Niacin for PTSD?

The NY Rescue Workers Detox Project began as a program to detoxify rescue workers who inhaled smoke and other impurities from World Trade Center destruction on Sept 11, 2001. The program was sponsored by the Church of Scientology, and based on the principles of that movement, specifically the “Purification Rundown,”  a controversial detoxification method.

The detox procedure involves high-dose dietary supplements and extended time in a sauna (up to five hours a day for five weeks). Sessions also include vigorous exercise on a treadmill. The idea, of course, is to get the toxins into the blood stream and induce sweating to help the body flush out the impurities. Exercise gets the toxins into the blood stream and the sauna helps sweat out the toxins.

At the end of the session participants eat healthy foods like raw veggies and low fat, low-salt snacks. Also, participants are put on mega doses of Niacin, and some other vitamins, to help in the flushing process. In the case of Niacin, participants begin at around 100 mg and go up to as much as 5,000 mg. According to the medical establishment, such high doses are dangerous and possibly toxic to the body.

Several years after the 9/11 attack, an increasing number of first responders were entering the program. These individuals were suffering PTSD and had tried a number of interventions to improve their state of mind. Many found their way into the Scientology program out of desperation, and the Church claimed an improvement rate of 85%. Psychologists and psychiatrists were generally skeptical of such a high rate of improvement, especially given that there were no controlled experiments evaluating the procedure against a control group; plus, the Niacin aspect seemed really questionable.

But let’s back up and look at this issue with a critical eye. There seemed to be no doubt that a fair number of participants profited from their involvement in the project. To the extent the improvement was indeed due to the program, what could be going on?

Well, let’s forget about the Niacin for a minute and ask, “What precisely is involved in these sessions?” The answer is: vigorous exercise, an emphasis on improving diet, a daily time commitment to participation over a period of several weeks, and, perhaps most important, social interaction. Yes, these sessions were not in isolation; the sauna and exercise sessions took place with others, as did the eating at the end of the session.

So, we have a case of troubled first-responders who have been wrestling with PTSD for a considerable period of time. Even several years later, these folks continue to be frustrated, angry, discouraged, and full of self-blame. In the detox program, they find themselves committed to getting off their butts and engaging in healthy activities; and, they find themselves interacting with fellow sufferers in a support context. Why wouldn’t we expect many of them to show improvement?

Note that this analysis does not include the Niacin variable. And, in fact, its relevance could only be shown in a controlled study where, in a double-blind procedure, half of the participants in the program were given Niacin, the other half a placebo. To my knowledge, no such study was ever conducted.

In the absence of direct evidence implicating Niacin as a factor, I would be inclined to attribute the improvement to the other factors, especially because those other factors (such as, exercise and having positive interaction with other victims) are known to contribute to successful coping with stress.