Paranoia: Theory and Treatments

Paranoia means abnormal suspiciousness. In one classification system schizophrenia is classified into different types. Paranoid schizophrenia is one type. This classification is not used in Russia.

Psychological theories are discussed in Refs. 1-4.

Cannabis

Ref. 5 reports paranoia from cannabis. Ref. 6 reports it from other drugs of abuse. This is evidence for the biochemical nature of paranoia. Psychology theories do not explain this. Cannabis is a neurotoxin, as are other drugs of abuse. Since an external neurotoxin can cause paranoia, my view is that in schizophrenia an endogenous (internal) toxin causes it. The chemical structures of amphetamine and methamphetamine are similar to those of catecholamines found in the brain, particularly dopamine metabolites. Dopamine has no methyl groups, but these drugs of abuse do. Metabolites of dopamine have methyl groups.

MRI Abnormalities

Ref. 7 reports MRI abnormalities in paranoia.

Steroids

Ref. 8 reports paranoia from corticosteroids. This is another piece of evidence for a biochemical basis for paranoia. Steroids cause changes in metabolism including the chemistry of glucose and that of amino acids. This is why they can build muscle, which is made out of amino acids. Further clues are seen in inborn errors of metabolism, which can be very toxic to the brain.

Inborn Errors of Metabolism

Ref. 9 describes inborn errors of metabolism. Paranoia can be seen in some.

"Over one-third of the inherited metabolic disorders are characterized by the central nervous system involvement and neurological symptoms are the presenting and the most prominent clinical problems associated with them. Among the neurometabolic disorders, there are particularly five common neurological presentations: chronic encephalopathy, acute encephalopathy, movement disorder, myopathy and psychiatric or behavioral abnormalities." (9)

This is an open-access article, meaning that it can be quoted at will provided the proper citation is given. One of these diseases is MELAS: mitochondrial encephalopathy lactic acidosis. This is such a vast and interesting area that I could write another article devoted to inborn errors of metabolism, which can be disastrous to the brain. Errors of amino acid metabolism are other examples. Mother Nature experiments with these inborn errors of metabolism. These experiments are very cruel, but often they can be treated by diet.

In MELAS the mitochondria are abnormal, which is disastrous to the brain. Lactic acid accumulates. The patient develops symptoms of schizophrenia.

Schizophrenia

Paranoia is often seen in schizophrenia. Unfortunately the chemical causes of it are not well understood. There is a theory that schizophrenics are dangerous. My view is that they are dangerous to themselves. They often kill themselves.

Numerous abnormalities have been reported in schizophrenia including pathology in the white matter. There are claims that the enzyme COMT is abnormal in schizophrenia.

Conclusions

Clearly there are chemical abnormalities that cause paranoia. Brain energy metabolism is probably impaired as in MELANS. Ref. 10 explains insomnia, which is a related psychiatric symptom. Anxiety is discussed in Ref. 11.

References

1. Insomnia and paranoia. Daniel Freeman, Katherine Pugh, Natasha Vorontsova, and Laura SouthgateSchizophr Res. 2009 March; 108(1-3): 280-284.

2. Freeman D., Garety P.A. Comments on the content of persecutory delusions: does the definition need clarification? British Journal of Clinical Psychology. 2000;39:407-414.

3. Freeman D., Freeman J., Garety P. Robinson Constable; London: 2006. Overcoming Paranoid and Suspicious Thoughts.

4. Freeman D., Gittins M., Pugh K., Antley A., Slater M., Dunn G. What makes one person paranoid and another person anxious? The differential prediction of social anxiety and persecutory ideation in an experimental situation. Psychological Medicine. 2008;38:1121-1132.

5. Two cases of "cannabis acute psychosis" following the administration of oral cannabis. Bernard Favrat, Annick Ménétrey, Marc Augsburger, Laura E Rothuizen, Monique Appenzeller, Thierry Buclin, Marie Pin, Patrice Mangin, and Christian GiroudBMC Psychiatry. 2005; 5: 17. Published online 2005 April 1.

6. Pharmacogenetic Treatments for Drug Addiction: Cocaine, Amphetamine and Methamphetamine. Colin N. Haile, Thomas R. Kosten, and Therese A. KostenAm J Drug Alcohol Abuse. Author manuscript; available in PMC 2009 September 29. PMCID: PMC2754046

Published in final edited form as: Am J Drug Alcohol Abuse. 2009; 35(3): 161-177. doi: 10.1080/00952990902825447.

7. MRI abnormalities of the hippocampus and cavum septi pellucidi in females with schizotypal personality disorder. Chandlee C. Dickey, Robert W. McCarley, Mina L. Xu, Larry J. Seidman, Martina M. Voglmaier, Margaret A. Niznikiewicz, Erin Connor, and Martha E. ShentonSchizophr Res. Author manuscript; available in PMC 2009 November 16. PMCID: PMC2777663

Published in final edited form as: Schizophr Res. 2007 January; 89(1-3): 49-58. Published online 2006 October 5. doi: 10.1016/j.schres.2006.08.004.

8. Clinical review: A systematic review of corticosteroid use in infections. Jody Aberdein and Mervyn SingerCrit Care. 2006; 10(1): 203. Published online 2005 November 22.

9. An insight into the biochemistry of inborn errors of metabolism for a clinical neurologist. Rita Christopher and Bindu P. Sankaran. Ann Indian Acad Neurol. 2008 Apr-Jun; 11(2): 68-81.

10. www.associatedcontent.com/article/2390658/insomnia_its_causes_and_treatments.html

11. www.associatedcontent.com/article/2371816/anxiety_causes_and_treatment.html