Eyes. Artist Mats Konradsson © Schizophrenia Federation

Schizophrenia - a form of rheumatoid arthritis in the brain?

Schizophrenia is an illness that often begins in adolescence or early youth and is usually lifelong. Although current medications can help keep the symptoms of psychosis under control, few people become completely symptom-free. The side effects of medication mean that many people do not want to take them either. In addition, people with schizophrenia have an increased morbidity in physical illnesses, especially immunological ones.

In recent years, several studies have demonstrated links between inflammation/autoimmunity and schizophrenia. One could hypothesize that schizophrenia is a disease similar to other autoimmune diseases, such as rheumatoid arthritis, but instead of the disease manifesting itself in destroyed joint cartilage, in schizophrenia it results in brain symptoms in the form of hallucinations and delusions.

Rituximab is a proven anti-inflammatory drug that is often used today for example in multiple sclerosis and severe rheumatoid arthritis. Between 2019 and 2022, Professor Susanne Bejerot at Örebro University Hospital conducted a pilot study in which severely ill people with schizophrenia were treated with rituximab on one occasion in addition to the regular antipsychotic treatment. Six out of nine patients improved significantly in their schizophrenia and reported fewer side effects. Because rituximab had never been tried before in mental illness, this pilot study, funded by the Torsten Söderberg Foundation, was groundbreaking.

Based on these positive results, Professor Bejerot is now proceeding with another study of rituximab treatment in schizophrenia, also funded by the Torsten Söderberg Foundation, among others. It is a placebo-controlled study that includes 104 adult patients from all over the country. Half of the participants will receive saline and half rituximab.

If this placebo-controlled, blinded study shows that rituximab significantly reduces psychotic symptoms and improves mood in people with schizophrenia, it is likely to revolutionize the understanding and treatment recommendations for schizophrenia and other similar conditions.

Research supported by the Torsten Söderberg Foundation.