Minocycline as adjunct therapy for a male patient with deficit schizophrenia

Abstract

Xiaohua Chen,1,* Zhenzhen Xiong,2,* Zhixiong Li,3 Yali Yang,4 Zhanying Zheng,5 Yonghong Li,6 Yan Xie,6 Zhe Li7,8 1Department of Central Transportation Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; 2School of Nursing, Chengdu Medical College, Chengdu, Sichuan 610083, China; 3The Third Department of Clinical Psychology, Karamay Municipal People’s Hospital, Karamay, Xinjiang 830054, China; 4The Second Department of Clinical Psychology, Karamay Municipal People’s Hospital, Karamay, Xinjiang 830054, China; 5The First Department of Clinical Psychology, Karamay Municipal People’s Hospital, Karamay, Xinjiang 830054, China; 6The Sleep Medicine Department, Karamay Municipal People’s Hospital, Karamay, Xinjiang 830054, China; 7Mental Health Center and Psychiatric Laboratory, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; 8The Mental Rehabilitation Center, Karamay Municipal People’s Hospital, Karamay, Xinjiang 830054, China *These authors contributed equally to this work Abstract: The pathophysiology of schizophrenia may involve increased production of inflammatory cytokines by activated microglia. Minocycline can inhibit activated microglia and may improve secondary negative symptoms and/or cognitive functions when used as adjuvant to antipsychotics. Effects on minocycline on primary and enduring negative symptoms in deficit schizophrenia (DS) are unknown. We present a male patient with a 3-year history of DS. He was treated for 12 weeks with risperidone at a maximal dose of 6 mg per day, then for 10 weeks with olanzapine at 20 mg per day. Symptoms did not improve, and body mass index increased from 20.41 to 22.84 kg/m2. Serum levels of several inflammatory cytokines were elevated, so we prescribed minocycline as adjunct to aripiprazole for 12 weeks. Negative symptoms and cognitive impairment improved, and serum levels of inflammatory cytokines decreased. Our case suggests that clinicians may consider minocycline as adjunct therapy to antipsychotics in patients with DS with elevated serum levels of inflammatory cytokines. This highlights the need for further research into possible relationships of minocycline with negative symptoms and cognitive function in patients with DS. Keywords: minocycline, adjunct therapy, deficit schizophrenia

Keywords

• Minocycline
• Adjunct therapy
• Deficit schizophrenia