ANTIMICROBIAL AGENTS – POTENTIAL ROLE
IN HUMAN PSYCHIATRIC DISEASES
Robert H. Yolken, Stanley Division of
Developmental Neurovirology, Johns Hopkins University School of Medicine
There is a growing consensus that most
diseases which are prevalent in the human population are complex disorders
caused by the interaction between genetic and environmental determinants.
I hypothesize that schizophrenia and bipolar disorder are complex disorders and
that many cases are caused by the occurrence of infections and other
environmental insults in genetically susceptible individuals. If this
hypothesis is correct, the natural history of schizophrenia and bipolar disorder
can be altered by the prevention and treatment of infection in such individuals.
There are a number of available
therapeutic agents which can modify the course of infectious diseases in humans.
These include antibiotics, anti-viral agents, anti-parasitic agents, and
modulators of the immune system. I will review microbial pathogens which may be
involved in the etiopathogenesis of human psychiatric disorders and
pharmacological interventions which are currently available for their prevention
and treatment. Most antimicrobial medications have very low toxicity and
are suitable for clinical trials in which they are administered along with
standard psychoactive medications over prolonged periods of time. The
evaluation of anti-microbial medications in carefully controlled clinical trials
of the treatment of psychiatric disorders will provide crucial information
related to the etiology of these diseases and may result in novel methods for