A Case History of Schizophrenic Recovery

>> ONE OF THOUSANDS OF CASE HISTORIES <<

Abram Hoffer

 

 

July 14, 1998

I interviewed a 24 year old woman, SN. For the past two years she suffered from intense fear and panic in the presence of people. She could barely cope having to interact with one, but with more than one the anxiety was intense, often leading to panic. For this reason she had been too fearful to even consult a psychiatrist. Her family doctor had prescribed the anti-depressant, Zoloft, 25 mg daily, a month earlier and this has been helpful in decreasing the level of anxiety. She was forced to leave her mother who she described as insanely jealous, difficult and hostile and lived with her father for two years. Since then she was on her own and when I saw her was unemployed and living on a pension. Her mothers behavior was typical of schizophrenic behaviour. My patient suffered from the two sets of symptoms characteristic of this disease.

 

She had perceptual changes such as feeling unreal, hearing her own thoughts, and believing people were staring at her. She was paranoid with some insight but believed people were talking about her in a derogatory way. She was also depressed, anxious and fatigued. I diagnosed her as suffering from schizophrenia and when I discussed this with her she agreed and said she had thought the same thing earlier and wondered whether she had gotten it from her mother.

 

I asked her to:

1. eliminate sugar from her diet,

2. to add niacin, 500 milligrams after each meal, and eventually to increase it to 1 gram three times daily [finally the dose went to 2.5 grams three times daily].

3. To this I added vitamin C 500 milligrams after meals,

4. folic acid 5 mg after meals,

5. pyridoxine 250 mg each day and finally

6. zinc citrate 50 milligrams each day.

 

I reassured her that if she followed this program her chances were very good that she would be much better within 6 to 9 months. Her intense anxiety and panic arose from her intense paranoid ideas.

 

She came back October 5, 1998. She was significantly better, felt less unreal, was less paranoid, had more insight and was beginning to regain social skills that her disease had removed from her. Her artistic skills were coming back. She had gone off her anti-depressant and vitamins for a week and during that week suffered a relapse with severe fatigue and more difficult paranoid ideas. I estimate that she is about 25% better. She was pleased as was I. I did not change the program.

 

February 1, 1999 she told me that two weeks ago she became aware that she was beginning to recover. Her thinking had become more organized, her mood was level, she had more energy. She had developed severe side effects to the anti-depressant she had had to take before. She discontinued the medication and continued to improve, She suffered much less pain and had fewer perceptual abnormalities. She still had a major problem. She was too jealous but she recognized this was a problem. This is called being paranoid with insight. She was troubled by this and I reassured her that this too would gradually disappear. I increased the niacin to 1.5 grams after each of three meals. She was concerned about her partner and had arranged that he too would be referred.

 

February 24, 1999 I saw her partner. His main complaint was that he could not think clearly, that he suffered from irrational ideas, that his short term memory was non existent and that he had zero concentration. As a result he had to be supervised by S.N. even in minor matters such as reminding him to eat. She had advised him to start on vitamins and he took niacin 1 gram each day for the month before I saw him. In that month he improved significantly, found his brain was coming under his control. I increased his niacin to 1 gram three times daily and asked him to continue the program S.N. had advised him to follow.

 

She came again in October, 1999. Her schizophrenia was much better with a major decrease in all the symptoms but she was still too depressed and did not sleep well. I added 25 milligrams of amitriptyline combined with 2 milligrams of perphenazine. These are very low doses but I have found them to be very effective for many patients who need very little medication. For many of my patients they are better than the hot shot new tranquilizers now available at exorbitant costs. She was still taking the vitamins and was on niacin 2 grams three times daily, in spite of her family doctor who advised her that this would cause liver damage. This is a myth, so well ingrained in the medical profession that it is a major factor in preventing them from giving their patients adequate doses. She had been through three stressful months because her partner was not well and his behaviour kept her under constant stress and uncertainty. But in spite of this major stress she continued to improve.

 

When seen last in November there was no doubt SN was better, was better able to function. I increased her niacin again to 2.5 grams three times daily and added one gram of salmon oil, for its omega three content, three times daily.

 

She came again with her father February 15, 2000. Her father told us that he had seen tremendous improvement in two years, much more than she herself felt had occurred. She knew she was getting better steadily but she was still concerned about anxiety which was not as bad as before and she was worried that she found it difficult to interact with more than one person at a time. She also had more insight and became aware that during childhood she had major problems controlling her thinking. She wanted reassurance that she would eventually become normal. I assured her that I thought this would occur over the next year or two during which time she would continue to improve. She spoke about her family and how she felt inferior and strange because she could not think as quickly as they could and that she felt comfortable only with her close friend. This is a phase that patients with schizophrenia often have to go through. They are much better and realize how ill they have been. Support and counseling are very helpful during this phase as is understanding from family and friends.

 

In May 2000, SN was in better touch with reality, was able to function better but was still depressed and troubled by disturbing thoughts. I added folic acid 25 milligrams daily to bring her out of her depression more quickly.

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