Early Intervention in Schizophrenia; What You and Your Family Should Know!
The Naturopathic Medical Research Clinic is a research-based clinic dedicated to mental health treatment that uses a unique targeted treatment and research approach for FES and prodromal schizophrenia. Our nutritional therapy approach is based on the clinical and physician-derived research on orthomolecular therapeutics.
This series answers common questions that families and patients have when early signs of psychosis or schizophrenia emerge. Diagnosis is often uncertain in the pre-illness (or prodromal) stages of schizophrenia. Clear-cut symptoms of hallucinations and delusions lasting 6 to 24 months are diagnostic indicators of first-episode schizophrenia (FES).
We have highlighted theplight of a Mom when early stage psychosis emerges in her Son and hit’s home. Schizophrenia is more common in males than females and Mom’s are usually the first to reach out to the medical community (women are also typically more open minded about health care). We provide a What You Need to Know section for each question posed by the prototypical Mom. We hope readers gain perspective on basic concepts and look at orthomolecular view as would an educated consumer as a viable treatment option. This is especially true because there are many myths about schizophrenia as a disease entity and myths about treatment.
Part 2: The Mom’s Plight, “Why is this happening? What did I do wrong as a Parent?”
Because of the stigma surrounding schizophrenia and the uncertainty of early diagnosis many parents feel disempowered and wonder “Why?” it’s happening. They feel the need to have questions answered frankly and simply. The first experience with psychotic symptoms is frightening and an internet search on diagnostic labels and symptoms of psychotic mental illnesses [brief psychotic disorder, delusional disorder, schizoaffective disorder, schizophreniform disorder, bipolar or mood disorder with psychotic episode, psychosis not otherwise specified] often leads to confusion. Parents dread having to face the stigma of psychotic labels and the prospect of ‘losing face’.
In diagnostically uncertain stages, orthomolecular treatment is a viable and extremely safe treatment option. The majority of all psychotic presentations are treatable with orthomolecular medicine, especially early stages cases. Research supports that profound good responder outcomes occur in early stage first-episode schizophrenia when patients are not exposed to neuroleptic drugs. I’m just relaying what the empirical finding are of hundreds of orthomolecular practitioners and my intention is not to disuade people from using neuroleptics when indicated. Neuroleptic drugs are major tranquilizer sedatives that block specific brain areas by blocking specific recptors. Orthomolecular nutrients by contrast are endogenous substances that when provided in augmented optimal doses attempt to correct nutritionally compromised aspects in the same brain vicinity as neuroleptics do. These nutrients do not interfere with neuroleptic functioning and do not work directly at the brain receptor level. Nutrients are in general extremely safe.
A good orthomolecular practitioner will discuss symptoms and diagnostic aspects frankly in easily understandable terms. A classic schizophrenic diagnosis is hard to miss. It is easily seen in cases where the person affected experiences clear cut distortions of sensory input (hearing voices or seeing things that aren’t there, i.e. hallucinations) that affect his or her output of thoughts in the form of delusional beliefs and, if these have lasted 6 consecutive months, he or she has schizophrenia. Its often plane to see but hard to accept, especially for the person sufferring from a constant bombardment of mis-information that makes it so difficult to distinguish reality from non-reality.
Lets get this straight, it’s not the Mom or Dad’s fault that their son or daughter has schizophrenia. There are clear biochemical nutrient imbalances in the genetic pool and the biochemical templates that predispose people to schizophrenia are likely in their gene pool but, not triggered by the parent nor their method of raising their children. Most schizophrenics that I see are smart and come from good families with a background of highly skilled productive members of society that support their children in all endeavors of life. It takes tremendous energy and dedication to support someone with schizophrenia and parents deserve credit for their attempt to work out problems in a loving manner that respects the individual while making decisions that do not compromise their optimal well-being.
The good thing is that orthomolecular medicine works for a great number of schizophrenics. Under orthomolecular care, stigma is neutralized automatically becuase you focus on the biochemical individual , the nutrient imbalanced individual. Foremost on the list of biochemical imbalances is the niacin (vitamin B3) deficiency aspect of schizophrenia. The top theory for twhy vitamin B3 works is that it has the ability to neutralize the brain’s production of hallucinogens made endogenously in states of stress where abnormal passive neurotransmitter oxidization dominates. Other Secondary causative factors are important to consider and we not uncommonly see schizophrenics with low thyroid metabolisms, B12/Folic acid deficiencies (under-methylation), heavy metal toxicities and protein deficiencies.
Conventional Psychiatric Standard of Care
First episode clinics keep the experience positive and thats good. It’s so hard to keep things positive because schizophrenics and their families know they are about to face uncertain times. Psychiatrists also educate patients that the they may or may not develop chronic psychotic illness; this is absolutely true, it could go away but research shows that this normalization is not a common occurance. So psychiatrists rightly find it difficult to provide a firm diagnose in cases not having consistant psychotic symptoms lasting 6+ months. Mention of the word schizophrenia can also be destabilizing so we see psychiatrists not using this term early on. I also have many parents asking me in advance not to mention the term schizophrenia for the same reason. A clear diagnosis or disease label may or may not be a comfort to many and in such uncertain times decisions need to be made and, if treatment doesn’t work, these young people face lifelong debilitating illness. Pharmaceutical medication is an option of choice in the mental health system and it is the standard of care that we see society embracing. The side effects are often discussed openly. Modern neuroleptic prescriptions include zyprexia (olanzapine), resperdal (resperidone), abilify (aripiprazole) and seroquel (quetiapine).
What You Need to Know
The NIH has endorsed some good research on outcomes of neuroleptic (antipsychotic) treatment, the CATIE trials, etc. Be open about your concerns and ask your family doctor (GP) or psychiatrist about the benefits of neuroleptics and the potential for side effects. There are appropriate uses for these medications.
In this early stage, it makes sense to implement orthomolecular medicine. Orthomolecular nutrients are inoculus in terms of side effects and they have good outcomes in first episode schizophrenia. This is a drug-free approach and we recomend it as a first-line intervention. Six double blind trials have been done on niacin therapy in schizophrenia and results are good for the majority of cases. Both classic and targeted advanced orthomolecular treatment have the ability to address the underlying nutrient-based imbalances seen in schizophrenia.
Not many people realize that schizophrenia is a neurodegenerative disease with classic 4th ventricle brain atrophy. So brain tissue loss is inevetible and even cases that are just passing the 2 years post-onset chronic threshold there is significant brain tissue loss. I mention this because orthomolecular medicine offers hope at preventing brain tissue loss (Horrobin).