Megavitamin Therapy
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MEGAVITAMIN THERAPY THE AMERICAN PSYCHIATRIC ASSOCIATION TASK FORCE REPORT ON MEGAVITAMIN AND ORTHOMOLECULAR THERAPY IN PSYCHIATRY Canadian Schizophrenia Foundation August 1976 MEGAVITAMIN THERAPY This is the second report published by the Canadian Schizophrenia Foundation to give wider dissemination to its members and to members of similar organizations in the U S A of corrections to the findings of the American Psychiatric Association Task Force Report #7, Megavitamin and Orthomolecular Therapy in Psychiatry The findings, opinions, and conclusions of these reports do not necessarily represent the views of the officers, members of the board, or all members of the Foundation Each report does represent the thoughtful judgment and consensus of Dr A Hoffer and Dr H Osmond who prepared it, and it is considered a useful and substantive contribution to the ongoing analysis and evaluation of problems, programs, issues, and practices in a given area of concern: orthomolecular psychiatry A. Hoffer, M13., Ph.D,, F.A,O.P., F,R.S.C.(C) President Canadian Schizophrenia Foundation MEGAVITAMIN THERAPY In Reply to the American Psychiatric Association Task Force Report on Megavitamins and Orthomolecular Psychiatry A Hoffer, PhD ,MD, F AO P ,R C P(C) H Osmond,MB,MRCP,FRCPsych Canadian Schizophrenia Foundation 2135 Albert Street Regina, Saskatchewan S4P 2V1 ACKNOWLEDGEMENT The authors gratefully acknowledge the assistance of the Academy of Orthomolecular Psychiatry which made publication of this book possible with a grant of $2,000 An Examination o Summary Addendum Section I - Brief Abstract of Orthomolecular Treatment by Saskatchewan Group Section II - Brief Abstract of Corroborative Reports Section III - Pauling Paper Section IV Letters to the Editor Section V - Comments on B. J. Wyatts Comment (1974) on L. Paulings Report Section VI - Comments on the Double-Blind (Placebo) Methodology Section VII Efficacy and Toxicity Section VIII Letters Section IX References Section X Reading List in Orthomolecular Psychiatry Section XI - REAL Attempts to Corroborate with Failure to Confirm to Original Studies Copyright 1976 by Dr. A. Hoffer and Dr. H. Osmond. Published by the Canadian Schizophrenia Foundation. 2135 Albert Street. Regina, Saskatchewan S4P 2V1. No part of this book may be reproduced by any mechanical, photographic. or electronic process or in the form of a phonographic recording, nor may it be stored in a retrieval system transmitted. or otherwise copied for public or private use without written permission of the authors We decided to answer the American studies might have been differently Psychiatric Association Task Force written However, having completed our Report on Megavitamins and Ortho- critical study of our critics we feel that it molecular Psychiatry with some reluc- has been worth the effort and hope that tance since this kind of controversy is our readers will agree tedious and not really productive—there As far as the Task Force members are are many other things to do connected concerned we would remind them of with the well-being of schizophrenic Bernard Shaws aphorisms: "If you would patients which should have higher injure your neighbor—better not do it by priority than answering the criticisms of a halves " committee none of whose members Since the report was clearly intended appear to have had direct clinical charge to injure us it was doubly botched of a single schizophrenic patient treated because, according to the American by orthomolecular psychiatric therapy Psychiatric Association, it was supposed- However, colleagues have pointed out ly a fair inquiry and as such it was a to us that we had a special responsibility failure from the start The moment that for replying to these critics, and if we we doubted the impartiality of the failed to do so it would be assumed that chairman and committee members our default indicated that we accepted (presumably selected by him) it ceased to some or perhaps most of their criticisms be an unbiased inquiry The APAs duty Our reluctance as we shall note later on was to ask us whom we would consider has been much more on account of the to be unbiased among their 25,000 multitude of errors than upon the high members or so, or how undue bias, one quality of the criticisms There is much to way or another, could be assured against be gained from the observations and Their arbitrary assumption that they even strictures of an intelligent, fair knew best is far more serious than the critic. We are not so conceited or so errors of Lipton, Mosher, Ban, et al provincial as to deny that, especially That four-fifths of the committee came with the benefit of hindsight, experi- from two institutions and that the other ments might have been done differently member was a rival experimenter in- and papers discussing and describing our dicated ineptitude and insensitivity. an examination of the american psychiatric association task force report "megavitamins and orthomolecular therapy in psychiatry" american psychiatric association, 1973 The Task Force To attain their stated objectives, a lack This report begins by stating that " we of bias and prejudice was essential It shall examine carefully and critically the may surprise those who believe that the claims, the supporting evidence, the American Psychiatric Association would theoretical basis and the contrary never allow its name to be attached to a evidence in detail." It is wholly proper document which did not meet these for a professional association to study a criteria to learn that three years before new treatment in this way The report this report was published the chairman of ends with these words, "this review and that Task Force was conducting himself critique has carefully examined the in a manner which did not suggest literature produced by megavitamin pro- impartiality Indeed, his behavior in- ponents and by those who have attempt- dicated to many who heard him speak ed to replicate their basic and clinical that he had already made up his mind work " It concludes that in this regard and was not inclined to change it "the credibility of the megavitamin At a public meeting in California proponents is low " The value that one arranged by Mr Joe Desilva of Local 770 attaches to the Task Force conclusions in Los Angeles, Dr. Morris Lipton read a depends largely upon the intelligence, paper on the theoretical aspects of zeal, honesty, and detachment with megavitamin therapy and touched briefly which its members approached the on treatment At this time none of the objective which they had set for them- Ban-Lehmann studies had been reported selves In this paper, we shall examine and Wittenborns work was still in the composition of the Task Force, the progress Nevertheless, Dr Liptons con- nature of its report, and the manner in clusions, which he expressed then, which it set out to examine megavitamin closely resembled what was published and orthomolecular therapy in psy- later by the committee of which he was chiatry, chairman We are not the first to have questioned manner, and, finally, explain, reason, the propriety of using this report as a and argue with other members of the source of information Linus Pauling, committee. It is with this in mind that in 1974, wrote: "The APA Task Force democracies government committees Repoft, Megavitamin and Ortho- always include members of the major molecular Therapy in Psychiatry, dis- political parties One-party committees, cusses vitamins in a very limited way however admirable their members may (niacin only) and deals with only one of be, are always suspect If a minority of two aspects of the theory Its arguments members believe that a report is in- are in part faulty and its conclusions are correct or unfair they can then register an unjustified " j Hoffer, 1974, following a official dissenting view which is pub- long and detailed examination, com- lished with the majority opinion The mented: "It is a mistake to use it as a presence of members experienced with reference source in evaluating mega- the treatment under review means that vitamin therapy because it is a mine of those appearing before the committee misinformation " These remarks may know that they will be questioned by any disappoint those who had supposed that one - of its members This deters people the APA would provide a useful and from presenting mere hearsay evidence reliable document, but they are less or opinions which cannot be backed with unexpected when one studies both the personal experience composition of the committee and its Second: Proponents of opposing views modus operandi may be allowed to cross-examine each When a committee is formed to report other. This is a procedure which was on a controversial issue, one assumes eventually done in the prolonged and that the matter is important enough to controversial F D A vitamin hearings warrant a careful, scholarly, and held in Washington recently Dr Miles detached examination. The APA Robinson, M D , asked to be allowed to Council on Research and Development cross-examine some of the witnesses was correct in appointing a Task Force to appearing before the hearing examiner examine megavitamin therapy for this This right was at first denied him, but Dr was a matter of interest, concern, and Robinson took the matter to court The discussion among both psychiatrists and examiner was then rebuked and ordered the public However, the Council erred to re-open the hearings to allow the gravely in failing to instruct the sub- cross-examination. The United States committee, chaired by Dr M Lipton, Court believed that a public inquiry that not only must the committee be fair should make every effort to determine and objective, but they must also appear the truth and decided that cross- to be so examination, which had been denied A committee can appear to be fair earlier, would further this process Either even when they are not truly so by using of these approaches alone increases the two procedures either alone or together.