A paper in press from Beumer et al. in the Netherlands reports the presence of elevated levels of numerous cytokines and chemokines in the serum of schizophrenic subjects. The presence of these small proteins is characteristic of an inflammatory state. As described in my book, this phenomenon has been seen many times before, but the current study includes a larger number of schizophrenic (144) and healthy control (138) subjects. This study also takes into account many possible confounding factors, including age, gender, body mass index and medications, which some prior studies did not.
Possibly related to this issue is another new paper, this time from researchers in England, Brazil and Pakistan. This was a double-blind, randomized, placebo-controlled study, meaning that the neither the patients or the researchers evaluating the patients knew whether the subject was receiving a placebo or the medication being tested. This medication was minocycline, an antibiotic that has known anti-inflammatory as well as neuro-protective activities. All subjects received standard antipsychotic medications in addition to the placebo or minocycline for one year, early in their disease. The key result was that minocycline improved the scores on tests of negative symptoms (apathy, blunting of emotions). These are the symptoms that are not improved by anti-psychotic medications, and they contribute to poor social and occupational performance. Patients in both the Brazil and Pakistan cohorts displayed improvement, although it was more striking in the Brazilian group. This is no “cure”, however, as the improvement is only about 20-30%. These results support similar, but much smaller studies of minocycline done previously in Japan and Israel. The fact that minocycline has multiple activities complicates the interpretation of the results, but this medication is well tolerated, which is why it is also being tested in other disorders that involve inflammation.