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.