Tranquilizers

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Tranquilizers

 

The Future of Psychiatry

by Abram Hoffer, M.D., Ph.D.

 

Recently, in an orthodox medical journal, the question

was discussed whether psychiatrists were still going

to be needed. Basically, modern psychiatrists have two

main treatment functions: they prescribe drugs -

tranquilizers or antidepressants; and they may also do

psychotherapy or counseling. It was suggested that

general practitioners are just as capable of

prescribing drugs, and that psychologists and

counselors are perhaps even more capable of doing

psychotherapy and counseling. In other words, the

family physicians could initiate the medical regimen,

and the psychologists could take over the counseling

function.

 

This was not a very radical idea as it has been

happening for many decades. Psychiatrists themselves

have started deserting the really seriously ill--the

schizophrenics, the senile states, the personality

disorders--and have devoted themselves more and more

to the more benign forms of disease such as depression

and mild anxiety conditions. And general practitioners

have become more and more skillful at treating

seriously ill psychiatric diseases. I know many

physicians (MDs, osteopaths, naturopaths,

chiropractors) who practice orthomolecular medicine,

and who have a much higher cure rate when treating

schizophrenics than do the psychiatrists in their area

who work only with drugs. In Saskatchewan many years

ago, a family physician was so effective local

psychiatrists complained about him. Later he lost his

license to practice medicine.

 

Over the past 100 years, psychiatric conditions that

were almost exclusively treated in

mental hospitals have disappeared from psychiatry

because they were treated successfully by general

practitioners. In a book on psychiatry written about

1900, the four differential diagnoses for psychosis

were pellagra, scurvy, general paresis of the insane

and dementia praecox. The treatment for pellagra was

dietary until niacin was recognized to be vitamin B3

in about 1935. Pellagra has disappeared; at one time

it made up as much as one-third of all admissions to

mental hospitals in the southern U.S.A. It became the

province of the early pellagrologists. But they were

no longer needed when synthetic vitamin B3 became

available and was added to white flour in the U.S.A.

and Canada. Most psychiatrists today would not

recognize it if a patient with pellagra walked into

their office. Scurvy severe enough to cause psychosis

is no longer present. Syphilis responded to the

physician and the needle, and is rarely found in

mental hospitals.

 

But dementia praecox, the disease, did not disappear.

It was simply renamed schizophrenia, and has remained

the major problem for psychiatry. Freud recognized

that psychoanalysis would have a short career, only

until the physicians with their syringe (drugs) came

along. He knew nothing about nutrition and nutrients

when he practiced. The process of breaking the broad

group of the schizophrenias into unitary syndromes

still goes on. Arising from our work in Saskatchewan

in 1960, Carl C. Pfeiffer was able to divide

schizophrenias into three broad groups: those

excreting krytopyrrole, the high histamine group, and

the low histamine group. Each group requires a

different treatment plan, and when they are followed

the results are very good. He recognized a fourth

large group, the cerebral allergies. But orthodox

psychiatry is not aware of this useful subdivision and

looks upon each schizophrenic as a member of the same

class-a class for which the only treatment is to be

tranquilized.

 

If modern psychiatry did its job effectively, there

would be no need to consider replacing them with their

more biochemically oriented colleagues. The results of

modern drug treatment are not very good compared to

what was obtained before the tranquilizers were

introduced. Thus, at a symposium held in Vancouver in

the fall of 1995 sponsored by the Canadian Psychiatric

Association, Dr. Alan Brier, Chief, Unit of

Pathophysiology and Treatment, Experimental

Therapeutics Branch, National Institute of Mental

Health, Bethesda, Maryland, is quoted as saying,

" Eighty-five percent of all people with schizophrenia

who are treated with neuroleptic drugs are deriving

suboptimal benefits. So it is clear that new and

better drugs are needed " . He should have said, more

appropriately, that we need better treatment.

Orthomolecular treatment is not new, but it is an

awful lot better than merely allowing patients to

vegetate on tranquilizers.

 

A fifteen percent response rate is pretty good if

there are no other treatments which yield a better

outcome. In fact, in 1850 Dr. J. Conolly in England

reported that fifty percent of his insane patients

were discharged well. The early mental hospitals in

the northeastern U.S.A. reported similarly good

results. What did they use? Good food, shelter,

sympathetic care, and respect. This fifty percent is

probably the natural recovery rate if our

schizophrenic patients were treated with the same

sympathetic care, good nutritious food and decent

shelter (not the city streets).

 

Modern psychiatry, with the huge expenditure of money

for drugs, has in 150 years gone down to a 15%

recovery rate. Yet its practitioners seem to be

content with this very dismal response rate while they

wait for the miracle-the drugs which will cure their

patients. Each year we hear the announcement of new,

ever more expensive drugs, with little evidence they

have any major impact on the problem as a whole. I

don't see reports that the schizophrenic homeless are

no longer homeless, or that the suicide rate among

young schizophrenic patients has gone down.

 

Recently, on Canada's news channel, Pamela Wallin

discussed schizophrenia. For the first fifteen minutes

a couple spoke about their schizophrenic son, still

ill. For the next fifteen minutes the Honorable

Michael Wilson, formerly Minister of Finance,

described his son's illness culminating in his

suicide. The first half hour, then, was devoted to

demonstrating the failure of modern psychiatry. The

third fifteen minute section was given to a modern

psychiatrist who seemed quite cheerful with the

present treatment of schizophrenia. He gave a good

account of the nature of the illness, but was pleased

with the tranquilizers and was cheerfully hoping for

that ever new, better tranquilizer. It appeared to me

that he had not seen the first half hour of this

program. The last fifteen minutes was given to a

schizophrenic patient who appeared well, and who

created and edits a journal for schizophrenics. It is

a good journal to which I have made several

contributions which have been accepted, indicating a

degree of broad-mindedness which does not exist in

standard psychiatric journals. This TV production

typifies the state of schizophrenia treatment today:

tranquilize, be content, wait for the new, ever-better

tranquilizer.

 

But how long can patients wait? A year in the life of

a schizophrenic can be like an eternity. Patients and

their families do not have the luxury of waiting for

the day when psychiatry will at last start treating

their patients properly. It does not provide much

solace to the Wilsons and other parents who have lost

their children to suicide. (The suicide rate for

schizophrenia is about 25 times that of the general

population).

 

In sharp contrast, at the 25th anniversary conference

of the Canadian Schizophrenia Foundation, held in

Vancouver in May 1996, two chronic schizophrenic

patients, who met and married after they had

recovered, described their own illness and their

recovery on the orthomolecular program. They had both

failed to respond to previous modern psychiatric

treatment.

 

Modern psychiatry has not been very good at treating

schizophrenia. One need only glance over at the

homeless people who live in the our city centers for

the evidence. Is there any other disease, other than

addictions, where so many sufferers are forced to wind

up in the streets for lack of proper medical

attention? Think what would happen if half the

homeless suffered from tuberculosis. Tuberculosis is

contagious, but in a social sense so is schizophrenia.

In my opinion, many patients today are no better off

than they would have been in 1950 when they were

incarcerated in hopelessly overcrowded dungeons called

hospitals. Perhaps they would have been better off

then, for at least they had a few nurses and doctors

to look after them.

 

Today patients are released early, after a short stay

in hospital in order to start them on tranquilizers.

They are discharged as soon as their major symptoms

are partially suppressed, but long before they have

regained enough health to permit them to live on their

own, or with their families. Or--and this is becoming

more frequent-- their diagnosis

is changed from schizophrenia to personality disorder,

and they are discharged with the unhelpful advice that

personality disorders can not be treated.

 

The reason why modern psychiatry has failed is that it

has such a narrow vision of what to do. All psychiatry

knows is to use tranquilizers, waiting for that

distant day when they will have a drug, the Holy

Grail, which will cure schizophrenia. I do not know of

a single xenobiotic chemical that has ever cured

anything, even though some of them are useful in

ameliorating the discomfort of the disease. The answer

to schizophrenia will come from recognizing more

clearly its causes and biochemistry and dealing with

them, as is done in orthomolecular psychiatry.

 

Modern tranquilizer psychiatry has been struggling for

the past forty years with the tranquilizer dilemma,

which they are aware of but have not clearly faced.

Very simply it is this: when one uses a tranquilizer,

one converts one psychosis, schizophrenia, into

another, the tranquilizer psychosis. I believe it was

Dr. Mayer-Gross who first suggested, in about 1955,

that tranquilizers converted one psychosis into

another.

 

Tranquilizers alleviate many of the symptoms of

schizophrenia, and make life more comfortable for the

patient and for their families, as well as for the

hospital and its staff. As the patient begins to

recover, she becomes more normal. However,

tranquilizers also make normal people psychotic-a fact

proven by the Soviet practice of committing dissidents

to mental hospitals and giving them tranquilizers.

Therefore, we can assume that as treatment continues

the patient becomes less and less schizophrenic, and

more and more psychotic from the drugs.

 

The tranquilizer psychosis is characterized by the

following features: fewer and less intense

hallucinations, fewer and less intense delusions,

difficulty in concentration, memory disturbances,

indifference, increased self interest, moderation of

moods and less agitation, social and behavioral

deterioration, and physical side effects such as

impotence, tardive dyskinesia, apathy, sluggishness,

obesity, deterioration of teeth from lack of saliva.

And perhaps most important of all, the inability to

engage in productive labor, i.e. to pay income tax.

That is why the average schizophrenic patient will

cost the community $2 million over a forty year life

span of disease, unless they are treated properly and

become well.

 

Patients prefer to be normal, i.e. they do not prefer

the tranquilizer psychosis over the schizophrenic

psychosis, but they have no choice and have to accept

elements of the tranquilizer psychosis in order to be

freed of elements of their original psychosis. The

modern solution is to keep them swinging between the

extremes of schizophrenia and the tranquilizer

psychosis. As they become more and more tranquilized,

the dose of drug is decreased to try and halt this

process, or the drug will be discontinued. In most

cases the original schizophrenia returns. They are

suspended in this uncertain world swinging between the

two psychoses. They can not escape, and the only

choice for these unhappy patients is to take to the

streets where they can avoid taking the drugs.

 

But with orthomolecular treatment patients are offered

a real choice, the choice of becoming and remaining

well. The large doses of nutrients and the diet will

maintain the patient in good health. One can combine

the rapid effect of the drugs with the slow curative

effect of the nutrients. As the patient begins to

recover one slowly reduces the dose of the drugs, and

this time instead of become psychotic from the drug

they remain well as the nutrients take over.

 

There is no other answer to this tranquilizer dilemma.

This is why acute patients treated for at least one

year will reach a 90% recovery rate. By recovery I

mean that they are free of signs and symptoms, they

are getting along reasonably well with their family

and with the community and they pay income tax. They

are working, or they are graduating and

getting ready to work.

 

I know of 17 young men and women who became

schizophrenic in their teens, were treated properly,

recovered, went to college, became doctors and

psychiatrists and are practicing. A few years ago the

father of one of them, a physician, was concerned

about his son. His son had been offered an appointment

as Chair of a large department in a medical school.

His father wanted to know if I thought it might be too

stressful for him. Patients pay income tax because

they are well enough to work. I challenge orthodox

psychiatric to show me any cohort of patients who have

been treated with tranquilizers alone of whom even ten

percent are gainfully employed in responsible jobs.

Since modern psychiatry has failed its essential task

of curing schizophrenics (in the same sense that

insulin and diet cures diabetes mellitus), since

modern general practitioners can give tranquilizers as

skillfully as psychiatrists, and since counseling and

psychotherapy can be given even more effectively by

psychologists and social workers and nurses, does it

not make sense to replace psychiatry with more

efficient health workers? Psychiatry should be allowed

to practice only if it is prepared to use the most

advanced treatments, and can show that it can do a

better job than could other physicians.

 

Reprinted with the permission of

Abram Hoffer, MD, Ph.D

3A-2727 Quadra Street

Victoria, B.C. V8T 4E5