Antibodies That Cause Encephalitis Linked to Psychosis

antibodies
Credit to flickr user Parthiv Haldipur. Used with permission under a Creative Commons license.

Psychosis, a break from reality, is a common feature of bipolar disorder. People can suffer delusions, hallucinations, depression, anxiety, and incoherent speech. The breaks are especially dangerous for postpartum women, who may harm their infants. The causes of psychosis are varied, ranging from mental illnesses such as schizophrenia or bipolar disorder, to sleep deprivation, substance abuse, or prescription drugs.

But new research has linked psychosis to antibodies that cause encephalitis, a life-threatening disease which inflames the brain. There is hope that removing these antibodies will treat psychosis just as much as doing so treats encephalitis. Some of the antibodies act against a nerve cell protein called NMDAR, or the NMDA receptor.

Belinda R. Lennox, a psychiatry professor at the University of Oxford in the United Kingdom, led a team of researchers who conducted a study on 228 people with first-episode psychosis. The scientists drew blood from the patients within the first six weeks of treatment. They also collected blood from a group of healthy people and used that as the control group for the study.

Seven–three percent–of the patients with first-episode psychosis presented with NMDAR antibodies. None of the controls did. A previous study from 2015 found that children experiencing their first episode of psychosis also had antibodies relating to the NMDAR.

The good news is that, Lennox and her team, using an experimental immunotherapy that targets the antibodies, successfully treated patients with psychosis, and helped them recover function after their episodes.

Three percent may not be much, but it’s three percent more of people who may be able to be treated with immunosuppressant therapies. This is a significant minority, one that shows promise. Lennox and her team plan to conduct a randomized, controlled trial of immune treatment in people with psychosis in 2017.

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