Book Corners: The Beginnings of Orthomolecular Psychiatry


Vitamin B-3 & Schizophrenia by Abram Hoffer, MD

Quarry Health Books, P.O. Box 1061, Kingston, Ontario K7L 4Y5 Canada

Phone 613-548-8429; fax 613-548-1556; E-mail:

Softbound; ISBN 1-55082-079-6; 1998; 160 pp.; $14.95 (US) / $19.95 (CDA)

In 1951, a Canadian psychiatrist named Abram Hoffer, with a PhD in agricultural biochemistry and an interest in research, met another psychiatrist named Humphrey Osmond. While in Britain, Dr. Osmond and Dr. John Smythies had hypothesized that a toxic compound, which was related to adrenalin, was responsible for the hallucinations found in schizophrenia. Psychoanalysis, not biochemistry, was the sanctioned focus for psychiatry at the time; but Hoffer and Osmond were practicing in Saskatchewan, which had no medical school to uphold that prejudice. Instead, the province had a mental health care system in desperate need of upgrading, government funding for psychiatric research, and far too many patients suffering from schizophrenia.

In Vitamin B-3 & Schizophrenia, Dr. Hoffer tells the story of their research that led to "a unified hypothesis of schizophrenia which united biochemical and psychosocial factors." Their pioneering work became known as orthomolecular psychiatry, which uses "optimum (often large) doses of molecules naturally present in the body."

Building on the Osmond-Smythies Hypothesis, Hoffer and Osmond began looking for an indole, related to adrenalin, that had a hallucinogenic effect on the brain. Then they learned about adrenochrome, which seemed to fit the profile, from Professor D. E. Hutcheon. Little was known in the 1950s about the biochemical reactions that turned noradrenalin into adrenalin and then into adrenochrome. The doctors realized that it would take years of research to understand the process, but in the meantime they had patients who desperately needed help. "We decided to assume the reactions were correct and to develop chemical treatments which were a logical offshoot from our adrenochrome hypothesis; i.e., use chemicals which would decrease the formation of adrenochrome and/or would act as an antidote." They began treating their patients with vitamin B-3 in the form of niacin or niacinamide. B-3, a natural methyl acceptor, competes with noradrenaline for the methyl groups that turn noradrenaline into a drenaline. With less adrenaline, less adrenochrome would form. B-3 also had been used previously to treat confusional conditions and depression with some success and was known to be safe in large doses.

Hoffer and Osmond tested the effect of vitamin B-3 in clinical and double-blind studies. The result from the first double-blind study on the use of 3 gm of niacin/niacinamide per day showed "we had doubled the two year recovery rate from about 35% to about 70%." Further studies showed that use of vitamin B-3 lessened the number of hospital days (and corresponding healthcare cost). In addition they found no suicides among patients who were on niacin in a 1966 study. Data from medical literature and their own records found that schizophrenics who were not on niacin had a suicide rate "about 20 times normal."

In Vitamin B-3 & Schizophrenia, Dr. Hoffer explains that "orthomolecular psychiatry has evolved from a simple use of one vitamin for treating one disease to a comprehensive holistic program which includes use of many different nutrients, in combination with standard psychiatric treatment." He uses drug treatment to control symptoms while waiting for the nutrient therapy to take hold. Although the high doses of vitamin B-3 has helped many, Dr. Hoffer found that not all patients recovered with vitamin therapy alone. In the 1970s, Hoffer began fasting patients for 4 to 5 days in order to determine if food allergies were creating symptoms of schizophrenia. "Drs. Marshall Mandell and William Philpott introduced the concept of cerebral allergies into orthomolecular psychiatry in 1979," Dr. Hoffer writes. "...It is easy to accept the concept when you have seen a schizophrenic become normal after a four or five day water fast, then relapse when the offending food or foods are reintroduced." I n addition to allergies, depression and/or psychotic symptoms result from an overload of mercury, lead, copper, cadmium, or iron. The book includes information about these other factors, such as cerebral allergies and mineral toxicity, that can cause schizophrenic symptoms, and current orthomolecular treatment to address them.

In its very early stages, schizophrenia may be diagnosed as depression, anxiety, personality disorder, or other disorder. Because nutritional treatment works most rapidly in early stages of schizophrenia, Drs. Hoffer and Osmond developed two tests to aid early diagnosis: a psychological test called the Hoffer-Osmond Diagnostic Test (which is included in the appendix) and a laboratory urine test for kryptopyrrole (KP). Although they used KP to diagnose schizophrenia, Drs. Hoffer and Osmond did not realize that KP caused vitamin B-6 and zinc deficiencies. "This was shown later by Dr. Carl Pfeiffer," the author explains. "We had found vitamin B-3 helpful and Dr. Pfeiffer had found pyridoxine and zinc helpful. There is no clash of ideas here. Dr. Pfeiffer also used vitamin B-3. Pyridoxine is essential in the conversion of tryptophan to vitamin B-3 in the body. Thus, a deficiency of vitamin B-6 would lead to a deficiency of vitamin B-3."

Vitamin B-3 & Schizophrenia chronicles the scientific and clinical beginnings of orthomolecular psychiatry by one of its pioneers. Dr. Hoffer's final section of the book explains the many reasons that orthomolecular methods, despite their effectiveness, have not yet been accepted by conventional medicine. He is optimistic, however, that "[t]he pioneering work we began in Saskatchewan in the early 1950s seems to be on the verge of becoming the medical paradigm of the next century." I sincerely hope he is right.


By Jule Klotter

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