Is niacin a possible successful treatment for schizophrenia?
Schizophrenia is a devastating disease. Characterized by hallucinations, delusions and disorganized thought, it destroys lives. While the condition can be controlled with appropriate medication, a cure remains elusive. But just what constitutes “appropriate medication” is controversial. “Antipsychotic drugs that block dopamine and serotonin receptors in the brain have been the mainstay of therapy, but the involuntary muscle movements, restlessness and tremors they can cause are troublesome. An alternative school of thought maintains that mental illness can be addressed with nutritional therapies, particularly with the use of certain vitamins in the right dose. This idea was first formulated by Dr. Abram Hoffer, a Canadian psychiatrist whose pursuit of science began with a degree in agricultural chemistry from the University of Saskatchewan, followed by a PhD in biochemistry, and finally a medical degree from the University of Alberta. During his graduate studies young Hoffer worked at a wheat products laboratory in Winnipeg where he was charged with developing an assay for vitamin B-3, commonly known as niacin. This triggered a life-long interest in the vitamin and its biochemistry, with Hoffer eventually concluding that it had a significant role to play in the treatment of schizophrenia. As a practicing psychiatrist, Dr. Hoffer came up with the ‘adrenochrome hypothesis’ which he believed explained the symptoms of schizophrenia and offered a hope for treatment with vitamins.
Dr. Hoffer’s basic idea was that schizophrenia was a biochemical abnormality characterized by the buildup of chemicals in the brain called adrenochromes. These are normally formed from adrenalin, but in a healthy nervous system they are quickly metabolized. In schizophrenic patients, however, the mechanism for breaking down adrenochromes is impaired. Hoffer claimed that administering adrenochromes to volunteers resulted in hallucinations reminiscient of schizophrenia and hypothesized that reducing adrenochrome concentrations in schizophrenic patients would result in the alleviation of symptoms. From his biochemistry background he knew that niacin could reduce the formation of adrenalin from its precursor, noradrenalin, which meant it would also reduce adrenochromes since these were made from adrenalin. He also rationalized that adrenochromes could be reduced back to adrenaline through the administration of vitamin C.
Starting in the 1950’s Dr. Hoffer began to administer high doses of niacin and vitamin C to his schizophrenic patients and claimed he noted an improvement after a month. Paranoia and delusional symptoms decreased to an extent that hospitalized patients could be discharged. But, Hoffer maintained that if they stopped taking the vitamins they would experience a relapse. However, if they continued with the regimen for years, there was a chance of a complete cure. The problem, though, was that other researchers were unable to confirm Hoffer’s successes, resulting in skepticism about his claims. Interestingly, subsequent research did show that schizophrenic patients have a genetic defect preventing them from successfully eliminating adrenaline metabolites, so the adrenochrome theory is not ready to be dismissed. Still we are left with the fact that no properly controlled clinical trials have demonstrated significant benefits of vitamin megadoses in schizophrenia. That’s not a great surprise because schizophrenia is a complex disease, not characterized by a single cause. Genetic vulnerability as well as environmental effects are significant factors and lack of oxygen just after birth may also play a role.
Nevertheless, some psychiatrists continue to administer megadoses of niacin to schizophrenia patients and claim they see improvement. But such evidence is anecdotal. Perhaps further research will reveal that some vitamins used appropriately are beneficial, but for now, the evidence is on the side of using mainstream antipsychotic medications. It certainly is unwise for patients to try megavitamin therapy without a physician’s supervision. While doses of niacin under 1,000 mg are considered safe, higher doses can cause liver damage, gastritis, diabetes and an increase in blood uric acid levels.