Strategies for Improving Schizophrenia Outcomes

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 *updated periodically 




Website is here:

New Tech Channels (more resistant to negative big pharma influence)

Google drive folder with research papers and other resources:
(Unfortunately it has no search function, therefore I do suggest downloading the whole folder to search through it much faster)

Research tools: Sci hub, library genesis

Other providers with decent info:
Chris Palmer
https://isom.ca/ (Jonathan Prousky)
Eva Edelman's book "Natural Healing for Schizophrenia"

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Tests
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I highly suggest you test yourself HERE to see how sick you are, then you will know how much the below solutions have helped or hurt your recovery when you retest (doubling down on helpful tips, and disregarding tips that you find detrimental).

The above test is thought to be just as accurate (if not more specific) than a typical psychiatrists diagnostic interview. And patients themselves often cannot tell if they are improving or not—unless the improvement is both quick and dramatic. Which is often not the case with schizophrenia, as gradual improvement over a longer timespan is more typical.

(other tests for schizophrenia that are trickier for you to do yourself are here).

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Problems
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work on hippocampus volume 
https://www.sciencedaily.com/releases/2016/08/160809122805.htm   

Brain has structural anomalies
http://news.yale.edu/2015/08/12/brain-abnormalities-are-present-even-onset-schizophrenia  **top 2
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4273663/#!po=12.5000 (hard to understand.) Conclusion: brains with good leftward connectivity in brain have worse positive symptoms whereas rightward connections have worse negative symptoms) (between left and right brains)

Naurons vary from healthy ones in 10nm xray, jagged edges (03/21 update)
https://medicalxpress.com/news/2021-02-schizophrenia-x-rays-neural-differences-treatment.html
Frayed white matter connections https://www.sciencedaily.com/releases/2017/10/171017091913.htm

To much dopamine (perhaps to much DMT from pineal gland?)(or NMDA receptor not working too), High status possability increases dopamine (to create spiritual connection with followers) can go awry. Those who are low status have less dopamine in their brains.

Extrasynaptic dopamine receptors over stimulated due to malfunction of synaptic dopamine receptors picking up a signal and the brain compensating by releasing more dopamine (NEW THEORY)
Depleted omega 3 in brain.

Lower zinc levels

Pernicious anemia (or other problems with B12 levels)

Higher oxadative stress in brain

amygdala gets bigger, hippocampus shrinks, amygdala stays bigger but hippocampus can grow again, they work as ying yang (check for link)

sleep efficiency is only 78% in schizo or 72% shizo plus schizo drugs. While general public is 95% efficient. Need more stage 3 and 4 sleep (REM sleep)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC487011/ 

Food allergy can cause microglia increase in prefrontal cortex and hippocampus (two area's that have been shown to have increased microglia in schizophrenics). Blood serum markers of allergy are present in this study too.
antipsychotics in terms of total SD (sexual dysfunction), such that, partially consistent with the traditional dichotomy between prolactin-raising and prolactin-sparing antipsychotics, quetiapine, ziprasidone, perphenazine, and aripiprazole were associated with relatively low SD rates (16–27%), whereas olanzapine, risperidone, haloperidol, clozapine, and thioridazine were associated with higher SD rates (40–60%).

Lack of sleep causes neurons to look schizophrenic (see sleep google drive)

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Solutions
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(in order of importance)

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STILL RESEARCHING
Likely theory that explains why most (but by no means all) positive interventions (listed below) work 
**Note: the interventions listed below must still be done to achieve an increased recovery rate**
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(low histamine/high copper 50% of patients, High histamine 20% of patients, pyroluria 30% of patients (some overlap with low and high histamine patients who also have pyroluria (hence numbers add up to 110%)), 10% other (often cerebral allergies),
Testing for histamine serum levels, copper serum levels, zinc serum levels, elimination diet, plus your symptoms, can all indicate which condition you might have
high serum ammonia levels can also be tested for if your curious)
A discussion of high copper:
Copper levels are high in schizophrenics raising ammonia levels compared to controls (excessive copper may be due to a ATP7B binding defect (need source)). Fixing this by supplementing B vitamins (B12 linked) and B6 and zinc may help. Dr. Carl Pfeiffer cured schizophrenia sometimes by reducing copper with zinc and B6 (high dose niacin reduces copper too) B12 gets depleted by excess copper (excess copper also lowers zinc, B6, B9, D, etc..) when B12 gets low at tissue level it causes methylmalonic acid to rise and this acid blocks enzymes in the urea cycle that convert ammonia to urea. When ammonia gets high it can cause hallucinations, paranoia, depression etc. (need source))(adrenal fatigue also causes copper build up (allergens cause body to produce adrenaline as an anti-histamine))(red meat reduces it through zinc, birth control pills raise copper). (acetl l carnitine also lowers ammonia levels (drive carnitine for other potential positive effects)) (manganese lowers ammonia) (gut bacteria effect ammonia) (I also believe there may be a drug that lowers ammonia levels (luctolose)) (more than half of patients in a mental hospital have high ammonia (need source))
ammonia is linked to criminal behaviour, H2S thought to be protective
High ammonia can cause sleep wake inversions, poor memory, short attention span, clumsiness, brain water build up, hypertension in brain,
sleepiness is associated, drug and alcohol use makes it worse, smoking makes it worse, exercise helps
High Ammonia causes brain inflammation(?)

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Open dialogue approach to schizophrenia, achieved 4.15x recovery rates in Finland. Treating schizophrenia not as the patients fault but as a problem with all the patients social connections. (Japanese call schizophrenia integration disorder). Entails quick crisis response with daily meetings with patient if needed until the crisis passes, the aim is to create dialogue with the patient to construct words for the experiences, which exist in psychotic symptoms (focusing on what the individual patient needs to move forward and how they can reshape their internal dialog if needed (a poor internal dialogue or failure to integrate information properly or deal with stresses or explain life events may cause the brain to produce hallucinations as the only possible response to the situation. Also focusing too much on your public persona (what other people think of you) may push your brain to invent voices and thought broadcasting, therefore it may help to rationalize away any looks or comments in a more meek than grandiose way. And focus more inwardly on yourself rather than focusing on what God or other people think. (don't lightly invoke God)). Open dialog occurs with close relationships and no discussion of the patient outside visits with the patient, medication is avoided if possible (only 20% are taking meds after 2 years, compared to the vast majority of patients not on the Open Dialogue approach). Treatment in open dialogue usually takes between 2 and 3 years.
MAY not be as useful in chronic schizophrenia, but the principles will likely still provide great benefit.
Difficult to implement without a team
For a basic summary of all the key components of open dialogue and other psychological things you can do to improve WATCH MY VIDEO HERE:
I'd recommend the book "Dialogical Meetings in Social Networks" by Tom Erik Arnkil and Jaakko Seikkula, if you want a deeper understanding.
For more (including the 7 steps of treatment) see here:
Also follow "TheMorningMist99: above and beyond schizophrenia" channel here for some inspiring and motivational speeches about how you can pull yourself up and follow a few simple steps to vastly improve your chances of recovery.

socialization and useful occupation (place in universe) supportive friends family (I'm TUFR strategy)
https://www.livingwithschizophreniauk.org/advice-sheets/recovery-strategies-for-schizophrenia/# (somewhat similar to the Open Dialogue approach)

Reducing inflammation stress responses

If your story doesn't make sense, your personality can fragment. Make your story whole and your personality heals.
Example:
There was a lady who thought her husband had died and was admitted to a psych-ward with psychotic symptoms, her doctors thought it would be jarring for her to see her husband who she was convinced was dead, so they suggested he not come in. However he did eventually come in and upon seeing her live husband her delusions went away and she suggested they head back to their home. Her story was made whole.

Medication minimum effective dose (doubles good outcomes) (Though leads to higher risk of relapse in short term but lower risk of relapse long term) (overall recovery rate may interest you at 7 year mark (40% recovered on drug reduction versus 20% on maintenance dose)(though avoiding medication is best if you can, or only taking it short term)
http://jamanetwork.com/journals/jamapsychiatry/fullarticle/1707650#yoi130041f2
helps cognitive function 
https://www.psychiatryadvisor.com/schizophrenia-advisor/schizophrenia-maintenance-therapy-reduced-dose-improves-cognitive-performance/article/755967/

Developing countries have 2x recovery rates (40% recovery versus 17% USA) and also often do not use medication. In India schizophrenics are more included in rural farm work and face less stigma, along with less use of medication. These factors all may lead to better outcomes.

Patients with an internal sense of control versus an external one were 35% more likely to not need medication (75% not need versus 40% not need). (You should therefore foster a sense of personal responsibility instead of thinking God is responsible (rationalize things rather than spiritualize)). It would also be better to actually talk to people rather than to imagine what they are thinking, this would help increase a sense of personal internal control rather than external control. Patients with good prognostic indices (can look-up what indicates more likely recovery in schizophrenia) or good premorbid functioning were also more likely to not need meds (35% and 25% better respectively.) Those not taking meds at 15 year follow-up had 40% recover rates versus 5% on meds at 15 year follow-up. They often had their drugs reduced early on in the course of their illness similar to the above drug reduction strategy.
(google drive link: NoMedsRecoverRateFactors)
Creating more individual and close connections spiritual strength versus public tide of spiritual energy (that can run you over) is therefore important

church attendance is linked to recovery (in the USA, mosques, temples ect... likely similar). Also tearfulness was linked to recover (see google drive prognostic factors church attendance)

**When adding supplements add one at a time, if you don't have a negative reaction continue taking them (please look up side effects for each supplement so you are aware). If you don't feel any better when taking them for the prescribed time you can likely discontinue, though some supplements take longer to work or may work more subtly. If it's not hurting it therefore may still be helpful.

EmpowerPlus multivitamin for the brain worth trying. Also sells amino acids (proteins) to help with antipsychotic withdrawal (tardive dyskinesia, energy spikes) and supplements for rushing thoughts, and nervousness.
They have lots of experience and walk you through the steps. Though they have mostly done research on bipolar disorder (with a 70+ cure rate for bipolar).
Schizophrenia is similar to bipolar biologically according to Chris Palmer. Therefore it likely has around a 70% cure rate for schizophrenia.
(Also see drive: truehope)
Note: EMP contains zinc and some other nutrients listed below (you often won't need these nutrients in greater quantities than are already contained in EmpowerPlus, exception maybe B3).
Both companies ship internationally (but you should check with them for your specific country to make sure).

Fish oil (omega 3's) (400% increase in recovery rate (but was used for at risk people before disease developed still beneficial after it develops though for neurogenesis and proper brain function) (20% improvement for established schizophrenia and affect seems to be retained if you discontinue after 4 months (they stopped fish oil and after 4 months still great outcome)) (omega 6's are bad) (they had them taking some vit c and vit e with fish oil in the established schiz study with a plus 7% boost to 27%)(effect sizes are on pos, neg and general portions of the PANSS test) (cod liver oil might naturally have the vit antioxidant boost but it has lower EPA content)
https://cosmosmagazine.com/biology/can-fish-oil-prevent-schizophrenia
https://www.nature.com/articles/ncomms8934
I recommend cod liver oil pills not a bottle as it spoils less easily. Take around 2 grams a day.

Aerobic exercise (1)(30% improvement to brain power.) (This counteracts much of the cognitive deficit after schizo starts. But not all the deficit that occurs since birth, (I am now using the phil maffetone method of slow and steady aerobic exercise to maximize mitochondria health.)) Also a 51% (10% placebo though (study had no placebo, but another study had 10% placebo effect on waitlisted patients)) reduction in PANSS scores in one study (both positive and negative symptoms reduced by 50+%)(see yoga study) effects really kick in at 6 weeks (one study had much less effect though, data is not as clear in high effect or low effect studies) (another study had 24% positive symptom reduction and 28% negative symptoms) (10% could be placebo (see third link yoga))
They exercised 3 times a week for 20 to 60 minutes each session (aerobic plus some weight training)
**Before starting an exercise routine it may be a good idea to lose excess weight. Using a calorie counter (such as MyFitnessPal) on your phone or computer takes about 3 minutes a day to input all your food. This gurentees consistant loss of weight, and achievement of a more optimal weight. Eating healthy foods can also help sustain weight loss if you begin to yoyo after losing weight using a calorie counter. Low impact aerobic exercise can also be done even with excessive weight, or higher impact exercises (for temporary stretches of time)**
Another review of 5 studies showed the average reduction in PANSS scores was 15%
Being active helps sleep efficacy (r value 0.54)

Yoga vs aerobic exercise (studies show that yoga is even more effective then aerobic exercise when they have been compared (Seems to affect positive and negative symptoms much more while exercise helps brain power. different effects perhaps, though in the below study exercise helped PANSS scores too) They both help!  (need a study comparing brain power affect between the two. seem to be a lot of studies comparing PANSS scores) (61% reduction in PANSS scores (10% placebo though(study had no placebo, but another study had 10% placebo effect on waitlisted patients) (see third link)) effects really kick in at 6 weeks (study did 10 1hr sessions in 2 weeks then 4 weeks of patients doing the same at home from memory) (yoga may help more negative symptoms in some studies, not as much positive symptoms)) (Yoga improved Quality Of Life scores in another study by 15%, PANSS 33% positive symptoms (24% improvement in the exercise group) negative symptoms 35% reduction (28% exercise) (10% of the change in PANSS maybe placebo effect, actually had 20% on positive symptoms for placebo, 10% total) 50% reduction in depression (21% exercise) Lack of energy had a large reduction of 29% in yoga (10% exercise) (they used moderately ill patients only in this study or worse not mildly ill ones, all on antipsychotics, they did 1 hr of Yoga 5 days a week for 3 weeks or physical exercise (the yogasanas were from the integrated yoga treatment developed by Swami Vivekananda Yoga Anusandhana Samsthana (SVYASA) (28). It was a 1-h programme consisting of (a) Sithilikarana Vyayama; (b) asanas including surya namaskar; (c) breathing practice; and (d) relaxation techniques. The ratio of Vyayama:asana:breathing practice was 1:1:1.)))
Yoga triples the levels of oxytocin in the blood (a brain hormone)
I'd suggest following along with a youtube video of beginners yoga
(See google drive)

Allergens!!

Cow milk free (1A casein free not A2?)
As an allergic reaction in the brain can severely exasperate your symptoms. Abram Hoffer said 2x increases in niacin supplementation were needed in the case of the presence of cerebral allergies to see improvements in schizophrenia symptoms (allergens included wheat (gluten), milk, sugar or whatever else one may be allergic to), compared to those without cerebral allergies. Abram Hoffer would use an elimination diet and water fasting to find this out. Abram Hoffer discovered that a large percentage (50%) of schizophrenics were allergic to milk and when it was eliminated they recovered from schizophrenia WITHOUT the need of any supplements. Although he also often used Niacin and B vitamin supplements along with others (see B vitamin entry below)
(SEE milk gluten sugar in drive)
It wasnt necessarily the lactose (carbohydrate) but the casein (protein) that caused issues.
((pickles have lactic acid bacteria (if not vinegar based), olives, (not that you need to avoid these)
schizophrenics have more lactic acid bacteria in their mouth microbiome:

Gluten free
I started a wheat free diet and saw an improvement in my symptoms (wheat is the worst source of gluten)) it cuts down on brain inflammation as gluten can cross the blood brain barrier. Societies that dont eat gluten have much lower levels of schizophrenia.
https://www.verywellmind.com/gluten-and-schizophrenia-562957
https://articles.mercola.com/sites/articles/archive/2013/06/22/gluten-grains-cause-schizophrenia.aspx
(see google drive)
Immune response possibility
Nmda immune response blood work worth checking (from less interesting)
Blood brain barrier is leaky in some schiz (causing immune response and inflammation)
Other foods that possibly cross react
Gut permeability may be damaged in schizophrenics explaining why they have greater bacteria diversity in their blood

KETO diet may have added benefits in addition to just avoiding gluten (7 to 55% reduction in panss score) and fasting has also been shown to help (more on that further on). Sugar should also be avoided. It decreases BDNF (A factor that grows new neurons), and causes anxiety. Long term keto may lower lifespan though (12% in some animals at 30% carbs could be higher at lower carb levels, but longer lifespan in mice in one study of true keto in mice), but some humans seem to be thriving on true keto (A new study had a four year loss of lifespan at 30% carbs in humans, could be higher on true keto)
Carnivore Diet seems to improve psychiatric symptoms (though schizophrenia wasn't singled out) carnivore is similar to water fasting (less reactive food) and Abram Hoffer and Yuri Nikolaev achieved 75% recovery rates through water fasting, though since we have to eat; more restrictive diets were resumed after the fasting with 47% success rate at the 6 year mark (in the case of Yuri) and 50% success rate (in the case of Abram) (see google drive carnivore) (see google drive milk) (see google drive fasting) 
(A 47 or 50% is not that great really as it is similar to the pre-antipsychotic period in terms of recovery rates, but the 75% rate during the fast is an impressive number.)
Keto had 46% average improvement in treatment resistant schizoaffective disorder, all patients (10) had clinically significant response (see keto schizoaffective google drive). 6 out of 10 managed to reduce their medication.
I am considering trying keto, I have considered trying carnivore at various point too. Water fasting I view as unnecessary as keto delivers many of its benefits (in the water fasting studies the therapeutic benefit (75% recovery rate) seemed to start when the body entered ketosis on the fifth morning of fasting). Carnivore may deliver added benefits if keto isn't sufficient for recovery though (or if dairy and gluten and sugar free aren't sufficient for recovery (these should generally be tried even before keto, as they are easier and less restrictive)). Carnivore might have additional benefits (over keto) because it provides more nutrients (because of bioaccumulation), or because meat is generally less allergenic to the body, or both. (Because of the added nutrients on the carnivore diet vitamin and mineral supplementation (such as EMPowerPlus) is less needed).
Water fasting also generally requires medical supervision while keto and carnivore do not.
Chris Palmer recommends a 4 to 1 grams fat to protein like in epilepsy treatment (90% calories from fat) he also says schiz symptoms can get worse during the keto flu stage and patients should be monitored by someone ideally.
Chris Palmer believes the scientific evidence shows that bipolar and schizophrenia are the same general disorder.
Keto also reduces seizures which may help Tardive Dyskinesia or parkinsonism??
The most common ketone body Î²-Hydroxybutyrate may be neuroprotective
Keto increases GABA decreases glutamate (increases agmatine also (in rats) (see drive))
You must be actively on KETO to have an effect.
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High insulin resistance as a kid (9 years old and up but not younger) is linked to psychotic disorders (3.22x risk increase)
High levels of glucose outside the cell but low levels in the cell
Antipsychotics may work by increasing glucose and insulin
(Chris Palmer)

Vitamin B supplementation: 2X recovery rate in none chronic schiz (80% recover). A Hoffer. Once chronic benefit occurs more slowly (after 5 years of continuous treatment at 3 grams a day niacin) (but did over double recovery rates in a group who had been ill 10+ years (average age 40) (65% recovered enough to work or take care of a child)) (with 10x lower days spent in hospital)
Used 1 gram niacin 3 times a day for 30 days which doubled recovery rates after a year (In those just diagnosed).
It also reduced suicides to zero in a group of 242 schizophrenics (followed 10 years) (when 9 died by suicide in the control group (of 450 patients) (followed 7 years)) In another group of 73 schizophrenics there were zero suicides, but in the control group there were 4 suicides.
Nicotinic acid or niacinamide works, maybe other forms too (I'd recommend trying nicotinamide riboside)
Often was taken with the same amount of vitamin c???? or less or none and zinc and B6 and occasionally manganese, B9 (folate) and B12.
Can be taken with an antipsychotic.
Nicotinamide riboside (at 1 gram a day) raises NAD+ 2.7X in one dose versus niacin (at 1gram a day) that raises it by 1.3X at 4 months and 2.3X at 10 months (but niacin is cheaper and NR hasn't been tested in schizophrenics)
Nicotinamide riboside has much better side effect profile, as Niacin increases diabetes risk (among other bad effects) (leading 5% increase in fasting glucose and a 25% increase to insulin resistance and a 55% increase in insulin resistance in those over 60). Though the increase to HDL cholesterol and the lowering of triglycerides likely provides therapeutic benefit (better than how statins do). KETO also increases HDL and lowers triglycerides (carivore even more so).
Abram Hoffer used to prescribe antipsychotics initially until the vitamins and minerals were effective and the antipsychotics were then almost universally withdrawn (he actually often used lower than normal doses of psychiatric meds in his patients in conjuction with vitamins and minerals (but still used them, but sometimes no meds were used too (if the vitamins and minerals were effective enough alone)) update*) .
Abram Hoffer claimed his entire orthomolecular approach to schizophrenia (that uses niacin and other modalities) achieved a 90% remission rate for schizophrenia vs. 45% who recover naturally vs. 10% who recover on drugs alone.
(See Google drive)
Adrenochrome theory of schizophrenia by A Hoffer - a more accurate medical model for schizophrenia
Some other ways to increase NAD
Exercise 12% increase aerobic, 25% increase weight training, in those under 55 (NAD increase)
Keto hippacampus had 50% more but frontal cortex was the same
Sauna’s NAD increased by 11% and NADH was reduced leading to a 2.6X improvement in the ratio
Reduce inflammation
Avoid alcohol (40% decrease in bad cases)
Low level laser therapy
Malic Acid like a 20x increase in NAD in worms (athletes use it to increase performance) no known side effects, can lower blood pressure, crosses blood brain barrier
used common creatine malate (CML) dose, which was of 0.07 g×kg of lean body mass in one study (see google drive) (5 grams for 70kg lean body mass)
livestrong recommended a dose of 200 to 2800mg a day
Apigenin 60% increase to NAD  (supplementing doesn't work because its unstable but it can be found in bacopa (brahmi) and chamomile 
Leucine 60% increase to sirt1 in mice (NAD modulated) body builders often add it to improve strength (works more in older people?), crosses the blood brain barrier, can cause low B3 why?, more complex than malic acid, increases insulin secretion so high doses can cause low blood sugar
leucine helped control mania in bipolar patents leading to a 20% reduction when taken with valine isoleucine in 4:3:3 ratio (see drive) and https://link.springer.com/article/10.1007/s002130000613
resveratrol helps similarly to leucine, changes how the liver breaks down drugs though
another study had up to 5x increase and tested in humans, crosses the blood brain barrier, works in conjunction with B3, but was given direct to cells, it disapears quickly from blood, half life 14 minutes
Pterostilbene may therefore be better (but unsure)
PQQ increases NAD by 50% (in cells not tested in humans) but doesn't cross into the brain
Dairy increases NAD
J. Firth, B. Stubbs, J. Sarris, S. Rosenbaum, S. Teasdale, M. Berk, A. R. Yung. The effects of vitamin and mineral supplementation on symptoms of schizophrenia: a systematic review and meta-analysis. Psychological Medicine, 2017; 1 DOI: 10.1017/S0033291717000022

Zinc supplementation leads to 30% reduction in negative symptoms 30% reduction to positive symptoms 10% cognitive symptoms. Much lower aggression score. It affects the NMDA function, lowering it. And also helps with inflammation. You can check out the study. They used 50mg of zinc 3 times a day for 6 weeks. But that amount is well outside the safe dose recommendation I would suggest 20-40mg a day. For 6 wks. (which is what I did, and it helped) Zinc can cause lower red blood cell counts so discontinue if u start getting light headed.
Effects largely retained. (perhaps top up zinc once a year?)
Continuous zinc supplementation might be recommended, but copper must also be added if taking zinc for more than 6 wks.
Pyroluria is associated with a lack of zinc and B6 and can be tested for with a urine stick. 50% of schizophrenics have the condition. The test for pyroluria is remarkably simple and very inexpensive. When you add a chemical known as Erhlich’s reagant to urine, it will turn mauve if there are krytpopyrroles present.
Adding 50 to 100mg B6 to the zinc may provide additional benefit, and doing the zinc and B6 treatment more often. (A Hoffer used 250mg to 750mg B6 but that is pushing at the edge of what is safe)
Zinc is not stored in the body and must be constantly replenished
Pyroluria is often a stress-related condition, with symptoms usually beginning in the teenage years after a stressful event such as exams or the breakup of a relationship.
Pyrolurics often have weak immune systems and may suffer from frequent ear infections as a child, colds, fevers and chills. Other symptoms include fatigue, nervous exhaustion, insomnia, poor memory, hyperactivity, seizures, poor learning ability, confusion, an inability to think clearly, depression and mood swings. In girls there can be irregular periods and in boys relative impotence. The pyroluric patient can have bad breath and a strange body odour, a poor tolerance of alcohol or drugs, may wake up with nausea, and have cold hands and feet and abdominal pain.
A lack of dream recall is very common. It is normal to remember dreams, and many people, whether or not they have mental health problems, report better dream recall once they start supplementing optimal amounts of vitamin B6 and zinc. Other tell-tale signs include pale skin, white marks on the nails and, in extreme cases, poor hair growth and loss of hair colour. Often a person with pyroluria also has skin problems such as acne or eczema.
Not all these symptoms are present in all pyrolurics, but if you are experiencing a number of them, it is well worth testing for.  
It can cause a sensitivity to light, sound and odour. Irritable bowel syndrome. Mood problems or behavior problrms. Impotence in men, irrigular periods, poor dream recall, Food intolerances.
This mentions zinc and b6 and its connection to progesterone which effects anxiety, depression, sleeplessness, excitability. Low progesterone can be caused by stress.
Adrenal fatigue: some more supplement suggestions
See also vitamin b supplantation with A. Hoffer below

Low vs high level of occupational engagement associated with 59% less  negative symptoms. 30% less pos symptoms (23% reduction medium occupied, 40% reduction highly occupied). 25% less depressive symptoms. 20% more internal locus of control. 24% better feeling of mastery. 23% more sense of coherence. Unsure if the less sick work more, or working more makes you less sick (likely both). Measured by looking at time use dairy (the profile of occupational engagement in people with schizophrenia(POES)). Getting a volunteer position, or attending school or religious services are all steps to keeping you more occupied.
https://ajot.aota.org/article.aspx?articleid=1865741
Daily rhythm of activity and rest
Social Environment
Social interplay
Variation of places
How well you reflect on your day
Initiation of tasks
Number of occupations
Meaningful occupations
Routine
Sample test available in Google drive link (TESTS folder)
low (9–18), medium
(19–27), and high (28–36) level of engagement scores.
https://m.slashdot.org/story/357248
Hospital admissions increased during economic slumps and working patients have better prognosis. Prisoners in solitary confinement often develop schizophrenia like symptoms. Therefore it may be beneficial to live in a commune like situation with lots of tribal contact. This may help you recover from schizophrenia.

Yokukansan (aka Yi Gan San) doesn't help in one (double blind placebo controlled) but does help in others: 25% improvement positive symptoms, 45% in negative and general symptoms in the PANSS test, severity of schizophrenia down by 60% (was tested in treatment resistant schizophrenics though, so if you have less symptoms it may be less effective (or if your symptoms are being masked successfully by an antipsychotic), stops tardive dyskinesia (87% average reduction).
2.5g powder 3 times a day before meals (7.5g total) or 1.5g extract 3 times a day duration 12 weeks
Google drive
No adverse reaction reported
Doesn't interact negatively with antipsychotic
Haven't researched supplement interactions with other recommended supplements yet.

Lion's Mane Mushroom - helps refractory schizophrenia, and none refractory too I imagine. Encourages nerve growth, helps fatigue, builds myelin sheaths, protects against neuron death from oxidative or endoplasmic stress (it's antioxidant activity is however 4x lower than vit C and can be combined with other antioxidants). amazing 25 to 30% improvement to positive negative and cognitive symptoms (across the board of the PANSS test, though used in refractory cases only in the study (those who still have symptoms after medication)) and some of the improvement is placebo.
Some of the benefit of Lion's Mane might be similar to the KETO diet: One study in rats fed a high-fat diet and given daily doses of lion’s mane extract observed 27% lower triglyceride levels and 42% less weight gain after 28 days. Several animal studies have shown that lion’s mane can cause significantly lower blood sugar levels in both normal and diabetic mice, even at daily dosages as low as 2.7 mg per pound (6 mg per kg) of body weight (35, 36). One way that lion’s mane lowers blood sugars is by blocking the activity of the enzyme alpha-glucosidase, which breaks down carbs in the small intestine (37). (Note that you seem to still get the benefit of calories from eating carbs just the process is slowed down (according to two papers), but I think it might lower calories a certain amount. UPDATE: metformin doesn't reduce PANSS scores so this effect is unlikely to be from glucose changes, though not sure of gut absorption versus liver production size effect on glucose, metformin is liver, lions mane is gut --- different points of action
Those who experienced the greatest improvement in cognition, mood, and sense of well-being were not on any prescription medication such as statins, hypertensive drugs, or blood thinners. Overall, the results of the study showed that Amyloban3399 improved mood, memory, and sense of well-being in 100% of those who were free of any medication.
(Google drive link)
Effect size is not retained (continuous treatment necessary (for above cognition study at least)
Dosage:
1000mg to 3000mg (2000mg average dose) Amyloban 3399 was used. Other brands work fine, but strengths can be different. I suggest you follow the recommended dosing from your provider.
Side Effects:
testing in rats @ high doses with no ill effects
Possible allergic reaction to the mushroom in some humans
Lions Mane has long been consumed as food in Asia
Precaution:
Lowers blood sugar
Lowers blood clotting (careful when having surgery, or if prone to bleeding (though no reports of this happening in humans)
blood test (for schizo diagnosis) (seems fairly accurate in young people only, High CRMP2 also causes dendrites to be smaller, potentially fixed by Lion's Mane)
PQQ (Pyrroloquinoline quinone) is similar but doesnt cross the blood brain barrier but oxapyrroloquinoline does, PQQ likeky wont work but OPQ might.
NAD levels increase (50% increase in one study in drive with PQQ)
PQQ is a very strong antioxidant (100X as strong as vitamin C) (not sure if it approaches NAC or retinol (active vitamin A) though) 
Both lion's mane and PQQ increase nerve growth factor

Folate deficiency in those with tested and verified low folate levels causes large problems (12% of schizophrenics have low red blood cell folate (don't test for serum folate, only use red blood cell folate). Supplementing with methylfolate (that crosses the blood brain barrier) leads to huge benefits in one study linked in Google drive (Half symptoms in the clinical rating scale). It effects the turnover of monoamines including dopamine and serotonin, helping make them, along with DNA, and provides vascular system support by lowering homocysteine levels.
Patients with a red-cell folate level below 200 ug/1 entered the double-blind, placebo-controlled
trial of treatment with methylfolate 15 mg daily for 6 months, 7.5mg a day is enough though
Another study which did not test for low folate first showed the following:
FOLH1 484T/T works(A) and 484C carrier doesn't (52% of schizos had  the T/T gene and benefited by 10%, but those without the allele seemed to benefit more from the placebo)
10% after placebo 20% before
10% Reductions PANSS folic acid @2mg in those with high homocysteine (Another study) 
They now fortify foods with folate
They sometimes suggest you take added B12 with folate.
Folate is generally considered safe
Benefits somewhat retained (effects most likely gradually wear off, could safely do 6 months on then: 1 month on two months off and repeat, may be better to just stay on continuously though)

Betaine leads to healthier non hyperbranching naurons in mice. Nauron hyperbranching is a physiological feature in schizophrenics (which have been shown to have a protein expression that could potentially be helped by betaine in the prefrontal cortex and potentially elsewhere too). In mice it helped the hippocampus naurons look normal. Vitimin b6 in the form of pyridoxamine (better?) not pyridoxine? also helps prevent hyper branching using the same pathway as betaine (carbonyl stress). Zinc also reduces carbonyl stress through the GLO1 gene. Preventing naurons from looking pathogenic (which they do under a microscope in schizophrenics) using betaine, b6 and zinc may provide significant therapeutic benefit.
?Betaine is also called trimethylglycine, or betaine anhydrous (dont get betaine hydrochloride?)?
(Also see google drive)
Betaine also can lower homocysteine 
(someone recommended it to me as it really helped them with their positive symptoms (voices) they saw large benefits at the two week mark, benefits disappeared with discontinuation, they used betaine hydrochloride though and I thought the research showed that betaine anhydrous was the right one to take)

Brain exercise tool (better then video games not as fun --- unless the video game is structured to help a particular mental pathway)
Video games (other brain exercises may alleviate structural brain abnormalities)  
http://www.kurzweilai.net/video-game-playing-found-beneficial-for-the-brain
Cognitive training really helped severe schizo in this inpatient study:
27% improvement to positive symptoms of schizophrenia (37% before accounting for placebo) (large decrease to verbal hallucinations and even larger decrease to voices conversing). The brain training focused on auditory training.
(see brain exercise in google drive)

Metformin - helps with weight gain, diabetes, prolactin increase and may decrease PANSS scores. Another entry below (with less hospitalisation and suicide when on metformin)
adjunct aripiprazole at <5mg a day significantly decreased prolactin.
study had no difference in PANSS scores
(and google drive)

Magnesium L-threonate: for energy, general health and brain health (recommended by Mike P.). Most people don't get enough magnesium and magnesium L-threonate crosses into the brain easier. (Has some positive effects on NMDA can be used in conjunction with zinc). It also benefits memory a lot in animals, likely in humans too, improves cognitive performance in the elderly. I take magnesium (also helps depression and anxiety)
magnesium acetyl taurate also seems better
High magnesium and calcium linked to suicide?? (can't read too much into study)

sex (1) (sex and religious devotion are largely interchangeable and likely complimentary) 

meditation (increases dopamine by 65% when meditating (james greenblatt) (1)
calorie restriction (1) (A calorie counter is recommended such as myfitnesspal on android and iphone)(try intermittent fasting?)
curcumin (1) (make sure to use extra bioavailable version. theracurmin double strength is what i used) ( it is also powerful antioxidant)(pepper can increase schizo drugs so dont take with pepper) I wouldn't mix it with other antioxidants that much,  https://naturalfactors.com/product/curcuminrich-theracurmin-double-strength/
enriched environment (1)
sunlight (1)
Vit D and probiotics:
Panss decrease 6% (mostly general cognition)
Moreover, taking vitamin D plus probiotic significantly reduced fasting plasma glucose (− 7.0 ± 9.9 vs. -0.2 ± 9.9 mg/dL, P = 0.01), insulin concentrations (− 2.7 ± 2.3 vs. + 0.4 ± 2.0 μIU/mL, P < 0.001), homeostasis model of assessment-estimated insulin resistance (− 0.8 ± 0.7 vs. + 0.1 ± 0.7, P < 0.001), triglycerides (− 7.8 ± 25.2 vs. + 10.1 ± 30.8 mg/dL, P = 0.01) and total cholesterol levels (− 4.9 ± 15.0 vs. + 5.9 ± 19.5 mg/dL, P = 0.04) and total−/HDL-cholesterol ratio (− 0.1 ± 0.6 vs. + 0.3 ± 0.8, P = 0.04).

Exercise and antipsychotics also help create new neurons.

Olive oil may help fuel your body and brain with healthy nutrients.
I had a bad experience that was fueled by coconut oil so not sure about it as a nutrient source.

Trying to make your body more alkaline may also help you. (Reduces inflammation)(schizos have too acidic brains)

High sugar intake is likely bad (it also causes depression, anger, anxiety and antisocial attitudes), bean intake good, eggs bad, dairy bad, cereals good, Nuts good, alcohol bad, meat bad, (nation state food intake versus schiz outcome--- POOR study but interesting)

Foods and nutrients that repair damaged DNA
(See lemon google drive)

Gum disease in your mouth leads to a 37% increase in risk of mental health problems, including severe mental illness (though schizophrenia wasn't singled out). Brushing and eating healthy help, oil pulling also seems to help
oil pulling better than antibacterial mouth wash

Overprotective parenting as a child is linked to non-recovery (4X). Childhood bullying is bad and bereavement (2X)
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0240504

Ceruloplasmin enhanced plasma injections seem to successfully resolve 80% of acutely ill schizophrenics (10% improved), also stopped LSD effects in rhesus monkeys, had benefits for subacute (50% resolved, 40% improved) and chronic (0% resolved, 80% improved) schizophrenia to a lesser degree (test in 30 schizophrenics) (copper carrier, mental agitation thought to increase ceruloplasmin levels to clean up high levels of fight/flight/freeze molecules produced during periods of stress)
(see drive ceruloplasmin) 
(speculative, please research more yourself (if these injection are safe), requires advanced medical laboratory access) 
Niacin (b3) also neutralizes LSD

Raloxifene (if more reductions needed (requires a prescription)) Adjunct helps PANSS score (16% avg-20% avg improvement) may hurt global cognitive functioning 60mg a day for 12 weeks (slight risk of blood clot) (It acts as estrogen in your brain could lead to cognitive changes and mood changes ect..)
https://www.medscape.com/viewarticle/892997
https://www.nature.com/articles/mp201511
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5762671/
Meta analysis

Schizo's have low calcium and zinc could try adding more calcium to diet
(see google drive)
Another study had just low folate and vit d, meta analysis

Viome test (microbiome test) is useful to measure your microbiome and give food suggestions that are compatible with your body. It is especially known to help with depression, anxiety, IBS and type 2 diabetes. Note that your microbiome creates many of your brains neurotransmitters giving your digestive system the nickname of the bodies second brain. Viome recommends foods and prebiotics and probiotics. Viome also does a cell energy test which is very useful.

A skin prick test may also be useful to test for food allergies. 

Heavy metal poisoning (such as mercury) can lead to neurotoxicity (effecting the glutamate pathway I believe (in the case of mercury)) Urine testing than urine testing again after chelation can detect the presence of heavy metals. I am not aware of much research into this and suspect that it is less common than other allergens. The phrase "mad hatter" described people suffering from mercury poisoning in the production of hats.

*** A note on schizophrenia and energy
Many people believe energy systems in the body are effected by schizophrenia. Including the main source of cell energy the mitochondria. Therefore taking some supplements for energy may provide a large benefit.
I'd recommend magnesium (see above), b vitamins including b12 (some info above), CoQ10, NAD boosters such as nicotinamide riboside (NR) acetyl l carnitine, french oak extract, two people had benefit from alpha lipoic acid (strong antioxidant so perhaps don't mix with cod liver oil, see below for other a-lipoic entry), PQQ has be known to provide energy benefits also (though it is a strong antioxidant so perhaps don't take cod liver oil and PQQ at the same time (switch to regular fish oil for a period) (acts similar in some ways as lions mane as noted above), exercise also helps energy (see above), fisetin, brahmi (see below for other brahmi entry),
acetyl l carnitine has been linked to lowering retardation and dementia in some patients and may improve symptoms of schizophrenia too (it also lowers ammonia levels)
(see drive carnitine)

I'd suggest the viome cell test to look at mitochondria health and give some suggestions (they also measure the microbiome (see above).

lack of energy is a big complaint of many schizophrenics.
***

First episode schizophrenics can benefit from an anti-inflammatory drug (cyclooxygenase (COX) inhibitors. The most broadly studied COX inhibitor is the COX-2 inhibitor **celecoxib**) which was only effective when used on patients that had been sick for less than 2 years. Leading to a significant improvement over just an antipsychotic in a 6 week trial (20% reduction in PANSS). It is potentially possible that longer term anti-inflammatory treatment helps chronic schizophrenics. Acetylsalicylic acid (ASA), another anti-inflammatory agent, has also shown positive effects in schizophrenia spectrum disorders.

John Nash thought living a quiet life free from grandiose visions helped him recover. A low class, humble, plus low craving existence cuts down on the extra dopamine flouting around i believe. Which should help. Chasing fame can lead to high dopamine (it helps create a spiritual connection with those around you (followers)) can go too far though. Low status may help turn off this spiritual connection. (wrong)

Though other studies had high status having high serotonin which would suppress dopamine, might be worth trying to be seen as valuable. (Right). Dopamine receptors are more prevalent in high status individuals but serotonin is also higher the higher status you are keeping you calm and well regulated. High status people might actually be able to think better as a consequence. Sudden loss of status may be extremely destabilizing.

Having a cup of cranberry juice in the morning is thought to eliminate the sometimes unpleasant smell of schizophrenics. (see abram hoffer chronic schiz drive)

-----------
Additional relevent information
------------

I have found it very helpful to have some olanzapine around in case of a flare up you can take some as needed (prn) as a temporary protective boost. Switched to as needed risperidone to avoid sedation, still effective.

(Was likely age standardized)Long acting medication or oral aripiprazole leads to 33% reduction in mortality taking no medication increases risk of death by 56% in those aged 16 to 64 in a nationwide swedish study of 30,000 patients, clozapine found to be safest in finish studies
https://www.epmmagazine.com/news/long-acting-antipsychotics-reduce-mortality-risk-in-schizoph/
https://www.schres-journal.com/article/S0920-9964(17)30762-4/pdf
Oral Flupentixol
Or long acting injectable Olanzapine best
https://onlinelibrary.wiley.com/doi/full/10.1002/wps.20699
another study found that drug use (and mixing multiple drugs) increased risk of death but only 100 Finish people studied (not the best study):
(google drive link)

Paliperidone breakdown (59% unchanged in urine, 83% excreted that way)

CBT extract from marijuana can treat schiz as effectively as atypical antipsychotics according to isreali researchers. THC causes schiz and M is generally bad for schiz. 800mg/day CBD was equivalent to the second most effective antipsychotic. Full Spectrum CBD at 100mg/day or a bit less was reported to be effective by a retired army doctor in a youtube presentation (so a follower says)
Smoked M 31hr halflife
Oral drops 1.5 to 12hr halflife
Hits system within 15 min (smoked)
50-60% bioavailability smoked vaped
Versus 15% oral (~4x difference)
31hr halflife smoked
5 hr halflife oral
800mg CBD oral
200mg CBD vape (smoked)
Maybe 100mg full spectrum or 25mg smoked (??)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6843725/#:~:text=CBD%20as%20monotherapy,were%20treated%20over%204%20weeks
CBD has less side effects than an antipsychotic

Risperidone reduces panss scores by 76% at 6mg and likely 4mg a day. It is half as effective at 2mg. Higher doses dont increase the effect. Invega sustenna long acting injection is a good choice 75mg equivalent to 6mg risperidone 50mg equivalent to 4mg a day risperidone.
http://mentalhealth.com/mag1/scz/sb-risp.html
BUT
Fda study shows it has 15% effect on panss score from baseline with higher doses being more effective for Invega sustenna
https://www.drugs.com/pro/invega-sustenna.html#S14.1
(both in google drive)

My favorite antipsychotics
Paliperidone lai (5th most effective out of 15)
Aripiprazole lai (long acting injectable)(9th most effective) (aripiprazole lauroxil (aristada) better than abilify maintena)
Risperidone lai (4th most effective)
Risperidone pills
Paliperidone pills
Aripiprazole pills
Amulsipride (very effective (2ed most effective antipsychotic)
Clozapine as last resort only
Not
Olanzapine
Haloperidol
(Antipsychotics can cause sexual dysfunction (see paragraph in problems section))

Antipsychotics block about 75% of D2 dopamine receptors at clinically effective dosages and varying degrees of D3 and D4 along with other receptors (olanzapine highly blocks histamine causing sedation)
(See google drive)

If trying to reduce your dose it is recommended to decrease by 10% increments. Or a new study demonstrated that hyperbolic dose decreases is likely better (with an eye at keeping the amount of dopamine blockade going down at a constant rate. Which faster then slower tapering does)
***
More info on tapering antipsychotic medications here:
***

--

(Toronto talk with good speakers (oxford+american))
(https://www.medpsychalliance.ca/home)(2017 speakers)

Olanzapine is considered not a good choice because of weight gain and metabolic problems. It also is the most sedating of the antiphychotics

Check lipids. Heart disease biggest cause of illness. Schiz less likely to recieve treatement for all diseases

Smoking, inactivity, diet, lonliness, poverty (all problems around schizophrenia for health)

Measure waist circumfrance

"go low go slow" with antiphychotics

If two or three different atypical antipsychotics had no positive effect on symptoms and clozapine has then been tried with no effect on symptoms then no medication should be prescribed to atleast prevent the negative side effects of the drugs.

Try going off antipsychotics after a couple years as some people recover (if feel in a good place?)

--

Combine clozepine with another LAI antipsychotic for greater effect in treatment resistant schizo
https://pubmed.ncbi.nlm.nih.gov/32678523/

medication adherence predictors
employment, social support, not thinking situations were always positive (3x bigger than the other predictors). Older age, not being female, taking typical antipsychotics, high global cognitive functioning
https://www.psychiatryadvisor.com/bipolar-disorder/medication-adherence-predictors-schizophrenia-bipolar-disorder-tecla-study/article/774487/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5975380/

family education about symptoms and types of treatment reduces risk of relapse from 37% to 10%

Movement disorders:
Tardive dyskinesia
Akathisia
Parkinsonism
Acute dystonia

-------------
Additional potential therapeutics 
--------------

Change your epigenetics, (epigenetics test can diagnose schizophrenia with 86% accuracy, versus 32% genome only, epigenetics measures gene expression through methylation patterns), Diet, Exercise, Sleep, Stress, Marijuana, Alcohol, Smoking, Weight loss, number of meaningful friends?

Aspirin 
5% effect size, but 1000mg a day, which can cause issues with long term use, only baby aspirin long term. Works by blocking production of prostaglandins (that cause inflammation and pain) it also helps prevent blood clots. 
Google drive or https://ebmh.bmj.com/content/13/4/122 (same study)

Iron definency was shown to increase negative symptoms of schizophrenia by 10% in first episode schizophrenics in one study.

Selenium may play a role in mental health (either too high or too low)
primrose oil may help some patients
selenium might be required for the body to effectively use omega 3's
(see google drive)

Pregnenolone (not sure)
Google drive link
30% reduction in SANS test (negative symptoms) 2 studies, one showed no improvement to PANSS positive subscale, other study showed (below)
 doesn't help lack of motivation much or cognition much, 12% positive symptoms, 5% negative, 3% cognition (PANSS), cognition goes up and down. Only 18 subjects, already treated with antipsychotics though (so the numbers have less room for improvement, thus 12% positive symptoms is pretty good).
Myelin sheath, grows dendrites, neurogenesis,  Gaba regulation (increases the action of the GABA neurotransmitter), NMDA, lowers inflammation 
Dosage (please look up)
500mg (slowly increased to this level over 1 month (100mg 2 weeks then 300mg 2 weeks then 500mg)
It is unknown if benefits are retained after discontinuation?
Side effects (please look up) but generally well tolerated in the above studies
Pregnenolone (slowly increased to 500mg/day for 8 weeks) Reduces AIMS 50% but very few patients had a score (involuntary movement), Helps schiz symptoms PANSS ~9% (POS 10% and NEG 10%, no general) Helps SANS 10% (negative symptoms) Disease severity 2.5%, cognition up and down.

Statins,  associated with 0.75 hazard ratio of getting hospilized in schizophrenia compared to those not taking them. (25% reduction, 45% reduction in self harm)(1)

calcium channel blockers 20% reduction (1)

biguanides (metformin) 27% reduction, 36% self harm reduction (berberine is a natural version of metformin which can be used instead if you want, it is slightly more effective. But it might slow drug metabolism (check this first)(one website said it was only a weak inhibitor of liver metabolism of some antipsychotics, but webMD said it was a moderate inhibitor https://www.drugs.com/medical-answers/berberine-3569378/) (1)
berberine helps negative symptoms and lowers c reactive protein
Berberine lowers weight and cholesterol in those with metabolic syndrome

Probiotics
Likely helps bowel movements
https://scholar.google.ca/scholar?start=0&q=probiotics+and+schizophrenia&hl=en&as_sdt=0,5&as_vis=1#d=gs_qabs&u=%23p%3DVVvePBBGdxEJ
May help positive symptoms in men without yeast infection of C. albicans in the gut. 20% improvement
https://www.sciencedirect.com/science/article/pii/S0889159116305219
One case study showed improvement to negative symptoms using a different probiotic to other study. Effect size not stated but was significant
https://scholar.google.ca/scholar?start=0&q=probiotics+and+schizophrenia&hl=en&as_sdt=0,5&as_vis=1#d=gs_qabs&u=%23p%3D_xgbpGMpF24J
Some studies showed no difference in PANSS scores

Seems to help healthy people with anxiety depression and stress.

The probiotic 
formulation, “Bifiform Balance” (Ferrosan A/S, Pfizer, Søborg, Denmark) contained 
approximately 109
 colony-forming units (cfus) of Lactobacillus rhamnosus strain GG and 109
Helped men no yeast
Helped men with yeast issues the most with bowel movements out of all the groups in the study. By displacing the infection

Case study probiotic
A probiotic preparation composed of a mixture of Streptococcus
faecalis, Clostridium butyricum and Bacillus mesentericus (BIO-
THREE®)3) was administered at a dose level of 3 g/day. One gram of
BIO-THREE® contains 10 mg of Lactomin(S. faecalis), 50 mg of C.
butyricum and 50 mg of B. mesentericus.

Helminth therapy (HDC) 95% effective in bipolar patients (sample size: 5 (effectiveness self reported)) may cure schizophrenia also.
(See drive)


If electroconvulsive therapy works at first. Several more treatments might stop schizo. (study did treatment resistant schizo.)
https://www.psychiatryadvisor.com/home/schizophrenia-advisor/electroconvulsive-therapy-may-prevent-symptomatic-relapse-for-clozapine-resistant-schizophrenia/ 

tryptophan or 5HTP (more research needed)
may help cognitive function makes more serotonin might help decrease affect of to much dopamine worth trying. when serotonin goes up dopamine goes down (which may also be why depression is often a precursor to schiz).

Some other possible supplements
https://youtu.be/xfB_Vt2muXw
Panax ginseng Acts similar to antiphychotic

Ginkgo biloba improves blood flow (but may cause your liver to breakdown schizophrenia drugs more slowly, effectively increasing your dose)

Brahmi helps neuron dendrites length and branching, helps brain function, reduces cortisol, antioxidant anti inflammatory, improves thinking speed and memory, Worth Trying. (doesn't react to risperidone or paliperidone, check liver enzyme overlap if you use antipsychotics)

Gotu kola also helps cognition, along with eating fruits and veggies

Lysine. Better positive symptoms (likely not worth trying similar to placebo effect)

Active form of Vitimin A called retinol. Powerful antioxidant. Cod liver oil has omega 3 and vit A.

Mangosteen (Possibly helpful - Studies show wide variation of helpfulness from none to lots)
1000mg a day mangosteen powder or matching placebo
20% improvement over placebo at 90 days
40% improvement over placebo at 180 days (helps positive and negative symptoms on the PANSS test)
~60% decrease to depression
30% decrease to CGI-S (clinical global impressions severity score - measurement of total mental wellness)
GAF 10% improvement
Large anxiety reduction (55% reduction)
(they claim 80% had a 75 to 100% reduction in their symptoms in a PANSS test, but that seems to not agree with their numbers above (but amazing result if true))
helps weight loss slightly
43% difference in those taking medication vs. placebo (which likely further helped the mangosteen group)
https://researchonline.jcu.edu.au/40097/ (impressively put together study (some small funding by mangosteen producers))
Another study showed little benefit
another study showed no benefit at 24 weeks (but cognition only not symptoms of schizophrenia)

Sarcosine (NMDA)
15% improvement to PANSS scores negative
15% to total panns score after placebo
2g a day (though some prefer 1g a day, most are better off at 2g a day)
One study showed 5% after placebo
 positive cogitive depression scores
Antiaxiety fixed (as much as antiaxiety meds)
Ocd 20% help
Odd slightly helped
Hypomanic symptoms decreased need for sleep elevated libido and mood
Sarcosine has been shown to be more effective than D-Serine in one study
Check google drive link

D-Serine (NMDA)
Does 30mg per kg a day (started at 10mg first week than 20mg second week than 30mg) in three divided doses
Thought to be most effective at 60mg per kg of body weight though (study had cognitive benefits at 60mg per kg)
16% negative symptoms improvement
13% positive symptoms
11% cognitive
18% improvement in depression score
placebo had 3 percent effect
treated for 6 weeks in above study
another study
60mg per kg 2 divided doses
33% improvement in at risk population measure by the scale of prodromal symptoms test (SOPS test) 
Had 18% placebo effect though
studies in drive
Another study had no effect
Seems safe at those doses (except if you have kidney disease)

L-thianine (Multiple effect pathways including NMDA)
200mg twice a day
Placebo
22 pos
26% neg
23% general

L thianine
33 pos
31 neg
30 general

250Mg once a day (Study 2)
10% effect no placebo was used for comparison

Quality of life went down slighly in both placebo and l thianine along with global functioning scores
L thiamine
helps schiz sleep and tinnitus increases gaba neurotransmitter plus nauroprotective plus effects glutemate NMDA receptor.  Placebo had large effect too (but l thiamine was greater)-- power of belief. Found in green tea, there were no adverse side effects reported in either study.
Google drive

Agmatine sulfate (NMDA) (wouldn't recommend)
May help (reduces glutamate) (may be a naurotransmitter)

L dopa (dopamine precursor)
600mg in three or two divided doses is the most effective dosage
50% plus respond if given within 10 years of onset, 17% respond after 10 years.
Remarkable improvement in 8 cases (9.5 %), moderate 17 cases (20.2%, slight amelioration 20 cases (23.8%), aggravation 5 cases (6.0%), unchanged 34 cases (40.5 % ) (see Table 3).
Twenty five cases (29.8 % ) showed remarkable or moderate amelioration. Four out of 8 cases of remarkable amelioration have left the hospital with remission. Three cases out of these 4 patients have been receiving intramural treatment, and are doing very well. But one case exacerbated because of the discontinuation of the drug.
It does have many side effects and can increase symptoms of schizophrenia in 6%
See Google drive (l dopa 84 patients) and meta analysis
It seems to increase slow effect dopamine but not increase fast effect dopamine (tonic versus phasic)
might increase D1 activation well D2 is still blocked by the antipsychotics.
It shouldn't be used in patients not on antipsychotics or likely also in poor or partial responders to antipsychotics.
L dopa may be addictive, ?? More research needed, appears to not be seriously addictive though?

a-Lipoic Acid may help as an adjunct at 100mg a day. But many studies have no effect at higher doses, or without antipsychotic a negative effect sometimes at lower doses. More research needed. But worth trying as 63% improvement in the below study helps pos neg and gen increases memory 40% but decreases verbal fluency 30%. (two people reached out to me to say it helped them)
See Google drive (sanders2017)

Night time light exposure is linked to mental illness (1.3x increased risk for depression in most exposed quartile vs. least exposed (1.27x self harm, 1.23x anxiety, 1.34x PTSD, 1.21x psychosis)) and daytime light exposure is preventative (0.81x risk of depression in most exposed quartile vs. least exposed (0.76x self harm, 0.82x PTSD, 0.69x psychosis, 0.96x anxiety (not statistically significant))
(also see drive mercola night time)

(not sure)
sodium benzoate (it is a common food preservative) (NMDA)
looks promising need to research more
it helps symptoms of schizo 
1 gram a day oral (6 weeks in their study saw improvement week by week (they split the dose so 500mg morning and night)
21% reduction in positve and negative PANSS score (7% was placebo though)
big quality of life improvement, depression improvement, 20% Global assesment of function improvement
worked best on risperidone haloperidol? . Chinese study showed it helped with clozapine and was better at 2 gram a day than 1 gram a day(treatment resistant schizo)(splitting the dose again to morning and night) but only 10% improvement to panss and global assesment of function. placebo helped cognitive functions more while benzoate made no change P values all none significant. Only 6 people in each group. While first study showed cognitive function improvement more robust study.
https://jamanetwork.com/journals/jamapsychiatry/fullarticle/1746121
http://www.psychiatrictimes.com/schizophrenia/food-preservative-schizophrenia
https://www.sciencedirect.com/science/article/pii/S0006322317322977
safe at that dose level 
https://en.wikipedia.org/wiki/Sodium_benzoate
http://www.inchem.org/documents/cicads/cicads/cicad26.htm#SectionNumber:11.1
Since glycine affect largely retained this effect might also be. But unsure. Affects nmda

quercetin helps rats recover in dizocilpine-induced model of schiz

(not sure)? Worth trying
NAC (antioxidant)  may be helpful in making you feel more normal then hyper or manic (in my mind but I wouldn't recommend trying it can make you feel too low)
may help schizo positive and negative symptoms but may? might? hurt cognitive function
i used 2g for 5 days then switched to 500mg for three weeks. They usually recommend 600 to 1800mg dosage range for NAC. Therefore id start with 500mg and increase to 1g and keep constant. could try a little for not long for lower mood (less long then me?) but i don't recommend. On the other hand it does help many people and i may have been an outlier. I believe it said only 1/3 of people get depressed while taking.
If feel upset stomach (discontinue?) May cause lack of bowel movements (discontinue?)
4 months to 2 months 2g a day in studies take with vit c (2-3x) and water may need zinc copper supplementation (affects not retained according to study but seem to be pretty well retained but likely just slowly wares off once discontinued
15% improvement to panss scores only 3 to 5% when accounting for placebo effect.
NAC has been used for quite long periods (3 year studies)
(see google drive)


Toki-shakuyaku-san (may help)

Protirelin (not that helpful)
Releases thyroid hormone
4mg a day (split into 2 doses) (oral)
4% improvement to symptoms
Subsequent study had more effect
See Google drive

(Not helpful)
Researched glycine and thought it wasnt beneficial for outpatients. Had some effect in hospital if i remember correctly. Similar target/goal to sodium benzoate
Glycine affects the nmda receptor like zink and sodium benzoate and D-Serine and sarcosine. Could try hyper dosing it but id try zinc or sarcosine first.
(see google drive)
 
Reishi mushrooms may help with sleep

**Note: it is important to develop a community of care around yourself, these are just general suggestions from the scientific literature and your unique circumstance may increase the benefits or decrease the benefits (even to the point of having an adverse reaction). Therefore it is important to listen to your mind and body and to consult with those who care about you about changes to your health routine.**

----------------------------
How to prevent schizophrenia in those at risk of developing it
----------------------------
--------------------------
Misdiagnosing schizophrenia
-------------------------

----------------------------
Less Interesting Info 
----------------------------

***
Less interesting info has moved (because this article is getting too long). It can be found here:
If you are interested.
***

Schizophrenia currently costs the US economy 0.75% of total GDP (2023)


I have published two papers on schizophrenia and public health. They are available at the following links:
They are also available on the Kobo and Amazon stores.

Comments

  1. AnonymousAugust 23, 2023 at 11:29 AM

    whats this? I have schizophrenia is there a cure

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    1. Matthew PierceAugust 23, 2023 at 11:50 PM

      Many illnesses can be cured—the brain/schizophrenia is particularly amenable to being healed (please see above)//

      Do note that 10% don't recover (of newly diagnosed patients) and 25 to 40% may not recover if they have chronic schizophrenia (5+years) *This does not mean that there will be no improvement however, just not enough for illness remission.

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