The First-Episode Schizophrenia (FES) Experience
Orthomolecular medicine research and treatment with its focus on biochemical nutrient causes of mental illness is typically embraced well by people. More and more, clients are recognizing and appreciating the dynamics of orthomolecular nutritional therapy versus drug therapy for the treatment of schizophrenia.
Orthomolecular Treatment in First-Episode Schizophrenia
Advancements since the 50’s have made it possible to implement advanced targeted clinical nutrition (orthomolecular) protocols as we see being used at the Naturopathic Medical Research Clinic (NMRC). In un-medicated, neurleptic-naïve, first-episode schizophrenia, my experience shows that it is fairly uncommon to experience no benefit and a significant portion are positive responders. An individualized advanced orthomolecular approach to first-episode schizophrenia is in great need in society. Six double-blind studies validated positive and profound outcomes in un-medicated FES and orthomolecular practitioners have successfully used the treatment approach over the past half century.
What FES patients are telling me
Newly diagnosed schizophrenics and first-episode schizophrenics report to me that they tell their doctors that they take neuroleptic meds but do not or they take much less than that prescribed. [Neuroleptics are major sedatives (tranquilizers) that attempt to palliate psychotic symptoms by blocking an array of brain cell receptor transmissions while leaving the underlying cause of the problem untreated and, in the process of doing so, transfer physician caused (iatrognic) symptoms, side effects, and endocrine and nutritional imbalances to the patient.] The high attrition rate for neuroleptics (i.e. the failure to take these meds) is widely known to be as high as 60+%, as several clinical papers report.
The ‘Neuroleptic Experience’ is not uncommon in schizophrenia, schizo-affective disorder, first-episode psychosis and bipolar disorder. Schizophrenic patients report to me that they feel ‘coerced’ with strong advisement form medical doctors to take neuroleptics.
Schizophrenic cases also report to me that forensic hospital institutions are a worst case scenario. Criminal charges, however minimal and often unintentional, make it difficult for care givers to intercede as an independent decision maker. As such, these care givers are removed from having any say in their sons or daughters drug treatment and often, such patients are heavily medicated with neuroleptics so they maintain the lowest societal risk to themselves and others. There is obviously a degree of common sense to this set of societal rules in overt criminal conduct cases but there are professionals and judicial bodies that my patients remark, are not uncommonly and perhaps not intentionally leading schizophrenic patients down a road of drug dependence and poorer quality of life.
As a naturopath, a ‘drugless practitioner’, I have no say in what patients do with their pharmaceutical prescriptions but I often write status reports to medical professionals with recommendations to lower meds and, minimize risks by eliminating/reducing where possible, meds that are either not working or are no longer needed. I find many general practitioners and psychiatrists in agreement with lowering meds and this is very encouraging. Most professionals care deeply about the welfare of their patients and understand that these drugs are potent and continued use warrants great responsibility. I see varying acceptance and understanding when it comes to the concept of receptor decompensation (rebound psychosis) with an adherent view that discontinuation of neuroleptics can be done at a rate just as fast as that of the recommended rate of initial dosing administrations described in the Compendium of Pharmaceutical Specialties (CPS). This fast discontinuation practice can lead to psychotic rebound.
The rate of discontinuation of neuroleptics needs to be done slowly as tolerated and I’m often sending doctors written ‘recommendations’ for patients who have been on neuroleptics 1-2 years, that no more that 10-15% drops of the ‘stabilized’ dose of neuroleptic be implemented every 3-6 months, and that faster withdrawals risk rebound psychosis. I ‘recommend’ such slow dose drops only after such cases respond to orthomolecular therapy with evidence of 40-60% consistent symptom improvement.
This belief that chronic neuroleptic consumers can come off these drugs as quickly as they are put on them is a big mistake. When such patients relapse coming off the neuroleptic, medical professionals often comment that this happened because they needed the drug.
Recognizing the need for Individualized Orthomolecular Mental Health Treatment
In mood disorder cases of depression and anxiety (and bipolar disorder) we see a similar layout of receptor sensitivity problems with anti-depressants and anxiolytics. The treatment outcome of orthomolecular medicine in depression, anxiety, ADD, OCD, and schizophrenia is exemplified in the case review “Orthomolecular Treatment Response”. This case study report gives us an idea of what to expect from advanced targeted orthomolecular medicine in a sample of mental health cases. Some patients do better on alternative approaches alone and some do better on a mix of the two.
Given the marginal outcome and severity of side effects from meds, many patients now opt to initiate orthomolecular methods as the first-line treatment of choice.