Psychiatry; Science or Science Fiction?

There is a little bit of both science and science fiction in psychiatry with a lot of speculation. Psychiatry has been rejected by Scientology, which is a case of throwing out the baby with the bath water. Antipsychiatry makes the same mistake. Scientology is science fiction. Antipsychiatry is too radical. Psychiatry itself is not perfect either, but at least there is some hope for it.

Neuroleptics

Ref. has questioned neuroleptics. Unfortunately this article does not appear to have been translated into English. I have always felt that the brain atrophy was due to the chemical imbalances. However, there is a point of view that it is caused by the medication. Brain atrophy was reported before the medications were invented, so it could be a bit of both.

Efficacy

"The addition of aripiprazole to risperidone or quetiapine was not associated with improvement in psychiatric symptoms but was generally safe and well tolerated."

(2)

This article doesn't say much for the efficacy of these drugs. There appears to be no efficacy.

Schizophrenia

Ref. 3 appears to implicate increased tryptophan metabolism in schizophrenia.

"The discovery of increased cortical KYNA levels in schizophrenia prompted the hypothesis that elevated KYNA concentration may underlie the working memory dysfunction observed in this population that has been attributed to altered glutamatergic and/or cholinergic transmission." (3)

There are a wide variety of theories for schizophrenia (4, 5, 6, 7).

Alzheimer's Disease

Ref. 8 reports abnormal tryptophan metabolism in Alzheimer's disease. Tryptophan metabolites were high.

"Blockade of NMDA receptors by KYNA may be responsible for impaired memory, learning and cognition in AD patients." (8)

"However, KYNA was increased significantly in the putamen and caudate nucleus of AD, by 192 and 177%, respectively." (8)

Various Neuropsychiatric Disorders

Ref. 9 reported hypercatabolism of tryptophan in a variety of "neuropsychiatric disorders". This means that there was excessive metabolism of tryptophan as measured by excessive metabolites of it. This brilliant report by neurologists from India appears to have been largely ignored in the US except by myself.

There is also a glutamate theory for schizophrenia. Glutamate has been found to be high in the brain. Both theories may be true. More than one amino acid could be involved.

Conclusions

Treatments are controversial. Ref. 10 advocates the use of healing foods. Ref. 11 advocates the use of micronutrients. Refs. 12-15 discuss psychiatric drugs and the use of diets.

My own theory is that a low tryptophan diet should be considered because there is substantial evidence of excessive tryptophan metabolism in the various forms of mental disease.

References

1. Lakartidningen. 2009 Oct 14-20;106(42):2704. [Important to scrutinize alarming findings about neuroleptics and brain atrophy].

2. J Clin Psychiatry. 2009 Oct;70(10):1348-57. A multicenter, randomized, double-blind, placebo-controlled, 16-week study of adjunctive aripiprazole for schizophrenia or schizoaffective disorder inadequately treated with quetiapine or risperidone monotherapy. Kane JM, Correll CU, Goff DC, Kirkpatrick B, Marder SR, Vester-Blokland E, Sun W, Carson WH, Pikalov A, Assunção-Talbott S.

3. Elevations of endogenous kynurenic acid produce spatial working memory deficits. Chess AC, Simoni MK, Alling TE, Bucci DJ. Schizophr Bull. 2007 May;33(3):797-804. Epub 2006 Aug 18.

4. Coyle JT, Tsai G, Goff D. Converging evidence of NMDA receptor hypofunction in the pathophysiology of schizophrenia. Ann N Y Acad Sci. 2003;1003:318-327.

5. Woodruff-Pak DS, Gould TJ. Neuronal nicotinic acetylcholine receptors: involvement in Alzheimer's disease and schizophrenia. Behav Cogn Neurosci Rev. 2002;1:5-20.

6. Schwarcz R, Rassoulpour A, Wu H-Q, Medoff D, Tamminga CA, Roberts RC. Increased cortical kynurenate content in schizophrenia. Biol Psychiatry. 2001;50:521-530.

7. Erhardt S, Blennow K, Nordin C, Skogh E, Lindstrom LH, Engberg G. Kynurenic acid levels are elevated in the cerebrospinal fluid of patients with schizophrenia. Neurosci Lett. 2001;313:96-98.

8. Baran H, Jellinger K, Deecke L. Kynurenine metabolism in Alzheimer's disease. J Neural Transm. 1999;106:165-181.

9. Neurol India. 2000 Sep;48(3):231-8. Tryptophan and tyrosine catabolic pattern in neuropsychiatric disorders. Ravikumar A, Deepadevi KV, Arun P, Manojkumar V, Kurup PA.

10. www.associatedcontent.com/article/2501095/healing_foods.html

11. www.associatedcontent.com/article/2496855/micronutrient_research_little_miracle.html

12. www.associatedcontent.com/article/2473238/psychiatric_drug_side_effects.html

13. www.associatedcontent.com/article/2462506/psychiatric_drugs_gods_or_frauds.html

14. www.associatedcontent.com/article/2456500/depressed_mice.html

15. www.associatedcontent.com/article/2452994/how_the_government_could_save_massive.html