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Association between doxycycline use and long-term functioning in patients with schizophrenia
Lot D de Witte1, Thomas Munk Laursen2, Cheryl M Corcoran3
1Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Importance And Objective:
The brain-penetrant tetracycline antibiotics, minocycline and doxycycline, have been proposed as potential candidate drugs for treatment of schizophrenia, based on preclinical studies and clinical trials. A potential long-term beneficial effect of these antibiotics for schizophrenia patients has not been investigated. This study was designed to determine if redemption of doxycycline prescription in schizophrenia is associated with decreased incidence of disability pension, a proxy for long-term functioning.
Design:
We performed a population-based cohort study with data from schizophrenia patients available through the Danish registers. Survival analysis models with time-varying covariates were constructed to assess incidence rate ratios (IRR) of disability pension after exposure to doxycycline or a non-brain penetrant tetracycline, defined as at least one filled prescription. The analysis was adjusted for age, sex, calendar year, parental psychiatric status and educational level.
Results:
We used data from 11,157 individuals with schizophrenia (4,945 female and 6,212 male; average age 22.4 years old, standard deviation (std) 4.50). 718 of these were exposed to brain-penetrant doxycycline, and 1,498 individuals redeemed a prescription of one or more of the non-brain-penetrant tetracyclines. The average years at risk per person in this cohort was 4.9, and 2,901 individuals received disability pension in the follow-up period. There was a significantly lower incidence rate of disability pension in schizophrenia patients who had redeemed doxycycline compared to patients who did not redeem a prescription of any tetracycline antibiotics (Incidence rate ratio (IRR) 0.68; 95 % CI 0.56, 0.83). There was also a significant lower rate of disability pension in schizophrenia patients who redeemed doxycycline compared to individuals who redeemed a prescription of one of the non-brain penetrant tetracycline antibiotics (IRR 0.69 95 % CI 0.55, 0.87).
Conclusions:
In this observational study, doxycycline exposure is associated with a reduced incidence of disability pension. These data support further studies on the potential long term neuroprotective effects of doxycycline and level of functioning in schizophrenia patients.
Insights
Doxycycline, a brain-penetrant antibiotic, was associated with a lower incidence of disability pension in schizophrenia patients. This suggests potential long-term neuroprotective benefits and improved functioning for individuals with schizophrenia.
Area of Science:
- Neuroscience
- Psychiatry
- Pharmacology
Background:
- Schizophrenia treatment often focuses on symptom management, with limited options for improving long-term functioning.
- Brain-penetrant tetracyclines like minocycline and doxycycline show preclinical promise for schizophrenia.
- The long-term impact of doxycycline on schizophrenia patient outcomes remains under-investigated.
Purpose of the Study:
- To investigate if doxycycline prescription redemption in schizophrenia patients correlates with a reduced incidence of disability pension.
- To assess doxycycline's association with long-term functional outcomes in schizophrenia.
Main Methods:
- Population-based cohort study utilizing Danish registry data.
- Survival analysis with time-varying covariates to compare disability pension incidence.
- Adjusted for age, sex, calendar year, parental psychiatric history, and education level.
Main Results:
- 11,157 schizophrenia patients were analyzed; 718 exposed to doxycycline.
- Doxycycline exposure was linked to a significantly lower incidence of disability pension compared to no tetracycline use (IRR 0.68).
- Doxycycline use also showed a significantly lower disability pension rate compared to non-brain-penetrant tetracyclines (IRR 0.69).
Conclusions:
- Doxycycline exposure in schizophrenia patients is associated with a reduced incidence of disability pension.
- These findings support further research into doxycycline's potential long-term neuroprotective effects.
- Doxycycline may positively influence long-term functioning in schizophrenia patients.
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