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JOM Volume 26, Number 2, 2011
Editorial
thomolecular pioneer, Dr. Richard Kunin, in When are patients going to be told
his article discussing the value of manganese the truth about their psychiatric
and niacin for drug-induced dyskinesias: medications?
Among the countless mentally unwell not seem to comprehend the disorder or em- patients whom I currently manage, I have one pathize with the incredible suffering of the case that weighs heavily on my mind. The pa- patient. Imagine the alienation such patients tient is a very pleasant 25-year old male* with experience in relation to their peers, who pronounced tardive dystonia. During his first can only interpret these indescribable move- year of college (sometime in 2004), my patient ments as manifestations of madness. But the began to withdraw from life, slowly losing unkindest cut of all is to find that this dis- contact with his friends and family. He also order is commonly diagnosed as anxiety or became agitated, requiring little sleep, and his hysteria by physicians and psychiatrists.”1 thoughts and therefore his behaviours be- came increasingly more bizarre to his fellow discuss honestly with their patients all the students and diminishing pool of friends. He potential risks and expected benefits from was eventually admitted to a nearby hospital the medications they prescribe. There is an and was given a diagnosis of schizoaffective emerging body of literature that advocates disorder. He was prescribed two mg daily of a drug-centered model of drug action, as risperidone (Risperdal) to manage both the opposed to the outdated disease-centered psychotic symptoms and agitation. Within model that espouses psychiatric medications about ten days his condition stabilized and as correcting some known and well validated he was discharged back into the community disease process.2 In the drug-centered model, with a referral to an outpatient psychiatrist it is recommended that psychiatrists inform and instructions to attend an outpatient pro- their patients that psychiatric drugs are psy- choactive, and “…induce complex, varied, of- ten unpredictable physical and mental states done, he developed frequent episodes of facial that patients typically experience as global, grimacing and painful upper body contrac- rather than distinct therapeutic effects and tures, characterized by having his shoulders side effects.”2 Patients should be told that being temporarily fixed into a shrugged po- these drug-induced altered states might be sition with concomitant tensing of the neck useful, for some altered states might sup- muscles. At the present time, the facial gri- macing (tardive dyskinesia) has lessened, but disorders; and that these altered states might his painful upper body contractures (tardive be harmful, for some altered states might in- dystonia) involving the upper trapezius and duce unwanted or even unexpected physical anterior cervical muscles, occur constantly. and/or mental manifestations. The patient has these dystonic episodes nu- merous times throughout the day. They have immediate stability induced by psychiatric drugs during acute crises and/or life-threat- wanted attention from his coworkers and ening situations, I am more in favour of their clients, which has become very distressing gradual discontinuation once the acute cri- ses have passed. Patients should be told that When this patient has questioned the the majority of psychotropic medications value of his medication with several psychia- produce a vast array of global psychoactive trists, each one has told him that the medi- effects (i.e., sedation, psychomotor slowing, cation is necessary for stability but not much activation, and altered sense perception), else. This is alarming but not so surprising. which are often associated with negative out- This patient’s unfortunate reality reminds comes.3 The ideal is to immediately place all patients on orthomolecular treatment dur- Journal of Orthomolecular Medicine Vol 26, No. 2, 2011 ing the acute period, so that once psychiatric problem is most evident in the treatment of schizophrenia. In this issue, we have a ‘tour de treatments can ensure ongoing stability, and force’ article from scientist extraordinaire, Dr. Christine Mil er, who has written an exquisite- ly up-to-date, comprehensive, and progressive thomolecular treatments are not associated article on genes and nutrition interactions as with negative global psychoactive effects, they pertain to schizophrenia. From reading and support rather than alter the proper her article, one can easily feel her passionate functioning of the brain by supplying it with naturally-occurring substances it has been cal minutiae of schizophrenia with the hope designed to require. Psychiatric medications of facilitating a better understanding of, and are not normally found in the human body, perhaps new alternative (i.e., orthomolecular) and cannot correct for genetic defects (i.e., treatment solutions to, the status quo. Her defective enzyme/coenzyme reactions), nor sincere commitment to schizophrenia is very compensate for increased individual needs of apparent in the concluding paragraph of her specific orthomolecules, nor can they offset article in which she mentions with sanguinity deficiencies of orthomolecules within the ce- “…there is ample reason to pursue nutritional rebrospinal fluid or other tissues of the body. therapies in schizophrenia” juxtaposed with To further illustrate my concerns, I offer an her concerns about current psychiatric op- excerpt from Breggin’s book, Brain Disabling tions since “…neuroleptics have potent side effects that prohibit even a near-normal level “The brain does not welcome psychiatric medications as nutrients. Instead, the brain Dr. Miller’s article champions a greater reacts against them as toxic agents and at- optimism about the future of orthomolecu- tempts to overcome their disruptive impact. lar medicine, a future where patients’ lives For example, when Prozac induces an excess are enriched and not harmed by psychiatric of serotonin in the synaptic cleft, the brain treatments, because the prescribed treat- compensates by reducing the output of sero- ments are “orthomolecular,” and are thus safe tonin at the nerve endings, by reducing the number of receptors in the synapse that can receive the serotonin, and by increasing the capacity of the transport system to remove serotonin from the synapse. Similarly, when antipsychotic drugs such as Risperdal, Zy- prexa, or Haldol reduce reactivity in the do- paminergic system, the brain compensates, producing hyperactivity in the same system by increasing the number and sensitivity of changed to protect the confidentiality of this dopamine receptors. All of these compensa- tory reactions create new abnormalities in brain function, sometimes causing irrevers- References
ible disorders, such as antipsychotic drug- 1. Kunin RA: Manganese and niacin in the treat- ment of drug-induced dyskinesias. Orthomol Psy- My clinical experience has revealed that 2. Moncrieff J, Cohen D: How do psychiatric drugs most patients are not educated about the dan- work? BMJ, 2009; 338: 1535-1537.
gerous and often life-changing effects that 3. Jacobs D, Cohen D: What is really known about might result from taking psychiatric medica- the psychological alterations produced by psychi- tions. Patients are usual y told that there are atric drugs? Int J Risk Safety Med, 1999;12:37-47.
no viable options, other than standard psychi- 4. Breggin PR: Brain-Disabling Treatments in Psy- chiatry. 2nd edition. New York. Springer Publish- atric care, for their mental health issues. This

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