A Short Report from the 159th APA Conference - Toronto - 2006

by Robert Sealey, BSc, CA

The 159th conference of the American Psychiatry Association visited Toronto, ON, Canada from May 20 to 25, 2006. The Convention Centre and four downtown hotels had just enough rooms for the thousands of US psychiatrists who met with Canadian colleagues and other APA members from around the world. Readers of the N&MH will not be surprised to learn that toximolecular medicine was alive and well at the conference, encouraged by lectures, workshops, symposia and research presentations, not to mention large displays by pharmaceutical companies and publishing firms. Even though many patients risk side and toxic effects not to mention drug-induced neurological disorders when they take prescription antidepressants, anticonvulsants, and antipsychotics, these drugs are routinely prescribed to trusting patients, in ever-increasing combinations and in ever-expanding applications across diagnoses. Clearly, US psychiatrists still use medications as their first-line of attack on most mental illnesses.

In the midst of their zeal to prescribe pills for the symptoms of mental illnesses and to expand the market for pharmaceuticals by researching new applications, the conference offered a sprinkling of cautionary findings. One research team tested four patients who responded poorly to a new antipsychotic, the dopamine D2 agonist aripiprazole. Based on that limited sample, they observed that patients who lack suffient cytochrome P450-2D6 enzyme "experience an 80% increase in exposure and their medication half-life doubles compared to subjects who have normal CYP2D6 activity". Maybe psychiatrists will warn patients that genetic enzyme anomalies can affect their metabolism and their responsiveness to pills. Maybe pharmacogenetic testing will identify poor responders without unsuspecting patients suffering from the pills prescribed to help with their symptoms.

With its tiny booth dwarfed by the huge and futuristic displays of big pharma, the International Schizophrenia Foundation showed the Journal of Orthomolecular Medicine and books about orthomolecular research, clinical progress and success. ISF staff explained how restorative care can complement the status-quo of drugs and more drugs.

Now that large drug companies also own vitamin manufacturing production lines, might they benefit from orthomolecular information? Could they ramp up vitamin sales by encouraging the vitamins-as-treatment paradigm and applying their powerful marketing and lobbying capabilities? Hopefully big pharma will soon realize how much more money they could make by encouraging mental health professionals to offer restorative care by combining the usual prescription medications with safe, researched, proven, effective and complementary regimens of vitamins, minerals and other supplements.

Over 1,000 posters presented recent research in psychiatry. A handful of researchers brought non-drug information. German researchers reported testing a chromium compound with bipolar patients and getting interesting results; when asked why they chose chromium chloride rather than the more readily absorbable forms chromium picolinate or chromium polynicotinate, the lead researcher thought that neither formulation was available in Germany. Research reported in the 1999 Journal of the American College of Nutrition proposed a chromium-containing oligopeptide as the biologically active form; a 1997 article in Biochemistry suggested that "chromium oligopeptide activates insulin receptor tyrosine kinase".

Researchers from Sunnybrook Hospital, Toronto brought MRI scans which showed reduced activity in the brains of 77 Alzheimer's patients; a poster by Korean researchers reported reduced antioxidant levels in the brains of patients with dementia of the Alzheimer's type and predicted oxidative neuronal damage. Unfortunately there was no poster to apply this research by testing antioxidant therapy even though Dr. Hoffer's Smart Nutrients, in 1994, recommended orthomolecular treatment for dementia using niacin and other supplements to restore and maintain near-normal brain function in older people.

Other Toronto researchers noted that migraines occur with above-average frequency among bipolar patients, suggesting co-morbid causality, still to be explained. Still other researchers noted that thyroid problems occur with above-average frequency among patients with schizophrenia but that did not prompt them to suggest thyroid supplements as a promising approach to the medical care of schizophrenia, even though that treatment was mentioned years ago in the Journal of Orthomolecular Medicine.

Another group of Toronto researchers tested adult males with major depressive disorder and found a subset of depressed patients with low testosterone. In a related medical lecture, endocrinologist Dr. Jerald Bain, a Toronto hormone specialist, spoke about the relevance of testosterone replacement therapy to psychiatry. His lecture attracted 80 psychiatrists who seemed interested to learn that many of their patients could be tested for testosterone levels, and if low, treated safely and effectively with testosterone replacement therapy. Dr. Bain suggested that psychiatrists who do not feel comfortable prescribing testosterone could consult with an endocrinologist, internist or urologist. He shared his success giving supplemental testosterone to gently aging male patients who suffer with depression, dysthymia and andropause. Dr. Bain has often noticed that symptoms improve during testosterone therapy, including brain functions, depressive episodes, memory functions, concentration and quality of sleep. Dr. Bain edited a book called Mechanisms in Andropause with clinical case reports.

Researchers from Cambridge, MA reported on the safety and efficacy which they observed when testing the combination of l-methionine, betaine and folate on patients with unipolar depression. The five patients tested were not on psychotropic medications but even so, their symptoms improved, with no toxic effects. The source of funding for this research - NARSAD!

These fascinating research findings might encourage forward-thinking APA psychiatrists to review their professional practice guidelines, test patients for underlying factors which may cause or contribute to symptoms of depression and schizophrenia and then improve treatments to include nutritional and biochemical supplements: chromium picolinate for atypical depression; l-methionine, betaine and folate for depression; thyroid supplements for schizophrenia; antioxidants for dementia and testosterone for depression related to andropause. The restorative approach would help patients recover and live well, without the side effects involved with antidepressants and without symptoms continuing for as long as underlying medical problems remain undiagnosed and untreated.

In spite of their obsession with drugs as the standard treatments for mental illnesses, psychiatrists who attended the 159th APA conference could easily learn from the research-in-progress that they could treat some patients restoratively with nutritional supplements. Readers of N&MH hope that the information which the founders of orthomolecular medicine worked so hard to research, develop, prove and share, for over 50 years, will eventually appear in the practice guidelines of psychiatry. No, we won't tell patients, families and caregivers to hold their breaths waiting for restorative care from mainstream psychiatrists, but we can report that orthomolecular 'news' is finding its way into the APA.

by Robert Sealey, BSc, CA
author of Finding Care for Depression - Mental Episodes & Brain Disorders and 90 Day Plan for Finding Quality Care

Robert Sealey, BSc, CA is an independent consultant in North York offering accounting, tax and planning services. His mental accounting and consulting services help people cope with depression, mental episodes or brain disorders or care for family members. Bob authors the SEAR series of layman’s guides.

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