(BlackDoctor.org) — Hallucinations and delusions are two
telltale signs of schizophrenia. According to research or other evidence, the
following self-care steps may be helpful in managing this serious mental
disorder:
What You Need To Know:
These recommendations are not comprehensive and are not intended to replace
the advice of your doctor or pharmacist. Continue reading the full schizophrenia
article for more in-depth, fully-referenced information on medicines, vitamins,
herbs, and dietary and lifestyle changes that may be helpful.
Dietary changes that may be
helpful
For many years there has been speculation that
certain dietary proteins may contribute to the symptoms of schizophrenia.1 2 3
Gluten, a protein from wheat and some other grains, and to a lesser extent
casein, a dairy protein, have been the targets of research on food sensitivities
as contributors to schizophrenia.4 People with schizophrenia have been shown to
be more likely to have immune reactions to these proteins, than the general
population.5 A preliminary trial of a gluten-free/dairy-free diet found that
patients with schizophrenia improved on the diet and had shorter hospital stays
than those eating normal diets.6 The results of double-blind trials, however,
have been inconsistent. The gluten-free/dairy-free diet improved responses to
medications in one controlled trial.7 These improvements were lost and symptoms
of schizophrenia were aggravated when gluten was re-introduced in a “blinded”
fashion. Another clinical trial found similar positive responses in only 8% of
patients.8 Other controlled trials have found no improvement when gluten and
dairy were removed from the diet.9 10 In one clinical trial, blinded
reintroduction of gluten appeared to cause improvement of symptoms.11 These
results suggest that some, but not all, people with schizophrenia may benefit
from a gluten-free/dairy-free diet.
Lifestyle changes that may be helpful
Exercise has long been recognized
for its benefits in treating mild to moderate depression and there is some
evidence that it may also be helpful in reducing anxiety.12 In one reported
case, physical activity improved the functioning of a man diagnosed with
schizophrenia.13 In another reported case, aggressive outbursts in a
schizophrenic patient were reduced after he began exercising.14 A preliminary
trial of an exercise program for hospitalized psychiatric patients with varying
diagnoses resulted in significantly reduced symptoms of depression and an
insignificant trend towards reduced anxiety.15 Additional research is needed to
determine the specific benefits of exercise in people with schizophrenia.
Other therapies
Psychological
counseling or electroconvulsive therapy (electrical current applied to the
brain) may also be recommended.
Vitamins that may be
helpful
People with schizophrenia may have a greater tendency
to be deficient in folic acid, than the general population16 and they may show
improvement when given supplements. A preliminary trial found that, among
schizophrenic patients with folic acid deficiency, those given folic acid
supplements had more improvement, and shorter hospital stays than those not
given supplements.17 In a double-blind trial, a very high amount of folic acid
(15 mg daily) was given to schizophrenic patients being treated with psychiatric
medications who had low or borderline folic acid levels. The patients receiving
the folic acid supplements had significant improvement, which became more
significant over the six-month course of the trial.18 The symptoms of folic acid
deficiency can be similar to those of schizophrenia, and two cases of wrong
“schizophrenia” diagnoses have been reported.19 20 In one of these cases, an
initial supplement of 20 mg daily of folic acid and a maintenance supplemental
intake of 10 mg daily, led to resolution of symptoms.21
In another double-blind study, daily supplementation with folic acid (2 mg),
vitamin B6 (25 mg), and vitamin B12 (400 mcg) for three months improved symptoms
of schizophrenia compared with a placebo.22 All of the participants in this
study had elevated blood levels of homocysteine, which can be decreased by
taking these three B vitamins. Based on this study, it would seem reasonable to
measure homocysteine levels in people with schizophrenia and, if they are
elevated, to supplement with folic acid, vitamin B6, and vitamin B12.
There have been several reports of glycine reducing the symptoms of people
with schizophrenia who were unresponsive to drug therapy.23 Large amounts of
glycine (0.8 gram per 2.2 pounds of body weight per day) have been shown to
reduce negative symptoms of schizophrenia and improve psychiatric rating scores
in one preliminary trial;24 however, these results have not been repeated in
later trials using similar (very high) amounts.25 26 Earlier double-blind trials
found significant improvements in depression and mental symptoms in people with
schizophrenia who took glycine for six weeks.27 28 Most trials demonstrated a
moderate improvement in schizophrenia symptoms in those taking glycine
supplements.29 Long-term supplementation with high amounts of glycine may be
toxic to nerve tissue, however. Some preliminary successes have been reported
using smaller amounts of glycine, such as 10 grams per day.30 Long-term studies
on the safety of glycine therapy are needed.
The term “orthomolecular psychiatry” was coined by Linus Pauling in 1968 to
refer to the treatment of psychiatric illnesses with substances (such as
vitamins) that are normally present in the body. In orthomolecular psychiatry,
high amounts of vitamins are sometimes used, not to correct a deficiency per se,
but to create a more optimal biochemical environment. The mainstay of the
orthomolecular approach to schizophrenia is niacin or niacinamide (vitamin B3)
in high amounts. In early double-blind trials, 3 grams of niacin daily resulted
in a doubling of the recovery rate, a 50% reduction in hospitalization rates,
and a dramatic reduction in suicide rates.31 In a preliminary trial, some
schizophrenic patients continued a course of vitamins (4 to 10 grams of niacin
or niacinamide, 4 grams of vitamin C, and 50 mg or more of vitamin B6) after
being discharged from the hospital, while another group of patients discontinued
the vitamins upon discharge. Both groups continued to take their psychiatric
medications. Those who continued to take the vitamins had a 50% lower
re-admission rate compared with those who did not.32 Several later double-blind
trials, including trials undertaken by the Canadian Me
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