Is Schizophrenia an Inflammatory Illness?

madness of adam and eve

The Madness of Adam and Even: How Schizophrenia Shaped Humanity

by David Horrobin (2001 Bantam Press)

Book Review

The Madness of Adam and Eve advances a dual hypothesis: 1) that schizophrenia is a whole body disorder, rather than a “brain disease, as promoted by Big Pharma and the psychiatric fraternity and 2) that schizophrenia stems from the same series of genetic mutations that led to the appearance of the human species (homo sapiens) 100,000 years ago.

The specific biochemical “error” Horrobin credits for causing schizophrenia is a defect in the metabolism of arachidonic acid (AA), a fatty acid that facilitates smooth signal transmission between nerve endings. Horobin believes a genetic mutation around 100,000 years ago caused a massive increase in AA production, enabling a giant increase in dendritic connections between neurons. This, in turn, resulted in a sudden explosion in human intellectual capacity, as well as the sudden appearance of art, music and organized religion.

Horribin also maintains that schizophrenia was a relatively mild illness in hunter gatherer societies, owing to a diet rich in the omega 3 fatty acids essential for optiminal brain function. With the major dietary changes that accompanied the agricultural and industrial revolution, schizophrenia has become much more severe. The switch from omega 3 and omega 6 fatty acids to saturated animal fat was by far the most significant, as saturated fats can suppress the uptake and utilization of omega 3 fatty acids.

Horrobin’s hypothesis is born out by WHO research revealing that schizophrenia is more severe in the industrialized west, studies showing that schizophrenics improve when given large doses of the omega 3 fatty acid EPA, and the failure of schizophrenics to experience a “niacin blush”* when exposed to megadoses of niacin.

Aimed at a lay audience, The Madness of Adam and Eve doesn’t always distinguish clearly between theory and established fact. While Horribin’s ideas make an important contribution to the understanding of mental illness, his overemphasis on genetic determinism in the origin of mental illness is clearly dated. In 2002, the field of epigenetics** was still in its infancy and there was limited understanding of the role of noxious prenatal influences on gene expression and the development of chronic physical and mental illnesses. Nor was the role of harmful intestinal bacteria and endotoxin-related inflammation recognized in the etiology of autism, schizophrenia and depression.

His portrayal of the intellectual inferiority of Homo neanderthalensis (Neanderthal man) is also obsolete. More recent archeological evidence suggests that Neanderthal man was the intellectual equal of homo sapiens.

*A niacin flush is sudden reddening and burning of the skin caused when niacin promotes conversion of AA to the inflammatory peptide prostaglandin. Several researchers have proposed using a niacin skin test as a research tool in studying schizophrenia.

**Epignetics is the study of hormonal and other prenatal influence that affect the expression of genes as specific protein enzymes.

When Horrobin died in 2003, the British Medical Journal wrote a particularly nasty obituary describing him as “the greatest snake oil salesman of his age.” A decade of research into the beneficial role of omega 3 oil in the treatment of depression (particularly post natal depression, bipolar illness, schizophrenia and premenstrual syndrome) has clearly vindicated him. The supplementation of prescription psychotropics with omega 3 oils is now standard psychiatric practice. 

Research into his theory that schizophrenia is a whole body inflammatory illness, rather than a brain disease, is also advancing. More recent studies focus on inflammation caused by endotoxin-producing by gram negative intestinal bacteria. Thus far schizophrenics’ demonstrated impairment in prostaglandin synthesis has failed to translate into viable treatment options.

There have been numerous studies suggesting a beneficial effect of non steroidal anti-inflammatory (NSAID) medication (such as ibuprofen and naprosyn) in the treatment of schizophrenia. Unfortunately NSAIDs, like psychotropics, have numerous serious side effects, including peptic ulcer disease and reduced kidney function.