B vitamins improve symptoms in patients with schizophrenia

Townsend Letter for Doctors and Patients, Feb-March, 2007 by Alan R. Gaby

Forty-two schizophrenic patients with plasma homocysteine levels >15 micromol/L were randomly assigned to receive, in double-blind fashion, folic acid (2 mg/day), pyridoxine (25 mg/day), and vitamin [B.sub.12] (400 mcg/day) for three months, and then the alternate treatment for an additional three months. Homocysteine levels decreased with vitamin therapy compared with placebo. The improvement in symptoms of schizophrenia, as measured by the Positive and Negative Syndrome Scale, was significantly greater in the active-treatment group than in the placebo group (p < 0.02). Neuropsychological test results overall, and Wisconsin Card Sort (Categories Completed) test results in particular, were significantly better after vitamin treatment than after placebo.

Comment: Many patients with schizophrenia have elevated homocysteine levels. The results of the present study indicate that treatment with homocysteine-lowering B vitamins improves symptoms of schizophrenia in patients with high homocysteine levels. It is not possible to determine from this study whether the reduction in homocysteine levels per se was the reason these patients improved. Carl Pfeiffer, a pioneer in the orthomolecular treatment of schizophrenia, observed that supplementation with folic acid and vitamin B12 improved psychiatric symptoms in patients with schizophrenia who had low blood levels of histamine. He attributed the improvement in symptoms to an increase in histamine levels. Pfeiffer also noted that folic acid in doses larger than 2 mg/day can interact with antipsychotic medications, resulting in myoclonic jerking with seizures. He further observed that much larger doses of vitamin B6 than those used in the present study were beneficial for schizophrenic patients who excreted kryptopyrrole in their urine.

Schizophrenia is almost certainly a syndrome that can be caused by many different biochemical abnormalities, some of which appear to be responsive to vitamin therapy. The results of the present study will hopefully rekindle interest in the nutritional treatment of this debilitating disease.

Levine J, et al. Homocysteine-reducing strategies improve symptoms in chronic schizophrenic patients with hyperhomocysteinemia. Biol Psychiatry. 2006;60:265-269.