THE ACID TEST FOR SCHIZOPHRENIA

Adventures in Psychiatry, The Scientific Memoirs of Dr. Abram Hoffer,
By Dr. Abram Hoffer, KOS Publishing, 364 pages, $30

While mathematician John Nash, of A Beautiful Mind fame, was battling
acute schizophrenia in the late 1950s, Dr. Abram Hoffer, a
Saskatchewan psychiatrist and research scientist, had a treatment that
might have saved Nash decades of torment.

And it all lay in a vitamin that would create possibly the greatest
controversy in psychiatric medical history.

The story of how Hoffer's Saskatchewan research team found a treatment
for acute schizophrenia, and the establishment's virulent opposition,
which continues to this day, can be found in the 88-year-old's
riveting memoir, Adventures in Psychiatry.

In the 1950s, Hoffer was a young physician just off the farm, with a
PhD in agricultural biochemistry, earned during years of research on
thiamin (vitamin B1). So rare was a biochemical background for
psychiatrists that, as a resident, he became director of psychiatric
research at Regina's General Hospital.

Initially, he was swept up in the "powerful trend of psychoanalysis,"
and admits to having once been a Freudian. But the allure soon
fizzled; schizophrenics took up half of Saskatchewan's hospital beds,
yet, Hoffer says, doctors wouldn't recognize schizophrenia as an
actual disease. And there was no treatment (not that there are any
useful ones now, a fact Hoffer decries).

While Hoffer witnessed schizophrenia being blamed on homosexuality and
on conflicts with authority figures, no one was getting well. Enter
psychiatrist Humphrey Osmond. Shunned in his native Britain for
researching mescaline's hallucinogenic effects, he joined Hoffer's
research, and the pair became an iconoclastic team to be reckoned with.

They used themselves as guinea pigs to discover why hallucinogens
cause symptoms resembling schizophrenia, why adrenochrome (an
adrenaline derivative) may cause the disease, and why niacin (vitamin
B3) may be a cure. (Hoffer himself tried Niacin before administering
it to patients, but never took LSD.)

One day, as his last rites were about to be read, a dying, catatonic,
schizophrenic, Ken, had the luck to be presented to the pair. In order
to save Ken's life (he had been in hospital for months, was
unresponsive and unable to eat or drink), Hoffer says he quickly
inserted a stomach tube into him, filled it with a huge dose of B3 and
vitamin C. In hours, the man began to recover.

The rest is history: From 1952-60, Hoffer (as chairman), Osmond and
four other members of the Committee on Schizophrenic Research (at the
University of Saskatchewan) proceeded to perform the world's first
double-blind studies in psychiatry -- six in all -- showing that B3,
given orally, could "cure" 75 per cent of acute schizophrenics within
two years.

The B3 research involved many beneficial offshoots, Hoffer says:
epileptics' EEGs returning to normal, alcoholics, including Alcoholics
Anonymous founder Bill W., no longer craving drink. Subsequent
research with LSD yielded similar results. (Hoffer's LSD tests also
resulted in the first diagnostic lab test for schizophrenia, owing to
biochemical similarities in the urine of schizophrenics and LSD
users.) The stage for what Nobel laureate Linus Pauling named
orthomolecular psychiatry was set, with the team's international
reputation growing. Some even saw dollar signs, such as Eversharp
Corp., which tried claiming the niacin approach for itself, retaining
Richard Nixon's law firm.

But, unlike with Banting and Best, the medical establishment was not
ready for Hoffer and Osmond. Not only would colleagues fail to
replicate their studies properly but, due to the "irresponsibility of
Timothy Leary," many of whose followers fell seriously ill after
overdosing on LSD, the backlash fell on Hoffer's team. He was accused
of selling LSD on the street, rumours spread that none of his research
could be trusted, and the Toronto chapter of the Canadian Mental
Health Association (CHMA) told the Saskatchewan chapter to cease
making claims for B3's efficacy.

Hoffer's memoir suggests that much of the psychiatric establishment,
feeling threatened by "a direct challenge to their growing
psychoanalytic view," looked for a way to undermine his work. They
thought they'd found one in LSD.

But Hoffer had supporters in high places, such as the (unnamed) dean
of the prestigious Johns Hopkins University medical school. At a
conference of international researchers, he "told us very seriously
not to be deterred from our work," Hoffer writes. "And nothing could
have deterred us."

His determination, with then-premier Tommy Douglas's government
support, seemed to put Hoffer 40 years ahead of his time, before the
2006 Final Senate Report on Mental Health would be born. He went
beyond research to "become" the mental health commission for
schizophrenia and created a holistic vision for patients.

To keep many victims off the streets until they were well, he had a
special hospital built in Saskatchewan. (Architect Kyo Izumi took LSD
to empathize with the schizophrenic experience for his design.) Then,
because no psychological test existed to determine schizophrenia in a
person, Hoffer's team created the Hoffer-Osmond Diagnostic test (H. O.
D test) to help diagnose the illness early.

Yet, it is not completely clear to Hoffer (or us) why, by 1967, most
colleagues wouldn't repeat his double-blind studies properly -- and
why they ignore the late '60s studies for the National Institute of
Mental Health by Dr. J. Wittenborn, who did. And, in the face of
schizophrenic suicides, and orthomolecular colleagues losing their
licences over their use of vitamin therapy, Hoffer inevitably went
through a dark night of the soul.

He wonders, "Were all the positive results we had seen in our
therapeutic trials wrong, were we deluding ourselves, were our critics
right? . . . Why was I doing this research?" After one particularly
dark night, the answer became clear: "I was doing it on behalf of
schizophrenic patients. . . . I would have to trust my own
observations, not the beliefs of the critics."

Fed up, he left his research and teaching posts to enter private
practice. In his final act, to inform schizophrenics and their
frustrated families that there is hope, he launched educational and
research bodies: the Canadian Schizophrenia Foundation, the Huxley
Institute of Biosocial Research and the International Schizophrenia
Foundation. The backlash would be inevitable.

Hoffer seems destined to have the last word in his autobiography. He
lambastes the CMHA, which "must bear a major share of the credit for
having delayed a very promising treatment . . . from widespread use by
several decades," and the American Psychiatric Association, which in
1973, dealt the death blow to orthomolecular psychiatry in the
antagonistic APA's Task Force Report on Megavitamin Therapy.

But the controversy is sure to continue. Seventeen of Hoffer's
patients, remarkably, became physicians. A couple are psychiatrists.
Their memoirs may be next.