Introduction
We (Dr. H, Osmond and I), began to use nicotinic acid nicotinamide
and ascorbic acid in large doses for treating acute schizophrenics
in 195 1. Based upon the results obtained from pilot studies,
we began the first double blind therapeutic trials in the history
of psychiatry in 1953. By then we knew that these vitamins were
safe even in multigram doses, that they could be taken for long
periods of time, and that the side effects were minimal and easily
dealt with. Our first two double blind experiments showed that
patients who were given vitamin B3 in doses of at least three
grams per day had a much better prognosis compared to those who
received placebo. We concluded that the addition of this vitamin
to the standard treatment of that day doubled the two year recovery
rate of acute schizophrenics. Our second conclusion was that chronic
patients did not respond to this vitamin, even with large doses,
This was based upon a large number of patients we had treated
at the Saskatchewan Hospital at Weyburn and at the Munro Wing,
and upon a study completed by O'Reilly (1955). Dr. O'Reilly was
a research psychiatrist associated with our research group. O'Reilly
found that there was slight therapeutic activity, but we did not
think it was adequate to alter our conclusion.
These two main conclusions are very important in view of the controversy
which erupted following our reports of the therapeutic efficacy
of vitamin B3, because the investigators who tried to repeat our
work did so by not repeating it, i.e. they used chronic patients
without acknowledging that their patients were different from
the type we had used on which we had based our original claims.
When they did their studies with chronic patients they found as
we had, that there was no response. The only investigator who
tried to corroborate our conclusions was Wittenberg (1973, 1974),
who published two studies. In the first he found no significant
improvement over placebo. In the second he found that the acute
members of their group responded exactly the same as had our acute
patients. Two-thirds of his group were chronic and they had not
responded. Wittenberg thus completely confirmed our claims. However
the critics have since then refused to refer to his second paper,
while giving full publicity to his first paper.
I had been placing almost all the patients under my care on the
vitamin, whether acute or chronic, and eventually I began to accumulate
evidence that it did have substantial activity but that it took
a long time for it to become manifest, and it required the use
of other nutrients and medication as well, Hoffer (1962), Hoffer
and Osmond (1962, 1966), Osmond and Hoffer (1963). Since 1965
1 have treated a very large number of chronic patients using the
entire orthomolecular approach. The results have been much superior
to those seen when only drugs are used. I concluded long ago that
for these patients the best treatment must include everything
which is available, The results are not as good as they are for
acute patients, but a major proportion of the patients can be
returned to a life which falls into a range normal for our diverse
society.
Antipsychotic drugs were introduced with great fanfare, once the
initial resistance from the National Institute of Mental Health,
Washington, was overcome. The initial skepticism of psychiatrists
was replaced by an overenthusiastic evaluation that these drugs
would rapidly restore patients to health. In our report in 1964,
Hoffer and Osmond summarized the results of a ten year follow
up of patients treated in two psychiatric wards, in Saskatchewan.
In Table 5 from that report, we showed that patients treated with
nicotinic acid plus other treatments responded much better than
had patients treated by drugs alone. The first study included
the first few patients given this vitamin, and before tranquilizers
came into general use, By the end of that ten year follow up period
tranquilizers had become the main
treatment. The latter is the University Hospital group. The first
group showed the following admissions data.
We also examined the number of suicides. There were five from
the untreated group (on tranquilizers and/or ECT only), and none
from the vitamin group. The suicide rate was 1,47 per 100 patients
over the seven year period. This was in agreement with an earlier
study when we found four patients killed themselves from a group
of 98, and none from a vitamin group of 73. Putting this data
together we found that the suicide rate for the non vitamin group
was 0.22 suicides per 100 per year or 220 per IO0,000. It was
a rate 22 times as great as the prevalent rates then for any normal
population. Johnstone et al (1991) reported that out of 532 patients
there were two suicides over the decade for women, 13 times the
expected rate from a normal population, and five suicides for
men, or about 19 times the normal rate. This is very close to
the Saskatchewan suicide rate of tranquilizer treated patients
compared to no suicides for the vitamin treated patients. The
English group were treated with tranquilizers, Placing schizophrenic
patients on tranquilizers only thus exposes them to a suicide
rate 22 times normal. We wrote, "We believe any drug which produced
this high a mortality would soon be removed unless of course no
other drugs were available to treat the conditions which untreated
produced a much higher risk of death."
The results reported completely corroborate the 1952 results.
The studies were conducted in two different hospitals in different
cities, and separated about five years from each other. The therapists
were different also. Finally, the second set of data was obtained
during the tranquilizer era of psychiatry. Yet both sets of data
were very similar. It is apparent tranquilizers have not decreased
readmissions very much, if at all. Nicotinic acid, on the other
hand, has made a great difference to the natural history of schizophrenia.
There can be few who can still doubt that every schizophrenic
patient should be given nicotinic acid therapy. it is clear we
greatly underestimated the ability of psychiatrists to be doubtful.
We concluded that "There can be no a priori reason why massive
nicotinic acid should not alter the outcome of schizophrenia.
Apart from deep prejudice or sheer inertia, it is worth trying
because it meets one of the major requirements of any treatment,
that of 'doing the sick no harm', Two-thirds of those who develop
schizophrenia are more or less crippled by it and return to hospital
for periods ranging from a few weeks to several years. Our studies
suggest that at least half of the crippled two thirds will be
well if given nicotinic acid, and some of the others will be helped,
We think that these young people who are doomed to be in and out
of mental hospitals for most of their lives, have a right to be
given nicotinic acid even if medical people are skeptical. Nothing
can be lost and as we have shown, belief or skepticism seems to
have very little bearing upon the effects of this treatment".
Eleven years later Bockoven and Solomon (1975) also found that
tranquilizers did not improve the long term prognosis of schizophrenic
patients. They compared the outcome of two five year follow-up
studies on patients treated at their hospital between 1947 and
1952, and between 1967 and 1972, The first group could not have
gotten any tranquilizers while the second group was given the
full benefit of this treatment. They concluded that the outcome
was almost the same with one possible exception, the tranquilizer
group fared worse and required much more social supports for them
to keep going. Almost every thorough study published since them
has shown the same results. The last one was reported by James
D. Hegarty of McLean Hospital, Belmont, Mass, Science News described
his findings as follows. "Many psychiatrists regard the introduction
of antipsychotic medication in the 1950s; as a boon for the long
term adjustment of people with schizophrenia, a devastating disturbance
of thought and emotion, But an analysis of research conducted
over the past century indicates that psychiatric definitions of
schizophrenia, rather than new treatment, primarily account for
observed improvements or decline in the condition of schizophrenics
over time. "James D. Hegarty and his colleagues identified 359
studies from the United States, Europe, Russia and China in which
scientists used specific criteria to diagnose schizophrenia in
15 or more individuals and then tracked the patients progress
for at least one year. At least 15 percent of the schizophrenics
studied from 1900 to 1930 showed significant improvement, Flegarty's
team contends. That figure rises to 30 percent between 1930 and
1970 and then declines to about 15 percent again in research covering
the past 20 years, they say. Studies in the first and last time
periods generally used narrow definitions of schizophrenia, often
requiring continuous signs of disturbance for at least six months.
Projects in the middle period relied on broader definitions with
no minimum time limits on symptoms. In studies for 1930 to 1970,
more patients got better because they had milder problems to begin
with. Hegarty maintains, The poorer outcome for schizophrenics
studied after 1970 may also reflect the discharge of many patients
from state mental hospitals and the lack of community mental health
care for people with severe psychiatric disorders, he adds." Johnstone,
E.C. and colleagues (1991) reported their results of a follow-up
study of 532 schizophrenic patients treated over a ten year period
beginning in Jan I , 1975. It is one of the most thorough studies
of this kind. They had a mean of 1.68 admissions before entering
this cohort with a range zero to 22 admissions. The total number
of admissions was 5,37 with a range of one to 40 admissions. During
the decade study they averaged 3,69 admissions, The group averaged
1.68 admissions before entering the study and this increased to
3,69 admissions on the average during the study, This again is
comparable to the data obtained in Saskatchewan where it was found
that tranquilized patients had to be admitted much more often.
It is difficult to compare these patients outcome with mine since
they used different criteria. Of major interest is their determination
that only two patients were in the best occupational level and
25 in the next best (level 2), i.e. only 27 out of 532 were in
the best two occupational levels (about 5 %). Fewer than 20% were
employed but there was no breakdown to illustrate the type of
employment they had. Over 50% of their sample still suffered from
morbid symptoms. They also compared a five year cohort beginning
in 1970 and found that they were almost identical with the latter
group in outcome, even though the latter group had much more contact
with social and medical agencies. From the latter group over 90%
were in good contact with the agencies, whereas from the earlier
group only 60% were in contact. The authors wrote, "More than
90% of patients received medical and/or social support, and 45%
were supervised by a consulting psychiatrist. This was much closer
supervision than had been provided for schizophrenic patients
from the same service ten years previously. Few patients are now
out of touch with the medical services and many more are receiving
specialist supervision, and yet they are no better in these terms.
The findings do raise the question of whether there is anything
to be gained by the increased level of care given to the later
sample." However although the patients were no better off, their
relatives did have more confidence in the service provided compared
to the relatives of the earlier group.
Over the past month I have seen a large number of my chronic schizophrenic
patients who have been under treatment with me for at least ten
years. I was impressed with their great improvement over what
they had been like the first few years after they started on this
treatment. I also thought how sad it is that psychiatrists have
refused to look at this treatment and thereby have deprived their
patients of their chance for an equivalent recovery and themselves
of the opportunity to see schizophrenic patients who are getting
well. They are not simply putting in time being heavily tranquilized.
I was reminded of the account given to me by an orthomolecular
psychiatrist in North Carolina, He had attended a training conference
put on by the Huxley Institute Biosocial Research in New Orleans.
At this meeting I casualty remarked to him that if he would follow
the program for at least one year he would never turn his back
on it. Six months later I received a letter from him where he
started out by reminding me of what I had said. Then he added,
"You were wrong. I have been following the program for six months
and I will never give it up". He added that he headed an outpatient
clinic where 1200 chronic schizophrenics came for their injections
of parenteral tranquilizers. He was so fed up with the whole procedure
and with seeing none of the patients ever get any better he had
decided to retire from psychiatry. However after he had started
the orthomolecular program within a month he began to see remarkable
improvement in his patients. He now found going to work each day
very exciting and he would ask himself which patient today will
I see starting to get better. He has since become an excited and
dedicated orthomolecular psychiatrist.
In 1992 I participated in a conference called reexamine the claims
made by orthomolecular psychiatrists. At the end of the meeting
everyone present voted for a resolution requesting that the Ministry
of Health proceed with further investigation of our claims. This
meant sending out teams of investigators to examine our patients
and our files. Yet even today there has been no indication that
even one of the eminent psychiatrists at that meeting have the
slightest interest in doing so. I have not given up hope. It is
possible that psychiatry, the least physiological of all the medical
specialties, may one day catch up and realize that they will have
to come into the newer medicine which is examining with great
interest a large number of nutrients and their potential benefit
to patients. These include nicotinic acid which lowers cholesterol
levels and elevates high density lipoprotein cholesterol, and
the antioxidant vitamins such as beta carotene, ascorbic acid
and vitamin E which have been shown to prevent the development
of arteriosclerosis, Pauling (1986), Pauling and Rath (1991),
Rath and Parading (1991, 1991a, 1992, 1992b), and to extend life,
Cowley and Church (1991). These and other vitamins used in optimum
doses, i.e. much larger than those needed to prevent the vitamin
deficiency diseases such as scurvy and pellagra are for the first
time in fifty years beginning to receive some attention as therapeutic
compounds which have a vast potential for helping patients. I
hope that by publishing these case histories and reporting exactly
what their present state is, this might increase the level of
interest among psychiatrists.
Research physicians publish rather brief papers for two main reasons:
(1) there is a keen demand for space and journals like to publish
as many authors as they can in one issue, i.e. without cutting
in too heavily into the pages devoted to advertising (up to 50%
of the pages). (2) Case histories have disappeared from journal
articles, as if living patients no longer existed or counted for
very much. Instead, authors describe their methods, describe what
criteria they used in selecting their groups of patients which
were used in their prospective double blind controlled studies,
and provide ample charts and statistics. I have read may papers
where it is impossible to get any feeling fears single patient.
In my opinion the object of medical report is to report honestly
what one has seen and in such a way that other physicians and
readers will understand what was done, what the results were and
what kind of patients were treated and what was the outcome, This
paper represents the type of paper that was common forty years
ago. By and large readers find these papers much more interesting,
This is why letters to the editor are so much more interesting.
They have not been vetted to death by skeptical reviewers as have
been almost all the papers published.
Orthomolecular Treatment
A treatment that started out simply by using one or two vitamins
and adding them to the current treatment program has become much
more complex as newer findings have been incorporated into the
program. Today it includes the following main elements,
A) The kind of food or diet which is followed
This has been one of the major stumbling blocks for orthodox psychiatrists
who have never been able to understand that food plays an enormous
role, not only in physical disease. There are two basic changes
which must be made. The first is to remove as much as possible
the many additives which are placed in modern prepared or processed
foods. One simple rule will remove a major proportion of these.
It is the no sugar rule. I advise my patients to avoid all foods
to which anyone has added sugar, such as pastry, candy, pop, ice
cream, cakes and soon, Any examinations of processed and packaged
foods shows the intimate association between sugar and other additives.
The second rule is to avoid any foods to which the patient is
allergic or which cause any physical or mental discomfort. Elimination
diets may be needed to determine these. In many cases a simple
allergy history will locate them. Hoffer (1983,1989) Hoffer &
Walker (1978)
B) The Vitamins
The main ones used in orthomolecular psychiatry are vitamin B3,
vitamin B6, ascorbic acid and to a much lesser degree vitamin
B12, and folic acid.
1) Vitamin B3
This term includes nicotinic acid, known medically as niacin and
nicotinamide, known medically as niacinamide. I prefer nicotinamide
for young people and for all patients who might not like the cosmetic
effect of flushing after they have taken nicotinic acid. However
nicotinic acid is the best one for elderly patients and for lowering
cholesterol levels. The dose varies from I to many more grams
per day. It is best given three times per day since it is water
soluble and easily excreted. The usual starting dose for adults
is I gram lid. Patients advised to start on nicotinic must be
warned about the flush and how to deal with it. If any dose level
causes nausea and later vomiting it must be lowered to below this
nauseant level, If this level is too low for either one, a combination
of both can be used. For a detailed discussion of the properties
of vitamin B3 see Hoffer (1962, 1963, 1965, 1966, 1967, 1967a,
1969, 1970,1971, 1971a, 1971b, 1972, 1972a, 1973,1974,1976,1976a,1977,1986),
Hoffer & Osmond (1960, 1966).
2) Vitamin B6 (pyridoxine).
There is one main indication for using this for schizophrenics,
This is the condition know as pyrolleuria. It is diagnosed by
a urine test which measure for the presence of kryptopyrole, a
compound we originally called malvaria, Hoffer (1965, 1966), Hoffer
& Mahon (1961), Hoffer and Osmond (1961, 1963). If the urine test
is not available it can be suspected by a few clear physical signs
such as white areas in the finger nails, stretch marks on the
body, premenstrual tension. The dose is usually under 1000 mg
daily. I start with 250 mg and occasionally have to increase it
to 500 or 750 mg. It is best given in association with one of
the zinc salts such as zinc gluconate or citrate or sulfate.
3) Ascorbic acid.
I consider this a most important nutrient for everyone, especially
when they are sick. It is a good antistress vitamin. It does not
decrease the stress but certainly increases the ability of the
person to cope with it. It prevents the development of arteriosclerosis
and also increases longevity. The books by Stone (1972), Pauling
(1986) Cathcart (1985) and Cheraskin (1988) Cheraskin, Ringsdorf
& Sisley (1983) must be considered essential reading for anyone
interested in using vitamin C, Dr.Pauling effectively disposes
of the myth that vitamin C causes kidney stones, see also Hoffer
(1985), For a discussion of vitamin C and the prolongation of
life for cancer patients see Hoffer & Pauling (1990).
C) The Minerals
All the minerals are essential but a few play a particularly important
role in the treatment of the mentally ill, Zinc and manganese
are important, especially in combination with vitamin B6 since
the double dependency exists so frequently, Pfeiffer (1975), Pfeiffer,
Mailloux & Forsythe (1988), and Pfeiffer, Ward, El-Melegi & Cott
(1970), particularly in areas where the drinking water is high
in copper leached from copper plumbing, and deficient in manganese,
which is removed from patients having tardive dyskinesia by tranquilizers,
1) Zinc.
The dose is between 50 and 100 mg per day which is safe for this
water soluble mineral. Any of the salts can be used, I see either
zinc gluconate or zinc citrate available in 50 mg tablets. The
indications are described by Pfeiffer (1975), Pfeiffer, Mailloux
and Forsysthe ( 1988), Pfeiffer, Ward El Melegi and Cott, A. (1970).
2) Manganese.
Kunin (1976) discovered that tardive dyskinesia is caused by a
deficiency of manganese which is bound by and excreted with the
tranquilizers used over a long period of time. When the manganese
is restored, in most cases combined with vitamin B3, the condition
is removed within a matter of days or weeks. I have seen how effective
it can be. Hawkins (1986) surveyed psychiatrists who had treated,
all together, over 58,000 patients. They could not recall a single
case of tardive dyskinesia. The dose is anywhere between 15 to
50 mg daily and may be combined in a solution with zinc.
D) Drugs
The major psychiatric drugs are used following the usual indications.
When combined with the dietary, nutrient program eventually much
lower doses are adequate. This has the major advantage that they
are less handicapped by the tranquilizers and there is much less
chance of getting the usual tranquilizer side effects and toxic
reactions. Orthomolecular doctors have never been opposed to the
use of drugs as part of the overall program. They are opposed
to the use of drugs only because they are not helpful in helping
patients become well when used this way.
Psychiatrists are faced with what I have called the tranquilizer
dilemma. I have not seen anyone else describe nor consider this
problem. It is the same kind of blindness to fact, the same kind
of denial which dogged psychiatry for years after these drugs
first came into general use. For a long time they could not believe
that these drugs could cause tardive dyskinesia. The psychiatric
literature contained many articles denying that this could happen
and attacking the psychiatrist who first brought this to public
attention and insisted it was a real phenomenon. The dilemma follows
from two true propositions: 1) That tranquilizers are helpful
in reducing and eliminating symptoms and signs from schizophrenic
patients. 2) That they are equally effective in making normal
people sick. The first proposition will never be denied by any
physician who has used them. The second proposition is based on
what happens to normal subjects when they take these drugs by
accident and upon the outcome of giving these drugs to normal
people in Russian mental hospitals. They had been incarcerated
there to get them out of the way or because the Russian psychiatrists
in these prison hospitals believed that anyone who was a rebel
against communism must therefor be considered mentally ill. The
object of giving drugs to patients is to start the process of
recovery. At first this is exactly what they do. They rather quickly
decrease the intensity of the symptoms and signs presented by
the schizophrenic patients. But as the patient begins this process
and their symptoms decrease in intensity and frequency, their
physiology, which must also become more and more normal, begins
to respond to the drugs as if they were well, i.e. it makes them
sick. They produce the tranquilizer psychosis. The tranquilizer
psychosis is iatrogenic, induced by the doctor who has prescribed
the drug, It causes both mental and physical symptoms.
The physical symptoms are lethargy, incoordination, tremor, fatigue,
excessive sleepiness, impotence, dry mouth, difficulty in urination,
increased sensitivity to sun and excessive weight gain. These
symptoms provide some of the main reasons why patients refuse
to take these drugs after most of their psychosis has come under
control.
But the mental symptoms are even worse. They include difficulty
in concentration, decrease in memory, disinterest, apathy, depression
and irresponsibility. Tranquilizers convert one psychosis to another.
This was first pointed out by Prof Meyer-Gross, shortly after
these drugs were introduced from France into England and the US.
He said "Tranquilizers convert one psychosis into another. "The
tranquilizer psychosis prevents the unfortunate patient from becoming
a normal member of society because with these symptoms no one
can function at jobs or occupations where these symptoms and signs
are a handicap such as practising law, medicine, being a normal
cook or architect or worker on the farms or in the factories.
Would you allow your surgeon to operate on you if you knew she
was taking 300 mg of chlorpromazine daily?
Psychiatrists have tried to deal with this dilemma in only one
way i.e. by decreasing the dose, by searching for newer drugs
which are less apt to cause severe side effects such as clozapine,
and in the extreme by placing the patient on a drug free program.
This would be great if the original psychosis did not start to
come back as it does in the vast majority of cases. The unfortunate
patient is caught between these two psychoses and like a swing
oscillates back and forth. Visualize two mountain ranges separated
by a valley. One mountain range represents the original schizophrenic
psychosis. The other represents the tranquilizer psychosis, Both
are equally undesirable with a major difference. Psychiatrists
seem to be more content to have their patients permanently on
the tranquilizer mountain range while patients try desperately
to escape into the valley which represents normality.
As soon as the drugs are started they begin to work and after
a few weeks or months both patients and their families are happy
since the major symptoms are moderated and the patient appears
to be getting well. Later on with the continued treatment as the
patient becomes more normal the tranquilizer psychosis begins
to appear. Eventually the entire schizophrenic psychosis has been
replaced by the tranquilizer psychosis. The major difference is
that society is much more tolerant of the latter psychosis than
it is of the first. The major difference for the patient is that
the psychosis has been changed from a " hot" to a "cool" psychosis.
The signs and symptoms of schizophrenia may be divided into "
hot " and " cool " categories. Hot S & S are those that families
and society find most intolerable and which are the reasons why
these patients are admitted to hospital or, if the mental hospitals
refuses to accept them into prison. By the latter I mean that
many psychiatric wards and hospitals will refuse to accept patients
if they do not want them for a variety of reasons and the easiest
way to keep them out is to find them not mentally ill, as with
the case with one of the patients I will describe later,
Hot S & S
These are the symptoms that most normal people will find intolerable.
They include the following:
In perception:
1. visions, especially if the patient talks about them;
2. voices, especially if the patients act upon them, e.g. by setting
fires;
3. other senses, if the patient responds with inappropriate behaviour.
Thought disorder: If these changes lead to inappropriate behaviour
such as wandering nude downtown, accusing someone of poisoning
them, etc
Mood disorder: Manic behaviour or suicidal depression.
Behaviour: Any abnormal persistent activity, e.g. hopping on one
foot all day, or rocking all day, or any inappropriate social
activity.
Cool S & S
These are the same S & S but decreased or eliminated so that the
overall behaviour is now much more tolerable to families and to
society. They are much more tolerable in an acute sense but in
the long run will become just as
intolerable, It is one of the main factors in making it impossible
for families to look after their chronic tranquilized children
and forces them into group homes or other sheltered homes like
those of the Salvation Army, Tranquilizers produce a variety of
cool symptoms which comprise put of the tranquilizer psychosis.
Tranquilizers cool the hot symptoms and add a few more to the
unfortunate patient. The tranquilizer psychosis is a combination
of cool symptoms originally present in the patient combined with
the new symptoms introduced by the drugs. The dilemma is that
while tranquilizers cool the hot symptoms they do not remove them
and they add their own form of toxic reactions. This does not
apply to the antidepressants which in most cases are much more
benign and do not restrict patients activities and behaviour to
the same degree. It is possible to be normal while on antidepressant
drugs. Of course this is also possible when the amount of drug
needed to cool or eliminate symptoms is so low the tranquilizer
psychosis symptoms are not generated. This is the case with many
of the chronic patients I will describe further on. The optimum
dose of drugs must be used at all stages of the treatment process,
They must be decreased as soon as possible, the objective always
being to eliminate them. Tranquilizers work very quickly compared
to much slower action of the nutrients, Here is a comparison of
the two major treatment modalities,
Tranquilizers
1.Act rapidly
2.Decrease intensity
3.Cause psychosis
Nutrients
1.Act slowly
2.Remove S & S
3.Non-toxic
The solution to the tranquilizer dilemma is to combine both treatments
as is done by orthomolecular psychiatrists. By combining these
two treatments one takes advantage of the rapidity of the drugs
with the much better final effect of the vitamins and minerals.
At the beginning of treatment patients, if they have hot symptoms
are placed on the appropriate drugs and at the same time the nutrient
program is started. As soon as the patient begins to respond the
dose of drugs is slowly and carefully decreased waiting weeks
or even months before any major reduction is made.
Eventually with most acute patients the drug is lowered to such
a low dose it can no longer produce the tranquilizer psychosis
or is eliminated. As the patient recovers the nutrients gradually
take over and once the patient is well they will in most cases
kept them well. If they do relapse it is not nearly as severe
and usually they respond much more quickly the second time around.
The revolving door syndrome whereby patients are rotated in and
out of hospital is eventually effectively removed. I have seen
patients who had 30 admissions when they were started on this
program who eventually did not need any more admissions.
The HOD test is very helpful in following patients and will warn
about an impending relapse long before it becomes apparent to
the patient or to the physician, Hoffer, Kelm & Osmond ( 1975),
Hoffer & Osmond (1963, 1966). A good example is that of a young
medical student who had recovered after a combination of nicotinic
acid, ascorbic acid and ECT. He had been well about five years
when he was admitted to medical school. I had advised him that
after five years the chance it would come back was slim. He therefor
went off his vitamin program. About five years later while he
was in third year medicine he noted a return of anxiety and depression.
He spoke to me about it. I had him do the HOD test . It showed
that the schizophrenia was coming back, The scores were very high.
I advised him to start back on nicotinic acid I gram tid. He was
so determined to get rid of the symptoms more quickly he doubled
the dose. One week later the scores were all normal and a relapse
was avoided. He finished medicine and has become a prominent and
good member of the medical profession.
E) Other Factors
The other factors are the hospital, or nursing home i.e. the place
where the patient is housed and sheltered, the ancillary services
such as social work, occupational therapy and the psychology division.
The nursing service is the most important in the hospital setting
since they know the patient and their progress much better than
any one else in the institution. All are important, but in my
opinion the most important is the treatment program. In the same
way the most ideal hospital dealing with diabetic will not get
very far if it ignores the use of diet and insulin or other antidiabetic
drugs
F) Community Support Services
These are vital, especially for the chronic patients many of whom
do not need to be rehabilitated, they must be habilitated. They
have never been normal and when they recover they will need a
total educational program to make them fit for social activity,
for work and so on.
When is a Patient Well
Institutions prepare annual reports for the governments who provide
the funds with which they operate. When I worked for the Dept
of Public Health in Saskatchewan I read each report put out by
the institutions with a great deal of interest. They provided
information such as the number of staff in various categories,
the number of patients admitted, discharged , still in hospital,
and the number of tests given. But nowhere did I ever see a breakdown
which would tell me how many were treated successfully. I would
have liked to see this statistic. When I would talk to my colleagues
in psychiatry and psychology about evaluating patients after treatment
, they were all very loathe even to get involved. Their usual
answer was that it was very difficult to determine when patients
were better and that it would require large research grants to
work out methods for making these measures. I understood why they
were go reluctant. It simply indicated that changes inpatients
after treatment were so subtle that only carefully worked out
subtle tests could make these determinations. On one occasion
at one of the morning clinical conference at the University of
Saskatchewan where I was one of the professors, I suggested to
the meeting that we should hold a type of psychiatric post mortem
whenever a patient who had been in hospital and discharged had
to be returned. I suggested that these returnees should be conferenced
and we would discuss why they had failed to stay in the community.
There was a cold, dead silence and nothing more was said about
this. I pointed out that surgeons were not reluctant to have pathologists
do post mortem examinations on their postsurgical patients and
that they learned a good deal from this.
Since most people can tell when a person is psychotic or bizarre
and this is known to members of the family, it must be relatively
easy to conclude whether or not it person has something the matter
with him or not. The solution was therefore to use common sense
criteria which any person could understand. It would be of no
value terry to judge the degree of thought disorder that was present,
or the quantity of depression or the intensity of the hallucinations.
One would merely disregard most of these subjective findings and
look at those variables which determine whether a person can function
in the community. I therefore selected four measures of recovery
or of wellness.
1) Freedom from symptoms and signs, one point.
2) Ability to get one reasonably well with family, one point.
3) Ability to get one reasonable well with the community, one
point.
4) Able to work at a job or to be active in the same way as was
the case before the illness struck. If the patient never had been
engaged in this kind of activity they would be judged by the ability
to perform any useful work, one point. The ability to pay income
tax is an important measure of recovery, With these criteria I
used the following scale;
Well 4 points
Much improved 3 points
Improved 2 points
Not improved I point
Clinical Descriptions of the Patients
1) Mr. K.G. Born 1945.
As a youngster he was shy and sensitive and occasionally had to
be given tranquilizers. At age 18 he had asian flu with high fever,
up to 105° F. He was admitted to hospital with hallucinations,
Following that he required several admissions including one to
Hollywood Hospital in Vancouver where he was started on a vitamin
program with marked improvement. Later he relapsed and was admitted
to Eric Martin Pavilion, Victoria, for a series of ECT. Then he
went to Riverview, Vancouver, for six months, had two more ECT
series receiving 30 treatments. After discharge he lived in a
boarding house for a year. When I saw him he was confused, his
speech was garbled, it was impossible to communicate with him
and he was very inappropriate. He was depressed, He required chlorpromazine
400 mg to keep some kind of control.
He was admitted Feb 27 to Mar 13, 1978 and again Aug 4, 1978 because
of obstructive jaundice caused by the tranquilizer. In 1978 he
was no better and he was switched to haldol and eventually to
long acting haldol by injection. He needed several more admissions
as follows Oct 17 to 27 1984, Oct I to Dec. 1986 and Jan 28 to
Feb 10, 1988. By then he was much better. When I saw him recently
he came alone, was well dressed, told me about his activities
in the group home and at a rehabilitation workshop. It was quite
easy to engage him in conversation . I classified him as improved.
He is on long acting haldol by injection, 200 mg every four weeks,
plus haldol 90 mg oral daily, and kemadrin 5 mg tid. His vitamins
include nicotinamide 500 mg tid, and folic acid 5 mg od.
He was seen the following number of times.
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2) Mrs. L.T. Born 1955.
When first seen in 1979 she complained she had been depressed
since 1972. It started in High School. She left home at age 16
because she could not stand her stepfather. She married at age
17 and divorced soon after. She felt no emotion during the separation
but later was depressed. She did not respond to antidepressants
which made her feel like a vegetable. When I saw her she was unreal,
had out of the body experiences, and heard her own thoughts. She
was paranoid when depressed and was at this time depressed. I
started her on the orthomolecular program and she began to respond.
This is shown in the following HOD scores.
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She was very depressed again and was admitted Mar. 7 for one month and received 6 ECT. She was then well until Nov 13, 1986 when she was admitted again for five more ECT, She has remained well since. She is on the following program, nicotinamide 1 gram tid, ascorbic acid 12 grams daily, pyridoxine 250 mg daily, zinc citrate 50 mg daily, ludiomel 100 mg daily, prozac 40 mg daily and chlorpromazine 200 mg daily. She married and has two normal children.
She has been seen the following number of times:
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Only a person who has come through the schizophrenic experience
can really relate what it was like, Here is her account of her
illness and recovery, " When I was fifteen, in 1970, my mother,
youngest brother and myself moved into some low income housing
on our own. My two older brothers had fled by then. It was at
this time when I acutely began to feel the difference between
myself and the other kids at school. I felt superior to them.
I never had to study, and felt a slight contempt for those who
did. I felt crazy, I remember spending classes engraving my eraser
with my compass to produce a rubber stamp which said insane. It
became my trademark. It was also about this time that I decided
to go on the pill, and, although I had not yet menstruated my
doctor prescribed them for me. When I spoke to this same doctor
about my confusion and depression, he assured me these were normal
teenage feelings. I figured the fault lay within myself. I maintained
the same inadequate diet, which I believe was of paramount consequences:
lots of cola drinks, pizzas, hot dogs, chips, cheezies, cakes
and candies. I started drinking anything alcohol, I began smoking
tobacco and pot, doing street drugs. I stopped short of taking
heroin. Part of this shift was due to peer pressure- living in
a large metropolis, peer pressure is difficult to avoid. Part
was also due to being sixteen and seventeen years old during the
hippie era. LSD was in. Most of it was an escape from the increasingly
difficult reality of my life. I tried school counsellors. They
told me I was having normal adolescent anxieties. I moved into
a boarding home. I went to doctors, another G.P., then a psychiatrist,
Both prescribed valium, This really did wonders for my depression.
I tried suicide twice. Then I went to live in the streets. I began
to think that if I didn't do something, I would really go crazy.
So I ended up marrying one of my street friends and leaving for
B.C. After two years the marriage collapsed and I found myself
alone and back where I had been born, in Victoria. Shortly after
my arrival in Victoria, I met someone very special. I know that
when I met him, but never realized just how special he was, until
it was all over and there he was still loving me. We were living
together when things really began getting worse. I started having
the hallmark auditory hallucinations, whispery, demeaning voices,
mild visual hallucinations, delusions and sometimes very vivid
illusions involved in schizophrenia. My thoughts did not make
sense- I had too many thoughts, violent and hateful thoughts.
I went from being extroverted to extremely withdrawn. I would
sit in one place for hours at a time. I was afraid to look in
the mirror. I became extremely agitated by sound, wouldn't answer
the telephone, refused to see anyone. I hated eating. I became
very superstitious. Anxiety attacks, where the earth fell away
or I was pulled up out of my skin. I lost all feeling, Time slowed
down. I would bang my head, would pull my hair to try and stop
the noise, the pain in my soul. I would circle around and around
upon waking, trying to figure our what I should do. Should l wash
my face, brush my teeth first. What should I do? Finally my common
law husband came home one day and said he'd heard about some old
fellow in town who might help me. He was a naturopath. For about
a year I visited this marvellous little man (who is over ninety).
He taught me about diet, and why. He told me to eat whole, raw
foods and to stay away from stimulants and why. He also piqued
my interest in vitamins. When it was clear that he could help
me no further, he told me about a specialist who would really
know what to do. A referral from a GP was necessary, but I thought
this would pose no problem. But the doctor I had been seeing for
four years, refused to refer me. He told me I would do better
coming to his group therapy sessions than in going to that "quack."
That quack you may have guessed was Dr. Hoffer. It took two more
doctors before finally finding one, albeit a reluctant one, to
get my referral.
My first visit to Dr. Hoffer hallmarked the turning point of my
life. He gave me the Hoffer-Osmond (HOD) Diagnostic test, which
confirmed I was schizophrenic. Then, he told me all about schizophrenia,
explaining carefully what I could do to overcome it. He prescribed
vitamins, minerals, medication and firmly spoke to me about proper
nutrition. I remember about three weeks into the program feeling
very despondent. I just didn't feel any better. Dr. Hoffer suggested
I do the HOD test again. Much to my amazement. there was a thirty
point difference in scores, This, along with some encouragement
and adjustments in medication and supplements, kept me going for
another three months, when the bottom fell out of my world. I
think because I had begun to get better, this particularly bad
slip seemed to me, worse than ever before. I went into hospital.
I had a series of ECT, or shock treatments. About two months after
getting out of hospital, I began to notice a climbing of mood.
Over the next few months, many other signs became apparent. Separately,
they did not seem like much, but collectively, they really pointed
at recovery. My menses became more regular, my muscles stopped
aching, my perceptions straightened out. I noticed I could remember
things better and retain more and more information. Even now and
I spoke to Dr. Hoffer about this recently, my brain actually feels
as though it is regenerating. I told him if this keeps up, I'll
actually be a genius by 1990.
Having reached my goal of becoming well, in 1980, at the age of
25, I felt a need to test out my health. Perhaps I could go back
to work? Having failed several times at holding a job for any
length of time in the past I found myself fairly shaky about the
idea. I decided to start with part time work. When that went alright,
it gave me the confidence I needed to move on to bigger and better
things, In May of 1981 I married the man I mentioned as being
so special earlier on. They say you marry for better or worse.
Certainly R. and I had already experienced the worst before we
got married. I would like to publicly acknowledge my husband's
outstanding contribution to my recovery. He was always there to
help, as best as he knew how, emotionally and financially, and
I don't think I could have made it without him.
In April of 1983, after three years of successful part-time work
and two years of a successful marriage, I completed a normal pregnancy
with the birth of a beautiful baby boy. I maintained my vitamin
program throughout the pregnancy, having managed with doctors
guidance to wean off all medications in the year prior to becoming
pregnant, I have been medication free ever since a total of four
years, keeping on with the diet, vitamins and lifestyle,
I found a job in a small office and shortly thereafter found myself
becoming involved as a volunteer in the Friends of Schizophrenia
Society ( FOS). I had discovered the group after attending a lecture
series on schizophrenia that was put on by the local hospital
and mental health centers. They were looking to establish a chapter
in Victoria, so I jumped in with both feet. This was the chance
I had been waiting for. Ever since I'd become well, I had been
trying to figure out a way to help other schizophrenics, Surely
what had worked for me would work for some of them as well. This
is where I began to make my being schizophrenic into a positive
force.
For the future I would like to see a pooling of all the accumulated
knowledge, a cooperative effort in research and ultimately, because
of these efforts an end to schizophrenia, I believe schizophrenics
can act as a powerful force in ensuring this end. We must keep
reminding those who are working for us, that they are working
for us, that there is no time for political quibbling and controversy.
So that all of us together can one day say, OUR MINDS USED TO
THINK WITHOUT US,"
This wish expressed by this patient arose from the controversy
that was generated in the group when she told them that a major
part of her recovery arose from the use of the vitamin program.
Other patients were interested but the professional people were
not, They had indoctrinated Friends of Schizophrenics into pursuing
their only main objective which was to provide support to the
friends of the patients. They were convinced that tranquilizers
were all that one could offer and that taking vitamins was a waste
of time.
3) Miss E.P. Born 1954.
I saw her in 1980 when she had been suffering since 1969. She
had been admitted to a psychiatric hospital in Winnipeg for six
months and there received 9 ECT. She had almost total amnesia
for that admission but she was told that she was very paranoid.
In 1975 she began to suffer from chronic fatigue. She started
on a vitamin program which she followed until 1974 and during
this time was much better, When she discontinued her vitamins
she became depressed and tired. When I saw her she complained
that people were watching her, worse when depressed. She had seen
visions in the past. She was paranoid with a lot of blocking and
she was tired and depressed. I admitted her Dec 1 to 7 , 1981
and again Feb 18 to Mar 21, 1982 for a series of seven ECT. Since
then she has been improving steadily with many swings into more
depressions. In 1958 she moved into her own apartment. It had
taken her about two years to feel ready to leave her parents home.
She is now well on the following program fluanxol between 4 1/2
mg and 9 mg; daily, Niacin 2 1/2 g daily, ascorbic acid 12 g daily,
lithium carbonate 300mg; tid and cogentin 1 mg daily , I consider
her well.
She was seen the following times.
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4) Miss E.B. Born 1953.
In 1974 she became very paranoid and withdrawn. She believed people
were laughing at her. Several months later she was well. When
I saw her she heard voices, heard a tape recorder in her apartment,
as she had earlier. She was again very paranoid believing people
were gossiping about her, and had been plotting against her in
the past. This included arranging for her to have a car accident.
She also felt bugged. Depression and fatigue were present. She
was admitted on three occasion June 18 - 22, 1981, Dec 11 to 19,1981
and Sep 4 to Jan 8, 1982. Early in 1985 she still saw visions,
black robed people walking through her apartment. By mid year
they were gone. The voices continued to bother her for several
years. But for the past three years she has been free of them.
She is on chlorpromazine 500 mg daily, nicotinamide 4 g arid ascorbic
acid 3 g daily. I classed her as much improved since she is still
not able to work.
She was seen the following times.
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On the HOD test she scored the following points,
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A retrospective score is a score based upon the way the patient
recalled her symptoms from the past. It is a composite of the
patient's experiences during previous illness,
5) Mrs S.D. Born 1953.
During her mid teens she became epileptic with grand and petit
mal seizures, She was well controlled with anticonvulsant medication
but from that time on she remained depressed. She was admitted
on seven occasions to psychiatric hospitals receiving ECT during
some of these. Then she went to Hollywood Hospital , Vancouver,
no longer in existence, and was given more ECT in combination
with a vitamin program, Following that she was much better. When
I saw her in 1979 she still suffered from visions and from voices
which ordered her to hurt herself, This she would often do by
holding a burning cigarette to her skin until she had punched
through the skin. She was very paranoid, depressed and nervous.
She was admitted Jan 15 to Mar 4, 1980 for more ECT. She married
in Oct 1984 to a very hard unsympathetic man who worked very hard
at two jobs. She was admitted again July 7 to July 13,1986, During
the summer of 1989 she went off all her program largely because
of her husband who did not approve of any of it and she suffered
a serious relapse. Her family physician restarted the program
and she improved and is now well. She is on modecate50mg intramuscularly
every two weeks, anaftanil 50 mg before bed, nicotinic acid 2
grams tid, ascorbic acid 4 grams per day, folic acid 5 mg daily
and zinc gluconate 100mg daily.
She has been seen the following times.
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6) Mr.J.L. Born 1949.
During the first visit, in 1976, it was impossible to get any
information from him. He walked in with his mother and promptly
turned his back to me and spent the next five minutes or more
looking over the books on my wall bookcase. His mother had to
persuade him to sit down facing me. She told me he had been uncoordinated
as a child and later had a learning problem. He did learn to read
and later became an avid reader, At age 18 he read about LSD and
then told his mother he had been seeing visions as long as he
could remember. In 1968 he was admitted and spent two months in
hospital receiving ECT which was continued afterward as an out
patient. He received about 100 treatments in all. In 1974 he was
readmitted for three months to Hollywood Hospital and there given
chlorpromazine 1600 mg daily. He had been started on a vitamin
program two years before. On examination he reported visions,
voices to which he responded and heard his own thoughts. In his
thoughts he was paranoid, blocked a lot, had a poor memory and
was not able to engage in any intelligent discussion. He also
had violent mood swings, Since then he has continued to improve
and is now improved. I saw him June 1992. His present state is
so good it is difficult to realize how sick and deteriorated he
was when I saw him first. We had a long discussion and reviewed
his earlier presenting symptoms. He remembered his voices and
visions which have been gone for many years, He was helpful in
the group home where he lived and took on more responsible tasks.
He was much more sociable both in the home and at a center for
schizophrenic patients that he attends. He laughed , had a good
sense of humour. Whereas at one time he would walk 8 to 10 miles
daily he had greatly reduced this since he had so many more useful
activities to do. He maintained close contact with his family
and
his non identical twin brother. He could be classed as much improved
but has lost so much out of his life from his chronic illness
that he will probably never be able to work and be self supporting.
It is possible to talk to him reasonably intelligently, he had
no more outbursts, creates no problems at the group home, continues
to read, He still walks a lot and is in good physical condition.
He was seen the following number of times.
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He is on the following program, Nicotinamide 2g tid, ascorbic
acid 1 g tid, pyridoxine 250 mg tid, vitamin E 400 IU daily, zinc
sulfate 220 mg bid, anafranil 75 mg before bed, trilafon 12 mg
before bed and valium 10 mg bid.
7) Miss G.H. Born 1963.
I saw this young girl for the first time as a result of a strange
series of events. In 1981 1 received a phone call from both parents
who were very disturbed about their daughter because she was in
prison. None of the psychiatric wards on the lower mainland of
B.C. would admit her to their hospital and the Judge had ordered
her to be held in prison. They wanted to know if I would admit
her to the Eric Martin Hospital in Victoria. I replied that I
could not do so since I had not seen her and that I would have
to evaluate her myself before deciding, They then appeared before
the Judge and told him that I would admit her believing that once
I saw her I would really agree that this was essential, A few
days later they all arrived and I was able to examine her. Her
mother told me she had always been a nervous child from age three
when she became hyperactive with a learning disorder, When 14
she went to a private school but had to drop out because she began
to binge on junk food and became disoriented. She gained 20 pounds
in a short time and later became bulemic and lost a lot of weight.
When she came home she was referred to the Health Sciences Center
University of British Columbia, for four months and later to The
Maples for 1 1/2 years. The latter was an institution for delinquent
and other behaviourally disturbed teenagers. At age 17 she was
made a ward of the government, Dept of Human Resources. Nov 1980
she was found to be unmanageable in the group home and she was
again admitted to a hospital for two months. She left against
advice to go home. In Jan 1981 she set fire to her mattress because
she was angry at the world. She was admitted again, then followed
up as an outpatient at Health Sciences Center, During this period
she made three serious suicide overdose attempts. Her behaviour
remained hyperactive and bizarre. For a while she was in and out
of institutions. This included two months at the Forensic Center
where they found her to be mentally normal and discharged her
home. Again she set a fire to her curtains, The RCMP were called
and she was arrested and taken to Oakalla prison because the Judge
could not find a single unit that would admit her. She had been
blackballed and since she had been found "mentally normal" by
the forensic center had no right to be admitted to a psychiatric
unit. She was released to her parents care by the Judge on condition
they see me. The Judge believed I had promised to admit her. She
told me about the visual hallucinations present from age 15 .
She saw people with knives and had told her mother about this.
She heard voices who ordered her to do bad things like setting
fires. She felt weird and heard her own thoughts. She was also
very paranoid, believing people were plotting against her, watching
her. She blocked a lot and could not concentrate, On top of all
these symptoms she was very depressed. I had no choice but to
admit her. Not to have done so would have been, in my opinion,
not only very bad psychiatry but malpractice.
She was in hospital from Sept 11 to Oct 11, 1981 for nine ECT
and again April 9 to July 18 1983 for another 16 ECT. Her final
admission was Feb 25 to April 16, 1986 because the voices had
come back and were ordering her to set fires which she would not
do. Since then she has been improving steadily and has been well
for the past four years. On her birthday, June 1, 1992 she called
me to tell me she felt great and that she was hoping she would
soon get a job for which she had applied. She has been taken care
of by a general practitioner in Vancouver familiar with the orthomolecular
treatment program. She is on the following program, nozinan 100
mg daily, lithium carbonate 300 mg tid. thyroid 60 mg daily, nicotinic
acid 1 g tid, ascorbic acid 1 g tid, kemadrin 5 mg bid and modecate
50 mg IM every seven days. I consider her well.
She was seen the following number of times:
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8) Mrs. D.P. Born 1961.
She became very restless and disturbed after a period of hectic
activity in preparing for going to University. Her mind ran out
of control and she began to hear Satan. At night in her home when
she heard the house creak she knew this was Satan. One night she
heard him knock three times and she knew this meant he was coming
to get her so that she could not go with Christ. The next day
she smashed a record she had been listening to the previous day
. I saw her later that year when she described her auditory hallucinations,
her paranoid ideas about being watched and her severe anxiety.
I admitted her Sept 16 to 25, 1980. Later she was able to trace
the onset of symptoms to 1977. Mar. 1981 she was well and working.
She was admitted again Feb 15 to 27, 1984 because the voices came
back but by the end of that year she was well. She tested as follows
on the HOD test.
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I saw her again in the summer of 1981. She had been told by her coworkers about her powerful body odor. She was so embarrassed that she quit. They had considered her dirty which she was not. She had a typical schizophrenic body odor. I reassured here and advised to drink one glass, of cranberry juice each morning. (One of my patients had discovered this and since then I have found it to be very effective. One nurse in charge of a group home eradicated the typical schizophrenic smell from her place by giving every one of her patients this drink.) Soon after she got another job and has remained well since, She is on nicotinamide I g tid, ascorbic acid 3 g tid, vitamin B6, 250 mg daily, zinc gluconate 50 mg daily, anafranil 75 mg before bed, and nozinan between 50 and 100 mg daily.
She was seen the following number of times
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I class her as well.
9) Mrs. D.M. Born 1954.
She was admitted April 19 77 because of manic like behaviour with
great over excitement. She had been working aboard a ship where
she became very delusional and developed hallucinations. She saw
Christ and God in peoples' eyes and heard Christ's voice in an
attitude of prayer. She heard herself think and felt unreal. She
showed thought disorder with confusion, paranoid ideas about plots
against her and with blocking. With these she was also deeply
depressed. She was admitted again May 19,1977 to Aug 2,1977 for
6 ECT. By 1978 she was well and has remained free of schizophrenia
since then. I have seen her often merely to monitor her treatment
and response. She has been well for many years, since 1978. In
the meantime she completed her masters degree and married and
is getting along well. She is on nicotinamide 1 g tid and ascorbic
acid 1 g tid , most of the time.
She was seen the following number of times.
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10) Mrs JX Born 1921.
Seen in 1977 she told me that she had her first breakdown in 1962.
She suddenly became psychotic and was diagnosed schizophrenic.
She began to feel peculiar and because of severe pain in her stomach
was afraid to eat. Her behaviour became bizarre, for example she
began to burn her objects in her house, practised yoga in the
street and urinated an the street. She heard voices. Recently
she once more described how frightened she had been with these
phenomena. She was admitted to hospital and was given one ECT.
She then persuaded her family to take her home and she was discharged
against advice. Since then she had remained very tired to the
point she did not feet human. When I examined her she had no perceptual
symptoms, she blocked a lot, had a poor memory and poor concentration,
her head felt dull and she found it hard to follow conversation.
She is the type of schizophrenic who would be counted as having
responded to treatment simply because she no longer appeared in
the mental health system even though she had never recovered but
was able to function in the community. Her daughter is a chronic
schizophrenic patient still in a mental hospital. f started her
on the vitamin program. By the end of 1980 she was well. She is
on nicotinic acid 2 g, ascorbic acid 2 g, pyridoxine 250 mg and
zinc gluconate 50 mg per day combined with serentil 20 mg, librium
10 mg daily and thyroid 60 mg daily,
She was seen the following number of times.
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11) Miss L.K. Born 1954.
She became ill in 1978 when she was very nervous. I saw her the
following yew when she complained she could hear her own thoughts,
was paranoid and blocked a lot and she was very anxious. I diagnosed
as an anxiety state and started her on a vitamin program. In 1980
1 re-diagnosed her schizophrenic after she told me about her visions
of people in the pictures on walls and hearing voices. She was
admitted Sept 2 - 29,1980 for 7ECT, In July 14-22, 1982 and for
the last time July 15 to Aug 3, 1985. Early in 1983 her child
was born. For awhile the department of Human Resources threatened
to take away her baby but her parents took on responsibility and
eventually took charge. She has been doing a fairly good job since
then with the help of her parents. Her parents at one point did
not accept that her unusual behaviour resulted from an illness
and had considered her as bad and lost to the family, Once they
understood what was happening they changed their attitude toward
her. She is now a single mother living in her one apartment and
looking after her child. I class her as well. She is on the following
program and follows it very carefully. Nicotinamide 3 g, ascorbic
acid 1.5 g, folic acid 15 mg, B complex (50), Nozinan 210 mg before
bed , Elavil 50 mg before bed and Kemadrin 5 mg daily.
She has been seen the following number of times.
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12) Miss J P. Born 1945.
She had developed very slowly and was considered retarded. Speech
began when she was 9 months, stopped until age 2 1/2 years. She
went to a special school but did not learn much. Three years in
a convent taught her more than all her years at the special schools.
She learned to read and write. At age sixteen she was admitted
to Ponoka , near Calgary, many times until age 20. She was then
started on a vitamin program by Dr. Max Vogel and thereafter was
a lot better. She and her mother moved to B.C. in 1977. When I
saw her she felt unreal and was paranoid believing people were
talking about her. She was depressed. She had visual illusions
and spoke to the Beatles , to their picture when she saw them.
She had physical evidence of a pyridoxine - zinc deficiency, I
started her on a revised vitamin program but could not see her
very often as she was living in Vancouver, After many months of
agitation and she was moved to a group home in Victoria and was
started on loxapine 60 mg daily. Since then I have been seeing
her more regularly, There has been a striking improvement and
she is now much improved. She got on well at the group home, is
taking rehabilitation courses and was looking forward to her mother
moving to retire to Victoria so that they could both live together
again. The change in her in a few months has been dramatic, She
is on nicotinamide 3 g, ascorbic acid 3 g, pyridoxine 500 mg and
vitamin B complex daily,
13) Mr. A.B. Born 1962.
I first saw him in 1978 after he had been ill for one year. He
had been admitted to hospital for one month. After discharge he
was not able to go to school and took a correspondence course
at home. He was started on vitamins four months before I saw him.
During that first examination he told me about feeling watched,
about the visions and voices he had in the past, and about his
paranoid ideas about people out to get him and having plotted
against him in the past. He was also depressed. I admitted him
Oct 27 to Oct 28, 1980 but he was discharged at the request of
his mother after one day because his father was seriously ill
at home. In 1987 his mother took him to Coral Ridge Hospital under
Dr. Moke Williams for 20 days. Since then there has been substantial
steady improvement year by year and he is now much improved. He
is on nicotinamide 3 g, ascorbic acid 3 g, ativan 1 mg before
bed and anafranit 50 mg before bed. He came in for his annual
check June 10, 1992. He told me that he was well except that he
had been slightly depressed for the past two weeks. His major
problem now was he had gained 20 pounds over the past yew. His
mother agreed that he was well.
He was seen the following number of times.
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14) Mrs. S.M. Born 1951.
She was always hyperactive according to her husband. In 1980 she
suffered a miscarriage giving birth to a dead fetus. She delivered
again in 1981 by caesarian section. For the next three weeks she
was hyperactive. Because she was overweight she was placed upon
medication to suppress her appetite. She became psychotic seven
days before admission Aug 4 to 11, 1982. She denied having any
perceptual symptoms, was delusional for example convinced she
was the sister of Terry Fox (a man who ran across Canada to bring
attention to the cancer problem), and her behaviour had been bizarre.
She fled into the street nude. She had two more admissions Sept
20 to Oct 8, 1982 and Oct 29 to Nov 15, 1982. In Jan 1983 she
separated . Since then she has been stable and well having worked
at her previous profession as a hairdresser most of the time.
She has had several relationships since and had dealt with them
in a normal manner. She is now on the following program lithium
carbonate 300 mg, nicotinamide 3 g, ascorbic acid 1.5g,pyridoxine
5OOmg,valium 30 mg, trilafon, 16 mg and elavil 560 mg, all daily.
She was seen the following number of times.
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15) Mr. J.W. Born 1950.
He came to see me in 197 9 when he told me he had been sick since
1963. At puberty he went " crazy", developed a fear of being seen
and hid as much as he could for the next five years. He also rubbed
his eyes incessantly until, he believed, he had damaged them.
Age 17 he was in hospital in North Bay , Ontario for three months.
He was admitted again when he was 28 in Terrace, B.C. In between
he married. This turned out well. When I saw him he believed people
were watching him. He told me about the visions and voices he
had experienced in 1978 and he still felt unreal occasionally.
In his thinking he was paranoid, confused, his memory was poor,
there was blocking, and ideas were running through his head. He
was also very depressed. At that time he was on 400 mg of chlorpromazine
per day. I admitted him in Dec 1979 for 17 days and gave him five
ECT. Feb 1980 be was nearly well. But he needed another admission
May 1980 for 18 days, June 1981 he completed his diploma at a
community college. Since then he has been working full time. He
is now on nicotinamide 500mg tid, ascorbic acid 4 g per day and
valium 15 to 20 mg per day. I classify him as well.
16) Mr. R.B. Born 1950.
In 1968 he developed a serious prolonged tremor. The following
year he was admitted to hospital for 10 days and later to the
closest mental hospital for eight months. By 1972 he had been
in the Hollywood hospital in Vancouver several times. He was then
given a series of ECT and started on a vitamin program. This he
had been following when I saw him in 1976. He then told me about
his voices to which he would talk or shout back, about feeling
unreal, about believing people were watching him. He was paranoid,
blocked a lot and was depressed. I continued him on the vitamins.
In t977 he developed infectious hepatitis. By April 1992 he was
improved. His program consisted of nicotinic acid 500 mg tid,
ascorbic acid 1.5 g tid, nicotinamide 1 g tid, haldol 2 mg before
bed, tofranil 25 mg in the morning and anafranil 25 mg before
bed.
He was seen the following number of times.
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17) Mr. B. W. Born 1965.
Seen in 1979 he complained that it all started in 1965 when he
was working with heavy equipment which was very noisy. He stated
that it " blew his mind." I have never been able to figure out
exactly what this meant to him but it has been a very disturbing
symptom since then. He was able to work until 1973. Then he %as
in a car accident and was in hospital for 14 days. He was treated
at Eric Martin Pavilion in 1978 for three months. When I saw him
he complained of people watching him, distorted sounds so that
he could not bear music properly, voices and feelings of unreality.
He blocked, his concentration was down and he was depressed.
Subsequently he was admitted to hospital Dec 5, 1979 for six days,
Jan 28, 1980 for seven weeks when he received nine ECT and June
17, 1981 for six weeks when he received another 13 ECT. He was
in again Aug 22 to Oct 23,1991. He is on the following program
nicotinic acid 1.5 g tid., ascorbic acid I g tid, haldol 75 mg
daily, cogentin 6 mg daily and ativan 4 mg before bed. I class
him as improved.
18) Mr. B.A. Born 1956.
In 1977 he dropped out of university to join a religious Cult.
Several years later he came back home still suffering from euphoria
and expressing similar religious convictions. When I saw him he
complained of his voices and visions and was convinced he was
getting messages from God. He was paranoid and blocked and suffered
from depression. In Feb 24,1943 he was admitted for three weeks
still complaining of the same symptoms. After that he continued
to improve. He had been fully employed for the past eight years.
He is on Tofranil 25 mg in the morning, Anafrinil 50 mg at bed,
Elavil 59 mg at bed, nicotinamide I g tid, ascorbic acid I g tid,
pyridoxine 250 mg daily, zinc sulfate 220 mg daily and nozinan
125 mg daily. I have him classed as well.
19) Mr. C.C. Born 1949.
This patient was very nervous in his teens and was first admitted
in 1972 for two months. After discharge he moved to a farm and
separated from his wife. In 1973 he was admitted again for two
months, After this discharge he ran out of money, stopped all
medication and relapsed requiring his third admission in 1974.
Until 1977 he remained on moditen but this left his mind in a
fog and he was changed to haldol. When I saw him he was having
visual and auditory hallucinations and believed people were looking
at him all the time. He was paranoid, delusional and his memory
and concentration were poor. He had continued to suffer episodes
of depression. He told me he had taken LSD over a period of time
about 60 times and also had drank too much alcohol. By 1979 he
began to improve but was still disorganized, depressed and found
it hard to express himself. In April 1979 I doubled his nicotinic
acid to six grams daily. In 1990 I saw him at a supermarket when
he told me that he had just completed his B.A. at the university
and was looking for summer employment. He was interviewed by a
reporter from the Times Colonist, Victoria, This is what he wrote.
"C.C. was diagnosed as schizophrenic in 1979. By that time he
had been sick for eight years and hospitalized four or five times.
After sailing through high school he entered university and began
working toward a degree in engineering. But he soon began to feel
unaccountably depressed and anxious. I used to start crying in
class because I was overcome by feelings of not being in control.
I started sleeping long hours. I would fall a sleep in the hallways
at the university. His trouble stayed nameless for as long time.
The big problem was I didn't know what was wrong with me. I was
never told the word schizophrenic; it was never applied to me.
His wife to whom he complained of hearing voices left him. His
behaviour drove her away. People abandoned me and I have forgiven
them because I was impossible, said C.C., who is articulate and
speaks in measured tones.
After he first began to get symptoms, rather than becoming quickly
psychotic, he began getting progressively more ill. His hallucinations
got worse. When he sat on a chair he felt it whirling him around
the room. When he looked at his arms he saw pictures but no flesh.
Gradually his life fell apart. Friends fled and the material props
of existence slipped out from under him. I was left all alone
in a house with no furniture, When they finally came to get me,
they found me curled up behind the refrigerator in the fetal position,
His arms were covered with burns. In an attempt to drive the illness
out he had branded himself repeatedly with a fireplace poker.
He was taken to hospital in a straitjacket. In 1978 he moved to
Victoria, wanting to make afresh start in a place that had a reputation
for being More spiritually and culturally evolved. He went to
see Dr. Hoffer and was relieved when the psychiatrist told him
he was sick and could be helped. Until then all he had heard was,
'You're weird. You're crazy. You're possessed.' Today he takes
a maintenance dose of an antipsychotic drug and doesn't think
of going off it. Having lost nearly two decades of his life, he
is back at school studying for a bachelors degree in biochemistry."
He is on nicotinic acid 2 g tid, ascorbic acid 1 g rid, vitamin
B6, 250 mg daily, zinc sulfate 110 mg daily and Valium 5 mg daily,
I consider him well.
20) Mrs. C.P. Born 1955.
I saw her first in 1978. Her first symptoms started six years
earlier while she was attending first year university. Three years
later she took the year off because she suffered from marked mood
swings. She moved around a lot and received counselling. Finally
she felt weird, began to hallucinate and believed that poison
had been put into her food. She was admitted to hospital for three
months receiving six ECT and medication. She was then advised
that she would never be well. When I saw her she described how
she had believed people were watching her, had voices and visions
and felt unreal. She was less paranoid than she been before but
still believed there was a plot against her. She blocked a lot
and complained that ideas were racing in her mind and that her
memory and concentration were poor. With that she was depressed,
She was admitted to hospital July 1981 for three months. By Oct
1981 she was well. But she was admitted again Feb 27,1982 until
Mar 20, 1982 on two certificates. She was suffering severe hallucinations,
I admitted her again July 1 1983 but on July 30 she discharged
me refusing to follow the program any more. Many years later she
re-established contact with me by writing me long detailed letters
about her progress. In April 1991 she told me she had married,
was getting one well and was, with her husband, operating a store.
Jan, 1992 she reported she was on a gluten free diet which she
found helpful. In April 1992 she once more wrote to tell me she
had been in hospital for three months and had received another
ECT series. Again the voices had been very severe. She was started
on clozapine. She had been on nutrients as well including nicotinamide
2 g per day, ascorbic acid 500 mg tid, zinc gluconate 50 mg od,
pyridoxine 100 mg daily and a vitamin B complex once daily. She
said that she had gone of this entire program July 1991 for about
two months but then went back onto it. I have classed her as well,
even though she had a brief resurgence which responded rapidly
to treatment. She was seen two times in 1979-1980, 13 times in
1981-82, three times in 1983-84 and once in 1991-1992.
21) R.W. Born 1940.
R.W. became psychotic in his early teens. He was then treated
in some of the top psychiatric institutions in the US including
1 1/2 years at the Menninger Clinic, one year at the Institute
of Living in Connecticut, and in a large number of other hospitals
ranging from Florida to New York State. Early in 1971 his father,
a New York industrialist, called and asked whether I would be
willing to take his son on for treatment, By then he had been
sick with no improvement for more than half of his life. By then
he had spent about 500,000 dollars on treatment. I was conducting
an experiment to determine what was the most important element
in any treatment program for psychiatric patients. I was then
at the University Hospital, at Saskatoon, Professor of Psychiatry
and Director of Psychiatric Research for the Province. The university
hospital cost 80 dollars per day and provided ideal ratios of
staff to patients. I believe there was at least one staff per
patient, perhaps more. At the same time the closest mental hospitable
treated the same type of patients and their daily cost was around
20 dollars per day. In those heady years when mental hospitals
were improving so fast it was commonly believed by psychiatrists
and by superintendents of hospitals that one could produce much
better treatment results by increasing the ratio of staff to patients.
They believed there was almost a direct correlation between this
ratio and outcome. I became quite skeptical about this when I
found out from research carried out in my division that the results
obtained in treating schizophrenic patients were as good at the
mental hospital at 20 dollars per day as they were at the university
hospital at 80 dollars per day. We should have seen an Outcome
from the latter up to four times as good.
The major elements in any treatment program are the treating staff,
the site of treatment, i.e. hospital, clinic, home, the streets
etc, and the treatment process i.e. psychotherapy, medication,
nutrition, nutrients, etc. The university hospital and the mental
hospital used the same treatment programs, provided the same quality
of food, and differed only in the staff to patient ratios. That
study suggested that staff to patient ratio was a minor factor.
To further test these conclusions I arranged with the proprietor
of a new nursing home in Saskatoon to admit chronic patients under
my care. They were coming from the rest of Canada and from the
US, The nursing home would charge the families 20 dollars per
day. It would provide nursing supervision, a single room and I
would be responsible for the treatment program. I had agreed to
have no more than two there at one time. They had none of the
usual facilities available to the patients at the university hospital
i.e. no psychologists, no social workers, no occupational therapists,
no physiotherapists, and no residents, nor medical students. My
first objective was to find out whether the nursing home could
manage these psychotic patients. Everyone was a treatment failure
from mental hospitals elsewhere. Within a month it was clear that
we were not having any unusual difficulties. The patients did
not run away any more than they would have from the hospitals.
In fact the elderly patients in these homes enjoyed having young
men and women schizophrenic patients around because they added
some life to the setting. Most of the patients offered to help
with looking after the seniles etc. I treated over 60 patients
in this nursing home over a period of several years, An analysis
of the follow up data showed that the results I was getting with
these very chronic sick patients was the same as the results I
obtained with similar patients at university hospital. This reinforced
my conclusion that the treatment is the most important single
variable. The results I was getting were much superior to the
results obtained by using ECT alone or tranquilizers alone. Of
course there must be adequate psychiatric and nursing supervision.
But more money should be put into the treatment program than into
the facilities and other aspects of treatment if one is to conserve
money and get the same good results.
I explained this to the patient's father and I agreed to take
his son into the nursing home. By then he had been treated by
Dr. Moke Williams in Florida who had to give him a series of ECT
and later he was treated by Dr. David Hawkins in New York who
also had to give him mother series of ECT. He was brought to Saskatoon
accompanied by a nurse and he was installed in the nursing home.
Very slowly he began to improve. Eventually I found a family in
Saskatoon who took him and when I moved to Victoria another fine
family took him in as a member. He now lives in Victoria in his
own area which includes his living room, bedroom, a private bathroom
and the run of the house. He eats with the family. He is almost
a member of the family. I see him every two weeks. If I were to
introduce him to any psychiatrist and not tell them anything about
his history I doubt they would diagnose him as schizophrenic this
time, not unless they spent a lot of time with him. He is still
paranoid at times but most of the time he is pleasant, cooperative,
well dressed. He spends a lot of timed reading books and magazines.
He goes with the family on outings. He is as happy as he will
ever be, But he still must remain on a very extensive nutrient
program with heavy doses of tranquilizers and with anafranil 75
mg daily. He has not needed any more ECT nor has he been admitted
to any hospital since coming under my care.
For the first few months after he started on the orthomolecular
treatment in Saskatoon he was totally confused. One time I saw
him sitting alongside a woman who was so deteriorated mentally
she did not know where she was or what she was doing. Yet R.W.
sat patiently beside her trying to teach her how to play checkers.
He was completely unaware that she was in an entirely different
world, I have classed him improved because he still suffers from
symptoms and he is still unemployable. In 1975 a colleague examined
him and wrote the following report. " He has a flat, inexpressive
face although at time he appears to be grimacing. His speech is
confused and rambling. His affect is basically flat but at times
inappropriate. He describes his moods as being very high or very
low. He feels that he enjoys life and that life is worth living.
He denies suicidal ideas. His thought content showed some rather
vague paranoid delusional ideas concerning religion, However there
appears to be no systematized delusional system. He denies having
had any hallucinations at any time. His thought processes show
thought blocking, circumstantial thinking and tangential thinking.
At times he also showed punning and clang associations, He tried
to be abstract in his thinking but tended toward concreteness.
There is no confusion, however both his recent and remote memory
are very poor. His general knowledge was very good and his intelligence
seems to be in the high normal range. Diagnosis: Chronic Hebephrenic
Schizophrenia." He is improved.
22) G.J. Born 1951.
I saw him in 1971 after he had been sick for two years. He had
become very nervous, could not concentrate and had to drop out
of school. He was admitted to Winnipeg General Hospital for three
months where he was given 20 ECT. After that he continued to feel
unreal, he felt numb and frozen. In 1970 he was admitted again
for 10 days, followed by three months at the Manitoba Hospital
at Brandon. He was discharged in April 1970 but was back in Dec.
for four days. When I saw him he suffered from visual illusions,
saw his face change in the mirror, heard voices, felt unreal and
heard his own thoughts. He was paranoid believing everyone was
watching him and he could not concentrate. His mood was flat,
he felt half dead.
April 1972 I admitted him to Extendicare, the nursing home which
was admitting my patients. He was given 10 ECT and placed upon
the vitamin program. He had to be admitted again in Winnipeg April
14, 1975 for another six ECT. He came under my care again in Sept
1975 and I admitted him to City Hospital, Saskatoon for three
weeks for treatment of his jaundice. By Oct. that year he was
better but still very ill, He was admitted in Kelowna for a few
weeks but since the hospital refused to give him his vitamins
he stopped going there.
Mar 1977 his aunt who was being very helpful wrote, " It has been
nearly two years since I have been in touch with you. G. is feeling
so well and hasn't had a real setback since you last saw him in
hospital in Saskatoon when you treated him for jaundice," In April
1987 I wrote to his doctor who had referred him, "I saw this patient
in Nov 1983 at which time he was getting along fairly well. He
had done reasonably well until last winter when he began to feel
sick, especially around Christmas. His modecate had to be increased
and now he is taking 25 mg every seven days, He is somewhat better
now but still not as good as he was. At times he tends to be very
paranoid and he is still preoccupied with thoughts which he finds
extremely unpleasant. He is also taking lithium 750 mg daily compared
to the smaller quantity he was taking before, but I think this
is a good idea. I have started him on anafranil 100 mg before
bed to replace the other antidepressant he was on." April 19911
wrote, "G. pointed out that the last summer had been difficult
for him because he was much more paranoid than he had been and
it required some readjustment of his medication. By fall, however,
he was better. This past winter has been better than the previous
winter, and since coming back to B.C. he has been feeling good.
He discussed some of his delusional ideas which he is trying hard
to control, Over the past four days his sense of taste has returned.
It first deserted him in 1978 when he became ill, He also reported
how lights appeared to be exaggerated last year but they are better
now. I think he is continuing to make slow subtle progress," His
program consisted of nicotinic acid 1.5 g tid, ascorbic acid 2
g tid, pyridoxine 800 mg daily, manganese 50 mg daily, selenium
200 micrograms daily, lithium carbonate 750 mg daily, zinc gluconate
50 mg daily and a few other vitamins. I have classed him much
improved,
23) Miss T.D. Born 1961.
T.D. became a behavioural problem in 1975. But for the previous
two years her work at school deteriorated, She became irresponsible,
sexually active and began to have temper outbursts. She began
to suffer blackouts, experienced visual hallucinations and illusions
and her behaviour became strange. She had taken LSD several times.
When I saw her she told me about her visions and voices, her feelings
of unreality e.g. her legs did not feel attached to her body.
Her concentration was poor, she was very paranoid and very depressed.
I started her on a treatment program but for several years she
refused to take even vitamins because she was convinced they were
poisonous. Eventually she trusted me enough and began to follow
the vitamin program carefully but she remained very suspicious
of drugs. Her baby was born Oct 1980. I admitted her to hospital
Nov. 1982f or four days. She had her last admission May 1986 for
10 days. She has been well for the past three years and has been
active in the movement to help schizophrenic patients. She is
currently taking nicotinic acid 1.5 g tid, ascorbic acid I g tid,
Elavil 225 mg before bed and chlorpromazine 25 mg before bed.
She was seen the following number of times.
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24) Mr. J.J. Born 1946
This patient is an example of a chronic patient who was treated
very intensively for many months but who did not remain on the
program after he went home. He is a good example of the type of
response usually obtained with chronic patients taking only tranquilizers.
I saw him for the first time in 1971 after he was admitted to
the nursing home I have already described. He came with his mother
who filled in the details of his history. He told me he had been
depressed for four years. One year after onset he was treated
at the Clarke Institute, Toronto, for 4 months receiving eight
ECT. He was slightly better . But there was evidence of trouble
long before. As a child he had been very nervous and as a youth
he suffered from a learning disorder. After discharge from the
hospital he tried several jobs but could not carry on with any
of them. In 1970 his psychiatrist suddenly stopped the chlorpromazine
he was taking . Two weeks later he was catatonic. It was necessary
to place him back on the high doses he was on before. When I saw
him he reported that people were watching him, told me about his
visions of various people and his voices and scenery, how he heard
his own thoughts and felt unreal, He was paranoid, spoke with
a peculiar phraseology and his concentration was poor. Both parents
were involved in a plot against him. He was in the nursing home,
Extendicare, Aug 31 to Nov 25 197 1. Then he returned home but
would not stay with the program. He continued to drink too much
and would not follow a sugar free diet. He came back again July
28 to Sept 5,1973. I was then told that he had refused to take
the vitamins because he had trouble swallowing pills and had to
chew them or grind them up. I gave him nine ECT. He received another
series of 13 May 14 to June 22, 1974. He then returned home somewhat
better but within a few weeks at home he once more became non
compliant and would not follow the program, His mother tried her
best to keep him on the program but his father was very skeptical
all along about the program and he made little effort to support
his wife, Recently I was informed that he is still ill, not doing
well at all and is in an institution.
Another young man was in the nursing home at the same time. He
too received a series of ECT and the vitamin program. He went
back home. Today 28 years later I received a phone call from his
mother who was visiting friends in Victoria. She called to bring
me up to date. I had forgotten about him and have not been able
to locate his file. She told me he was doing well. He had not
needed to go back to any hospital. After his treatment in Saskatoon
he had done remarkably well and was working five hours each day
in one of the supermarkets. He was living in a group home and
still followed his vitamin program with the support of his psychiatrist.
He again illustrates the beneficial effects of the orthomolecular
program if it is maintained. J.J. illustrates what happens when
it is not followed.
25) Mr. J. M. Born 1968.
J.M.'s mother wrote to me in June 1971. Following that discussion
she brought him to Saskatoon and I saw him July 2,1971. 1 found
that he had been treated at Sunnybrook Hospital, Toronto, in 1968
for two weeks. He was clearly psychotic hearing voices with a
series of paranoid delusions. He believed that the world was going
to end, that he, somehow was influencing events outside including
the weather and the world international situation. He was inappropriate,
agitated. The conditions had settled in after a few weeks. He
was started on medication and responded but remained apathetic,
without drive, always worried and nervous. He showed the early
manifestations of the tranquilizer psychosis, He had to be readmitted
shortly after discharge to readjust his medication which had been
causing severe side effects. When I examined him he spoke to me
about his feeling people were watching him, about being very self
conscious, unreal and about his deep depression. He responded
very rapidly to the vitamin program but in Dec 1973 became jaundiced.
The doctors immediately concluded he has developed a vitamin B3
jaundice but it turned out to be obstructive and cleared and when
he went back on the vitamins has not recurred. He still continued
to suffer from anxiety and episodes of depression. In May 1974
he did a four day water fast to determine what foods he might
be allergic too. On the fourth day he was well. Thereafter he
avoided certain foods. In 1979 his mother told me he had completed
first year nursing and was well. He had married and had a daughter.
In 1986 I was informed that he was well. In 1991 he is still well
and now has two children. He has been working at his profession
since he graduated about ten years ago. As a professional watcher
of my colleagues I am interested in their reaction to patients
who tell them they have gotten better on vitamins when they have
failed to respond to tranquilizers This family ran into the usual
number of roadblocks in their attempt to get their son well. For
example, one of the psychiatrists, who had never tried out any
of the program, told them when they came to see him, "You Hoffer
people do have your believers" sarcastically, He suggested by
this, that only their faith in me had made him well. This is curious
since no double blind experiments has ever shown that faith alone
will help schizophrenics get well, even though faith is an important
ingredient in any program and should accompany the use of tranquilizers
as well. Another psychiatrist told the family in 1974, "Vitamin
therapy is pure crap." He interpreted the disease in their son
as arising from family hostility. He told the family, "J. was
like a fluffy little bird in the nest and that not just his mother,
but the whole family was not willing to release him to anyone
else." This is very poetic but neither scientific nor medically
correct. Shortly after that he was transferred to a different
hospital where the attitude to them was more sympathetic and helpful,
and less tainted by Freudian jargon. I have classed him as, well.
26) Miss G.L. Born 1954.
G.L. became sick in 1974 following taking LSD on three occasions.
She became very depressed and suicidal and was admitted for two
days. In 1975 she practised transcendental meditation, went to
first year University and drank heavily. Following her second
suicide attempt she was admitted to Health Sciences Center, UBC
for one month, diagnosed schizophrenia. After discharge she became
more obsessional, felt she was falling apart and again was admitted
for another month. In Nov 1975 she was in again for two months
and againin1976. Later she was admitted to Eric Martin Pavilion,
Victoria, and readmitted July 5, 1977 when I saw her for the first
time. By then she believed people were watching her. The feeling
was so strong she was afraid to ride in buses or to go out. She
saw walls falling in on her and once saw a suit hanging in her
closet become a person of whom she was very fearful. She also
heard voices. She was very paranoid, believing people were talking
about her, running her down. Her concentration was poor. On top
of all that she was very depressed, tense and suicidal. She then
told me she had taken a ten day fast in 1975 and toward the end
had felt marvellous, I started her on the orthomolecular program.
She recovered and remained well until 1980 when she began to drink
wine heavily. Aug 1983 she was depressed but by mid 1986 she was
well again and still on her vitamin program, Dec that year she
made another suicide attempt by setting fire to her apartment.
She was in a group home for awhile. In 1991 she married but later
they separated. She had remained well, had one child, had developed
her own business which required 10 employees. May 1992 she was
again pregnant but then it was discovered she had thyroid cancer
and this was resected. She was placed on a different vitamin program
including a lot more ascorbic acid. Two weeks after surgery she
told me she felt great and was back administering her business.
I class her as well.
27) Mr. R.S. Born 1958
I first saw this patient during his third admission to hospital.
He described his visions of God and of Love, and his voices which
were of two types, the good and the bad. He also believed people
were watching him. He was paranoid believing that someone was
going to kill him and his mood was inappropriate. He was in hospital
May 20 to June 16, 1979. 1 then started him on the orthomolecular
program. By July that year he was much better, Early in 1980 he
began to
show signs of tardive dyskinesia which cleared in one month when
he was started on manganese. In Mar 1980 he made a suicide attempt
by over dosing, was seen in the Emergency but did not have to
be admitted. He was admitted again Dec 25 to Jan 2, 1980. I saw
him in 1984 when he reported he had not taken his vitamins but
had remained on medication. He appeared well and was able to hold
two jobs. But after going off all the medication for one month
he relapsed and was readmitted June 19 to June 30. 1988. He then
had been off his vitamins for seven years, I placed him back on
this program again. He has been compliant since then and has been
well many years, on haldol 3 mg daily plus niacin and ascorbic
acid. He is still fully employed and gets on well with his employer.
He was seen the following number of times.
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The patient told me he had stopped taking his niacin for one month
because he wanted to re-experience his hallucinations again. Within
a few days his voices came back and they were the same as they
had been before. He became paranoid again. He felt his judgement
was affected. For example he began to believe everything he read.
He then resumed the niacin and within four days the hallucinations
were gone again.
Discussion
This series of 27 schizophrenic patients is not a randomly selected
sample from a larger population of schizophrenics, They were selected
using the following criteria. 1) They have been under treatment
at least ten years. 2) With a couple of exceptions they have been
ill an average of seven years before they came for treatment.
Their average age was 40. 3) They had not been responsive to any
previous treatment.
The clinical data and present condition of these chronic schizophrenic
patients is shown in Table 1.
From this group of 27 , excluding the one chronic patient who
did not follow the program, 11 are working, two are married and
looking after their family and home, two are single mothers looking
after one child, and three are managing their own business. One
received an M.A., another received a B.Sc. and a third received
a diploma from a community college, Johnstone (1991) found only
two out of 532 who were in the best occupational level, It is
apparent from her description of the patients that in her group
there were many more acute patients compared to my series of 26
of whom only two had been ill a year or less.
Table 2 shows the mean number of times the patients were seen
over two year intervals beginning with the years 1977-78 and ending
with the years 1991-92.
Omitting the first interval because there were only six patients
in that group it is seen that from a maximum of 9.6 times seen
there was a steady decrease in this statistic until in the last
two years it was around four. Number of times seen is one of the
criteria I use in determining how patients are getting along.
The sicker they are the more frequently are they seen, This is
a joint decision since in most cases once they have started to
improve I ask them to decide whether they should be seen at intervals
of one month, or two , or three or when they think they would
like to come back again, If it is left open they are told they
may call to set up another appointment whenever they feel there
is a need to do so. The nurse in charge of group homes decides
when they should be seen again, for the two patients living in
these homes, In my opinion chronic patients who are still taking
tranquilizers should be seen once or twice each year to monitor
progress and to detect side effects. I have found over the past
40 years that patients are more compliant when they are in steady
contact with their physician. This means that even when well the
mean number of times seen per two year period will be between
two and four.
Chronic patients respond very slowly to treatment and in this
series there was little change in the first half of the follow
up period, Only in the past five to seven years has there been
a steady and enduring improvement. This cannot be ascribed to
the use of new and improved tranquilizers since with these drugs
alone this is not the usual response. However it is possible that
combined with the nutrients the newer tranquillizers; may have
become more effective. Another factor might have been the use
of antidepressants, especially clomipramine, I have found
Table 1. Clinical Data on Chronic Schizophrenic Patients
Table 2. Mean Number of Visits Per Two Year Period
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this to be very useful in reducing and eliminating paranoid ideas.
I consider recurrent paranoid ideas equivalent to obsessive compulsive
ideas. I began to use it when I realized I had never seen cheerful
paranoids. It occurred to me that if I could remove their depression
it might be easier to let go of their paranoid ideas. This slow
response is a major disadvantage since few psychiatrists in private
practice are willing to work that long with their patients and
too often in mental hospitals patients who are discharged are
not followed long enough by the same psychiatrist. In my opinion
follow up must be done by physicians who can change the medications
and nutrients as needed.
There undoubtedly is some bias in this chronic population. They
were willing to stay compliant for this period of time. The patients
who would not follow the program would not appear in this kind
of follow up, In my opinion compliance is much less of a problem
when orthomolecular treatment is used since the dose of tranquilizers
is much less and there is less incentive for patients to go off
the program.
Because of these factors one can not generalize beyond the parameters
of this study. But it does show that chronic patients who are
compliant over enough years do improve substantially. To deprive
them of this chance for recovery a