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Schizophrenia Information > Complementary Treatments

Complementary Schizophrenia Treatments

Important Warning: The following web page is provided for information purposes only. It covers possible complementary treatment approaches that may be used in concert with antipsychotic (neuroleptic) medications. The adoption of any of these complementary treatments should be done with a qualified psychiatrist or psychologist's knowledge and approval as part of a person's complete treatment plan. This summary of possible complementary treatments is for informational purposes only.

For general information on dietary supplements, see the NIH website: Dietary Supplements: Background Information

Complementary Schizophrenia Treatments - Table of Contents


      Personal Therapy and CBT (Cognitive Behavioral Therapy) - Personal Therapy is a psychosocial intervention designed to help patients with schizophrenia recognize and respond appropriately to arousing stimuli improves function and reduces relapse. Personal therapy, as it is called, aims to create a therapeutic umbrella to protect the patients from undue personal stress. Recent studies have suggested that over the long haul, individual psychotherapy tailored to strengthen interpersonal skills and control social stress markedly helps many people suffering from the disorder.

      This new form of schizophrenia treatment has resulted in lower relapse rates and progressively better social functioning over 3 years, at least for people able to live with family members and meet basic survival needs, contend social worker Gerard E. Hogarty of the University of Pittsburgh School of Medicine and his colleagues.

      Cognitive Behavioral Therapy (CBT) has been judged by the Cochrane review as potentially positive for people with schizophrenia, stating that evidence suggests " that it [CBT] may well be of value, at least in the short term. Cognitive behavioural therapy should be further evaluated in various clinical settings and comparing effects for both expert and less skilled practitioners." Source; Cochrane Review

      Family therapy and assertive community treatment have clear effects on the prevention of psychotic relapse and rehospitalization. However, these treatments have no consistent effects on other outcome measures (e.g., pervasive positive and negative symptoms, overall social functioning, and ability to obtain competitive employment). Social skills training improves social skills but has no clear effects on relapse prevention, psychopathology, or employment status. Supportive employment programs that use the place-and-train vocational model have important effects on obtaining competitive employment. Some studies have shown improvements in delusions and hallucinations following cognitive behavior therapy. Preliminary research indicates that personal therapy may improve social functioning.

      Research suggests that relatively simple, long-term psychoeducational family therapy should be available to the majority of persons suffering from schizophrenia. Assertive community training programs ought to be offered to patients with frequent relapses and hospitalizations, especially if they have limited family support. Patients with schizophrenia can clearly improve their social competence with social skills training, which may translate into a more adaptive functioning in the community. For patients interested in working, rapid placement with ongoing support offers the best opportunity for maintaining a regular job in the community. Cognitive behavior therapy may benefit the large number of patients who continue to experience disabling psychotic symptoms despite optimal pharmacological treatment. (Source - psychosocial treatment, 2001 - see below)

      Glycine Therapy

      Glycine (an amino acid sold as a dietary supplement) has been a subject of research for over 15 years as a potential treatment for the negative symptoms of schizophrenia. Only a handful of human clinical trials with fewer than 50 people in each trial, have been completed (though one trial with 150 people has recently completed and has not yet been published). The trials published to date are reporting that the results have been quite positive, showing a significant reduction (averaging around 24%) in negative and cognitive symptoms based on the PANSS (Positive and Negative Schizophrenia Symptoms) scale. The clinical trials have shown that Glycine did not help people who are taking Clozapine, but it did help (in reducing negative symptoms) in people who were taking risperidone (Risperdal), and olanzapine (Zyprexa). The clinical trials suggest that the optimal dosage may be in the range of 30 grams to 60 grams a day. The biggest downside to taking glycine seems to be upset stomach and nausea which, researchers tell us, is quite common in people who take 60 grams of glycine a day for a month or two. Approaches used by the researchers to minimize this problem have been to start at lower doses (e.g. 5 to 10 grams split into two doses per day) and then to slowly phase up to higher doses over a period of weeks. Also - taking it after meals may assist in reducing side effects.

      One hypothesis of schizophrenia pathology suggests that NMDA-receptor disfunction (a special kind of glutamate receptor in the brain) may contribute to disordered synapses and brain atrophy, which ultimately result in the visible symptoms. Glycine may turn out to be a very beneficial supplemental treatment (when added to standard antipsychotic medications) for some people with schizophrenia. We hope to see longer and larger trials for glycine supplemental treatments. Talk with your doctor if you think you may benefit (review the report below for information on what glycine does and who it might help). See special report below for more information:

    • Sarcosine (N-methylglycine)


        One hypothesis of schizophrenia pathology suggests that NMDA-receptor disfunction (a special kind of glutamate receptor in the brain) may contribute to disordered synapses and brain atrophy, which ultimately result in the visible symptoms. Glycine (or glycine-like supplements such as Sarcosine) may turn out to be a very beneficial supplemental treatment (when added to standard antipsychotic medications) for some people with schizophrenia.

        In a recent (2004) Harvard Medical School study with consumers who suffer from schizophrenia it was revealed that patients who received N-methylglycine (sarcosine) treatment had significant (on the order of 10 to 15%) improvements in their positive, negative, cognitive, and general psychiatric symptoms. This looks very promising, but the research needs to be duplicated with some larger sample groups of people. N-methyl glycine (Sarcosine) is apparently a amino acid. We'll report more on this potential treatment as more new trial results are published.

      • Articles and Research:
    • Animal-Assisted Therapy
      Research has shown that pets (dogs and cats) may offer a low cost, yet helpful type of therapy for people with schizophrenia. What the researchers call "Animal-assisted Therapy" has been shown to encourage mobility, interpersonal contact, and communication and reinforced activities of daily living, including personal hygiene and independent self-care.
    • We could only find a single study on this topic - so it remains to be seen if this approach to therapy proves effective in larger, more rigorous studies. It seems that a calm and friendly dog (not a puppy that requires a lot of attention) could provide good companionship for people who have schizophrenia and don't socialize much.



    • Gluten Free Diet for Schizophrenia
      Some research has shown that people with celiac disease, a genetic gluten (a type of protein found in wheat and other grains) intolerance have up to a 300% increased risk for developing schizophrenia. While the percentage of people that this impacts is small (less than 3% of people that have schizophrenia are estimated to have this intolerance), a wheat-free diet is theorized as potentially being helpful for these people.
    • Trancranial Magnetic Stimulation (TMS) - There's preliminary evidence that TMS offers a less drastic alternative to electroconvulsive therapy (ECT), the treatment of last resort for people with severe depression. At the same time, investigators acknowledge that there's much they don't know about how TMS affects the brain. Researchers propose that TMS may help treat schizophrenia, a brain disorder for which few effective drugs exist.

      In the March 25, 2003 Lancet, investigators at the Yale University School of Medicine, report that repetative TMS (also called "rTMS", significantly reduced auditory hallucinations experienced by a dozen people with schizophrenia.

      The hallucinations, usually perceived as voices in the head, afflict 50 to 70 percent of such people and are often difficult to eliminate with antipsychotic drugs. "These voices can be very disruptive and produce some really bad consequences," noted study leader Ralph E. Hoffman.

      Brain scans of people with schizophrenia suffering auditory hallucinations have revealed abnormal activity in a speech-related brain region—the left temporal parietal cortex. Scientists suspect, says Hoffman, that "these auditory hallucinations arise from parts of the brain that are ordinarily involved with processing spoken speech."

      To test that theory, Hoffman and his colleagues directed magnetic pulses at the left temporal parietal cortex of schizophrenia patients for up to 16 minutes daily for 4 days.

      In most cases, the severity and frequency of auditory hallucinations decreased more with the real TMS treatment than with sham applications. In one person, the improvement lasted 2 months.

    • Additional TMS validation studies are needed and are underway. For more information, or to participate in the studies, contact Yale University PRIME TMS Research. or Other Groups working with TMS.

Music Therapy - Music therapy is a type of psychotherapy in which the patient is encouraged to utilize music to improve interpersonal and communication skills in ways that regular dialogue is limited. Forms of music therapy generally are based around cognitive/behavioral, humanistic or psychoanalytic frameworks or a mixture of approaches. There are usually both active and receptive parts of the therapy, meaning that at times music is listened to and at other times there is the use of musical improvisation or creation. There have not been many studies on music therapy and schizophrenia, but the Cochrane review looked at the data available for a recent review.

There were 4 studies included in the review. These studies looked at short term benefits of music therapy when used in addition to more conventional pharmaceutical treatments. The authors combined the results of these 4 studies in a “meta-analysis” meaning that the studies were similar enough that the data could be combined and form a larger sample. The number of sessions used in these studies varied from 7 to 75 and the length of time studied ranged up to 3 months duration.

The results were encouraging. In one study, it was shown that the global state in the short term was frequently improved. Using a statistic called “number needed to treat (NNT)” it was described that to show an improvement in one patient, you only needed to put two patients through the therapy. (This compares with NNT in many situations of several hundred patients needed to be given a treatment in order to notice benefits in one person.) It was shown that the number of sessions had a direct impact on the success of the treatment with more sessions being better.

It was also seen that active participation was better than a more passive approach to treatment. However, the length of treatment in theses studies was short and the benefit in the long term was unknown.

Tharyan P, Adams C. Electroconvulsive therapy for schizophrenia. Cochrane Database Syst Rev. 2005 Apr 18;(2):CD000076. Click here for article 1 on PubMed

Gold C, Heldal T, Dahle T, Wigram T. Music therapy for schizophrenia or schizophrenia-like illnesses. Cochrane Database Syst Rev. 2005 Apr 18;(2):CD004025. Click here for article 2 on PubMed

Simpling listening to music listening may also, however, be useful as a means of relaxation or group discussion stimulus. A medical review article (April 2005) has indicated that music therapy may be beneficial for people already on a standard treatment for schizophrenia. Music therapy should in no way replace a standard treatment regimen. Future research may reveal more positive results.

Relevant Research:

"Traditional Chinese medicine (TCM) has been used to treat mental health disorders, including schizophrenia, for more than 2000 years. Chinese herbs may also have antipsychotic properties when used in a Western biomedical context. In this review we sought and found trials relevant to the effects of both approaches for schizophrenia. Traditional Chinese medicine methodology has been evaluated for schizophrenia, but the one included study was too limited in terms of sample size and study length to guide good practice. However, this pioneering study does show that TCM can be evaluated for its efficacy for people with schizophrenia , and should encourage trialists to undertake further, more comprehensive trials in this area.

The use of Chinese herbs in a Western medicine context, without incorporating TCM methodology, has been evaluated in six trials, although again these are limited by their sample size and study length. The results of these six trials suggest that using Chinese herbs alone for psychotic symptoms may not be indicated, but if used in conjunction with Western antipsychotic drugs, they may be beneficial in terms of mental state, global functioning and decrease of adverse effects. However, further trials are needed before the effects of TCM for people with schizophrenia can be evaluated with any real confidence."

Source: Cochrane Review: Chinese herbal medicine for schizophrenia (2006)

 

Future Potential Therapies

    • Stem Cell-Based Therapies - In 2003, researchers from the University of Illinois Department of Psychiatry stated that "The use of stem cells for neuroreplacement therapy is no longer science fiction--it is science fact. We have succeeded in the development of neural and mesenchymal stem cell transplantation to produce neural cells in the brain. We have seen the improvement of cognitive function in a memory-impaired aged animal model following stem cell transplantation. These results may promise a bright future for stem cell strategies. "

      Right now, stem cell research is showing the most promise for treating certain kinds of brain disease (for example, Alzheimer's and Parkinson's) in which discrete populations of neurons are dying. Stem cell research also looks promising for therapies in other areas - diabetes, sickle cell anemia, spinal-cord injury, heart disease, vision and hearing loss are among the diseases being examined for stem cell therapies.

      Because we are still at a very rudimentary understanding of what goes wrong in the brains of people with schizophrenia, it is unlikely at this point that stem cell research will provide a therapy. Schizophrenia does not seem to be caused by a problem in neurogenesis (the creation of new brain cells); instead, it appears that brain cells are present in correct numbers and places, but are not sending the right sorts of signals at the right times. The brain matter loss shown in schizophrenia is a loss of neuron axons and dendrites - the long processes that neurons use to send signals - rather than a loss of the neuron cell bodies themselves.

      There was a suggestion at one point that schizophrenia might be caused by a deficiency in reelin, a protein that helps new brain cells know where to migrate. Although this is still being investigated, the deficiency has only shown in postmortem brains of people with schizophrenia - thus, it is impossibel to tell whether reelin deficiency is a cause or a consequence of the disease.

      According to Dr. Arnold Kriegstein (MD, PHD) of the Dept. of Neurology and the Director of Development and Stem Cell Biology Program at UCSF, we may be able to find a creative way to use stem cells for schizophrenia once the pathophysiology of the disorder is better understood. He believes that reelin is probably not the issue - that differentiation of cells, not migration, is more likely at the root of the problem. (Source: lecture given at UCSF on stem cell research, June 2005).

      Probably a more likely role for stem cells in the realm of schizophrenia is in researching the cause of the disorder.

      In 2001, President Bush halted a National Institutes of Health plan to fund research on embryonic stem cells. Key supporters of the administration believed that the research immorally destroys early human life. The cells are extracted from days-old embryos created in fertility laboratories, consisting of about 150 cells, that are together smaller than this "." at the end of this sentence. Excess embryonic stem cells are regularly discarded from human fertility clinics when they are no longer needed.

      (Photo of a microscopic view of a colony of undifferentiated human embryonic stem cells)

      In 2001, the US House of Representatives had passed a bill that criminalized reproductive cloning, or making cloned babies. But it also targeted creating cloned human embryos in the laboratory. Many scientists believe such methods are potentially important in stem-cell research; for instance, as a way to create customized stem cells bearing the DNA of living individuals.

      Currently there is very little embryonic stem cell research taking place in the US due to the Bush Administration's regulations. (Update - California has recently started a $3 Billion, 10 year research effort to find medical cures based on embrionic stem cells so there is much more hope for treatments now).

      If you believe that a potential cure for chronic diseases, and research into the causes of many others, is worth diverting some of the thousands of embryonic stem cells from the fertility clinic garbage cans to University researchers working on cures for these diseases, please support therapeutic embryonic stem cell cloning (duplicating) and research.

       

      Discredited or Disproved or Over-marketed "treatments" for Schizophrenia

      • EM power+ (Empowerplus) by Synergy, or Truehope Nutritional Support
      • EM power+ (also referred to as Empowerplus) is a vitamin and mineral product that was formulated by two lay people (i.e. non-scientists) in Alberta, Canada as a supposed cure for various psychiatric conditions like bipolar disorder and schizophrenia. The product contains 36 different ingredients and was originally made by a lab in Utah but is now apparently made by another lab in California and with a different formula than the original product but has the same name.

        The company, called Synergy or Truehope Nutritional Support, claims that there is considerable research to back up their claims but the early research at the University of Calgary was very preliminary (one short study with only 11 people - see information below) and the clinical trial that was begun at Calgary was halted by Canadian government officials as the product was not approved. In fact, the Canadian government has issued a health hazard warning informing people not to use the product because it has not been proven safe and because the company is encouraging people to go off prescribed medications.

        The Office for Human Research Protection (OHRP) in the US felt that the research into this product that was also being done at the University of Utah did not have sufficient benefit to outweigh the risks. The OHRP also found that no research was being conducted on this product at Harvard. Another group is working on a class action lawsuit against Truehope and the company is now facing six additional charges by the Canadian government related to unproven claims that the company has made. We believe that these products are still freely sold in the USA because there are few laws regulating sale of "supplements" in the USA. In July, 2006 some of the charges by the government of Canada were dismissed in the courts - but we do not know if all the lawsuits are dismissed.

        A recent (July, 2004) news article from Canada suggested that:

        "An Alberta health food company (Truehope) that claims to have a cure for mental illnessesis facing six charges under the Food and Drugs Act for allegedly importing and selling its product without government approval.

        The charges come nearly a year after RCMP and Health Canada raided the Raymond main office of Truehope Nutritional Support Ltd.

        Truehope, along with its related company Synergy Group of Canada Inc., markets a nutritional supplement called Empowerplus that it believes can cure a variety of mental illnesses such as bipolar disorder.

        But Canadian law forbids companies from making health claims about its products without first compiling a certain amount of scientific proof to back them up, and Health Canada says Synergy has not yet met those standards.

        Empowerplus is an amalgam of about 36 vitamins, minerals and anti-oxidants, many of which are commonly sold over the counter. (Note: the product sells for up to $300+ per month -- depending upon dosage -- making it one of the world's most expensive mix of common vitamins.)

        Health Canada issued an advisory June 6, 2003, warning people not to take Empowerplus because it could put their health at risk."

        If you've been tempted to consider this product we encourage you to read up on the history of the product and company, compare prices for other vitamin pills (see information above), talk with your psychiatrist and make your own fully-informed decision.

        In our opinion this product is unproven, with risks and costs that currently outweigh possible benefits. In fact we agree with Dr. Philip Long's assesment of the product:

        "This commercial group (TrueHope/Synergy) has claimed to have discovered a vitamin mixture that has "totally resolved Bipolar Disorder, Schizophrenia, Depression, Autism, Chronic Fatigue Syndrome, and Fibromyalgia" (quoting from a brochure I received in Vancouver advertising their lecture at Douglas College). These false claims of miraculous cures are a medical fraud - period."

        "Think about it - if there was a vitamin mixture that cured Bipolar Disorder, Schizophrenia, Autism etc. - why wouldn't the recipe for this major discovery just be posted on the Internet so all could benefit. EM Power is just a mixture of commonly used vitamins and minerals that anyone can buy at a local health foods store. Why the big secret? Why won't EM Power publish what is in their vitamin mixture? You know the answer - money. EM Power is a typical medical scam promising miracle cures. This isn't the first, and it won't be the last, of medical frauds that use naive individuals, like Dr. Kaplan, to promote a totally bogus miracle cure for mental illness."

        Quote from (Dr. Philip Long), the psychiatrist founder of Internet Mental Health.

        The product is, in our opinion, burdened by excessively positive marketing claims (it is our belief that any claims that a product is a "cure for schizophrenia" need large, duplicated research studies done by independent research organizations (i.e. Universities) otherwise they are just marketing hype and something to be avoided.) Given the minimal testing the Empowerplus product has received, as well as by lack of information (the company won't reveal what is in the product) and very high costs - we've seen estimates that monthly costs we've seen can range from $60 to $400+ Canadian $ for a vitamin mix that would likely cost only a couple of dollars if purchased independently) - suggesting gross profit margins for the TrueHope "Nonprofit" in the 95% or higher range - which, if not illegal, certainly is (in our view) of questionable ethics for a company/nonprofit (they seem to have a bit of both) that claims to be focused on helping mentally ill people. For more information and research on Empowerplus, as well as expert opinions, see:

      • A book on the company and products is available at http://www.pigpills.com
      • Here is the Dr. Phil Long's analysis and opinion on Empowerplus (Note: Dr. Long is a well known Canadian psychiatrist who founded the non-profit web site Mentalhealth.com - one of the world's leading mental health web sites)
      • Information on the company and its product history is available at: Canadian Quackery Watch - Scroll Down Page to get to the Empowerplus information.
      • The Medical Post article on the company: "Vitamin Company Tells Psych Patients to Stop Meds"
      • Another Story: Pigs Will Fly - Medical Post, January/February 2004
      • Even Dr. Hoffer - a strong supporter of vitamins use in the treatment of schizophrenia, states that any advice that a psych patient should go off his meds "should be condemned".
      • Health Canada Warning on Empowerplus:

      • Health Canada executes search warrant related to EM Power plus
      • Here is the formal complaint against the University of Calgary by health Canada. To go to subsequent pages, click on the links on the bottom:

        http://www.friendsoffreedom.org/images/Research%20Articles/True-Hope-vs-Health-Canada/bonnie.html
      • Raid! - First by halting a Calgary trial and then by seizing product shipments, Health Canada has pulled the plug on a controversial neutraceutical being sold as a treatment for mental health disorders.
      • Citizens For Responsible Care and Research - on Empowerplus research

       

      Niacin and Nicotinic Acid - the marketing of niacin (also known as vitamin B3 and Nicotinic Acid) as a "cure" for schizophrenia began over 30 years ago by Dr. Abraham Hoffer. In what must surely be classified as one of the most "optimistic" viewpoints ever to hit the field of schizophrenia Dr. Hoffer continues to push this approach despite significant amounts of research to the contrary. We believe that this is a very good reason to be skeptical when anyone claims any cure for schizophrenia. When a cure is finally discovered for schizophrenia, you should expect to see it on the covers of every major newspaper and magazine in the world. Dr. Irwin David Irwin of Vancouver, Canada summarizes the current view of Dr. Hoffers Theories - which even now still gets covered in newspapers and public forums - in this statement in a letter to the Editor of the Vancouver Sun newspaper:

      "At a time of real progress in treatment of schizophrenia, Dr. DeMarco has written about an approach which Dr. Abram Hoffer and others developed in the 1950s, but which by the 1970s was proven to be fruitless. The work of Dr. Hoffer and others is discussed in detail in the American Psychiatric Association Task Force Report, July 1973, which points out methodological flaws in the early work and reviews later studies which failed to show any benefit for such treatments.

      In recent years, new medicines, with improved side-effect profiles and techniques to overcome problems with social and occupational functioning, have been well proven advances for the treatment of schizophrenia. Early intervention programs should prevent some of the serious dysfunction of the disease.

      Serious illnesses like schizophrenia require proven treatments. Vitamin treatments as "alternative" therapy for schizophrenia should not be recommended.

      David Irwin, MD
      Department of Psychiatry
      Vancouver General Hospital
      Source: The Vancouver Sun, January 23, 1998 "

      Supporting Information and Research:


       Acupuncture - Acupuncture has been used to treat mental health disorders, including schizophrenia, for more than 2000 years. However, in an analysis by the Cochrane Review (the leading medical review publisher) in early 2006 it was determined that there is:

      "insufficient evidence to recommend the use of acupuncture for people with schizophrenia. The numbers of participants and the blinding of acupuncture were both inadequate, and more comprehensive and better designed studies are needed to determine the effects of acupuncture for schizophrenia."

      Source: Cochrane Review: Acupuncture for schizophrenia




    • Vitamin B6 - Vitamin B6 has also in the past been claimed to be a "cure" for schizophrenia (wrongly, as the data below indicates). As you should expect by now - if anyone makes any claims about a cure for schizophrenia - ask for some 3rd party validation studies from the major schizophrenia research centers around the world.

      Relevant Information and Research: Mega-Vitamin Therapies - Mega-dose Vitamins (very large - i.e. 200%+ of RDAs (Recommended Daily Allowances) of vitamins have also been marketed as a "cure" for schizophrenia in the past. Again - research has proved this claim innacurate many years ago. As you should expect by now - if anyone makes any claims about a cure for schizophrenia - ask for some 3rd party validation studies from the major schizophrenia university research centers around the world.

      Relevant Information and Research:


        Art Therapy for Schizophrenia

      The Cochrane Review (a leading medical review publication) has this to say about Art Therapy for Schizophrenia.

      "The British Association of Art Therapists definition of Art Therapy is "the use of art materials for self-expression and reflection in the presence of a trained art therapist. Clients who are referred to art therapy need not have previous experience or skill in art, the art therapist is not primarily concerned with making an aesthetic or diagnostic assessment of the client's image. The overall aim of its practitioners is to enable a client to effect change and growth on a personal level through the use of art materials in a safe and facilitating environment." It has proved to be difficult to estimate how widely this intervention is available. However, there are descriptions of its use with people with schizophrenia, individually and in groups, in inpatient and outpatient settings as well as in the private sector.

      Unfortunately we only found two randomised controlled trials that studied the use of art therapy for people with schizophrenia. Both studies did not include enough participants to make the results meaningful and we were unable to draw clear conclusions regarding the benefits or harms of art therapy from these studies. More research is needed to determine the value of art therapy in this population."

      Source: The Cochrane Review: Art therapy for schizophrenia or schizophrenia-like illnesses



 


 

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