Diskussion:Orthomolekulare Psychiatrie

Zweifel an der Kritik des Artikels

"Als kritisch sind hingegen weitergehende Schlussfolgerungen des Systems und deren offensive Vermarktung im Sinne von Heilungsversprechen anzusehen."

Zu allgemein, bitte wenigstens zwei weitergehende Schlussfolgerungen mit Quellen und ein Beispiel der offensiven Vermarktung mit Heilungsversprechen angeben.

--Rohi 20:59, 31. Okt 2005 (CET)

fachartikel zum thema

Die orthomolekulare psychiatrie anhänger können leider ihre therapieempfehlungen nicht mit seriösen, neutralen studien begründen. Dagegen gibt es studien die zeigen dass ein derartiges vorgehen keinen vorteil für die patienten bringt. Andere arbeiten belegen sogar gefahren derselben. Mehrere fachverbände weltweit haben sich nach durchsicht der forschungsergebnisse eindeutig gegen diese ausgesprochen.

Literatur zum thema:

Aust N Z J Psychiatry. 1999 Feb;33(1):84-8.

Megavitamin and dietary treatment in schizophrenia: a randomised, controlled trial.

Vaughan K, McConaghy N. Palmerston Centre, Hornsby Hospital, New South Wales, Australia.

OBJECTIVE: The aim of this study was to assess the efficacy of adjunctive megavitamin and dietary treatment in schizophrenia. METHOD: A random allocation double-blind, controlled comparison of dietary supplement and megavitamin treatment, and an alternative procedure was given for 5 months to 19 outpatients with a diagnosis of schizophrenia. In addition to usual follow-up, the experimental group received amounts of megavitamins based on their individual serum vitamin levels plus dietary restriction based on Radioallergosorbent (RAST) tests. The control group received 25 mg vitamin C and were prescribed substances considered allergenic from the RAST test. RESULTS: Five months of treatment showed marked differences in serum levels of vitamins but no consistent self-reported symptomatic or behavioural differences between groups. CONCLUSIONS: This study does not provide evidence supporting a positive relationship between regulation of levels of serum vitamins and clinical outcome in schizophrenia over 5 months.

Lipton M and others. Task Force Report on Megavitamin and Orthomolecular Therapy in Psychiatry. Washington D.C., 1973, American Psychiatric Association.

Nutrition Committee, Canadian Paediatric Society. Megavitamin and megamineral therapy in childhood. Canadian Medical Association Journal 143:1009­1013, 1990, reaffirmed April 2000.

Committee on Nutrition, American Academy of Pediatrics. Megavitamin therapy for childhood psychoses and learning disabilities. Pediatrics 58:910­912, 1976.

LaPerchia Adolescence. 1987 Fall;22(87):729-38. Behavioral disorders, learning disabilities and megavitamin therapy.

Kleijnen J, Knipschild P. Niacin and vitamin B6 in mental functioning: a review of controlled trials in humans. Biological Psychiatry 29:931-941, 1991.

Pfeiffer SI and others. Efficacy of vitamin B6 and magnesium in the treatment of autism: A methodology review and summary of outcomes. Journal of Autism and Developmental Disorders 25:481-493, 1995.

Omaye ST. Adv Exp Med Biol. 1984;177:169-203. Safety of megavitamin therapy. .... Vitamin supplements can be suggested only in the unusual cases of patients having inadequate intake, disturbed absorption (genetic or otherwise), or increased tissue requirements. A well-balanced diet that includes a wide variety of foods from each of the four food groups is adequate for the supply of vitamins, as well as other nutrients, in healthy people. This paper will review some of the recent findings regarding vitamin toxicity and the mechanisms of toxicity.

Davidson RA. South Med J. 1984 Feb;77(2):200-3. Complications of megavitamin therapy. A patient with pancytopenia, severe sensory neuropathy, and a six-year history of excessive vitamin intake showed portal hypertension on evaluation. A liver biopsy revealed hypervitaminosis A. His sensory findings were characteristic of a recently described syndrome of sensory neuropathy secondary to megadoses of vitamin B6. The patient's neuropathy has improved, but his pancytopenia has persisted. The practice of ingesting large doses of vitamins is increasing in a considerable segment of our population. Many claims of therapeutic benefit have been made, but few have been demonstrated in controlled clinical trials. Although there are indications for the use of large dosages of certain vitamins, they are rare. Physicians should be aware of the toxicities of megavitamin therapy.

Haslam RH, Dalby JT, Rademaker AW. Pediatrics. 1984 Jul;74(1):103-11. Effects of megavitamin therapy on children with attention deficit disorders.

The effectiveness of a megavitamin regimen utilizing a two-stage trial in 41 subjects with attention deficit disorders was studied. Stage 1 was a 3-month clinical trial of vitamins (daily maximum: 3 g of niacinamide and ascorbic acid, 1.2 g of calcium pantothenate, and 0.6 g of pyridoxine). State 2 consisted of four, 6-week, double-blind repeated crossover periods. Twenty-nine per cent of the subjects showed significant behavior improvement during stage 1, and these subjects were used in the double-blind crossover phase of the study to evaluate megavitamin therapy. Using analysis of variance methods for crossover studies, there was no significant difference (P greater than .05) in most behavior scores between children receiving vitamin and those receiving placebo during stage 2. Children exhibited 25% more disruptive classroom behavior when treated with vitamins v placebo (P less than .01). There was no significant difference in serum pyridoxine and ascorbic acid levels between subjects and control subjects. Forty-two per cent of subjects exceeded the upper limits of serum transaminase levels while receiving vitamins. It is concluded that megavitamins are ineffective in the management of attention deficit disorders and should not be utilized because of their potential hepatotoxicity.

Redecke 12:51, 1. Nov 2005 (CET)

Arnold LE, Christopher J, Huestis RD, Smeltzer DJ. Megavitamins for minimal brain dysfunction. A placebo-controlled study. JAMA. 1978 Dec 8;240(24):2642-3.

Preliminary to a stimulant comparison study, 31 children with minimal brain dysfunction randomly received either placebo or a megavitamin combination. During a two-week trial, only two children responded so well that stiumlants were not considered necessary; both were in the placebo group. Change scores from pretest to posttest on four blind ratings by teachers and parents did not show a significant difference between the placebo and vitamin groups.

Shaywitz BA, Siegel NJ, Pearson HA. Megavitamins for minimal brain dysfunction. A potentially dangerous therapy.JAMA. 1977 Oct 17;238(16):1749-50.

Vitamin A intoxication as a consequence of megavitamin therapy for minimal brain dysfunction occurred in a 4-year-old boy. An early clue to diagnosis was provided by an abnormal bone scan.

Davidson RA.Complications of megavitamin therapy. South Med J. 1984 Feb;77(2):200-3.

A patient with pancytopenia, severe sensory neuropathy, and a six-year history of excessive vitamin intake showed portal hypertension on evaluation. A liver biopsy revealed hypervitaminosis A. His sensory findings were characteristic of a recently described syndrome of sensory neuropathy secondary to megadoses of vitamin B6. The patient's neuropathy has improved, but his pancytopenia has persisted. The practice of ingesting large doses of vitamins is increasing in a considerable segment of our population. Many claims of therapeutic benefit have been made, but few have been demonstrated in controlled clinical trials. Although there are indications for the use of large dosages of certain vitamins, they are rare. Physicians should be aware of the toxicities of megavitamin therapy.

Petrie WM, Ban TA. Vitamins in psychiatry. Do they have a role? Drugs. 1985 Jul;30(1):58-65.

Deficiencies of specific vitamins produce consistent symptoms of psychiatric disorder. Thiamine deficiency, which is common in alcoholism, can produce confusion and psychotic symptoms, in addition to neurological signs. Vitamin B12 and folate deficiency may contribute symptoms of disorientation, depression or psychosis; their measurement is a part of routine dementia work-ups. Pyridoxine deficiency results in seizures, although the effects of exogenously administered pyridoxine are not clearly understood in depression and anxiety - the disorders in which it is most frequently used clinically. The use of vitamins has been most prominent in psychiatry in the treatment of schizophrenia, where large doses of nicotinic acid were initially given alone and later combined with other vitamins and minerals. Several theoretical models were described to support the use of vitamins in schizophrenia. These included: the parallels of schizophrenia to the psychiatric symptoms of pellagra; hypotheses of a defect in adrenaline metabolism; and the accumulation of psychotoxic substances which produce psychotic symptoms. Initially, positive results were reported over 30 years ago, but have not been replicated by thorough investigations. An extensive series of comprehensive placebo-controlled trials failed to show efficacy for any of the vitamin therapies tested. Although clearly less effective than antipsychotic drug treatment, vitamin therapy is not without risks - adverse effects have been reported with nicotinic acid, pyridoxine and vitamin C.( Für alle die eine Gute Zusammenfassung auf Englisch interessiert sei auf http://www.quackwatch.org/01QuackeryRelatedTopics/ortho.html verwiesen. Ist irgend jemand eine seriöse Seite mit der Selbstdarstellung von Orthomolekularer Psychiatrie/oder Medizin bekannt. Ich persönlich bin bisher nur über Marketingseiten gestolpert. Letztere bieten in der Regel unbewiesene Schlagwörter und reichlich Verkaufsangebote an. Im seriösen medizinischen Internet ist mir bisher keine Studie begegnet, die einen Nutzen von Orthomolekularer Psychiatrie/oder Medizin darstellen würde, habe auch in Medline unter verschiedenen Suchbegriffen (Orthomolecular und psychiatry, medicine, schizoprenia, depression, ADHD, usw.) keine Studie gefunden, die eine ernsthafte Grundlage für die gebotene Werbung bieten könnten 3.1.2005

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--Zwobot 11:18, 9. Feb 2006 (CET)

Broschüre

Als erschwingliche - der OMP positiv gegenüberstehende - Broschüre, die zum Preis von US-$ 5.95 allerdings in englischer Sprache verfaßt ist, möchte ich hinweisen auf:

Hoffer, A.: Orthomolecular Treatment for Schizophrenia, Broschüre in der Reihe: "Good Health Guide" von Keats, (C) 1999. 55 Seiten mit ausführlichem Literaturverzeichnis (76 Quellenangaben), ISBN 978-087983910-9 (ISBN-13) und ISBN 087983910-4 (ISBN-10)

Hier wird auch auf diese Internetquelle verwiesen. --Anaxo 21:20, 25. Mai 2009 (CEST)

Zweifel am "Kritik"teil des Artikels

Momentan handelt es sich um reines Bashing der O.P. ohne jeglichen Beleg. Bitte den Abschnitt löschen oder mit Belegen versehen. Für den Abschnitt Gegenwärtiger Stand gilt das selbe. --Œuf, œuf, que lac je 08:13, 24. Mär. 2010 (CET)

Wenn die Befürworter der OMP keine Wirksamkeitsbeweise beibringen, wird sich an der IMHO berechtigten Kritik der evidenzbasierten Wissenschaft an der OMP auch nichts ändern. Den Beleg müssen hier die OMP-Anhänger bringen, niemand anders.--87.144.112.217 20:34, 8. Jun. 2010 (CEST)

Soweit ich verstehen kann besteht in Wikipedia Belegpflicht für ALLE Aussagen in einem Artikel, unabhängig von der Einteilung in "Befürwortung" oder "Kritik", siehe gleich der Beginn in Belege. Es geht um eine DARSTELLUNG dessen, was an relevantem Wissen zu dem jeweiligen Lemma aufzufinden und belegbar ist Damit könnte dann einen großen Teil dieses Artikels in der jetzigen Form streichen, nirgendwo sind die Aussagen einzeln belegt und der pauschale Verweis auf "Fachartikel" etc. reicht weder für die eine noch für die andere Seite aus. --Hartmuoth 10:18, 29. Jun. 2010 (CEST)

Hier handelt es sich nicht um evidenzbasierte Wissenschaft, sondern um den Themenkreis Medizin. Medizin arbeitet nicht immer evidenzbasiert. Welcher Ethikrat würde Studien an Insulinpflichtigen Kindern zustimmen? --zopiclon 08.00, 03. Jan. 2017 (CEST)