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Orthomolecular psychiatry is the use of orthomolecular medicine for mental illness. The approach uses unorthodox forms of individualized testing and diagnosis to attempt to establish an etiology for each patient’s specific symptoms, and claims to tailor the treatment accordingly, using a combination of nutrients, dietary changes and medications that are claimed to enhance quality of life and functionality as well as to reduce or eliminate symptoms and the use of xenobiotic drugs.
Abram Hoffer in the 1950s was the first major practitioner. Hoffer’s therapies focused on using niacin, among other nutrients, to treat acute schizophrenia, which was identified using the Hoffer-Osmond test. In 1973, a task force of the American Psychiatric Association examined niacin monotherapy of patient populations with chronic schizophrenia and bipolar disorder and rejected the practice.[1]
The origins of orthomolecular psychiatry can be traced to as early as 1927,[2] and the broad roots of modern orthomolecular medicine involving Linus Pauling trace back to the 1930s.[3] Orthomolecular psychiatry per se is generally accepted to have begun in the 1950s with the work of Abram Hoffer and Humphry Osmond, continued by the work of Carl Pfeiffer. For a time in the late 1950s and early 1960s, research into orthmolecular treatments was given much more prominence but the availability of faster acting sedatives and antidepressants, with clinically proven effects, began to dominate conventional psychiatry.[4] In 1968, Pauling gave the name and principle to the discipline of ‘orthomolecular psychiatry’.[5][6]
The assertions by proponents of orthomolecular psychiatry were rejected in 1973 by a panel of the American Psychiatric Association.[7][8] Orthomolecular psychiatry has subsequently found little support in mainstream psychiatry[9] and is currently considered to be an unproven system of treatments. After 1975, research directly associated with orthomolecular psychiatry was primarily reported in Orthomolecular Psychiatry, now the Journal of Orthomolecular Medicine.
Proponents of orthomolecular psychiatry claim to have identified the causes of some psychiatric syndromes, in particular those that cause psychosis; according to orthomolecular proponents, testing for these causes guides diagnosis and treatment. Diagnostic measures and therapies commonly employed include “individual biochemical workup”, fasting, identifying suggested allergies, dietary changes, megavitamin therapy, amino acids, and other so-called pharmacologic nutrients.[10] These diagnoses have not been accepted by mainstream medicine.[9]
Treatment generally involves the administration of the ‘right’ substances (ortho meaning right in Greek); generally this involves administration of high doses of vitamins, essential fatty acids and other substances already produced or required by the body. Orthomolecular psychiatrists do not categorically refuse to prescribe psychotropic medications; antipsychotics are often used to stabilize a patient, and anti-epileptics (dilantin in particular) are occasionally used to treat the conditon called by orthomolecular doctors, ‘histadelia.'[10]
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