Minocycline augmentation of Clozapine for Treatment Resistant Schizophrenia: A Multicentre randomised double-blind placebo-controlled trial (MAC)

Schizophrenia is a chronic disabling mental illness. Despite of major advances in the anti-psychotic medicines , One third of patient do not respond adequately to the anti-psychotic medicines. Treatment resistant schizophrenia (TRS), thus has become a major public health concern especially in low income countries such as Pakistan. Clozapine, an atypical antipsychotic is best alternative for such resistant patients but still 70% of the patients treated with Clozapine, respond only partially and continue to have debilitating symptoms (Chakos, Lieberman, Hoffman, Bradford, & Sheitman, 2001). There is now ample evidence that Minocycline, a lipophilic antibiotic from tetracycline family has therapeutic potential in Schizophrenia. This is a 12-week, mutli-center (Rawalpindi, Karachi, Hyderabad and Quetta) randomized double-blind placebo controlled trial of minocycline added to clozapine (Treatment as Usual) in TRS would be the first such study in the Pakistan.