Niacinamide provides water-soluble vitamin B-3, which participates in the release of energy from carbohydrates within microscopic power plants in cells called mitochondria. It also contributes to the formation of fat from carbohydrates and assists in the processing of alcohol. For nearly 50 years, several clinicians and researchers have advocated for the use of niacinamide, as well as niacin, in the treatment of schizophrenia. Although niacinamide's use for this purpose is controversial, proponents suggest that for certain patients, it can reduce symptoms and enhance social and occupational functioning with usually mild side effects.
How Niacinamide Works
DNA within cells, cell walls and other tissues undergoes constant degradation by free radicals -- rogue, unstable oxygen molecules that steal electrons -- in a process called oxidation. These oxidation processes may contribute to the development of schizophrenia. Niacinamide inhibits the formation of free radicals by reducing the depletion of NAD molecules, which participate in various reactions to decrease oxidation. Niacinamide protects mitochondria by increasing the levels of glutathione, a protective substance, and by enhancing the integrity of mitochondria membranes. Niacinamide also decreases inflammation through various actions and decreases anxiety by stimulating certain receptors called GABA receptors.
Treatment of Schizophrenia
Orthomolecular psychiatrists administer high amounts of vitamins to treat psychiatric conditions. Early proponents of this approach, including Linus Pauling and particularly Abram Hoffer, advocated the use of niacinamide to manage symptoms of several psychiatric conditions, including schizophrenia. On the basis of his early clinical work and initial experimental work during the 1940s to 1960s, Hoffer concluded that 1.5 to 6 g of niacinamide administered for three months to five years can decrease schizophrenia symptoms. He reported 50 percent reduction in hospitalization rates and significant reductions in suicide rates, based on double-blind trials and concluded that niacinamide is most effective for those in early stages of schizophrenia or who have acute symptoms, especially when given in conjunction with their traditional anti-psychotic medications. He initially felt it was ineffective for the treatment of chronic schizophrenia but later suggested that it can contribute to the remission of symptoms when administered for seven or more years. Hoffer and others have concluded that niacinamide can decrease anxiety, hallucinations and delusions as well as so-called negative symptoms of schizophrenia that can develop as side effects from anti-psychotic medication, such as avolition.
Controversy
During the 1960s and 1970s, several attempts to replicate Hoffer’s early success with niacinamide failed to confirm his findings. Some research, mostly coming from Hoffer and his colleagues, affirmed the effect of niacinamide, while independent research produced mostly negative findings. The psychiatric community criticized his research design, and psychiatry never embraced the use of niacinamide for the treatment of schizophrenia. Hoffer and a few orthomolecular psychiatrists continued to use the treatment and to claim success, offering their own criticisms of the design and implementation of studies that failed to find positive effects. An article published in the December 2010 edition of “Medical Hypotheses” suggests that the antioxidant properties of alpha lipoic acid, or ALA, and niacinamide might help protect mitochondria from oxidative stress and reduce the risk of schizophrenia and other psychiatric conditions.
Side Effects
Niacin therapy poses several potentially serious side effects and should be undertaken only under the supervision of a physician or psychiatrist. Mild side effects can include dermatitis, an uncomfortable flushing sensation, increased blood sugar, nausea, heartburn and increase of liver enzymes. Dosages below 1,000 mg are generally considered safe, but larger dosages can possibly elevate the risk of diabetes, gastritis, liver damage and increased blood levels of uric acid. Niacinamide has chiefly been studied as an adjunctive therapy administered in addition to anti-psychotic medications.
References
- “American Journal of Psyhchiatry”; An Evaluation of Niacinamide in the Treatment of Childhood Schizophrenia; Gerald Greenbaum; July 1970
- Better Nutrition: Be Well with Vitamin B-3
- DrDemarco.com: A Unique View of Schizophrenia
- “Journal of Schizophrenia”; Treatment of Schizophrenia Based on the Medical Model; David Hawkins; 1968
- “Medical Hypotheses”; Is it Time to Reassess Alpha Lipoic Acid and Niacinamide Therapy in Schizophrenia; Sheila E.J. Seybolt; December 2010
- WellCorps.com: Therapeutic Effects of Niacin from Niacinamide
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