Nutritional Approaches to Schizophrenia

Before the 1950s most patients, diagnosed with schizophrenia, were kept in mental hospitals. There was no treatment. Then two things changed.

Firstly, Drs Abram Hoffer and Humphrey Osmond discovered that high doses of Vitamin B3 and sometimes vitamin C reversed schizophrenia in newly diagnosed patients. Dr Hoffer, Associate Professor of Psychiatry at the University of Saskatchewan, found 90% of first time patients could be cured and the other 10% improved. He also found 60% of chronic schizophrenics also improved, though this took much longer.

Secondly, about the same time, phenothiazine drugs were discovered. These were an effective treatment for schizophrenia. They worked faster than vitamins but came with a worrying list of side effects such as fatigue, weight gain, fatty liver and cognitive difficulties which often meant rehabilitation into the outside world was difficult. However the discovery of these drugs overshadowed the discovery of vitamin B3 even though these vitamins were cheaper, safer and had better long-term benefits.

Hoffer and Osmond’s first case was on a boy in a catatonic stupor who had not responded to insulin or electric shock therapy. He was given 10g of niacin and 5gms of vitamin C by a stomach tube. Two days later he was out of a coma and kept drinking the vitamins with water. Two weeks later he had completely recovered.

The discovery of vitamin B3 was met with little real interest by psychiatrists even though Hoffer and Osmond published two double blind trials in medical journals (using 3 grams of niacin daily). They also did long-term follow studies for 5 to 10 years and those using supplements showed excellent results. This contrasted markedly with those on standard therapy.

Psychiatrist Dr Michael Lesser in his book “Nutrition and Vitamin Therapy” describes several cases. He describes Robert who had a long history of severe schizophrenia. He had been hospitalized for four and a half years, had electroconvulsive treatment, various drugs and psychotherapies with little change. He was being considered for lobotomy so nutritional therapy was tried as a last resort. Robert had tests for various nutrients and was put on a high protein diet with removal of refined carbohydrates, coffee, sugar and cigarettes. He was given B vitamins, niacin and vitamin C. Five months later there was a remarkable improvement. He was calm, reading books and had no more hallucinations. Hoffer describes many moving cases, one who became a professor after recovering from schizophrenia. Another lady with severe schizophrenia described how her whole brain function and thinking reverted to normal 6 months after staring vitamin treatment and following many years of unsuccessful conventional treatment by other doctors.

They describe other cases where he successfully used this regime of niacin, vitamin B6 and vitamin C combined with a high protein diet.

Treatment with Vitamin B3 can be more complex than with drugs as other nutrients are sometimes needed; changing the diet is also important. Typically this means reducing sugar, junk food, alcohol, additives and white flour products. Some patients with schizophrenia have an abnormality in their urine. They have excess kryptopyroles (this can be tested for at Biolab). Those with high levels (can be abnormal in 30% of schizophrenics) will need extra vitamin B6 and zinc. If this test is abnormal and the deficiencies corrected then 45% will have a complete recovery. Some have low histamine levels and high copper and need vitamin B12 and folic acid. Other workers have found a variety of nutritional deficiencies in schizophrenics, notably of zinc and manganese (they need 15 to 60mg of manganese daily).

Although this sounds complicated, most will patients with schizophrenia will respond to a combination of niacin (nicotinic acid) or niacinamide (nicotinamide) and vitamin C.


Food intolerance is common and many schizophrenics suffer from wheat intolerance. Many showed marked improvement on removal of wheat with relapse on restarting it (6). Other food intolerances have been noted.

Basic Regime

  1. Vitamin B3 1.5 grams to 9 grams daily.

Vitamin B3 deficiency resembles schizophrenia and this vitamin is highly beneficial, though it works slower than drugs. It has been found to reduce hallucinations and delusional thinking. There are 3 forms of vitamin B3.

The form used most is niacin (also known as nicotinic acid) and the dose of niacin is 1.5 grams daily built up slowly as doses over 100mg can cause flushing. (Note the trials were done with 3 grams niacin daily). Flushing is less likely if it is taken with a heavy meal. Michael Lesser starts with 50mg three times daily, doubling every few days until maximum mental improvement is achieved. An eventual dose of 250mg 6 times daily is suggested but sometimes double this is needed.

Another form of Vitamin B3 is Niacinamide (nicotinamide). An advantage is that it not cause flushing and it is a good choice where flushing is the problem. It is now hard to get this vitamin in large doses. Nature’s Best do a 250mg dose.

It is also possible to use inositol hexanicotinate (INH) which produces similar benefits to niacin without the flushing. It may be slightly less effective.

  1. Vitamin C 1.5grams daily


  1. Vitamin B6 200mg daily
  2. Multi-B vitamins. B vitamins work best in combination. Other B vitamins such as folic acid and B12 can be low in schizophrenia. In addition some workers have used the B vitamin PABA at up to 2 grams daily with benefit. Carl Pfeifer believes that schizophrenia starting in middle age is often due to B12 deficiency.

One way to cover most possibilities is to use a mega B vitamin with Vitamin B3 and vitamin C as this covers B6, B12 and folic acid.

  1. Essential fatty acidsespecially Omega 3 fats. There are many brands available.
  2. High protein diet – niacin may be ineffective without this.
  3. Avoid sugar, refined carbohydrates, coffee and cigarettes.