Werbach
In “Nutritional Influences on Mental Illness”, Werbach continues to compile evidence from the work of others about the relationship between psychiatric disorders and vitamin or mineral deficiencies (folic acid, B 12, C, calcium, lithium). Taking the viewpoint of orthomolecular medicine that “mental” disorders are in fact physical “central nervous system disorders,” Werbach contends that omega 3 fatty acid has great value in the treatment of bipolar or mood disorder.
Manifestations
Besides the work of Werbach on orthomolecular medicine for mental illness, much work has been done to augment or refine the field.
UK-based therapist and founder of the British Association for Nutritional Therapy Lazarides (n.d.) cites research dating back the 1980s in support of vitamin C and lecithin supplementation for bipolar disorders and the risk posed by excessive vanadium intake. For instance, she points to a double-blind, placebo-controlled trial by Naylor et al. (1981) where manic-depressive patients showed remarkable improvement after just one 3-gram megadose of vitamin C and also evinced progress when vanadium intake was reduced. Cohen et al. (1982) showed that lecithin alone worked well with manic patients. Somewhat later, Coppen et al. (1986) discovered that a 200-mcg folic acid was a useful adjuvant when lithium was administered for manic depressive illness.
Much more recently, we find that inputs from orthomolecular medicine will presumably remain necessary because lithium remains in the treatment arsenal of mainstream psychiatry for bipolar disorder. This despite the complications and cumbersome monitoring that residents endure, the commercialization in 1994 of valproate for acute mania, and the procession of new medications and associated psychosocial interventions that followed. (van Kammen, 2007).
The new mood stabilizers, Belmaker (2007) reports, count carbamazepine, lamotrigine, and such antipsychotic drugs as olanzapine or quetiapine. But perhaps the signal contributions of Belmaker are that:
- Despite the risk of provoking mania, use of antidepressants and electroconvulsive therapy should continue on an individualized basis, especially for those who present with severe and sustained depression.
- He strongly urges serious consideration for nutrient therapy employing inositol 14 and n-3 fatty acids.
Even as teacher in “mainstream” Psychology Medicine, Vaddadi assents to the Werbach viewpoint and points to “a growing body of evidence examining the role of neuronal phospholipid abnormalities in the pathogenesis of psychiatric illness…” (2006, 81). There have been eye-opening outcomes, he acknowledges, employing Eicosapentaenoic acid (EPA or icosapentaenoic acid), an omega-3 fatty acid, to ameliorate mood disorders. Taking off from his own findings circa 1989 about the ameliorative benefits of gamma-Linolenic acid (an omega-6 fatty acid) in cases of schizophrenia, this psychiatrist-researcher now feels compelled to call for longitudinal randomized controlled research to compare the efficacy of omega-6 and omega-3.
Recap
For all the weight of popular literature around the benefits of “nutraceuticals”, the mainstream of medical arts has not truly embraced the orthomolecular theories and adjunctive therapies espoused by Werbach and other researchers whose work he compiled in the book. Nonetheless, there are hopeful signs – notwithstanding this very brief survey of what is available – that physician researchers are increasingly convinced by empirical evidence that environmental factors and, in particular, dietary supplementation have a role to play in the management of mental disorders and even organic diseases with a genetic basis.
References
Belmaker, R.H. (2007). Treatment of bipolar depression. The New England Journal of Medicine, 356 (17) 1711-22.
Cohen, B.M. et al. (1982). Lecithin in the treatment of mania: Double-blind, placebo-controlled trials. Am J Psychiatry, 139(9):1162-4.
Coppen, A. et al. (1986) Folic acid enhances lithium prophylaxis. J Affect Disord 10(1):9-13.
van Kammen, D. P. (2007). Advances in treatment of bipolar disorder: Review of Psychiatry, Volume 24. The American Journal of Psychiatry, 164 (1) 179.
Lazarides, L. (n.d.) Health and nutrition database and resources. Web.
Naylor, G.J. et al. (1981). Vanadium: A possible aetiological factor in manic depressive illness. Psychol Med, 11(2):249-56.
Vaddadi, K. (2006). Essential fatty acids and mental illness. International Review of Psychiatry, 18 (2) 81 – 84.