Minocycline: Therapeutic Potential in Psychiatry
Abstract
Pharmacological interventions to treat psychiatric illness have previously focused on modifying dysfunctional neurotransmitter systems to improve symptoms. However, imperfect understanding of the aetiology of these heterogeneous syndromes has been associated with poor treatment outcomes for many individuals. Growing evidence suggests that oxidative stress, inflammation, changes in glutamatergic pathways and neurotrophins play important roles in many psychiatric illnesses including mood disorders, schizophrenia and addiction. These novel insights into pathophysiology allow new treatment targets to be explored. Minocycline is an antibiotic that can modulate glutamate-induced excitotoxicity, and has antioxidant, anti-inflammatory and neuroprotective effects. Given that these mechanisms overlap with the newly understood pathophysiological pathways, minocycline has potential as an adjunctive treatment in psychiatry. To date there have been promising clinical indications that minocycline may be a useful treatment in psychiatry, albeit from small trials most of which were not placebo controlled. Case reports of individuals with schizophrenia, psychotic symptoms and bipolar depression have shown serendipitous benefits of minocycline treatment on psychiatric symptoms. Minocycline has been trialled in open-label or small randomized controlled trials in psychiatry. Results vary, with findings supporting use in schizophrenia, but showing less benefit for nicotine dependence and obsessive-compulsive disorder. Given the limited data from rigorous clinical trials, further research is required. However, taken together, the current evidence suggests minocycline may be a promising novel therapy in psychiatry.
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Minocycline promotes hippocampal neurogenesis and exerts anti-apoptotic and anti-inflammatory activities, reducing the expression of pro-inflammatory cytokines and up-regulating anti-inflammatory cytokines.
“Minocycline promotes hippocampal neurogenesis and exerts anti-apoptotic and anti-inflammatory activities, reducing the expression of pro-inflammatory cytokines (e.g. IL-1β, IL-6, IL-2, TNF-α, INF-γ) and up-regulating anti-inflammatory cytokines (e.g. IL-10) [99].”
From Cognitive remission: a novel objective for the treatment of major depression? (2016) · cites this paper as [99]
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Where now for schizophrenia research?
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Queiroz, A. I. G., Filho, A. J. M. C., Araújo, T. D. S., Lima, C. N. D. C., Machado, M. D. J. S., Carvalho, A. F., Vasconcelos, S. M. M., de Lucena, D. F., Quevedo, J., & Macêdo, D. S. (2017) · Journal of Affective Disorders · doi:10.1016/j.jad.2017.07.053 · Cited by 15 · see citing works
Antipsychotic-like effect of minocycline in a rat model.
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Future Directions for Pharmacotherapies for Treatment-resistant Bipolar Disorder
Dodd, S., Fernandes, B. S., & Dean, O. M. (2015) · Current Neuropharmacology · doi:10.2174/1570159x13666150630175841 · Cited by 13 · see citing works
Self-citationAssociation of Lyme Disease and Schizoaffective Disorder, Bipolar Type: Is it Inflammation Mediated?
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A Proteogenomic Approach to Unveiling the Complex Biology of the Microbiome
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Modeling schizophrenia: uncovering novel therapeutic targets
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Anti-inflammatory treatment of bipolar depression: promise and disappointment
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Minocycline-induced transient depersonalization: A case report
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- Authors
- Dean, O. M., Data-Franco, J., Giorlando, F., & Berk, M.
- Affiliations
- Barwon Health (AU)
- Mental Health Research Institute (AU)
- The University of Melbourne (AU)
- Corresponding author
- Dean, Olivia M.
- Venue
- CNS Drugs
- Published
- 2012-05
- Volume
- 26
- Issue
- 5
- Pages
- 391-401
- ISSN
- 1172-7047 (ISSN-L)
- OpenAlex
- W2159126784
- Cited by
- 131
- References
- 98
- Citations by year
- 2026: 5 · 2025: 2 · 2024: 10 · 2023: 7 · 2022: 8 · 2021: 6 · 2020: 13 · 2019: 8 · 2018: 7 · 2017: 6 · 2016: 7 · 2015: 11 · 2014: 18 · 2013: 19 · 2012: 4
- FWCI
- 12.12
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- CNS Drugs (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Yale University
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Life Sciences › Neuroscience › Biological Psychiatry › Tryptophan and brain disorders
- Keywords
- minocycline, adjunctive therapy, schizophrenia, bipolar depression, psychosis, nicotine dependence, obsessive-compulsive disorder, oxidative stress, neuroinflammation, glutamate excitotoxicity, neuroprotection, antioxidant activity, mood disorders, addiction
- MeSH terms
- Animals, Anti-Bacterial Agents, Mental Disorders, Humans, Inflammation, Minocycline, Nerve Growth Factors, Drug Delivery Systems, Oxidative Stress, Glutamic Acid
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