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Overview: The Biopsychopharmacology of Vitamin B6

From Innovative Psychopharmacotherapy

Vernon M. Neppe and Willem J. Serfontein

Vitamin B6 (pyridoxine), in a variety of chemical forms, is a coenzyme in a large number of extremely important metabolic processes in the nervous system. Consequently, deficiency could theoretically produce such diverse pictures as neuropathy epilepsy, and behavior disturbance. In practice, however, despite several studies suggesting that mild deficiency states are common in both psychiatric patients and the normal population, few patients appear symptomatic. Pyridoxine is frequently used in the management of premenstrual syndromes and in pregnancy-related depression. There is substantial theoretical support for this empirical approach. It also has been used in atypical cases of infantile autism in megadoses, but this therapy is unproven. Its use in schizophrenia is also unproven and it is unlikely that it causes any kind of improvement. It is extremely promising, however, in some types of homocystinuria and Down's syndrome, and in both there are appropriate biochemical correlates that motivate its use. It is clearly indicated in pyridoxine deficiency infantile epilepsy. The drug may become more useful when used in appropriate combinations, e.g., one study suggested its combination use with magnesium in autism. Moreover, tempering its increased use is the discovery of a predominantly sensory neuropathy that is reversible on cessation of high-dose daily vitamin B6 therapy. Guidelines for future research and for possible use in psychiatry are made. The varying formulations of vitamin B6 have different kinetics and may imply different use.

Keywords

Ascorbic acid - Attention deficit disorder - Autism - Behavior disturbance - Down's syndrome - Drug interactions - Epilepsy - Homocystinuria - Hyperventilation syndrome - Megadose therapy - Mental retardation - Monoamine oxidase inhibitors - Neuropathy - Premenstrual depression - Pyridoxal phosphate - Pyridoxine - Schizophrenia - Theory and practice in psychiatry - Vitamin B6.

 

 


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