Minocycline (Minocin)
Antibiotic (antiinflammatory, inhibits glutamate release)
- Treatment Resistant Depression4, particularly with inflammation2
- Lithium-acne
- Schizophrenia negative symptoms3
- OCD3
Features
Dosing
50mg 1 qd x7days, then 1 bid x7 days then 2 bid.
May work better combined with low -dose aspirin (81mg) for mood.
INTERACTIONS: May accentuate effects of anticoagulants; absorption decreased by antacids containing aluminum, calcium, magnesium, or iron.
Management
Give with probiotic since this is an antibiotic. Works best when hs-CRP elevated > 3.
TOLERABILITY: Diarrhea, headache, dizziness, photosensitivity.
RISKS: Rare hepatotoxicity.
EMR Text
Depression
Minocycline use based on randomized controlled trials in depression (Qiu Y et al, Front Psychiatry. 2023;14:1139273).
Minocycline side effect, including liver, reviewed with patient.
OCD
Minocycline use based on randomized controlled trials in OCD (Esalatmanesh S et al, Psychiatry Clin Neurosci. 2016;70(11):517-526).
Minocycline side effect, including liver, reviewed with patient.
Schizophrenia
Minocycline use based on randomized controlled trials where it improved negative and cognitive symptoms of schizophrenia (Zhang L et al, Schizophr Res. 2019;212:92-98).
Minocycline side effect, including liver, reviewed with patient.