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Release: Sept. 26, 2000

Chewing betel nuts decreases severity of schizophrenia symptoms

IOWA CITY, Iowa -- People with schizophrenia who regularly chew betel nuts show less severe symptoms, according to a recent University of Iowa study published in the British Journal of Psychiatry. Betel nut, an acorn-shaped seed found on betel palms, contains arecoline which is the fourth most widely used drug, after nicotine, ethanol and caffeine. Betel chew, also called betel quid, is a combination of betel nuts, creeping vine leaves and the chemical lime. It is chewed primarily by people living in countries from the east coast of Africa to the western Pacific.

John S. Allen, Ph.D., a UI visiting associate professor of anthropology, and research fellow in the UI department of neurology, is one of the study's five authors. The study examined two groups of patients with schizophrenia living in Palau, Micronesia, those who chewed betel quid and those who did not. The severity of schizophrenic symptoms were measured using the Positive and Negative Syndrome Scale (PANSS), a psychiatric assessment tool. The chewing group's PANSS scores were significantly lower than those of the non-chewing group, indicating less severe symptoms of schizophrenia.

Allen believes these findings are relevant to the issue of self-medication of patients with schizophrenia.

"Cigarette smoking may be so popular for schizophrenia patients due to specific neurochemical effects of nicotine," Allen said. "In the same way, people with schizophrenia may derive a direct benefit from betel nut chewing."

Allen says an unfortunate aspect of these findings is the association of betel nut chewing and an increased risk of mouth cancers. For that and other reasons, he does not believe betel nut chewing will be a viable treatment option for people with schizophrenia in the United States.

"What with all the spitting and staining the teeth red, I can't see it becoming too popular here," Allen said. He added that two of the three elements of betel quid come from tropical plants that are not readily available in the United States.

However, Allen thinks this study may lead to an increased interest in drugs that work like arecoline, the active ingredient in betel nuts.

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