As a preadolescent, R. M. was having worse than usual behavioral problems at school and at home. Interestingly enough, the child had already been taking physician-prescribed little bits of niacin, though totaling less than 150 mg/day, but evidently it wasn’t enough to be effective. When tried, drugs (especially Adderall) actually made him worse: more angry and still more confrontational, bordering on paranoid.

The boy did not want to take much niacin because he so strongly objected to the flush. Knowing that the dose had to be increased far over 150 mg/day for any hope of success, his mother finally tried giving him 500 mg niacinamide three times daily (1,500 mg total). There was noticeable improvement. At 3,000 mg/day, the youngster was doing even better, but developed nausea from the niacinamide, and the dosage was cut back. In time, the boy had a violent psychotic episode severe enough that his parents had to hold him down while the now 13-year-old lad screamed death threats at them.

After that, to increase the B-3 dose without nausea, the mother now gave him plain niacin. With about 500 mg every two hours (6,000-8,000 mg/day), the boy was a new person. He was now a cheerful, cooperative, affectionate youngster. Adding vitamin C and B-6 to his regimen helped even more. His school performance soared, and the teachers loved him. When his liver function tests read high, the niacin dose was again reduced, but not by so much this time. At age 15, his maintenance dose was about 3,000 mg/day.