Schizophrenia

//Western Diagnosis// psychosis, hallucinations, delusions, abnormal thinking, flattened affect, diminished motivation, disturbed work and social functioning

Epidemiology
1. 1% worldwide 2. gender equality 3. onset a. 18-25 yrs old for men b. 26-45 yrs old for women

Etiology
1. genetic 2. pre and peri-natal complications 3. viral CNS infections 4. maternal exposure to famine, influenza in 2nd trimester pg 5. environmental stressors may trigger episodes

Signs & Symptoms
positive and negative sx

positive sx a. excessive or distorted normal functions b. delusions, hallucinations d. bizarre behavior, thought disorder

negative sx a. decrease or loss of normal functions b. blunted affect c. poverty of speech d. anhedonia e. asociality

Diagnosis
1. clinical 2. 2 or more sx for 1 month 3. with social impairment for 6 months

Prognosis
1. intermittent or continuous 2. 70% have subsequent episodes after 1st 3. worsens over 1st 5 yrs, then plateaus 4. 10% risk suicide 5. decreased life span by 10 yrs 6. moderate risk of violent behavior 7. 1/3 improve 8. 1/3 permanently incapacitated

Treatment
1. antipsychotic drugs 2. psychotherapy 3. support 4. Abram Hoffer, M.D.: orthomolecular medicine - [] 5. food sensitivities 6. avoid sugar and chemicals 7. vit. B3 - 500-2,000 mg TID 8. vit. C - 2 gm TID 9. vit. B6 - 500 mg/day 10. zinc, copper, selenium

//TCM Pathology// A severe disorder of thought characterized by distorted perceptions of reality, impaired reasoning, disorganized speech and behavior, and lost capacity for the spontaneous experience of emotions. Delusional beliefs and auditory or visual hallucinations may also be present, and there is typically diminished motivation and grossly impaired occupational and social functioning. The general definition of schizophrenia includes the requirement of a course greater than 6 months.

Schizophrenics typically have a higher than chance occurrence of neurologic soft signs, including diminished dexterity and increased blink reflex. There is a higher than chance occurrence of apraxia or inability to carry out tasks, attributed to dysfunction of the right parietal lobe. Neuro-psychological test data and functional brain-imaging studies reveal dysfunction in the temporal and frontal lobes, principle brain regions in language and executive functioning including abstract reasoning.

Relevant TCM Diseases: Withdrawal and mania (Dian Kuang), Manic condition (Kuang Zheng), Feeblemindedness (Chi Dai)

Symptom Patterns in Western Psychiatry:
 * Paranoid Subtype:** Delusions or hallucinations, no disorganized or catatonic behavior
 * Disorganized Subtype:** Disorganized speech, behavior or inaapropriate affect, no catatonic behavior
 * Catatonic Subtype:** Motoric immobility (including posturing) or excessive motor activity, Extreme negativism, Repeats words or actions of others
 * Undifferentiated Subtype:** Meets criteria of schizophrenia in general but no specific distinguishing symptoms
 * Residual Subtype:** Symptoms are preent but in an undifferentiated form

Psychotic Disorders Related to Schizophrenia:
 * Schizophreniform Disorder:** Same symptom pattern as schizophrenia, symptoms last 1 month+ but less than 6 months
 * Brief Psychotic Disorder:** Same symptom pattern as schizophrenia, symptoms last more than 1 day but less than 1 month
 * Delusional Disorder:** Non-bizarre delusions, symptoms last at least 1 month, never diagnosed schizophrenic
 * Scizoaffective Disorder:** Same symptom pattern as schizophrenia, in context of manic or depressive symptoms during the period of active psychosis
 * Substance-Induced Psychotic Disorder:** There is evidence that psychotic symptoms are due to the effects of a substance and the patient is not psychotic when not using that substance

Differential Diagnosis: Medical Disorders: A. CNS Lesions including brain tumors B. Hyperthyroidism C. Systemic Lupus Erythmatosus (SLE) D. Multiple Sclerosis (MS) E. Delirium F. Dementia Effects of Substances: A. Alcohol or illicit substance intoxication or chronic use B. Side effects of certain medications including steroids, L-DOPA, others

TCM Etiology and Pathogenesis: “According to Chinese medical theory, the causes of schizophrenia are closely related to the damage due to excesses of the five minds and seven affects. For instance, excessive anger, fear, and fright or unfulfilled thoughts and preoccupations may cause disturbances in the function of the viscera and bowels and loss of reulation in the balance of Yin and Yang. This may then produce Qi depression, phlegm congelation, fire evils, blood stasis, and other pathological changes which may cloud the heart orifices and harass and cause chaos to the spirit brilliance, thus resulting in loss of psychological normalcy. The causes and mechanisms of schizophrenia may also be closely related to former heaven natural endowment and constitutional strength and weakness. If the righteous Qi exists internally and Yin is level (or calm) while Yang is secreted, then psychological stimuli may cause psycho-emotional discomfort but they will not cause disease. However, if the natural endowment is habitually vacuous or if Yin or Yang are inclined in one direction or another, then such stimuli may lead to the spirit brilliance’s easily being harassed with the consequent development of withdrawal or mania”1

TCM Pattern Differentiation: Yang Disease Pattern 1 Excited, agitated stirring, visual hallucinations, delusions, difficulty thinking and disturbed, chaotic thoughts, odd usual eccentric behavior, form exhuberant, body replete, red complexion and eyes, dry stools (A)CV-12, HT-7, SP-6 (B) BL-15, BL-18, BL-20, ST-40 Liver-Galbladder replete fire, psychomotor excitation prominent: //Use Long Dan Xie Gan Tang//1 Phlegm obstructing heart orifices, turbid Qi clouding heart: Use //Di Dan Tang//1 Blood stasis symptoms, excited, agitated stirring, delusions prominent: Use //Dian Kuang Meng Xing Tang//1 Phlegm fire harassing above, withdrawal and mania, agitated and manic prominent: Use //Sheng Tie Luo Yin//1
 * A. **** Acute Episodes **
 * Tongue:** red tongue, yellow coat
 * Pulse:** bowstring, rapid forceful
 * Treatment Principles:** Drain fire, flush phlegm, quicken the blood and dispel stasis, heavily settle and quiet the spirit
 * Acupuncture Treatment:** Alternate use of the below with strong stimulation, draining technique. GB-30 will also calm spirit
 * Herbal Treatment:** Choose from the following as applicable

Yin Disease Pattern 1 Flat affect, abnormally slow reactions, lack of will, difficulty thinking, fatigued, form vacuous, body weak, Qi timidity, lassitude of the spirit, somber white complexion (A)GV-26, LU-11, SP-1, PC-7, ST-40 (B) GV-16, GV-14, GV-12 (C) CV-15, CV-13, CV-12, ST-40 (D) GV-26, GV-16, PC-8, PC-7 Qi and Blood dual vacuity, essence spirit listless: Use //Yang Xin Tang//1 Yang vacuity, chronic, simple, catatonic: Use //Di Huang Yin Zi// or Wen //Yang Xing FenTang//1
 * Tongue:** pale tongue
 * Pulse:** deep, fine
 * Treatment Principles:** Nourish the blood and supplement the heart, warm Yang and excite
 * Acupuncture Treatment:** Alternate use of the below treatments with even technique.
 * Herbal Treatment:** Choose from the following as applicable

Liver Qi Depression and Binding 1 Emotional depression, dull affect, taciturnity, illogical speech, tendency to uncommon anger, suicidal thoughts, no desire to live, self-injury, chest and rib-side fullness/oppression, tendency to sigh, no thought of food or drink, menstrual irregularity [Chai Hu (12g.), Xiang Fu (10g.), Bai Shao (10g.), Zhi Ke (10g.), Chuan Xiong (6g.), Yuan Zhi (10g.), Su Geng (10g.), Chen Xiang (6g.), Gan Cao (3g.)] Enduring or extreme depression transforming heat1: + Huang Qin, Huang Lian With spleen vacuity loss of fortification1: Use //Xiao Yao San// with additions and subtractions Liver-spleen disharmony w/ depressive heat1: Use //Dan Zhi Xiao Yao// San or //Xiao Chai Hu Tang//
 * B. **** Remittent Stage **
 * Tongue:** dark tongue, thin white coat
 * Pulse:** bowstring
 * Treatment Principles:** Drain Course the liver and resolve depression
 * Acupuncture Treatment:** LR-3, PC-6, HT-7, LI-4, ST-36, CV-17. Draining technique
 * Herbal Treatment:** //Chai Hu Shu Gan San Jia Wei//1
 * Modifications:**

Phlegm Qi Depression and Binding 1 Emotional depression, a flat affect, paranoia, lots of worries, illogical speech, murming to oneself, laughing and crying without constancy, tendency to sigh, chest and ribside distention and fullness, no thought of food or drink, possible plum pit Qi, tendency to profuse phlegm [Chen Pi (10g.), Ban Xia (10g.), Dan Nan Xing (10g.), Fu Ling (15g.), Xiang Fu (10g.), Shi Chang Pu (15g.), Mu Xiang (7g.), Kuan Xian Dan (2-3 pills swallowed with decocted materials)] Chest and diaphragmatic fullness and oppression, profuse phlegm drool in mouth: Use //San Sheng San// to promote vomiting, seize phlegm drool by force, and hurry other medicinal effect Spirit clouded, dull affect, confused, chaotic speech: first use //Su He Xiang Wan//, then use //Si Qi Tang// + Dan Nan Xing, Yu Jin, Shi Chang Pu, Yuan Zhi Qi depression tramsforming heat, insomnia, easy fright: Use //Wen Dan Tang// + Huang Lian combined w/ //Bai Jin Wan// With spirit clouding and chaotic mind: Use //Zhi Bao Dan//
 * Tongue:** slimy coat
 * Pulse:** bowstring, slippery
 * Treatment Principles:** Rectify the Qi and resolve depression, tansform phlegm and open the orifices
 * Acupuncture Treatment:** GV-26, HT-7, PC-6, CV-12, ST-36, LR-2, ST-40. Even technique
 * Herbal Treatment:** //Shun Qi Dao Tan Tang He Kong Xian Dan Jia Jian//1
 * Modifications:**

Phlegm Dampness Obstructing Internally 1 Difficulty thinking, inattentiveness, a dull flat affect, slow movements, fatigue, lack of strength, cowering, solitariness, possible visual and auditory hallucinations, torpid food intake, heart vexation, insomnia [Dang Shen (12g.), Bai Zhu (10g.), Fu Ling (20g.), Gan Cao (10g.), Mu Xiang (6g.), Sha Ren (6g.), Sheng Jiang (10g.), Gan Jiang (10g.), Chen Pi (10g.), Ban Xia (10g.), Cang Zhu (10g.), Yuan Zhi (6g.), Shi Chang Pu (10g.), Huo Xiang (10g.), Pei Lan (10g.)] Pronounced spleen vacuity: + Huang Qi, Sheng Ma Kidney vacuity signs: + Shan Yao, Bia Bian Dou
 * Tongue:** fat swollen tongue with teeth marks, slimy white coat
 * Pulse:** slippery or deep, relaxed
 * Treatment Principles:** Warm Yang and fortify the spleen, transform phlegm and open the orifices
 * Acupuncture Treatment:** GV-26, HT-7, PC-6, CV-12, ST-36, LR-2, ST-40. Even technique
 * Herbal Treatment:** //Xiang Sha Liu Jun Zi Tang He Li Zhong Tang Jia Wei//1
 * Modifications:**

Phlegm Fire Harrassing Above 1 Emotional tension and agitation, breaking things and injuring other people, foul speech, an angry look in the eyes, red complexion, red eyes, bound constipated stools [Tie Luo (30-60g.), Dan Nan Xing (10g.), Bei Mu (12g.), Ju Hong (12g.), Shi Chang Pu (12g.), Yuan Zhi (12g.), Fu Shen (12g.), Xuan Shen (12g.), Tian Men Dong (12g.), Mai Men Dong (12g.), Lian Qiao (12g.), Zhu Sha (1g.)] Severe phlegm fire: + //Meng Shi Shi Tan Wan// To clear heart, open orifices: can use //An Gong Niu Huang Wan// Mainly liver-gallbladder fire: Use //Dang Gui Long Hui Wan// Mainly Yangming heat: Use Da Cheng Qi Tang + Zao Jiao and pig bile Spirit mind clear but vexation, insomnia due to phlegm fire: Use //Wen Dan Tang// + //Zhu Sha An Shen Wan//
 * Tongue:** red tongue, slimy yellow coat
 * Pulse:** bowstring, large, slippery, rapid
 * Treatment Principles:** Settle the heart and flush phlegm, clear the liver and drain fire
 * Acupuncture Treatment:** GV-14, GV-26, PC-6, PC-8, ST-40, LR-3. Draining technique
 * Herbal Treatment:** //Sheng Tie Luo Yin Jia Jian//1
 * Modifications:**

Heart-Spleen Dual Vacuity 1 Excessive thinking, worry and anxiety, dreaming of ghosts, confusion, heart palpitations, easily frightened, predilection to sorrow and a desire to cry, poor memory, difficulty thinking, sluggishness, illogical speech, somber white complexion, fatigue, reduced food intake [Dang Shen (12g.), Bai Zhu (12g.), Fu Shen (30g.), Huang Qi (30g.), Gan Cao (6g.), Dang Gui (12g.), Long Yan Rou (30g.), Suan Zao Ren (30g.), Yuan Zhi (6g.), Mu Xiang (10g.), Sheng Jiang (6g.), Da Zao (6 pieces)] Excessive thinking, worry, anxiety, predilection to sorrow, fright, fear, restlessness, disturbed heart spirit: Use //Yang Xin Tang//
 * Tongue:** pale tongue
 * Pulse:** fine, forceless
 * Treatment Principles:** Fortify the spleen and nourish the heart, boost the Qi and quiet the spirit
 * Acupuncture Treatment:** BL-15, BL-20, PC-6, HT-7, ST-36. Tonifying technique
 * Herbal Treatment:** //Gui Pi Tang//1
 * Modifications:**

Yang Vacuity Depletion& Detriment 1 Advanced age, bodily weakness, or enduring disease that does not heal resulting in spleen disease reaching and damaging the kidneys w/ difficulty thinking, sluggishness, inattention, cowering, scanty speech, no thought for food or drink, bodily vacuity and lack of strength, lusterless complexion, fear of cold, chilled extremities [Dang Shen (20g.), Shu Di (15g.), Fu Zi (10g.), Rou Gui (10g.), Rou Cong Rong (15g.), Yin Yang Huo (15g.), Gan Jiang (6g.), Gui Ban (15g.), Chen Pi (10g.), Ba Xia (10g.), Gan Cao (6g.), Fu Ling (15g.)] Severe phlegm blocking heart orifices: +Shi Chang Pu, Yuan Zhi With blood stasis: + Dan Pi, Yu Jin Pronounced Qi vacuity: + Huang Qi, Shan Yao
 * Tongue:** pale tongue, thin white coat
 * Pulse:** deep, fine, weak
 * Treatment Principles:** Warm and supplement the spleen & kidneys assisted by transforming phlegm and opening the orifices
 * Acupuncture Treatment:** BL-23, GV-4, BL-20, BL-21, CV-4, GV-20. Moxa
 * Herbal Treatment:** //Wen Yang Xi Fen Tang Jia Jian//1
 * Modifications:**

Yin Vacuity Fire Effulence 1 Enduring manic disease gradually worsening, fatigue, excessive speech, susceptibility to fright, emotional anxiety and tension, occasional vexation, emaciated form, red complexion, 5-palm heat, dry mouth w/out desire to drink [Sheng Di (30g.), Mai Men Dong (12g.), Xua Shen (12g.), Fu Ling (12g.), Suan Zao Ren (20g.), Huang Lian (10g.), Mu Tong (8g.), Zhu Ye (12g.), Deng Xin Cao (3g.), Gan Cao] Dry stools: + Huo Ma Ren, Yu Li Ren, Tao Ren Dry mouth, torpid intake, no thought for food or drink: + //San Xian// Devitalized essence spirit w/ sluggish stirring: Tai Zi Ren, Huang Qi, Sheng Ma
 * Tongue:** red tongue, scanty or no coat
 * Pulse:** fine, rapid
 * Treatment Principles:** Enrich Yin, downbear fire, quiet the spirit and stabilize the mind
 * Acupuncture Treatment:** HT-7, PC-7, LR-3->KI-1, SP-6. Even Technique
 * Herbal Treatment:** //Er Yin Jian//1
 * Modifications:**

Blood Stasis Obstructing Internally 1 Emotional lability, sometimes agitated, sometimes still, speaking to oneself, torpid spirit, paranoia, delusional thinking, auditory and visual hallucinations, dark stagnat complexion, piercing lancinating headache [Tao Ren (12g.), Hong Hua (10g.), Dang Gui (10g.), Sheng Di (10g.), Chuan Xiong (6g.), Chi Shao (6g.), Jie Geng (5g.), Chuan Niu Xi (10g.), Chai Hu (3g.), Zhi Ke (6g.), Gan Cao (6g.), Shui Zhi (6g.)] Bitter taste in mouth, Dry throat, short reddish urination, feeling of brewing heat internally: + Mu Tong, Huang Qin Excitation, restlessness, lack of calm: + Dan Pi, Sheng Di Restless sleep, depression, oppression, discomfort: + He Huan Pi, Ye Jiao Teng Scanty speech, scanty movement, lusterless complexion, fatigue: + Huang Qi, Dang Gui
 * Tongue:** dark red tongue, static macules or spots, possible engorged tortuous sublingual veins
 * Pulse:** bowstring, choppy
 * Treatment Principles:** Rectify the Qi and resolve depression, quicken the blood and transform stasis
 * Acupuncture Treatment:** HT-7, PC-6, SP-10, LI-4, BL-15, BL-17, BL-18. Draining Technique
 * Herbal Treatment:** //Xue Fu Zhu Yu Tang Jia Wei//1
 * Modifications:**

Qi Stagnation w/ Blood Stasis
this pattern roughly corresponds to the paranoid type of schizophrenia 3 of 5 symptoms should be present, or two pronounced. 2/4 primary points +SP-10, BL-17
 * Psychiatric symptom:** (1) Primary Hallucination, (2) verbal auditory hallucination; (3) Loose Associations; (4) Conflicting Emotions; (5) Strange Behavior
 * Disease Duration:** Psychotic symptoms should have a minimum of continuous duration of one month
 * Tongue:** Purple or dull-colored Tongue; scant tongue fur w/ Blood stasis & distention in the sublingual veins
 * Pulse:** Rough or String-like
 * Acupuncture:**

Phlegm-Fire Harassing Internally
this pattern roughly corresponds to the hebephrenic or disorganized type of schizophrenia 3 of 5 symptoms should be present, or two pronounced. 2/4 primary points + 2 to 4 of the following: HT-5, ST-43, BL-21, CV-12, LR-2, ST-45, HT-9, TW-5, GB-41, SI-3, BL-62, ST-44 Herbal Treatment: (Glowing fire and excess phlegm) Pill of Radix angelicae sinensis, radix gentianae and aloe Long Dan Cao 3 chiens Fried Zhi Zi 3 chiens Dang Gui 3 chiens Zhi Shi 3 chiens Shi Chang Pu 3 chiens Huang Qin 3 chiens Magnetite 10 chiens dens draconis 4 chiens Ban Xia (treated w/ Exudate of bambosae in taenia)
 * Psychiatric symptom:** (1) Disorganized Thinking; (2) vivid hallucinations; (3) Emotional Lability; (4) Childish or Inappropriate Behavior; (5) Excitable & Compulsive Behavior
 * Disease Duration:** Psychotic symptoms should have a minimum of continuous duration of one month
 * Treatment Principle:** Sweep Phlegm & Open Orifices
 * Tongue:** Red or Crimson Tongue; thick yellow or yellow-slimy coat
 * Pulse:** Slippery, Rapid, Strong
 * Acupuncture:**
 * Modifications:**

Effulgent Yin Vacuity Fire
this pattern roughly corresponds to the catatonic type of schizophrenia 3 of 5 symptoms should be present, or two pronounced. 2/4 primary points + 2 to 4 of the following: GV-24->GV-23 (drain), KI-7, ST-36 (tonify), CV-4 (Tonify), LU-7, KI-6,LI-11, GB-34 Sheng Di Huang (raw) 4chiens Mai Men Dong 3 chiens Semen Forsythize 3 chiens Yuan Zhi (treated) 2 chiens Bei Mu 3 chiens Tian Nan Xing (bile treated) 3 chiens Fu Ling3 chiens Dan Shen 4 chiens Shi Chang Pu 2 chiens Magnetic oxide of iron (decoct in advance) 20 chiens
 * Psychiatric symptom:** (1) Delusions & Hallucinations; (2) Suspiciousness & Hostility; (3) Flat Affect w/ Occasional Excitation; (4) Social Withdrawal w/ a Feeling of Loneliness ; (5) Prolonged Stupor, Possibly w/ Sudden & Brief Excitatory States
 * Disease Duration:** Psychotic symptoms should have a minimum of continuous duration of one month
 * Treatment Principle:** Enrich Yin & Downbear Fire
 * Tongue:** Red or Crimson Tongue; lack of or peeled coat
 * Pulse:** Slippery, Rapid, Strong
 * Acupuncture:**
 * Herbal Treatment:** Decoction of magnetic oxide of iron

Phlegm-Damp Obstructing Internally
this pattern roughly corresponds to the simple type of schizophrenia 3 of 5 symptoms should be present, or two pronounced. 2/4 primary points + SP-9, ST-36, CV-12 Chen Pi 3 chiens Ban Xia (treated) 3 chiens Zhi Shi 2 chiens Tian Nan Xing (bile treated) 2 chiens Fu Ling 3 chiens Xiang Fu (treated) 3 chiens Shi Chang Pu 3 chiens Yu Jin 3 chiens Gan Cao 1.5 chiens
 * Psychiatric symptom:** (1) Lack of Thought; (2) Emotional Indifference; (3) Laziness and Passivity; (4) Lack of Motivation; (5) Impaired Social Skills
 * Disease Duration:** Psychotic symptoms should have a minimum of continuous duration of two years
 * Treatment Principle:** Dry Damp & Transform Phlegm
 * Tongue:** Puffy Tongue, possibly w/ toothmarks; white, slimy coat
 * Pulse:** Slippery or Sunken, moderate
 * Acupuncture:**
 * Herbal Treatment:** (congestion & entanglement of phlegm & Qi) Decoction for smoothing the Qi and conducting out the phlegm

Yang Vacuity Damage
this pattern roughly corresponds to the chronic type of schizophrenia 3 of 5 symptoms should be present, or two pronounced. 2/4 primary points + 2 to 4 of the following: LR-5, KI-3, CV-4, GV-20,LI-4, ST-36, CV-17, CV-14, CV-12, LR-3, PC-6, SP-4
 * Psychiatric symptom:** (1) Lack of Thought; or Significant Thought Content; (2) Flat Affect; (3) Lack of Motivation; (4) Withdrawal Behavior; (5) Taciturn (disinclination to talk)
 * Disease Duration:** Psychotic symptoms should have a minimum of continuous duration of two years
 * Treatment Principle:** Supplement vacuity & support Zheng Qi
 * Tongue:** Pale Tongue; thin white coat
 * Pulse:** Sunken, Fine, Weak
 * Acupuncture:**

Deficiency of Both Heart & Spleen
Dang Shen 3 chiens Fu Ling 3 chiens Dan Shen 4 chiens Dang Gui 3 chiens date seed 4 chiens Ban Xia (treated) 3 chiens Fructus triticum aestivum L 10 chiens Gan Cao 2 chiens Da Zao 7 pieces
 * Treatment Strategy:** Strengthen Spleen, tonify Blood, nurture Heart & Calm Shen
 * Herbal Treatment:** Decoction for nurturing Heart and

ST-40, SP-6, PC-5->TW-6, CV-5,->CV-13, GV-20-> Si Shen Cong, KI-1, BL-15, BL-18, BL-20, Ding Shen, HT-7, GB-20 GV-26, PC-6, Yen Tang, BL-44, GV-24, Hu Bian, GB-34, KI-4, PC-7, SI-16, LR-5, ST-36, CV-12, Bi Zhong, GV-26, CV-11, HT-5 Manic Fits: + LR-1, GV-18, CV-15, PC-8, LU-11, LR-3, GV-26, LR-5, PC-6, LI-11, LR-8, HT-6, CV-24, SP-1, GV-23->GV-20, LI-4->SI-3, KI-3->KI-1 Depression: + BL-15, BL-18, BL-20, BL-23, CV-14, PC-7, PC-8, KI-1, CV-17, LR-3, LR-2, Yin Tang, PC-6->TW-5, LI-4->PC-8 Negative symptoms of Schizophrenia: GV-20, GV-24->GV-23 Auditory Hallucinations: + SI-19, GB-2, TW-3, TW-17, SP-4 Visual Hallucinations+ TW-17, BL-1, Yu Yao Anxiety: + PC-6, LR-3, PC-8, CV-14 Obsessions: + GV-20, Tai Yang, Yin Tang Forgetfulness: + GV-11, PC-6 Agitation, Irritability & Excitability: + LR-3 Fear & Fright: + BL-19, PC-4, CV-14 Poor Appetite: + ST-36 Headache w/ Dizziness (side effect of antipsychotics): + GV-20, Tai Yang, Yin Tang, LI-4, Ashi head points Dizziness w/ Tinnitus & limp, aching lumbus & knees (side effect of antipsychotics) : + BL-23, KI-3 Amenorrhea & lactation (side effect of antipsychotics) : + CV-4, BL-20, BL-23, ST-36, LI-4, LR-3, CV-3
 * Primary Acupuncture Points**
 * Secondary Acupuncture Points**
 * Supplementary Points According to Symptom**

Auricular Points
Primary: Kidney, Occiput, Heart, Stomach, Ear Shen Men, Central Rim, Subcortex, Sympathetic, Endocrine, Heart of Posterior Surface Secondary: Brain Stem, Adrenal Gland, External Ear, Internal Ear, Lesser Occipital Nerve, Neurasthenia Region