Vitamin B-3 and Schizophrenia.

Many schizophrenic patients or their families call me seeking an orthomolecular physician, or preferably, psychiatrist. I refer them to the closest physician, often practising hundreds of miles from their home. Many are helped. Some are not, and when they call me back I learn that the physician has done a fine job of advising them, but in almost every case has not given them high enough doses of vitamin B-3. This is confirmed by the few patients who arrive in my office from the United States. For many, all that is needed is to increase the dose to the amount I have been recommending--going back now at least 50 years. This is described in my new book [1] and latest outline of the treatment program. [2]

I remain surprised at the reluctance of my colleagues to use the proper doses. With schizophrenia there is a clear dose response and if the dose is below the therapeutic level, even if only one gram below, there will be little response. I have seen my patients on 3 grams per day for months show no response, but after doubling that dose to 2 grams after each of three meals there was a sudden and marked improvement.

I think the reason is that there is the pervasive idea in medicine that niacin, and to a lesser degree niacinamide, is liver toxic. I will discount the mythology that some doctors adhere to that it causes kidney damage etc. Where has the notion come from that it is liver toxic? Once it hit the textbooks every new edition and every new book simply repeats the old' idea without reexamining the data upon which it was first based.

Over fifty years ago toxicity trials on rats with niacin showed that the LD50 was about 4.5 grams per kilogram of rat. For a 60 kilogram human this means that it is nearly half a pound per person per day. Of course this quantity is simply impossible to ingest, would cause severe nausea and vomiting, and probably would be toxic for many. One of my young female schizophrenic patients in a fit of anger swallowed the whole bottle of niacin, 200 tablets, 500 milligrams each. She had a sore stomach for three days. But these extraordinarily high, dangerous dosed are much higher than the recommended dosage which usually are under 10 grams per day, most often between 3 and 6 grams dally. These are the recommended doses for niacin to lower cholesterol levels, to lower triglyceride levels, to lower lipoprotein A and to elevate HDL. When the rats were sacrificed they were found to have fatty livers, i.e. about 10% of their livers were fat. …

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