
information, Medline, the most powerful system for making florid psychosis,) it has been like a miracle. I am getting
the results of medical research available to the public, has my old enthusiastic son back again. He is so motivated,
determined it will not cover the journal of Orthomolecular calling his friends for a planning meeting, discussing his
Medicine. This is one of the most blatant examples of medical career and actually doing so much. He now feels that
censorship by a United States government agency. And the the program he has been attending at university is not
governing bodies which control the professions frown upon for him but for people who are "sick." He wants to get
and suppress I he use of these treatments, as they are outside on with his life and pul his illness behind him.
the box and not acceptable to the psychiatric profession.
No church loves its heretics. It is amazing that patients on 3* You did tell me on July 5 that he would be better in 3
orthomolecular treatment do as well as they do with all these months so ! can't wait to see the further Improvements
forces and resources working against them and their recovery. in September. He has a nice acting job lined up to start
on September 26 and I was worried before about this
The Idea! Orthomolecular Psychiatry but f know now that he will be just fine* Let us wait
until next month and until the job concludes at the end
The ideal treatment solution would be to use the best of November He will be acting on Stage at the Vogue
of what is available today. It would be a combination of in October and November
the Quaker model i.e. adequate shelter, good food, and
civility, with orthomolecular treatment that is accepted by Thank you, thank you again. I know the vitamins are
the community and by the professions* If this were in effect working and Z is also taking his Risperidone but as you said
today I predict that there would be an amazingly quick turn eventually he could be weaned off this or continue on an
around in the oullook of schizophrenic patients and that extremely low dose. You can be assured that by the end of
134 135

this year I will be spreading the message of orthomolecular due to the revolving door policy, patients are not allowed to
treatment tor early psychosis and schizophrenia. I look eat well long enough for it to do them any good.
forward to continued progress. Even if Z maintains his present
disposition, this will be a huge success story. Thanks again," Civility

Why Has Orthodox Drug-Only Treatment Failed? Modern psychiatry has become too much like a business
and too little like a vocation. This is certainly not true for
The reasons are very clear and simple. Modem psychiatry many very good psychiatrists who are interested in helping
has failed because it has ignored the basic principles of good their patients but have been handicapped by not being taught
medical practice such as shelter, food and civility and because how best to do so. Perhaps the McGill medical school En
ti has become totally dependant upon the use of modem Montreal may have set the process in motion to correct this
medication. hasic shortcoming. It has announced that it will be starting to
teach their medical students how to become healers, I gather
Shelter they mean that they will teach the importance of the doctor
patient relationship, the need to understand their patients, the
Modern psychiatry pays little attention to the shelter needs need to be civil and to take seriously the ancient dictum "Do
of their patients. Patients who have responsible and caring No Harm*
families and good homes are very lucky. The ones living on
the streets of our cities are being deprived of one of the basic I may be biased rn my view of modern psychiatry because
necessities of life and cannot and will not recover unless that the majority of my patients who were schizophrenic or
shelter is improved to the point that they can restore their bipolar, or had other conditions that had not responded to
own inner psychological and biochemical resources. Modern treatment, told me as pari of the history what had happened
hospitals can and do provide good shelter even if one may to them at the hands of their previous psychiatrists, and also at
have to pay several thousand dollars each day in order to get the hands of other doctors to whom they had gone for help,
it. But the modern revolving door method ensures that even 1 think medical schools would do well lo follow the McGill
though these shelters are available they will be used very example. Here are a few examples to illustrate what has
sparingly because the community has been persuaded that occurred.
they cannot afford to pay for them.
In October, 2005, a middle-aged woman appeared
Food covered with sores and open lesions on her skin, complaining
that she had suffered from this condition for many years with
Modern hospital food is no better and probably is worse itching and depression. She had consulted nine different
than the food that was provided En 1950. It is better than what dermatologists. No one was able to diagnose or help her,
the homeless schizophrenic patient gets on the streets or on and toward the end it was decided that she was causing the
welfare living in run down rooms or group homes hut again, harm lo herself. A clinical conference concurred with ibis.
She was advised that she must stop hurting herself and one Even worse they were not helped and the ancient Injunction
dermatologist spent a half hour telling her husband lhat he DC) NO HARM was not observed.
must prevent her from doing so. She protested bitterly that she
was not and that the lesions were appearing even on her back Several years earlier a young woman and her father came
where she could not possibly reach to scratch herself. It was from Vancouver She had been diagnosed with schizophrenia
obvious that they considered her a personality disorder. The and had achieved fair control with Haidof. About this time
diagnosis devastated her and her husband and added to her Olanzapine came on the market and her psychiatrist had
depression decreased her morale even more and she spent agreed to get this product and place her on it. Within 6
days sitting tn the bathroom crying. Her referring doctor did months she had gained 60 pounds. She had turned from
not agree with any of this and eventually referred her to me. an attractive looking 19 year old girl into a fat, shapeless
mess and she was totally depressed. She pleaded with her
As soon as I saw her I recognized that she had the skin psychiatrist that she wanted to go back on the Haldol but
lesions typical of pellagra. She started on the B vitamins he was determined that she would not and told her bluntly
including niacinamide and in one month she was clear and ''Better fat and well than thin and psychotic/' Jn fact he was
well. Her depression was gone and she had gone back to wrong because she was now both fat and psychotic. I have
work. To both the patient and her husband this was a miracle. seen a profound lack of respect for the metabolic syndrome
A few weeks later her husband appeared and complained that (hat is a common feature with modern anti psych of ics, as if the
over the past two years he had developed symptoms which treating doctors had no concern about what these changes
had been diagnosed as multiple sclerosis. He was 60 years old were doing to their patients. Some patients gain 100 pounds,
which is rather late for this disease to appear. They had moved In this they are not being treated civilly because there is no
to this area 2 years earlier. Where they had lived before he understanding, no support and their safety is jeopardized.
had been exposed lo sunshine as he was active in sports. In Since schizophrenic patients are slightly more susceptible to
Victoria we lack ultraviolet for B months of the year and it is the metabolic syndrome, the drugs create biochemical havoc
now recognized that one of the factors in the development with these unfortunate patients. The death rate from non
of multiple sclerosis is lack of ultraviolet and vitamin D-3. cancer causes has gone up.
He told me he had just seen a neurologist. The doctor told
him, "You have multiple sclerosis. Good bye. You will be in i nere is no end Jo these stories. If you want lo learn ..
a wheel chair in three months-" I started him on a program ask any of your relatives or friends who are schl/ophrmtli or
for multiple sclerosis which l have been using for 50 years but schizoaffective to tell you what has happened to them
added large amounts of vitamin DT! and assured him that he
would probably not wind up in that wheel chair. When I tell Orthomolecular Treatment
this story to my close friends they are horrified. This family
was not treated with civility decency or understanding, and Modern psych iatry rejected orth o nri< ■ I ■ m u |, h n i j I m<1 i i I
were given no support by any of the specialists they had seen. without examining the data on which il tmlhmi developed,
and it still continues to do so. This is h.istnl mm tin Amerli an
138 139

Psychiatric Association Task Force Report on Megavitamins which only appeared with large doses and which were easier
and Orthomolecular Therapy in Psychiatry published in 1973. to control with other medication.
This report is as accurate as would be a report released by
Saddam Hussein to account for his behaviour. But it has been Lieberman et aIs found that Perphenazine, one of the
accepted as a bible even though I doubt more than 1 percent original antipsychotics was as effective and free of side effects
of the present membership of the APA has ever read it. Our as the modern antipsychotic drugs and it cost only ten percent
reply was ignored. It is available at http://www.iahf.com/ of the new drugs. This should be welcome news to the drug
orthomoiecular/reply_to_apa_tfr_7.pdf. This is described in plans that pay for these drugs.
Chapter 17 in my memoirs "Adventures in Psychiatry"*,
Modem psychiatry fatted the population of schizophrenic
Dependence on Antipsychotic drugs patients by paying no attention to the most vital treatment
factors: shelter, food, civility and orthomolecular therapy.
As t have stated, these powerful drugs can play a Increasing the number of psychiatrists, the number of
significant role in treating schizophrenic patients, but when hospital beds, or the number of new drugs will not do a bit
they are used alone they do not allow patients to get well. of good. One naturopath, not trained in psychiatry but using
They have all the hall marks of the perfect drug from the point orthomolecular methods, will get much better results tre^iting
of view of the drug companies. They help but do not help schizophrenic patients than one thousand psychiatrists not
enough, and they are addictive. The last decade witnessed a using the method and depending only upon drugs. It is about
surge in new drugs which it was claimed were more effective time we moved on from the mustard plaster type treatment
even though they were not compared in double blind for pneumonia ] was given as a child to modern specific
controlled trials to drugs already in existence. They only had treatment in use today.
to be a little better ihan placebo if the sample size used was
large enough. It was also claimed that they had fewer side The message in this book is very simple. The most
effects. After J became familiar with these compounds it was effective treatment for the schizophrenias must include
obvious to me that they were no more effective and I hat they shelter, food, compassionate care and respect as well as
had as many toxic side effects, probably more dangerous than orthomolecular treatment. None of these were used in 1930
those of the earlier drugs such as Haldol and Chlorpromazine. and the results of treatment were dismal. Patients were
Orthomolecular psychiatrists seldom saw any tardive incarcerated rn overly crowded inadequate institutions,
dyskinesia because by using orthomolecular treatment they given minimal quality foods, minimal respect and care and
needed smaller doses of drugs. The older drugs did not as no orthomolecular treatment. None of these iactors was
often cause the metabolic syndrome which is much more considered important The main reason for incarceration was
dangerous in the long run than were the muscular side effects to protect the public. Admission was a life sentence with no

3 Lieberman JA, Stroup TS. McEvoy JPct at. Effectivenes!) of


2 Hotter A. Adventures in Psychiatry, The Scientific Memoirs of Antipsychotic Drugs iii I'atienls with Chronic Schizophrenia, New
Dr. Abram 11 offer. Kos Publishing. Toronto, 2U05 England J Medicine 2005;353:1209-1223.
140 141

time off br good behaviour. Fifty years later the situation is treatment. As l have pointed out all of the four components
no fetter. The only essential difference is that incarceration in are necessary, but orthomolecular therapy is most important.
buildings is not used. Instead we use chemical incarceration
by legally sanctioned palliative psychiatric chemotherapy. RA, born in 1975, was first admitted to hospital when
The patients who were locked up within walls now have she was 15. She began to hallucinate in her late teens.
their brains locked up with toxic drugs. Many years ago These visions were both visual and auditory and were
when companies were looking for a laboratory measure of frightening. Since then she had some of the best available
anti psych os is they used the catatonic test. If a drug made non-orthomolecular treatment, spending almost ten years in
animals catatonic, it had antipsychotic properties. It is private mental hospitals. She returned home about six months
unbelievable that there has been no progress in fifty years in before E first saw her. Her chief complaint was anxiety arid a
spite of billions wasted on research. Perhaps the word wasted great fear of seeing and hearing things. Her mother placed her
is the wrong term since it has benefited many, especially Gig on a good high protein diet and she lost 35 pounds. A dietary
Pharma and the huge medical pharmacological industrial history showed that she was getting about half her calories
complex. Modem antipsychotics are superb at controlling from dairy products. Her psychiatrist recorded that she was
behaviour. They have little value in restoring health when they free of psychosis. Apparently she did not tell him about her
are used alone as is the case with modern psychiatry. Has any hallucinations. She was on an enormous number of modern
other branch of medicine been as progressive (regressive) as antipsychotic medications. These included:
psychiatry? Effexor 300 mg
Seroquel 600 mg
Modern psychiatry no longer needs much skill in Clozaril 600 mg
diagnosing, treating or prog nosing. What is available is dozens Buspar 40 mg
of powerful drugs which are used more or less at random by Clorwepan 1,5 mg
trial and error. You try one and if the patient complains you When her family asked about giving her niacin the
try another or you try various combinations and permutations. psychiatrist replied that 100 milligrams might be safe bul that
With the number of drugs available today the number of anymore would be dangerous!!!!! Will someone explain to me
combinations that can and are being used is enormous. And how any physician could assume that over 1500 milligrams of
since it takes time to assess each treatment protocol one can some of the most toxic modern drugs is safe while more than
play this game for a lifetime, the players being the therapists 100 milligrams of niacin will be toxic?
and their unfortunate patients and families.
KT was born in 1979. Ten years before I first saw her she
Here are two more cases to illustrate what E ve been became depressed, and could not concentrate. Early in 2001
saying. These patients had the first three requisites of any good she became delusional and had to be admitted to hospital
treatment program. Their families were able to provide shelter, for five months. The next year she was treated with ECT and
food and care and compassion either at home or in private medication. Since then she had been in several treatment
institutions, but they had not been given orthomolecular institutions and had been given the following medication In
142 143

various co mb [nations: Depakote, Haldol, Cogentin, Ability, behaviour became eccentric. He was committed to hospital
Geodone, Seroquel, Risperdal, Lexapro, Lametta I, and for about six months where he was given several series of
Clozapine. I have seldom seen a young patient as sick as ECT. He had a stormy course after that and a few years
she was. She heard voices constantly. At home she stayed in later was again admitted to hospital for about 1ft months.
bed day and night She was obsessed with food and would He began to improve gradually after having been started on
only answer questions about eating something. Her lace was a vitamin program but came to see me for a program that
contorted with grimaces and random movements from the would decrease his chance of relapse. When I saw him he
multiple toxic effects of l he drugs. Her mother s home had In was still paranoid and suffered a few minor illusions. I started
essence been converted into a surrogate mental hospital and him on nicotinamide 1 gram after each of three meals, the
her mother was forced to provide nursing care equivalent to 4 same amount of ascorbic acid, a multi mineral preparation and
nurses. a B complex preparation. Two months later he was normal.
He has remained well, overcoming a severe accident for
What did these two unfortunate patients have in common? which he needed surgery. Fortunately his family persuaded
They were schizophrenic and treatment was started early. the hospital to keep him on his orthomolecular program
They received the best of modern psychiatric care which while he was m hospital. Here is what his family wrote to the
did not include orthomolecular treatment. They were treated hospital about him. "Richard is, as I am sure you were told by
with a large number of drugs one after the other. They did his wife, a diagnosed schizophrenic. It began In his twenties
not recover and after years of treatment were damaged by and he spent many years in institutions and received every
the disease and the side effects of the toxic drugs they were available conventional treatment including psychotherapy,
given. They share these common features with the majority of drug treatment and when the treatment did not work he
schizophrenic patients treated today. Their history represents received numerous sessions of electric shock treatment.
the type of patient I have been seeing tor decades, refugees None of that was of any assistance. We learned of some
from standard tranquilizer treatment. I started these iwo success with mega-vitamins and we wanted for Richard to try
patients on a vitamin program and expect they will recover, that approach. We and he had nothing to lose. Incredibly It
worked and Richard has since married and had a steady job
I thought I would end the book with these 2 exa lit pies and lived a normal life He began using these vitamins about
of how modern psychiatry fails patients but I have changed 25 years ago," This letter was very persuasive. As of August
my mind, I receive so many letters from former patients who 2Q07 he is still well and adhering to the program, He is
tell me how well they are doing that I thought I would share symptom free, gets on well with his family and the community
one of these optimistic stories with you. We have too much and pays income tax. He was fortunate in that he was given
unhappiness in our world. the ideal treatment: shelter, food, living with a warm and
supportive family and receiving orthomolecular therapy I lb
Richard consulted me in 1977 when he was 34 years old. recovery saved the province between one and two million
As a child he had been very hyperactive and very intelligent. dollars.
When he was 26 he became depressed and paranoid and his
144
145

The following history summarizes the major change rhai preferably psychoanalysis weekly or more often if he could
has occurred from psychiatry in 1950 and orthomolecular afford it for up to ten years because it was believed that
psychiatry today. In June, 2007 a forty year old man came paranoid ideas arose from unexpressed homosexuality. At
to see me wilh his brother. He was a very busy and skillful one of our conferences a presenting psychiatrist described
artisan. He told me that he had suffered from anxiety and a similar case and then told us the patient was homosexual
depression most of his life, and latterly from a delusional When I asked what the evidence was, the doctor replied that
disorder; he would become extremely suspicious of any of course he was homosexual since Freud had shown this in a
girlfriend he had, believing her to be unfaithful. This always book be had written about one paranoid psychotic judge. He
broke up the relationship, hive years ago he was diagnosed was paranoid which proved he was a latent homosexual. The
with schizophrenia, but recently was given a more esoteric odds are that this patient would eventually have wound up in
diagnosis of "Othello's Syndrome" by his psychiatrist, For this some chronic mental hospitaf ward and later if he survived
he was prescribed Risperdal 3 milligrams per day. Risperdal would have been driven into the streets as is the case wilh so
makes him more anxious and he is depressed most of the many of these patients today.
time. He denied having experienced visions or voices. He
had been in a psychiatric ward twice, the last time for five This recovery shows that in this person no psychological
days at the end of April. He had been abstinent from pot and complexes were involved; he did not need any psychotherapy
cigarettes for the past two months. He was given the information every doctor must give to their
patients. He did not have Othello's syndrome whatever thal is.
There was dear evidence that he was allergic to dairy I! is another example of a psychiatrist attempting to develop
products. He was advised to follow the following nutrient fancy diagnoses by describing (he expression of the illness in
program; more and more detail and by attaching a name to it that gives
Niacin 1 gram three times a day il more cachet. The patient was another example of a pellagra
Ascorbic acid 1 gram three times a day psychosis, the vitamin B-3 dependency, which can take
B-complex 100 milligrams once a day almost any clinical form. When modern psychiatry becomes
Vitamin D 4000 IU per day during the four summer better informed ft will depend upon simple laboratory tests
months and 6000 IU the rest of the year and I he response to vitamins to make the diagnosis. No one
Zinc citrate 50 milligrams per day diagnoses syphilis by describing the clinical symptoms. It
Selenium 200 micrograms per day is done by laboratory tests. In brief, in 1950 there was no
R-G 250 milligrams once a day treatment. Today there is - what a difference.
Salman oil 1 gram three times a day
Apple cider vinegar 1-2 tbsp in water with meals

Two months later he was normal "Othello" had vanished,


driven away by a few simple vitamins. Had he gone for help
in 1950 he would have been offered deep psychotherapy
Made in the USA
313&7564RG0084
Sari Bernardino. CA
□S March 3016
Advances in modem medicine - with the exception of psychiatry - are fantastic.
Who would accept I he surgical techniques of 1950, today? Which hospital would
allow a surgeon fully trained in 1950 to even enter a modem surgical suite? In
psychiatry, modem treatment does no belter than it did in 1950. Psychiatry has the
worst record of any medical specialty. This assessment is based on my observations
from 1950 when I began in work in the mental hospitals in Saskatchewan. At
that time patients were locked up in awful buildings placed far from centers of
population. The treatment used by the Quakers In 1840, which yielded fifty percent
discharge recoveries, was forgotten. Admission to mental hospital in 1950 was a litr
sentence, with no time off for good behaviour.

The situation is different today. Pa bents are no longer locked up, but their
brains are imprisoned by powerful, toxic chemicals from which they can not and
are not allowed to escape. Orthomolecular treatment, which developed before
these toxic drugs were found, has been ignored Modem psychiatry uses only drug1
and ignores the three most important elements of treatment, i.e. shelter, food, and
treatment with civility and respect. The evidence is provided an this book. The
optimum treatment in 1350 when drugs were not available yielded fifty percent
recovery; today it is less than ten percent if the criteria are Freedom from symptoms
ability to get along well with family and the community, and paying income tax.

Abram Hoffer PhD MD RNCP is Internationa Ely recognized as the founding father
of orthomolecular psychiatry and medicine, and was a practising psychiatrist until
his retirement at the end of 2005.
For over fifty years his discoveries have been instrumental in establishing link-,
between malnutrition and mental illness, in diagnosing and treating schizophrenia,
in using niacin to lower cholesterol, and in the use of nutritional therapy in the
treatmenl of disease. He is President Emeritus of the International Schizophrenia
Foundation, and h Editor-in-Chlef of the Journal of Orthomolecular Medicine.
He is the author of more than 500 medical articles and fifteen clinical nutrition
books, including Healing Schizophrenia, Healing Children's Attention and Behavior
Disorders, Healing Cancer, co-authored by Linus Pauling, and Feel Better, Live
Longer With Vitamin B-3, co-authored by Harold Foster.
September 2007 he received the Community Addiction Recovery
Association's first Abram Hoffer Lifetime Achievement Award. November 2007
he was honored by the Lotte & John I techt Memorial Foundation, receiving the
inaugural Dr. Rogers Prize for Excellence in Complementary and Alternative
Medicine for his work using nutrition and vitamins to treat disease, shared with Dr.
Alastair Cunningham, a Toronto cancer researcher, December 2007 the Nutrition
Business Journal announced he had won their Scientific Achievement Award,
Today, as president of the Orthomolecular Vitamin Information Centre
in Victoria, Canada, he is a private consultant in nutrition, continues to write
extensively, and to educate the public of the vital importance oF nutrition and
nutrients in the treatment of disease and the maintenance of health.

ISBN 142515563-^
mi mu mi Ill I 111 IIIII lilll