By Erin Hawkes, MSc

Decades of research have investigated the possible treatment of the symptoms of schizophrenia with several of the B vitamins.

Thiamine (Vitamin B1):

When taken with acetazolamide (more usually prescribed for glaucoma or epilepsy), this vitamin may improve a variety of symptoms of schizophrenia.

Niacin (Vitamin B3):

Once thought to manage schizophrenia, this claim has since been questioned. However, symptoms, as assessed by the Global Assessment of Functioning (GAF), are associated with lower niacin sensitivity; this may indicate a potential therapeutic use of niacin.

Pyridoxine (Vitamin B6): 

Has shown promise by decreasing movement disorders such as akathisia (extreme restlessness) and tardive dyskinesia (involuntary movements). B6 has also been proposed as a general adjunct to antipsychotics.

Folate/Folic Acid (Vitamin B9): 

The most recent study has discovered a link between those with a variation of a gene important in metabolizing folate and its effect on negative symptoms of schizophrenia. Researchers at Massachusetts General Hospital followed 140 people with schizophrenia over 4 months and found those with a high-functioning FOLH1 gene responded better to folate (2 mg) and B12 (400 mcg) supplements. This was attributed to better processing of the supplements, resulting in a reduction of apathy, withdrawal, and inability to display emotion. One researcher stated the study results are important since to date, there has been nothing widely accepted shown to work.

Vitamin B9 may also reduce metabolic syndrome (which, among other things, includes cardiovascular changes and weight gain) that some people develop while taking newer antipsychotics.

Cobalamin (Vitamin B12):

When taken with folic acid, it can improve negative symptoms of schizophrenia, perhaps because B12 metabolism is altered in some people with schizophrenia.

There is little recent research regarding other B vitamins and their potential roles in the development, progress, or side effect management of schizophrenia.

Selected references

1) Miodownik C, et al. Vitamin B6 versus mianserin and placebo in acute neuroleptic-induced akathisia: a randomized, double-blind, controlled study. Clinical Neuropharmacol. 2006.;29: 68-72.

2) Lerner V, Miodownik C, Kaptsan A, Cohen H, Loewenthal U, and Kotler M . Vitamin B6 as add-on treatment in chronic schizophrenic and schizoaffective patients: a double-blind, placebo-controlled study. J Clin Psych. 2002; 63: 54-58.

3) Lerner V, Miodownik C, Kaptsan A, et al.  Vitamin B(6) in the treatment of tardive dyskinesia: a double-blind, placebo-controlled, crossover study. American J Psych. 2011;58: 1511-1514.

4) Burghardt KJ, and Ellingrod VL.Detection of metabolic syndrome in schizophrenia and implications for antipsychotic therapy: is there a role for folate? Mol Diag  Therapy. 2013; 17: 21-30.

5) Roffman JL, Lamberti JS, Achtyes E, et al.  Randomized Multicenter Investigation of Folate Plus Vitamin B12 Supplementation in Schizophrenia. JAMA. Psychiatry [2013[Epub ahead of print].