Author Interviews, Mental Health Research, Schizophrenia / 07.11.2025
Edinburgh Study Suggests Doxycyline May Abate Progression of Schizophrenia in Adolescents
MedicalResearch.com Interview with:
[caption id="attachment_71333" align="alignleft" width="100"] Prof. Kelleher[/caption]
Ian Kelleher PhD, MB BCh BAO (Medicine)
Professor of Child and Adolescent Psychiatry
Academy of Medical Sciences Professor
Institute for Neuroscience and Cardiovascular Research
University of Edinburgh
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Schizophrenia is a severe mental illness associated with hallucinations, delusions and a marked decline in functioning. It usually begins in adulthood, in the 20s, but we know from recent research that as many as half of all individuals who develop schizophrenia had attended child and adolescent psychiatry services earlier in life for other mental health problems. That’s exciting because it suggests: maybe there’s something we could do to reduce risk of schizophrenia in adolescent psychiatry services. But, at present, we don’t have evidence that any intervention reduces schizophrenia risk in this clinical population.
Lots of researchers are interested in the antibiotic doxycycline, and the structurally similarly minocycline, because it has potential neuroprotective effects. It crosses the blood brain barrier and seems to reduce inflammation and apoptosis (or programmed cell death). We think that excessive synaptic pruning may play a key role in the development of schizophrenia. In laboratory studies, doxycycline seems to reduce the level of synaptic pruning by its effect on the immune system. Some research suggests that even low dose exposure to doxycycline may lead to long-term effects in “dampening down” activity by microglia, the brain’s resident macrophages, which are central to the process of synaptic pruning.
Prof. Kelleher[/caption]
Ian Kelleher PhD, MB BCh BAO (Medicine)
Professor of Child and Adolescent Psychiatry
Academy of Medical Sciences Professor
Institute for Neuroscience and Cardiovascular Research
University of Edinburgh
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Schizophrenia is a severe mental illness associated with hallucinations, delusions and a marked decline in functioning. It usually begins in adulthood, in the 20s, but we know from recent research that as many as half of all individuals who develop schizophrenia had attended child and adolescent psychiatry services earlier in life for other mental health problems. That’s exciting because it suggests: maybe there’s something we could do to reduce risk of schizophrenia in adolescent psychiatry services. But, at present, we don’t have evidence that any intervention reduces schizophrenia risk in this clinical population.
Lots of researchers are interested in the antibiotic doxycycline, and the structurally similarly minocycline, because it has potential neuroprotective effects. It crosses the blood brain barrier and seems to reduce inflammation and apoptosis (or programmed cell death). We think that excessive synaptic pruning may play a key role in the development of schizophrenia. In laboratory studies, doxycycline seems to reduce the level of synaptic pruning by its effect on the immune system. Some research suggests that even low dose exposure to doxycycline may lead to long-term effects in “dampening down” activity by microglia, the brain’s resident macrophages, which are central to the process of synaptic pruning.
Maria Tan[/caption]
MedicalResearch.com:
Maria Y. Tian, MBS
Department of Medical Education
Geisinger College of Health Sciences
Scranton, Pennsylvania
MedicalResearch.com: What is the background for this study?
Response: Schizophrenia-spectrum disorders are severe, disabling conditions that are associated with substantial economic burden. Approximately one-third of patients have treatment-resistant schizophrenia, which clozapine is the only evidence-based therapy for. Clozapine also provides unique benefits, including reduced suicide risk, aggression, and all-cause mortality. Despite this, it has historically been underutilized due to concerns over adverse effects, required blood monitoring, patient adherence, and limited clinician training. Previous research in Medicaid populations had demonstrated marked state-level variation in use, but little was known about prescribing trends in the U.S. Medicare system, which covers nearly half of individuals with schizophrenia. This study analyzed Medicare Part D data from 2015–2020 to assess national and regional trends in clozapine prescribing and to identify states with significantly different prescribing patterns.
One of the most startling aspects of the connection between schizophrenia and substance abuse is the high prevalence of substance use disorders among those with schizophrenia. Studies consistently show that individuals diagnosed with schizophrenia are more likely to engage in substance abuse compared to the general population. This connection can be best demonstrated using the self-medication hypothesis. According to this hypothesis, individuals with schizophrenia may turn to substances as a way to self-medicate or alleviate their distressing symptoms. Imagine dealing with hallucinations or disorganized thoughts—some may use alcohol or drugs to temporarily escape from this internal turmoil.
