Schizophrenia and Disorders With Psychotic Features Clinical Trial
Official title:
The Benefit of Minocycline on Negative Symptoms in Schizophrenia: Extent and Mechanisms
The purpose of this study is to investigate if minocycline limits the development of negative symptoms in early psychosis and to test via what mechanism of action this change occurs.
Background
Negative symptoms of psychosis do not respond to the traditional therapy with first- or
second-generation antipsychotics and are among main causes of a decrease in quality of life
observed in individuals suffering from the disorder. Minocycline, a broad-spectrum
tetracyclic antibiotic displaying neuroprotective properties has been suggested as a new
potential therapy for negative symptoms. In the two previous clinical trials comparing
minocycline and placebo, both added to the standard care, patients receiving minocycline
showed increased reduction in negative symptoms. Three routes to neuroprotection by
minocycline have been identified: neuroprotection against grey matter loss, anti-inflammatory
action and stabilisation of glutamate receptors. However, it is not yet certain what the
extent of the benefit of minocycline in psychosis is and what its mechanism is. This proposal
is for a multi-centre double-blind randomised placebo-controlled clinical trial entitled The
Benefit of Minocycline on Negative Symptoms of Psychosis: Extent and Mechanism (BeneMin).
Methods
After providing informed consent, 226 participants in the early phase of psychosis will be
randomised to receive either 100 mg modified-release capsules of minocycline or similar
capsules with placebo for 12 months in addition to standard care. The participants will be
tested for outcome variables before and after the intervention period. The extent of benefit
will be tested via clinical outcome measures, namely the Positive and Negative Syndrome Scale
score, social and cognitive functioning scores, antipsychotic medication dose equivalent and
level of weight gain. The mechanism of action of minocycline will be tested via blood
screening for circulating cytokines and magnetic resonance imaging with three-dimensional
T1-weighted rapid gradient-echo, proton density T2-weighted dual echo and T2*-weighted
gradient echo planar imaging with N-back task and resting state. Eight research centres in
the United Kingdom (UK) and 15 National Health Service Trusts and Health Boards will be
involved in recruiting participants, performing the study and analysing the data.
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