Inflammation in Schizophrenia: Pathogenetic Aspects and Therapeutic Considerations

Norbert Müller


Schizophr Bull. 2018;44(5):973-982. 

In This Article

Other Immune-related Substances in Schizophrenia

As described above, microglia activation is involved in inflammatory processes in the CNS. The antibiotic minocycline crosses the blood-brain barrier is known to inhibit microglia activation and, consequently, is of interest in schizophrenia. In animal models of schizophrenia, it has been shown to improve cognition.[121] In patients with schizophrenia, double-blind, placebo-controlled add-on studies also found positive effects of minocycline on negative and cognitive symptoms.[122,123] Case reports have described positive effects of minocycline on the overall symptom spectrum in schizophrenia.[124]

Substances with anti-inflammatory and other effects, including acetylcysteine and omega-3 fatty acids, have been found to have some beneficial effects in schizophrenia.[104] The cytokine interferon-gamma (IFN-γ) stimulates the monocytic type 1 immune response and has shown encouraging, although preliminary, results in schizophrenia.[125] Treatment with IFN-γ requires careful monitoring of side effects, including unwanted immune effects.

Because the immune system and cytokines in particular appear to be involved in schizophrenia, monoclonal antibodies against pro-inflammatory cytokines may be expected to show positive effects in schizophrenia.[126] The data from the few studies performed to date indicate that treatment with monoclonal antibodies is feasible and may show efficacy, but further research is needed.[126]