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 Alternatives to anti-psychotic drugs

NaturalHealthLine EXCLUSIVE:

Abram Hoffer, MD, PhD
Natural Medicine Pioneer Looks Ahead
Part Two

by Peter Chowka

The first part of this extensive new interview, conducted during the second week of December 1999, was published in Natural HealthLine on Dec. 15, 1999. Here is the second and final part.

Abram Hoffer, MD, PhD was born in Saskatchewan, Canada in 1917. He was awarded a PhD from the University of Minnesota in 1944 and an MD from the University of Toronto in 1949.

During a career spanning more than five decades, Hoffer has not only made some of the most original contributions in the area of natural healing, particularly for mental illness, but he's also pioneered the entire field of orthomolecular medicine. (Orthomolecular medicine achieves or preserves health by manipulating substances such as vitamins that are normally present in the body). Hoffer's work has always been based on sound science and exceptional clinical work. He combines the best attributes of an innovative research scientist and a compassionate clinician. His work overall represents an absolutely vital and original series of contributions to contemporary natural medicine, particularly in view of the fact that he began his career decades ago when alternative therapies were not highly regarded by the mainstream and when clinical innovation was particularly disfavored. Hoffer is the author of more than 600 papers in the medical and psychiatric literature plus twenty books including his latest, Vitamin B-3 and Schizophrenia - Discovery, Recovery, Controversy. Another recent book, about cancer and nutrition, began as a collaboration with the late Linus Pauling, PhD. Hoffer has had extensive experience treating people with cancer and other diseases, in addition to mental illness.

In the midst of my extensive interview with Abram Hoffer, MD, PhD, a news story appeared and received major play in the nation's media:

"Few Seek to Treat Mental Disorders, U.S. Study Says"

Dec. 13, 1999

Robert Pear
New York Times Syndicate

WASHINGTON -- One in every five Americans experiences a mental disorder any given year, and half of all Americans have such disorders at some time in their lives, but most of them never seek treatment, the surgeon general of United States says in a comprehensive new report.

This story prompted several questions to Dr. Hoffer, after which we discussed orthomolecular medicine in some detail.

Peter Chowka: What do you think of this news? Do you agree with the U.S. Surgeon General that mental illness is so prevalent? Is it possible that many behaviors are now being medicalized? If so, why do you think that is? Is there a danger when experts claim that so much mental illness exists, that truly serious conditions like schizophrenia or psychosis may be marginalized or lumped in with quasi-mental illness?

Abram Hoffer, MD, PhD: I do agree that mental illness is very prevalent but the number of people who are ill depends on how one defines mental illness. Surveys over the past fifty years have shown that many people do have mental problems. I think one should divide the so called mentally ill into the major psychoses diagnosed as early as possible and the non-psychotic disorders such as anxiety states and depression. But the question cannot be easily resolved because diagnosis is driven by the American Psychiatric Association (APA) Manual on Diagnosis which becomes heavier, like the phone book, every time it is revised and adds new terms to the diagnostic list, each with its own number.

It has been argued that if this APA trend continues, then one day every person will be considered a psychiatric problem with his or her own diagnostic number. Sometimes, the APA backs down. For example, for many years homosexuality was considered to be a mental disease. Later, it was removed from the diagnostic list.

There is a major tendency to use diagnosis as a descriptive device that has no causal value nor any treatment value. Thus there are about fifty terms for children with learning or behavioral disorders. If a child has a problem with mathematics, that is given one term. If a child has a problem reading, it is given another term. In my opinion based on two thousand children under age fourteen whom I have treated since 1960, most of these children can be classified causally into two major groups: those with allergies and those needing orthomolecular doses of many of the B vitamins and some of the essential minerals and essential fatty acids.

All in all I think that about five percent of the population will have one or more major psychotic episodes during their lifetimes, that another five percent will suffer from one of the addictions including alcoholism, and another ten percent will have problems with depression and anxiety. I think about twenty percent of the population will have conditions that can be treated successfully by orthomolecular means. Pharmaceutical drugs should be used with caution and as support to the orthomolecular treatment only, not as the primary treatment.

Chowka: What are the conventional therapies for schizophrenia? How successful is conventional medicine in reversing it or controlling it?

Hoffer: Conventional treatment may be divided into two components: psychosocial and biochemical. Psychosocial therapy has never been very effective and no one has ever claimed that one could improve results over natural recovery rates. For this reason psychoanalysis quickly took hold especially in the United States and by 1955 it was in full swing to the detriment of thousands of patients and to the whole field of psychiatry as a science. While every other branch of medicine was advancing very rapidly, psychiatry was stuck in the same old mold until the first tranquilizer, chlorpromazine, a major anti-histamine, was shown to be active by a French surgeon, Dr. H. Laborit, in about 1950.

Since then, psychiatry has paid tremendous lip service to the need for psychotherapy even though in practice it is mostly ignored. What is in fact very essential is counseling, support, and understanding for chronic patients who have been damaged by the disease and by the way it was treated over the years, and rehabilitation and education for patients hit early and kept away from the mainstream of life for many years. But any psychosocial treatment used alone without biochemical treatment is a waste of human life and money.

The biochemical or medical treatment consists of the old and more recent tranquilizer medication. The main difference between the old and the new is that the new ones are much more expensive since they are still covered by insurance. Recent reports that discussed these treatments point out that there is little difference in efficacy, that both sets of compounds have side effects but that these side effects are different. In my opinion it does not make them better. The major side effect of the old treatments was tardive dyskinesia which is more rare with the new treatments but the new ones have major side effects such as excessive weight gain, and may still cause tardive dyskinesia.

Other drugs include the anti-depressants, which can be very useful and do not have the same degree and intensity of side effects. Lithium is used commonly but first these patients are diagnosed as bipolar even though they have pathological perceptual changes and thought disorders. Only later is it recognized that they were schizophrenic all along. The anti-anxiety drugs may also be used. These are the diazepines, which tend to be addictive and from which it may be very hard to wean patients.

Drugs are very helpful in decreasing the intensity of the symptoms. Hallucinations are moderated and delusions greatly decreased in intensity. Agitated behavior is controlled and many patients will gain a degree of insight. Therefore, the drugs are very helpful and need to be used. They also work very quickly. However, very few patients ever recover to the point they can pay income tax. I challenge any psychiatrist not practicing orthomolecular medicine to describe any of their patients who are so well that they can go back to gainful employment, free of symptoms and signs. On the contrary, with orthomolecular psychiatry most of the patients sick for less than two years will recover. I see them every day in my office.

Tranquilizers induce what I call a "tranquilizer psychosis." In other words, the natural psychosis "schizophrenia" is replaced by iatrogenic [doctor-caused] psychosis. This condition was first suggested by Dr. Mayer Gross, a psychiatrist practicing in England over forty years ago, when he stated that these drugs converted one psychosis into another. The tranquilizer psychosis is marked by a decrease in the frequency and intensity of symptoms and signs, by a decrease in the intensity of the thought disorder, and by a calming effect on the patient. But it also causes concentration problems, memory problems, difficulty in thinking, apathy, inertia, and inability to function in normal activity.

In the short term, tranquilizers are helpful but they merely maintain a person in a chronic state of invalidism. This is the tranquilizer dilemma. And it is based on the following two conclusions with which no one will argue: The first is that these drugs do help patients initiate the process of recovery and the second is that they make normal people psychotic. In fact the original animal model for these drugs was the catatonic test. Animals were given drugs and those that made them catatonic became our tranquilizers.

So when drug treatment is started there is an improvement and as the condition gets better clinically, it is obvious that the disease process must also be getting better. As the process of recovery continues, the person becomes more normal in their biochemistry as well, and at a certain point the drugs begin to produce the tranquilizer psychosis. There is a change over from one psychosis to the other. Psychiatrists know this but will not talk about it. They deal with it by reducing or eliminating the drug but the unfortunate result is that the original condition recurs and the unhappy patient is left swinging between two extremes.

Modern treatment is helpful in controlling the disease and in keeping patients out of hospital but in terms of restoring these patients back to society, the treatments are singularly unhelpful.

Electro-convulsive treatment (ECT) has helped many patients but only when it is used in combination with orthomolecular treatment. It is used much more rarely now.

Chowka: Is it possible to diagnose schizophrenia or recognize it early on? Are there benefits to early diagnosis and treatment?

Hoffer: It is possible to diagnose early. In fact it is essential that this be done for the therapeutic results are so much better and quicker when an early diagnosis is made. Our book, How To Live With Schizophrenia, described very clearly what it is, what are the symptoms and signs, and how to make early diagnosis. Also our HOD test is very helpful in assisting early diagnosis. Ideally, the diagnosis should be made by the first physician who sees the patient. In Canada this is the family physician or general practitioner. When they are trained to recognize the disease and have simple tests like the HOD to help, they do diagnose early and treatment in their hands is very effective. I know several of these doctors who test their patients much more successfully than do any of the local psychiatrists because they do recognize them early and treat vigorously with orthomolecular methods. In many cases there may be no need for drugs. Late diagnosis condemns the patient to chronic invalidism and their family to a life full of stress and despair.

Chowka: In your experience, what is the optimum treatment? And please define "orthomolecular medicine."

Hoffer: The term "orthomolecular psychiatry" or "orthomolecular medicine" was developed by Linus Pauling, PhD in his famous report to Science magazine in 1968. He defined it as the use of substances that are normally present in the body using the optimum amount. He referred to nutrients such as vitamins, amino acids, essential minerals, and so on. The key words are naturally present and optimum. Because the optimum doses may vary enormously from very small - the usual RDA or vitamin doses - to very large - the megadoses.

In practice, orthomolecular medicine is combined with any other treatment that is effective. Thus, in treating many schizophrenic patients, I have found that they need rapid control and this is achieved by the drugs. But they also need to recover and this is obtained by the use of orthomolecular methods.

In brief, this is what the treatment consists of in my practice:

a) Nutrition - The diet is cleaned up by eliminating, as much as possible, all the junk in our food. "Junk" I define as any food that contains added simple sugars. It includes pastry, candy, soft drinks, and sugar in the drinks but does not include fruit to which sugar has not been added. One also looks for food allergies and eliminates them when they are found.

b) The right nutrients in optimum amounts - Thus with vitamin C one may need to use a range from 500 milligrams to thousands of milligrams daily. The sicker the patient is, the more vitamin C will be needed. In treating schizophrenia one may need 500 milligrams of B-3 with each meal up to 3000 milligrams after each meal. I can not give the details here. They are described in the orthomolecular literature and on my Web page. The nutrients include vitamins, minerals, amino acids, essential fatty acids, enzymes, and other natural substances .

c) The optimum amount of medication - This must be removed as soon as possible as the aim is to get and keep patients well without needing drugs, for the reasons described above.

d) Support, counseling, encouragement, hope, and above all, patience - Patients also have to be advised that they must be patient. Seldom are there quick cures.

One should expect the following results (my criteria for recovery are four):

  • freedom from symptoms and signs
  • getting along well with one's family
  • getting along well with the community
  • paying income tax.

My patients do not shoot up school children or go on murderous rampages.

Sick for less than two years - treated for at least two years - 90 percent recovery. Sick for many years, treated until they get well, and this may take up to twenty years; over 50 percent will recover and the rest will be much

Chowka: Can schizophrenia by prevented?

Hoffer: Yes, in many cases it can be prevented but not by using tranquilizer medication. There are two aspects to this. One is to use preventive treatment for people from vulnerable families. This applies to about 40 percent of the schizophrenics and their families. The rest of the schizophrenic population comes from families in which there is no family history of disease.

For society the first step is education about the illness, how to diagnose it, and how to get it treated very early before the classical symptoms are formed. The public should be advised of the many factors that can cause schizophrenia, such as food allergies. Parents should be advised to watch their children develop and if there are disturbing signs, such as slow speech development, hyperactivity, or changes in personality, they should immediately take action - because, from this group of young children will come many of the new schizophrenic patients. Parents who have schizophrenia should be aware that with one parent ill or who has been ill, one tenth of the children might also develop it. If both parents have been or are ill, it
may affect half of their children.

Thus, children of schizophrenic parents should be given special attention and be exposed to the best nutrition and the use of extra vitamins from an early age. In 1960 in Saskatoon [Saskatchewan] I treated a father and a mother for schizophrenia. They both recovered. The father has been working ever since. The mother, after recovering, became a nurse, took advanced education, and went into administration. They have four children. Three were not well. But they were all treated and have been well since. This is what I mean by seeking out vulnerable persons and getting them treated early.

For the rest of society this will not be possible. For this latter group the best advice is to be aware of the problem that can develop and what to do about it. Real prevention should follow the model of pellagra and how it was controlled in the United States. Before synthetic niacinamide was added to flours, pellagra was endemic and for many years was epidemic. Adding a tiny amount of a vitamin to flour prevented most cases of pellagra from developing. I think that adding 100 milligrams to the diets of every person would within ten years have a major effect in decreasing the incidence of schizophrenia.

Chowka: You have worked to treat other medical conditions as well, including cancer, using a more natural, orthomolecular approach. Is what you have observed or learned in treating schizophrenia applicable to our understanding of other serious illness -- clinically and politically, for example?

Hoffer: Orthomolecular treatment began with our double blind placebo controlled therapeutic trials on schizophrenia patients in 1951, the first such study in world psychiatry. The design we published in 1954 is the same as the one highly touted today by medical investigators. But we learned over the years that it may be applied to almost every disease. Who can doubt that even the most serious diseases such as cancer and tuberculosis will not benefit from having the patients be as nutritionally healthy as possible? I cannot understand how anyone could argue with this conclusion. It is being used world wide to treat almost every medical disease and is especially being studied in the treatment of cancer. This follows the observations made by Ewan Cameron and Linus Pauling that large doses of vitamin C were very helpful in extending the life of cancer patients and improving the quality of life. I have treated eleven hundred cancer patients since 1977 and have written a book describing my results. There is no doubt that the addition of orthomolecular methods to the standard treatment has been very beneficial to my patients with a large number of patients recoverring from their so-called terminal disease.

Politically, it has been easier to introduce orthomolecular methods into general medicine. The greater political battle is still with psychiatry which is the least biochemically oriented of all the branches of medicine. The work is moving forward but very slowly. Psychiatry prefers to use drugs and nothing else and refuses to examine the claims made by orthomolecular psychiatrists and physicians.

Chowka: What percentage of your patients do you treat for schizophrenia?

Hoffer: I see about fifty patients each week. Of these, about 25 percent are schizophrenic. I have under my care about five hundred chronic patients in the city of Victoria and Southern Vancouver Island. Almost all of them are residues from previous treatments that failed. My new patients do not enter the chronic pool. None of the five hundred chronic patients is worse. About fifty percent are well, and the rest are better. I see them at intervals ranging from once every two months to every three or four years.

Chowka: Could you discuss the work of the Canadian Schizophrenia Foundation and your drive to raise money for the Hoffer Endowment Fund? What will that money go for? How can people learn more about the work or contribute?

Hoffer: The Canadian Schizophrenia Foundation (CSF) was organized about thirty years ago. We are federally incorporated as a not-for-profit foundation.

CSF and the Huxley Institute of Bio-social Research in New York but now no longer in existence as a national body were instrumental in introducing nutritional medicine at an age when most physicians had never heard about it. We trained many of the physicians who have since then become world leaders in this field, like Allan Cott, C. C. Pfeiffer, and so on.

Our mission it to take the treatment of schizophrenia and other diseases into the 21st century so that patients with schizophrenia will no longer have to hide their heads in shame and can expect to recover when they go for treatment. To achieve this we have a very large assortment of books and other scientific materials covering every aspect of orthomolecular medicine. We have annual scientific meetings alternately in Toronto or Vancouver. Next April [2000] we meet in Vancouver. These are two and one-half day meetings with participants and faculty from around the world. The International Society of Orthomolecular Medicine (ISOM) also meets at the same time. ISOM has 17 member countries. Japan will be the next addition. At a recent meeting in Japan arranged by Dr. Michael Lesser, one of the orthomolecular pioneers from Berkeley, over two thousand people were there including over two-hundred doctors.

The CSF also provides information to the media and tries to get our message, a message of hope, out, as often as possible. Recently, the actress Margot Kidder recovered from her psychosis of many years duration and became our spokes person. She narrated a film and also appeared in it, Masks of Madness: Science of Healing. This one-hour film is superb; it features my schizophrenic patients who have recovered. One female patient who appears in the film was not allowed by her psychiatrist to take vitamins. She was married to one of my recovered patients. A few months ago she committed suicide. She was the only one not on orthomolecular treatment. Schizophrenic patients under my care do not commit suicide. This video is available for sale from the CSF.

We are funded by private contributions, and by income from the sale of our literature and books. We have not been given any grants from government and that has allowed us to be critical of the way government medicine deals with patients. However, we must ensure our survival and for this reason the board decided to launch a drive to raise at least two million dollars for an endowment fund called the Dr. Abram Hoffer Endowment fund. Once we have achieved this goal we will be able to operate indefinitely using the income from this fund and the money generated by our activities.

I am one of the two founders. The other was Dr. H. Osmond. I am President and have been for the past 30 years or so. My work is well known. I have authored about twenty books and over 600 scientific and other papers in the medical and psychiatric literature. I was one of the three who discovered that niacin lowered cholesterol levels and this led to niacin becoming the first vitamin accepted by the FDA to be used in megadose levels. The paper we published in 1955 marks the beginning of the new paradigm in medicine, the use of vitamins as treatments and not merely to prevent the few classical deficiency disease. With Dr. Osmond and Dr. John Smythies, I developed the adrenochrome hypothesis of schizophrenia. This hypothesis, long reviled by classical psychiatry, is now coming back strong into modern research psychiatry in England.

I hope that as many people as possible will contribute to the Canadian Schizophrenic Foundation. Two million dollars is the cost of one patient's treatment with drugs alone or not treated at all over their forty year life span. When we reach our target of $2 million we can continue to educate the profession and the public about how they do not have to depend on tranquilizers alone, that there is something better - and that is, to get well by using orthomolecular treatment.


For more information,

Canadian Schizophrenia Foundation
16 Florence Ave.
Toronto, Ontario M2N 1E9
Telephone: 416 733 2117. Fax: 416 733 2352
E-mail: centre@orthomed.org
Web site: http://www.orthomed.org/csf/csf.htm

A. Hoffer, MD, PhD, FRCP(C)
3-2727 Quadra St.
Victoria, BC V8T 4E5

The Second World Conference on Nutrition & Vitamin Therapy
San Francisco February 20-22, 2000
Featuring Hoffer

Hoffer on Cancer

Hoffer on Schizophrenia

Orthomolecular Medicine Online

Hoffer CV


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