Re: Call to pay schizophrenics to take medication

[Guest guest]

I have a problem with the term " mental illness " . I also have a

problem with labeling human beings " schizophrenics " .

They are people. They have been labeled with " mental illness " and

with " schizophrenia " .

Maybe so few people want to take the Rx because something wrong with

the Rx, not with the people.

Of course, when people are poor and desperate, they will do things

they wouldn't otherwise do for money. Does that mean it's beneficial,

or even okay?

Of course not.

God bless,

>

>

>

> Call to pay schizophrenics to take medication

> 03.01.07

> Add your view

>

>

> http://www.thisislondon.co.uk/news/article-23380291-

> details/Call+to+pay+schizophrenics+to+take+medication/article.do

>

>

> Paying schizophrenics to take their medication could help sufferers

> stay out of hospital, a study has controversially claimed.

>

> The authors of the report said the benefit of adopting such a

> practice " seemed beneficial " and no harm was " intended or caused " .

>

> They conceded that the ethical aspect needed further consideration,

> but added that the incentive may increase the number of people

taking

> their medication properly.

>

> " Money for medication may be an effective option to achieve

> medication adherence in otherwise non-adherent assertive outreach

> patients, " the authors wrote.

>

> The report, published in the Psychiatric Bulletin, was co-written

by

> psychiatrists including Dr Dirk Claassen, consultant psychiatrist

at

> the East London and the City Mental Health Trust, and Professor

> Stefan Priebe, professor of Social Psychiatry at Queen

> University, London.

>

> It said schizophrenics not taking their medication posed a " major

> obstacle to effective treatment " .

>

> Between 20 per cent and 50 per cent of people in general adult

> psychiatric services do not take their medication.

>

> This figure was thought to be even higher in areas where patients

> live in the community and rely on " assertive outreach " services,

> where patients are visited at home and encouraged to take

medication.

>

> As part of the study, five outreach mental health patients in east

> London with a history of not taking medication were offered between

> £5 and £15 for each treatment, in the form of single depot

injections.

>

> Four accepted the deal and managed to continue living independently

> with fewer problems with police and neighbours.

>

> Three did not need to be re-admitted to hospital while the fourth

saw

> the number of days in hospital drop from 319 in the two years

before

> the scheme to 37 since March 2005.

>

> A questionnaire was also sent to 150 assertive outreach teams

asking

> if they used financial incentives and what they thought of such

> practices.

>

> Although only 47 per cent responded and none had offered money, 10

> per cent said they had used food and other indirect incentives to

> improve " treatment engagement " .

>

> More than three quarters (76 per cent) objected to the idea of

> financial incentives while 42% thought the practice unethical.

>

> Dr Claassen said: " The results in terms of reduced hospital

> admissions for the patients who accepted the offer seem beneficial.

>

> " There is no harm intended or caused, the service user can revoke

the

> offer at any time, and the treatment is generally available.

>

> " Some team managers feared a negative impact on their therapeutic

> relationships, but the researchers said they did not see this in

> their clinical practice, and their results in east London are

> encouraging. "

>

>

>

> Share this articleWhat is this?

>

> DiggRedditDel.icio.usNewsvineNowPublic

>

> Reader views (2)

> Add your view

>

> Here's a sample of the latest views published. You can click view

all

> to read all views that readers have sent in.

>

> I know where this will end up - with people faking mental illness

> until they are " prescribed " money to take drugs. Then they'll throw

> the drugs in the bin, never hear any voices again " because the

drugs

> are working " , and have a nice little earner for life.

>

> - Nigel, London

>

> Are they stupid? they are treating a serious mental illness as

though

> it is something that can be switched on and off by a few quid.

>

> - Pat, sussex

>

>

>

> Add your comment

>

>

> Edit Message Delete Message Lock Thread Respond to this

> message

>

[Guest guest]

<<<<I know where this will end up - with people faking mental illness

until they are " prescribed " money to take drugs. Then they'll throw

the drugs in the bin, never hear any voices again " because the drugs

are working " , and have a nice little earner for life.>>>>

Yes, that's probably also true. Hadn't even thought of that. Tee, hee.

God bless

bryce_j_j <jeremybryce1953@...> wrote:

Call to pay schizophrenics to take medication

03.01.07

Add your view

http://www.thisislondon.co.uk/news/article-23380291-

details/Call+to+pay+schizophrenics+to+take+medication/article.do

Paying schizophrenics to take their medication could help sufferers

stay out of hospital, a study has controversially claimed.

The authors of the report said the benefit of adopting such a

practice " seemed beneficial " and no harm was " intended or caused " .

They conceded that the ethical aspect needed further consideration,

but added that the incentive may increase the number of people taking

their medication properly.

" Money for medication may be an effective option to achieve

medication adherence in otherwise non-adherent assertive outreach

patients, " the authors wrote.

The report, published in the Psychiatric Bulletin, was co-written by

psychiatrists including Dr Dirk Claassen, consultant psychiatrist at

the East London and the City Mental Health Trust, and Professor

Stefan Priebe, professor of Social Psychiatry at Queen

University, London.

It said schizophrenics not taking their medication posed a " major

obstacle to effective treatment " .

Between 20 per cent and 50 per cent of people in general adult

psychiatric services do not take their medication.

This figure was thought to be even higher in areas where patients

live in the community and rely on " assertive outreach " services,

where patients are visited at home and encouraged to take medication.

As part of the study, five outreach mental health patients in east

London with a history of not taking medication were offered between

£5 and £15 for each treatment, in the form of single depot injections.

Four accepted the deal and managed to continue living independently

with fewer problems with police and neighbours.

Three did not need to be re-admitted to hospital while the fourth saw

the number of days in hospital drop from 319 in the two years before

the scheme to 37 since March 2005.

A questionnaire was also sent to 150 assertive outreach teams asking

if they used financial incentives and what they thought of such

practices.

Although only 47 per cent responded and none had offered money, 10

per cent said they had used food and other indirect incentives to

improve " treatment engagement " .

More than three quarters (76 per cent) objected to the idea of

financial incentives while 42% thought the practice unethical.

Dr Claassen said: " The results in terms of reduced hospital

admissions for the patients who accepted the offer seem beneficial.

" There is no harm intended or caused, the service user can revoke the

offer at any time, and the treatment is generally available.

" Some team managers feared a negative impact on their therapeutic

relationships, but the researchers said they did not see this in

their clinical practice, and their results in east London are

encouraging. "

Share this articleWhat is this?

DiggRedditDel.icio.usNewsvineNowPublic

Reader views (2)

Add your view

Here's a sample of the latest views published. You can click view all

to read all views that readers have sent in.

I know where this will end up - with people faking mental illness

until they are " prescribed " money to take drugs. Then they'll throw

the drugs in the bin, never hear any voices again " because the drugs

are working " , and have a nice little earner for life.

- Nigel, London

Are they stupid? they are treating a serious mental illness as though

it is something that can be switched on and off by a few quid.

- Pat, sussex

Add your comment

Edit Message Delete Message Lock Thread Respond to this

message

__________________________________________________

[Guest guest]

Maybe there's a good reason they're not taking the medication in the

first place. For me, I'd stick with the Schizophrenia if the meds made

me psychotic and/or suicidal/homicidal, or the anti psychotics which

turn you into a walking zombie.

[Guest guest]

I wonder how many Schizophrenics have unresolved trauma issues that are

being ignored or (worse) dismissed? Severe trauma can cause a whole

host of symptoms including psychosis and sucidal ideation. Is PTSD

being ignored in Schizophrenia? Are they not getting the psycho-social

intervention or other therapy that they need?

[Guest guest]

I just have a problem with all of it. I don't buy any of it any more.

None of it has been tested out. None of it can be scientifically

proven. There's too much unknown here for me to accept any of these

professional labels or recommendations, especially when they carry very

real, definitely scientifically proven harmful effects with them.

I'm just a human being, not a doctor, but as part of the human race, I

make that statement.

Merrie

wrote:

> I have a problem with the term " mental illness " . I also have a

> problem with labeling human beings " schizophrenics " .

>

> They are people. They have been labeled with " mental illness " and

> with " schizophrenia " .

>

> Maybe so few people want to take the Rx because something wrong with

> the Rx, not with the people.

>

> Of course, when people are poor and desperate, they will do things

> they wouldn't otherwise do for money. Does that mean it's beneficial,

> or even okay?

>

> Of course not.

>

> God bless,

>

>

>

[Guest guest]

This is right in keeping with what I said to my son's last

psychologist. I told him that I knew enough about my son's OCD that I

could easily duplicate it and convince someone I had it.

I didn't get any argument from the doctor. He knows it's true.

Merrie

Goodavage wrote:

> <<<<I know where this will end up - with people faking mental illness

> until they are " prescribed " money to take drugs. Then they'll throw

> the drugs in the bin, never hear any voices again " because the drugs

> are working " , and have a nice little earner for life.>>>>

>

> Yes, that's probably also true. Hadn't even thought of that. Tee, hee.

>

> God bless

>

[Guest guest]

I hate to say it, but between five and fifteen British pounds per

treatment? That's nothing!! You couldn't even buy groceries with that.

On 1/3/07, bryce_j_j <jeremybryce1953@...> wrote:

>

>

>

> Call to pay schizophrenics to take medication

> 03.01.07

> Add your view

>

> http://www.thisislondon.co.uk/news/article-23380291-

> details/Call+to+pay+schizophrenics+to+take+medication/article.do

>

> Paying schizophrenics to take their medication could help sufferers

> stay out of hospital, a study has controversially claimed.

>

> The authors of the report said the benefit of adopting such a

> practice " seemed beneficial " and no harm was " intended or caused " .

>

> They conceded that the ethical aspect needed further consideration,

> but added that the incentive may increase the number of people taking

> their medication properly.

>

> " Money for medication may be an effective option to achieve

> medication adherence in otherwise non-adherent assertive outreach

> patients, " the authors wrote.

>

> The report, published in the Psychiatric Bulletin, was co-written by

> psychiatrists including Dr Dirk Claassen, consultant psychiatrist at

> the East London and the City Mental Health Trust, and Professor

> Stefan Priebe, professor of Social Psychiatry at Queen

> University, London.

>

> It said schizophrenics not taking their medication posed a " major

> obstacle to effective treatment " .

>

> Between 20 per cent and 50 per cent of people in general adult

> psychiatric services do not take their medication.

>

> This figure was thought to be even higher in areas where patients

> live in the community and rely on " assertive outreach " services,

> where patients are visited at home and encouraged to take medication.

>

> As part of the study, five outreach mental health patients in east

> London with a history of not taking medication were offered between

> £5 and £15 for each treatment, in the form of single depot injections.

>

> Four accepted the deal and managed to continue living independently

> with fewer problems with police and neighbours.

>

> Three did not need to be re-admitted to hospital while the fourth saw

> the number of days in hospital drop from 319 in the two years before

> the scheme to 37 since March 2005.

>

> A questionnaire was also sent to 150 assertive outreach teams asking

> if they used financial incentives and what they thought of such

> practices.

>

> Although only 47 per cent responded and none had offered money, 10

> per cent said they had used food and other indirect incentives to

> improve " treatment engagement " .

>

> More than three quarters (76 per cent) objected to the idea of

> financial incentives while 42% thought the practice unethical.

>

> Dr Claassen said: " The results in terms of reduced hospital

> admissions for the patients who accepted the offer seem beneficial.

>

> " There is no harm intended or caused, the service user can revoke the

> offer at any time, and the treatment is generally available.

>

> " Some team managers feared a negative impact on their therapeutic

> relationships, but the researchers said they did not see this in

> their clinical practice, and their results in east London are

> encouraging. "

>

> Share this articleWhat is this?

>

> DiggRedditDel.icio.usNewsvineNowPublic

>

> Reader views (2)

> Add your view

>

> Here's a sample of the latest views published. You can click view all

> to read all views that readers have sent in.

>

> I know where this will end up - with people faking mental illness

> until they are " prescribed " money to take drugs. Then they'll throw

> the drugs in the bin, never hear any voices again " because the drugs

> are working " , and have a nice little earner for life.

>

> - Nigel, London

>

> Are they stupid? they are treating a serious mental illness as though

> it is something that can be switched on and off by a few quid.

>

> - Pat, sussex

>

> Add your comment

>

> Edit Message Delete Message Lock Thread Respond to this

> message

>

>

>

[Guest guest]

http://alternativementalhealth.com/articles/default.htm#O

http://www.ocd-free.org/nutrition.asp

www.onelook.com to figure out what they are saying

I agree completely!

I just have a problem with all of it. I don't buy any of it any more.

None of it has been tested out. None of it can be scientifically

proven. There's too much unknown here for me to accept any of these

professional labels or recommendations, especially when they carry very

real, definitely scientifically proven harmful effects with them.

I'm just a human being, not a doctor, but as part of the human race, I

make that statement.

Merrie

wrote:

> I have a problem with the term " mental illness " . I also have a

> problem with labeling human beings " schizophrenics " .

>

> They are people. They have been labeled with " mental illness " and

> with " schizophrenia " .

>

> Maybe so few people want to take the Rx because something wrong with

> the Rx, not with the people.

>

> Of course, when people are poor and desperate, they will do things

> they wouldn't otherwise do for money. Does that mean it's beneficial,

> or even okay?

>

> Of course not.

>

> God bless,

>

>

>

[Guest guest]

The absolute LAST thing these poor people need is DRUGS..

http://www.foodforthebrain.org/content.asp?id_Content=1638

Food for the Brain

Schizophrenia

Schizophrenia is a loaded word, feared by patient and public alike. It

conjures up images of dangerous and crazy people. In truth, most

members of the public have no real idea what is meant by this word,

often believing that sufferers have split personalities, like Jekyll

and Hyde. About one in a hundred people have schizophrenia, a

diagnosis that is made on the basic of a collection of symptoms including:

• Depression

• Anxiety

• Fears, phobias and paranoia

• Disperceptions and thought disorders

• Illusions and delusions

• Auditory and visual hallucinations

• Anti-social behaviour.

A person labelled schizophrenic may have any or all of these, but at a

level of severity that makes either them unable to cope or others

unable to cope with them. The lack of firm, objective signs is perhaps

the crux of the continuing argument as to whether schizophrenia has

any physiological or biochemical basis or is just `in the mind'.

However, more and more evidence is emerging to suggest that most

people with this label do have biochemical imbalances, or

predispositions, sometimes also triggered by traumatic life events.

Do you have symptoms of psychosis?

Most of us have, at some time or other, experienced some level of

psychosis, a temporary losing touching with reality as we collectively

know it. The experiences of schizophrenics are reproduced in certain

toxic or feverish states. The normal person recovering from the

delusions brought on by a high fever can breathe a great sigh of

relief at the thought that his experience was only temporary. The

person under the influence of the hallucinogenic drug LSD can at least

rely on the clock, since the drug-induced schizophrenia will wear off

with time. Some people's experience of so-called schizophrenia can be

likened to a nightmare state from which they may awaken

intermittently. For some, schizophrenia is like living in a nonstop

nightmare.

What causes schizophrenia?

Although there are cases where people go crazy for purely

psychological reasons, there is now overwhelming evidence that in most

people so diagnosed, something isn't right in the brain. Researchers

from the London Institute of Psychiatry have confirmed that the

frontal cortex of the brain is involved in schizophrenia. Using

functional magnetic resonance imaging (fMRI), they have also been able

to show that the deterioration in brain function in schizophrenia is

not irreversible.

The best results we've seen in helping those with so-called

schizophrenia are achieved by investigating a number of possible

avenues. These include:

• Blood sugar problems made worse by excess stimulant and drug use

• Essential fat imbalances

• Too many oxidants and not enough antioxidants

• Niacin (Vitamin B3) therapy

• Methylation problems helped by B12 and folic acid

• Pyroluria and the need for zinc

• Food allergies

Quite apart from these nutritional factors having good psychological

support and a stable home environment make a major impact upon those

with mental health problems.

You can find out which of these factors is likely to affect you be

completing the FREE Mental Health Check.

To find out more about these factors read on, or click on our

Action Plan to Overcome Schizophrenia

DIET & NUTRITION – WHAT WORKS

BALANCE YOUR BLOOD SUGAR AND AVOID STIMULANTS

Your intake of sugar, refined carbohydrates, caffeine, alcohol and

cigarettes, as well as stimulant drugs, all affect the ability to keep

one's blood sugar level balances. On top of this common antipsychotic

medication may also further disturb blood sugar control. Stimulant

drugs, from amphetamines to cocaine, can induce schizophrenia.

Excessive smoking2, is also linked to an increased risk. The

incidence of blood sugar problems and diabetes is also much higher in

those with schizophrenia3.

Therefore it is strongly advisable to reduce, as much as possible,

your intake of sugar, refined carbohydrates, nicotine, caffeine and

stimulant drugs and eat a low glycemic load diet.

INCREASE ESSENTIAL FATS

We build our brain from specialised essential fats. Of course, this

isn't a static process. We are always building membranes, then

breaking them down, and building new ones. The breaking down, or

stripping of essential fats from brain4, membranes, is done by an

enzyme called phospholipase A2 (PLA2). This is often overactive in

people with schizophrenia, and this leads to a greater need for these

fats, which are quickly lost from the brain5,6. This explains earlier

findings that schizophrenic patients have much lower levels of fatty

acids in the frontal cortex of the brain. So, what's the evidence

that increasing a person's intakes of essential fats makes a difference?

The World Health Organization conducted a survey of the incidence and

outcome of schizophrenia in eight countries in Africa, Asia, Europe

and the Americas. They found that while the incidence was

surprisingly similar in all countries, the outcomes were very

different. In some countries, schizophrenia seemed to be a relatively

mild and self-limiting disease, whereas in others it was a severe and

life-long condition. Of all the factors considered which might

explain this, by far the strongest correlation was with the fat

content of the diet. Those countries with a high intake of essential

fats from fish and vegetables, as opposed to meat, had much less

severe outcomes7.

Dr Iain Glen from the mental health department of Aberdeen University

found that 80 per cent of schizophrenics are essential fat deficient.

He gave 50 patients essential fat supplements and reported a dramatic

response8. A larger placebo-controlled, crossover, 10-month study of

the effects of EFA supplementation in schizophrenics, including

supplements of zinc, B6, B3 and vitamin C with omega-6 fats, also

produced significant improvements in schizophrenic symptoms9. Two

trials giving omega 3 fish oil high in EPA produced significant

improvement10. But not all results are positive. A trial using only

omega-3 fats versus placebo found no significant improvement in mental

health11.

To date, the evidence strongly suggests that some people diagnosed

with schizophrenia do need, and respond well to, increased amounts of

both omega-6 fats, such as evening primrose oil or starflower oil, and

omega-3 fats from fish oils, together with the `co-factor' nutrients

(zinc, B6, B3 and vitamin C) that help convert them into vital brain fats.

Where's the evidence? Enter `omegas' and `schizophrenia' into the

search field for a summary of studies that demonstrate the effect of

essential fats on schizophrenia.

Side effects? None known.

Contraindications with medication? None known.

See action plan for our recommendations.

UP ANTIOXIDANTS

There's another part to the essential fat story. These fats are also

prone to destruction in the brain, and in the diet, by oxidants.

Indeed, there is evidence of more oxidation in the frontal cortex of

those with schizophrenia. Therefore, as well as increasing the intake

of essential fats, it makes sense to follow a diet (and lifestyle)

that minimises oxidants from fried or burnt food and maximises intake

of antioxidant nutrients such as vitamins A, C and E. These alone have

been shown to help. Vitamin C is also an anti-stress vitamin and may

counter too much adrenalin, which is often found in those diagnosed

with schizophrenia. Smoking is both a source of oxidants and destroys

vitamin C.

Vitamin C deficiency is also far more common than realised in people

with mental health problems, often because they don't look after

themselves properly and eat poorly. Pronounced vitamin C deficiency

can make you crazy, as reported by Professor Derri Shtasel from the

department of psychiatry at the University of Pennsylvania School of

Medicine in Philadelphia. She describes a case of a woman who was

confused and hearing voices, as well as having physical symptoms. She

was tested for vitamin C status and found to be very deficient. After

being given vitamin C she had fewer hallucinations, her speech

improved and she became more motivated and sociable12. Vitamin C has

been shown to reduce the symptoms of schizophrenia in research

trials13, and a number of studies have shown that people diagnosed

with mental illness may have much greater requirements for this

vitamin – often ten times higher – and are frequently deficient14.

Where's the evidence? Enter `antioxidants' and `schizophrenia' into

the search field for a summary of studies that demonstrate the effect

of antioxidants on schizophrenia.

Side effects? None reported.

Contraindications with medication? None known.

See action plan for our recommendations.

CONSIDER NIACIN

One of the classic vitamin deficiency diseases is pellagra – Niacin

(vitamin B3) deficiency. The classic symptoms of this condition are

the '3 Ds' – dermatitis, diarrhoea and dementia. A more extensive list

of symptoms might include headaches, sleep disturbance,

hallucinations, thought disorder, anxiety and depression.

If you have these symptoms you may need a lot more niacin than the

basic RDA, sometimes as much as 2,000mg or 100 times the RDA. We call

this `vitamin dependency', but of course we are all vitamin dependent.

It's just that some people need more, perhaps for genetic reasons,

than others.

The use of `megadoses' of niacin was first tried by Drs Humphrey

Osmond and Abram Hoffer in 1951. So impressed were they with the

results in acute schizophrenics that, in 1953, they ran the first

double-blind therapeutic trials in the history of psychiatry. Their

first two trials showed significant improvement giving at least 3gs

(3,000mg) a day, compared to placebos. They also found that chronic

schizophrenics, not first-time sufferers but long-term inpatients,

showed little improvement. The results of six double blind controlled

trials showed that the natural recovery rate was doubled. Later they

found that even chronic patients, treated for several years with

niacin in combination with other nutrients, often recovered.

Hoffer's discovery was, however, side-lined partly due to some studies

which gave niacin to long-term schizophrenic patients who had been on

medication for several years and failed to respond to niacin in the

short-term.

Since then, Dr Hoffer has published ten-year follow-ups on

schizophrenics treated with niacin, compared to those not treated with

niacin. In the niacin patients there were substantially fewer

admissions, days in hospital and suicides. He continues to treat acute

schizophrenics with niacin, plus other nutrients, including vitamin C,

folic acid and essential fats, and reports a high recovery rate in

acute schizophrenics who follow his nutritional programme. Now in his

eighties and still actively practising in Vancouver, Canada, Dr

Hoffer has recorded 4,000 cases and published double-blind trials. He

is convinced that his approach is a major breakthrough in the

treatment of mental illness.

Just how niacin works is still a bit of a mystery. Knowing that people

with schizophrenia had hallucinations, Dr Hoffer's explanation is that

niacin stops the brain from producing adrenochrome from adrenalin, a

chemical known to induce hallucinations. Working together with vitamin

B12 and folic acid, niacin helps keep adrenalin and noradrenalin

levels in balance, and prevent the abnormal production of adrenochrome

in the brain. These nutrients are `methyl' donors and acceptors, and

act intelligently in the brain to keep everything in check. Once

again, some people may simply need more to stay healthy.

Niacin, through its flushing action improves oxygen supply to the

brain. Niacin is also needed for the brain to make use of essential

fats. The `happy' neurotransmitter serotonin also needs niacin.

Serotonin is made from the amino acid tryptophan, but only in the

presence of enough niacin. So there are many possible ways this

vitamin could affect brain function.

Hoffer has also found that patients who test positive for pyroluria

(see below) are more likely to respond well to increased intakes of

niacin. So large doses of niacin are most likely to be effective for

acute, not chronic, schizophrenics who are pyroluric and have some of

the classic low histamine symptoms of hallucinations, anxiety and

thought disorder.

Where's the evidence? Enter `niacin' and `schizophrenia' into the

search field for a summary of studies that demonstrate the effect of

niacin schizophrenia.

Niacin comes in different forms. Niacin (formerly known as nicotinic

acid) causes a harmless blushing sensation, accompanied with an

increase in skin temperature and slight itching. This effect can be

quite severe, and lasts for up to 30 minutes. However, if 500mg or

1,000mg of niacin are taken twice a day at regular intervals, the

blushing stops.

Some supplement companies produce a `no-flush' niacin by binding

niacin with inositol. This works, so it's probably the best form, but

it is more expensive. Niacin also comes in the form of niacinamide,

which doesn't cause blushing either. It has to be said, however, that

both of these forms appear to be slightly less effective than niacin.

This may be because the blushing effect of niacin improves blood flow,

and hence nutrient supply to the brain.

Contraindications with medication? None known.

Side effects? The amount of niacin that's needed is around 1 to 6g a

day. A minimum therapeutic level is 1g a day. These levels are in the

order of 100 times the RDA. Levels of niacin much higher than these,

particularly in sustained-release tablets, can be liver toxic. Out of

perhaps 100,000 people taking megadoses of niacin at levels of several

grams over the past 40 years, there have been two deaths due to liver

failure. In a third case, jaundice resulted from a slow-release

preparation. When the same patient was placed back on standard niacin,

he no longer got jaundice. In any event, anything over 1g is best

taken under the supervision of a qualified practitioner. If you become

nauseated, that is an indication to stop supplementation and resume

three days later, with a lower amount.

See action plan for our recommendations.

METHYLATION, B12, FOLIC ACID AND B6

Methylation is a critical process in the brain that helps maintain the

right chemical balance. An indicator of faulty methylation is having a

high level of a toxic protein in the blood called homocysteine. The

body makes homocysteine from dietary protein and, provided you are

getting enough of certain vitamins15, especially folic acid, B12 and

B6, homocysteine levels decrease. Many people with schizophrenia,

especially young males, tend to have a high level of the toxic protein

called homocysteine, despite no obvious dietary lack of these

vitamins. High levels of homocysteine and low blood levels of folic

acid have been reported by many research groups16,17. These

unusually high levels don't appear to relate to diet or lifestyle

factors, such as smoking18. People diagnosed with schizophrenia are

more likely to have inherited a genetic variation of a key

homocysteine lowering enzyme19,20, which may make them need more of

these and other nutrients.

The best results are achieved, not by supplementing only niacin, but

by combining niacin with folic acid, B12 and B6. Both folic acid and

vitamin B12 are often relatively deficient in people diagnosed with

schizophrenia have been proven to help reduce the symptoms – but only

at high doses21. Research at Kings College Hospital psychiatry

department in London has found high doses of folic acid to be highly

effective in schizophrenic patients22. They used 15mg a day, which is

75 times the RDA! Folic acid is not toxic at this level. We recommend

starting with 1mg a day, increasing the dose only under supervision of

your health care provider.

Vitamin B12, which like folic acid is involved in methylation, has

also been shown to help schizophrenic patients23. Vitamin B12 is

difficult to absorb, especially in large amounts, and some doctors

have reported good results giving weekly, or twice-weekly, injections

of 1mg of vitamin B12. A form of B12, methyl B12, is more easily absorbed.

A combination of folic acid, B12 and vitamin B6 has been shown to most

effective in improving the mental health, and lowering the

homocysteine levels of schizophrenia patients with high homocysteine

levels24.

Where's the evidence? Enter `folate' or 'folic acid' and

`schizophrenia' into the search field for a summary of studies that

demonstrate the effect of folic acid on schizophrenia.

Side effects? Folic acid supplementation can mask the symptoms of an

underlying B12 deficiency, so we don't recommend suppelementing folic

acid on its own.

Contraindications with medication?

See action plan for our recommendations.

ARE YOU PYROLURIC? THE ZINC LINK

Possibly one of the most significant `undiscovered' discoveries in the

nutritional treatment of mental illness is that many mentally ill

people are deficient in vitamin B6 and zinc. But this deficiency is no

ordinary deficiency: you can't correct it by simply eating more foods

that are rich in zinc and B6. It is connected with the abnormal

production of a group of chemicals called `pyrroles'. A person with a

high level of pyrroles in the urine needs more B6 and zinc than usual,

since they rob the body of these essential nutrients, increasing a

person's requirements to stay healthy. More than 50 per cent of people

diagnosed with schizophrenia have `pyroluria'.

The test for pyroluria is remarkably simple and very inexpensive. When

you add a chemical known as Erhlich's reagant to urine, it will turn

mauve if there are krytpopyrroles present. Dubbed `mauve factor' in

the 1960s, this was found in 11 per cent of normal people, 24 per cent

of disturbed children, 42 per cent of psychiatric patients and 52 per

cent of schizophrenics25. Dr Carl Pfeiffer and Dr Arthur Sohler at

Princeton's Brain Bio Center worked out that these abnormal chemicals

would bind to B6 and zinc, inducing deficiency. With this knowledge,

effective therapy was at hand. Since 1971, thanks to Dr Pfeiffer's

pioneering work, thousands of pyroluric patients have been

successfully treated with B6 and zinc, both at the Brain Bio Center

and more recently at the Institute for Optimum Nutrition in London.

The Signs and Symptoms of Pyroluria: Pyroluria is often a

stress-related condition, with symptoms usually beginning in the

teenage years after a stressful event such as exams or the split-up of

a relationship. Those with pyroluria often become reclusive and

socially withdrawn, depending on the family and avoiding any stressful

situations.

Pyrolurics often have weak immune systems and may suffer from frequent

ear infections as a child, colds, fevers and chills. Other symptoms

include fatigue, nervous exhaustion, insomnia, poor memory,

hyperactivity, seizures, poor learning ability, confusion, an

inability to think clearly, depression and mood swings. In girls there

can be irregular periods and in boys relative impotence. The pyroluric

patient can have bad breath and a strange body odour, a poor tolerance

of alcohol or drugs, may wake up with nausea, and have cold hands and

feet and abdominal pain.

A lack of dream recall is very common. It is normal to remember

dreams, and many people, whether or not they have mental health

problems, report better dream recall once they start supplementing

optimal amounts of vitamin B6 and zinc. Other tell-tale signs include

pale skin, white marks on the nails and, in extreme cases, poor hair

growth and loss of hair colour. Often a person with pyroluria also has

skin problems such as acne or eczema.

Not all these symptoms are present in all pyrolurics, but if you are

experiencing a number of them, it is well worth testing for. A simple

urine test measures the level of kryptopyrroles in the urine, which

should not be above 0.08 units.

Many of these symptoms are now recognised as classic signs of zinc

deficiency, but this possibility is rarely tested for or corrected

with zinc supplements. It amounts to a tremendous oversight within

psychiatry: zinc is, after all, probably the most commonly deficient

mineral. The average intake in Britain less than a day, while the RDA

is 15mg, so almost half the population gets less than half the RDA of

zinc. Seeds, nuts, meat, fish and wholefoods are all rich in it.

There's more to the story, however. People with pyroluria often come

from families with a history of mental health problems. Dr Pfeiffer

also noted that it was more common in all-girl families. Although

nothing is proven at this stage, it is likely that pyroluria is a

genetic predisposition that makes an individual need more vitamin B6

and zinc to feel well. Like so many imbalances discussed in this book,

it illustrates how we are all biochemically unique and need to

discover our own optimum nutrition to stay healthy and mentally well.

For people with pyroluria, this means both eating a healthy diet and

supplementing relatively large amounts of zinc, starting with 25mg and

going up to 50mg a day, as well as vitamin B6, starting at 100mg and

going up to 500mg. Those with pyroluria seem to do better on

relatively low protein diets, or, at least, not high protein diets.

Some pyroluric patients react badly to high protein foods such as

meat. This may be because you need adequate amounts of B6 and zinc to

digest, absorb and use protein.

Where's the evidence? Enter `pyroluria' and `schizophrenia' into the

search field for a summary of studies that demonstrate the effect of

pyroluria on schizophrenia.

CHECK FOR ALLERGY

Some people with mental health problems are sensitive to gluten,

especially wheat gluten, which can bring on all sorts of symptoms of

mental illness. This has been known since the 1950s, when Dr Lauretta

Bender noted that schizophrenic children were extraordinarily subject

to coeliac disease (severe gluten allergy)26. By 1966 she had

recorded 20 such cases from among around 2,000 schizophrenic children.

In 1961 Drs Graff and Handford published data showing that four out of

37 adult male schizophrenics admitted to the University of

Pennsylvania Hospital in Philadelphia had a history of coeliac disease

in childhood27.

Side effects? None reported.

These early observations greatly interested Dr Curtis Dohan at the

University of Pennsylvania. He suspected that the two were linked and

decided to test his theory by randomly placed all men admitted to a

locked psychiatric ward in a Veterans Administration Hospital in

Coatsville, Pennsylvania, either on a diet containing no milk or

cereals, or on one that was relatively high in cereals. (Milk was

eliminated from the diet because some people do not benefit when only

glutens are removed.) All other treatment continued as normal. Midway

through the experiment, 62 per cent of the group on no milk and

cereals were released to a `full privileges' ward. Only 36 per cent of

those patients receiving a diet including cereal were able to leave

the locked ward. When the wheat gluten was secretly placed back into

the diet, the improved patients once again relapsed28.

These results have since been confirmed by other double-blind

placebo-controlled trials. In one, published in the Journal of

Biological Psychiatry, 30 patients suffering from anxiety, depression,

confusion or difficulty in concentration were tested, using a

placebo-controlled trial, as to whether individual food allergies

could really produce mental symptoms in these individuals. The

results showed that allergies alone, not placebos, were able to

produce the following symptoms: severe depression, nervousness,

feeling of anger without a particular object, loss of motivation and

severe mental blankness. The foods/chemicals that produced most

severe mental reactions were wheat, milk, cane sugar, tobacco smoke

and eggs29.

In another study Dr Philpott followed up Dr Dohan's theory by

testing 53 patients diagnosed with schizophrenia. Sixty-four per cent

reacted adversely to wheat, 50 per cent to cow's milk, 75 per cent to

tobacco and 30 per cent to petrochemical hydrocarbons. The emotional

symptoms caused by allergic intolerance ranged from dizziness, blurred

vision, anxiety, depression, tension, hyper-activity and speech

difficulties to gross psychotic symptoms. At the same time, the

individuals also experienced various adverse physical symptoms such as

headaches, feeling of unsteadiness, weakness, palpitations and muscle

pains30.

However, more recent research hasn't found that coeliacs disease in

more prevalent among those with schizophrenia or vice versa31.

However, the possibility of allergy to other foods may be worth

investigating, especially if allergic symptoms, including eczema,

asthma, digestive problems, ear infections, sinusitis or rhinitis are

also present.

Where's the evidence? Enter `allergies' and `schizophrenia' into the

search field for a summary of studies that demonstrate the effect of

allergies on schizophrenia.

See action plan for our recommendations.

References :

1. G. D. Honey et al., Proceedings of the National Academy of

Sciences, Vol 96, 1999, pp. 13418-23.

2. Vanable PA, Carey MP, Carey KB, Maisto SA.Smoking among

psychiatric outpatients: relationship to substance use, diagnosis, and

illness severity.

Psychol Addict Behav. 2003 Dec;17(4):259-65.

3. Hyperglycemia and diabetes in patients with schizophrenia or

schizoaffective disorders.Diabetes Care. 2006 Apr;29(4):786-91.

4. Cohen D, Stolk RP, Grobbee DE, Gispen-de Wied CC, Membrane

phospholipid composition, alterations in neurotransmitter systems and

schizophrenia,Prog Neuropsychopharmacol Biol Psychiatry. 2005

Jul;29(6):878-88.

5. D. F. Horrobin DF et al., `Fatty acid levels in the brains of

schizophrenics and normal controls', Biol Psychiatry, Vol 30, 1991,

pp. 795-805

6. D. F. Horrobin et al., `The membrane hypothesis of schizophrenia',

Schizophrenia Research, Vol 13, 1994, pp. 195-207

7. O. Christensen and E. Christensen, `Fat consumption and

schizophrenia', Acta Psychiatr Scand, Vol 78, 1988, pp. 587-91

9. K. S. Vaddadi et al., `A double-blind trial of essential fatty acid

supplementation in patients with tardive dyskinesia', Psychiatry Res,

Vol 27(3), 1989, pp. 313-23

10. Emsley R, Oosthuizen P, van Rensburg S, 'Clinical potential of

omega-3 fatty acids in the treatment of schizophrenia', CNS Drugs.

2003;17(15):1081-91.

11. W. S. Fenton et al., `A placebo-controlled trial of omega-3 fatty

acid (ethyl eicosapentaenoic acid) supplementation for residual

symptoms and cognitive impairment in schizophrenia', Am J Psychiatry,

Vol 158(12), 2001, pp. 2071-4

12. D. Shtasel et al., Psychiatric Services, Vol 46(3), March 1995, p. 293

13. G. Milner, Brit J Psychiat, Vol 109, 1963, pp. 294-99

14. K. Suboticanec et al., Biol Psychiatry, Vol 28, 1990, pp. 959-66

15. Ref: B. Regland et al, J Neural Transm Gen Sect, vol. 100, no. 2

(1995), pp. 165-169

16. Goff DC et al Am J Psychiatry. 2004 Sep;161(9):1705-8

17. Levine J et al Am J Psychiatry. 2002 Oct;159(10):1790-2.

18. Applebaum J et al J Psychiatr Res. 2004 Jul-Aug;38(4):413-6.

19. Regland B et al J Neural Transm. 1997;104(8-9):931-41

20. SJ et al Am J Med Genet B Neuropsychiatr Genet. 2005 Feb 23

21. M. W. Carney and B. F. Sheffield, `Serum folic acid and B12 in 272

psychiatric in-patients', Psychol Med, Vol 8(1), 1978, pp. 139-44

22. P. Godfrey et al., `Enhancement of recovery from psychiatric

illness by methylfolate', Lancet, Vol 336(8712), 1990, pp. 392-5

23. B. Regland et al., `Homocysteinemia and schizophrenia as a case of

methylation deficiency', J Neural Transm Gen Sect, Vol 98(2), 1994,

pp. 143-52

24. Levine J et al., Homocysteine-Reducing Strategies Improve Symptoms

in Chronic Schizophrenic Patients with Hyperhomocysteinemia

25. P. O. O'Reilly et al., `The mauve factor: an evaluation', Dis Nerv

Syst, Vol 26(9), 1965, pp. 562-8

26.L. Bender, `Childhood schizophrenia', Psychiatric Quarterly, Vol

27, 1953, pp. 3-81

27. H. Graff and A. Handford, `Celiac syndrome in the case history of

five schizophrenics', Psychiatric Quarterly, Vol 35, 1961, pp. 306-13

28. F. C. Dohan et al., `Relapsed schizophrenics: more rapid

improvement on a milk and cereal-free diet', Brit J Psychiat, Vol 115,

1969, pp. 595-6

29. D. S. King, `Can allergic exposure provoke psychological symptoms?

A double-blind test', Biol Psychiatry, Vol 16(1), 1981, pp. 3-19

30. W. Philpott and D. Kalita, Brain Allergies, Keats Publishing (1980)

31. West J, Logan RF, Hubbard RB, Card TR. Risk of schizophrenia in

people with coeliac disease, ulcerative colitis and Crohn's disease: a

general population-based study.

Aliment Pharmacol Ther. 2006 Jan 1;23(1):71-4.

>

>

>

> Maybe there's a good reason they're not taking the medication in the

> first place. For me, I'd stick with the Schizophrenia if the meds made

> me psychotic and/or suicidal/homicidal, or the anti psychotics which

> turn you into a walking zombie.

>