Orthomolecular Psychiatry

Introduction The late Dr. Carl Curt Pfeiffer of New Jersey favored "an orthomolecular approach to balancing body chemistry". In other words he wanted to treat mental illness with "nutrition". He had ideas similar to Linus Pauling except that he was interested in more than vitamins. He was also interested in minerals and amino acids. Pfeiffer was right, but it was a difficult task. First one has to know what the chemical errors are. Then one has to correct them. Neuropathology In 1982 Dr. Janice Stevens published a brilliant neuropathology study of schizophrenics. She found gliosis in the basal forebrain, particularly the substantia innominata. The basal forebrain is a cluster of areas located behind the eyes that are high in dopamine. This finding suggests a toxic factor. The location of the pathology suggests that the toxic metabolite may be a dopamine metabolite. Nutrition and Mental Disease This author has proposed a diet low in amino acids. This diet is similar to the diet used for kidney malfunction, which is also a low protein diet. The rationale is different, however. In kidney malfunction the body has trouble getting rid of urea and other protein wastes. In mental disease amino acids flood the neurons and glia. Pauling put too much emphasis on vitamins. The fact that vitamin C is being destroyed in mental illness may simply be a side effect of the disease. It could be the result of excessive methylation. Nevertheless Pauling was close to the truth. Conclusions This author has put together the pieces of the puzzle called "schizophrenia". Depression is very similar. Craig Olson
Curing the Terrible Diseases Schizophrenia This terrible disease is called "metabolic dysperception" by orthomolecular scientists. The purpose of this name is to point out that the disease is caused by metabolic errors. However, the term "metabolic dysperception" is not in common use. Therefore I use the old term "schizophrenia". There is new genetic evidence that the transmethylation theory, favored by orthomolecular psychiatrists, is correct. This theory was invented in 1952 by Osmond & Smythies. Since that time Smythies has backed off a bit from the theory. Smythies still feels that a toxic factor in the blood causes schizophrenia, but he suspects that it might be similar to melanin. Melanin is a catecholamine metabolite. Neuromelanin comes from dopamine. In the original 1952 paper, DMPEA was supposed to be the toxin. DMPEA is created by methylation, and hence the name of the theory. The methylation is thought to be abnormal in schizophrenia. It is from this theory that Hoffer & Osmond recommended methyl acceptors as treatments. One of these was NAD. This author, Olson, feels that they chose the wrong methyl acceptors. They should have used polyphenols, which are found in the diet. Because all of this nutrition is hard to digest, this article will be written in installments. To Be Continued Craig Olson Brighton, MA

ORTHOMOLECULAR MEDICINE by Craig Olson Introduction Linus Pauling was born in 1901. Ninety years later he was still going strong. At the end he lived in Menlo Park, California. Although Pauling is now deceased, unfortunately, his work is still being carried on by Dr. Abram Hoffer of Victoria, British Columbia, in Canada and by others. Osmond is in Tuscaloosa, Alabama. Richard Kunin is in San Francisco, California. Amino Acids In 1968 when Linus Pauling invented the term "orthomolecular", there was only a modest interest in amino acids. This was a mistake. Paper after paper coming out of Detroit implicated amino acids in schizophrenia. Frohman et al (1960) reported an unknown toxic factor in schizophrenia. The factor was a protein. It was quite labile. It had a pronounced effect onthe transport of amino acids into the cell. The most marked effect was with indoleamino acids (Frohman et al, 1969). Tryptophan and 5-hydroxytryptophan were taken up at an abnormal rate. A good factor that destroyed the bad factor was also identified. Russian Work Tikhonov, Lozovsky, and Glezer (1967) reported a study in which blood serum from schizophrenics was added to rat brain slices. They found swelling and fragmentation of the mitochondria. Lideman and associates reported extensive lesions in the myelin of a frog nerve when it was incubated with serum from schizophrenics. Romasenko found similar results when rats were injected with serum from patients. He used electron microscopy to find that the membranes of both cells and mitochondria deteriorated. This was observed in the cerebral cortex. Thus there appears to be a membranolytic substance in the serum of patients with schizophrenia. Conclusions It appears that certain amino acids, particularly tryptophan and alanine, are flooding the cells. They probably are causing the swelling in the mitochondria. It would appear that a diet low in amino acids should be tried. Such a diet was tried by Dr. Soheil Saleh of Canada. Saleh (1990) claimed success with such a diet. The diet is tricky because carbohydrates stimulate the production of insulin, which causes certain amino acids to be taken up into muscles. However, it is probably the brain that is the real problem. There may be too much tryptophan in the brain.
BRAVE NEW BRAIN: A REVIEW by Craig Olson Introduction This book was written by Nancy Andreasen in 2001. She has also written other books including "The Broken Brain" and "Schizophrenia: From Mind to Molecule". I am trying to get "Schizophrenia: From Mind to Molecule", and that could be a subject of a future review. "The Broken Brain" is dated as it was written in the Eighties. I have read that book, which does have considerable merit. Unfortunately it does not have all the answeres. Psychiatry Andreasen discusses unipolar major depression, manic-depressive illness, and schizophrenia. She also discusses Alzheimer's disease. She favors drugs. According to one theory there is a serotonin deficiency. This theory is used to justify Selective Serotonin Reuptake Inhibitors such as Celexa. However, this theory is very weak. Direct measurements in the brain have shown that there is no serotonin deficiency. Genetics Andreasen feels that there is a very strong genetic component in mental disease. On this point she is probably correct. There is also a lot of good basic neurology in the book. Much of it is aimed at the average lay person. Much of this book is a rehash of basic science, which is not bad. I was hoping for brilliant new relevations. Dopamine Dopamine is found in high concentration in the basal ganglia. It is also found in the limbic system the frontal areas, and theventral tegmental area. Dopamine is altered in certain diseases, including PKU. PKU is a genetic disease treated by diet. Neuroimaging There are a number of different techniques used in neuroimaging, including the CT technique. Enlarged lateral ventricles have been seen in schizophrenics using CT scans. Three planes are often used. These three planes are transaxial, coronal, and sagittal. Tissue is classified as gray matter, white matter, and cerebrospinal fluid. With increasing age the CSF areas get larger. The Case of Phineas Gage This case was a very strange one, and has been grist for the mill in psychiatry and neurology. Gage got a severe injury in his prefrontal cortex. This caused disastrous changes in his ability to make mature social judgements and "appropriate emotional responses". Schizophrenia Enlargement of the cavum septi pellucidi has been seen in schizophrenia. Alzheimer's Disease In Alzheimer's disease the ventricles are greatly enlarged. Alois Alzheimer was a German psychiatrist. Conclusions The book is useful, and even the illustrations are good. Some of the great scientists, including Cannon, Papez, MacLean, Pavlov,etc, are mentioned. The 1983 book "The Broken Brain" did not have any magical solutions either. My own opinion is that in 1968 Linus Pauling was ahead of where Andreassen was in 2001. Andreassen gets an A for the illustrations, but a B for the text. Pauling got an A because of the difficulty of the task he attacked.

THE ETIOPATHOGENESIS OF SCHIZOPHRENIA By Craig Olson Introduction Orlovskaya and co-workers discovered a factor in the blood of schizophrenics which had various effects on rabbits. Serum from schizophrenics was injected into rabbits. The blood glucose of the rabbits went up, presumably due to the toxic protein factor. The unknown factor appears to be causing a kind of diabetic state which may not be the same as the usual diabetes. It appears to inhibit glycolysis. A strict vegan diet is recommended because amino acids are flooding the cells. This is why the glucose metabolism is slowed. The brain is burning amino acids instead of glucose.