Adjunctive minocycline in schizophrenia: what one well-conducted study can tell us (and what it cant)

Commentary on: Deakin B, Suckling J, Barnes TRE, et al. The benefit of minocycline on negative symptoms of schizophrenia in patients with recent-onset psychosis (BeneMin): a randomised, double-blind, placebo-controlled trial. Lancet Psychiatry 2018;5:885–94.

What is already known on this topic

Minocycline has been proposed as treatment for negative symptoms in schizophrenia due to its neuroprotective and anti-inflammatory properties. In two recent meta-analyses1 2 of randomised controlled trials (RCTs), minocycline outperformed placebo regarding total, general and negative symptoms. However, negative results of a large RCT (BeneMin)³ have been recently published.

Methods of the study

Population: Patients with first-episode schizophreniform disorder, schizoaffective disorder or schizophrenia within 5 years of illness onset, mild to moderate severity and positive symptoms (Positive and Negative Symptoms Scale (PANSS) items 1, 2, 3 and 6 scores >borderline).

Intervention: Minocycline 300 mg/day (n=104) versus placebo (n=103).

Outcomes: Primary outcome was prevention of PANSS negative subscale score worsening. Secondary outcomes included PANSS total and positive subscales, global…

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