F. Perry Wilson, MD
@fperrywilson.bsky.social
Director, Clinical and Translational Research Accelerator @Yale. Columnist @medscape.
How Medicine Works and When It Doesn't in bookstores now!
How Medicine Works and When It Doesn't in bookstores now!
Here's how that would mess things up:
Some kids who wouldn't normally need psychiatric care get pushed over that edge by doxycycline. Now they're in the study group, but they're actually the HEALTHIEST kids in that group.
Some kids who wouldn't normally need psychiatric care get pushed over that edge by doxycycline. Now they're in the study group, but they're actually the HEALTHIEST kids in that group.
November 6, 2025 at 6:42 PM
Here's how that would mess things up:
Some kids who wouldn't normally need psychiatric care get pushed over that edge by doxycycline. Now they're in the study group, but they're actually the HEALTHIEST kids in that group.
Some kids who wouldn't normally need psychiatric care get pushed over that edge by doxycycline. Now they're in the study group, but they're actually the HEALTHIEST kids in that group.
But I have doubts.
First, there's no clear dose-response effect. Higher doses should show stronger effects if this is causal. The medium dose looks best here, which is... odd.
First, there's no clear dose-response effect. Higher doses should show stronger effects if this is causal. The medium dose looks best here, which is... odd.
November 6, 2025 at 6:41 PM
But I have doubts.
First, there's no clear dose-response effect. Higher doses should show stronger effects if this is causal. The medium dose looks best here, which is... odd.
First, there's no clear dose-response effect. Higher doses should show stronger effects if this is causal. The medium dose looks best here, which is... odd.
The researchers did good work ruling out some obvious confounders. The main one? Acne. That's probably why these teens got doxycycline.
But when they looked at non-tetracycline acne drugs, no protective effect. So it's not just treating acne that helps.
But when they looked at non-tetracycline acne drugs, no protective effect. So it's not just treating acne that helps.
November 6, 2025 at 6:41 PM
The researchers did good work ruling out some obvious confounders. The main one? Acne. That's probably why these teens got doxycycline.
But when they looked at non-tetracycline acne drugs, no protective effect. So it's not just treating acne that helps.
But when they looked at non-tetracycline acne drugs, no protective effect. So it's not just treating acne that helps.
The results over 15 years:
- No doxycycline: 2.74% developed schizophrenia
- Low exposure: 2.22%
- Medium exposure: 1.42%
- High exposure: 2.0%
That's a 20-50% reduction. If real, this would be the first preventative treatment for schizophrenia.
- No doxycycline: 2.74% developed schizophrenia
- Low exposure: 2.22%
- Medium exposure: 1.42%
- High exposure: 2.0%
That's a 20-50% reduction. If real, this would be the first preventative treatment for schizophrenia.
November 6, 2025 at 6:41 PM
The results over 15 years:
- No doxycycline: 2.74% developed schizophrenia
- Low exposure: 2.22%
- Medium exposure: 1.42%
- High exposure: 2.0%
That's a 20-50% reduction. If real, this would be the first preventative treatment for schizophrenia.
- No doxycycline: 2.74% developed schizophrenia
- Low exposure: 2.22%
- Medium exposure: 1.42%
- High exposure: 2.0%
That's a 20-50% reduction. If real, this would be the first preventative treatment for schizophrenia.
The design choice here is smart. Comparing doxycycline users to ALL non-users would be messy. Maybe they just have better access to care or something. Using other antibiotics as the comparison group controls for that. Other differences were adjusted statistically.
November 6, 2025 at 6:41 PM
The design choice here is smart. Comparing doxycycline users to ALL non-users would be messy. Maybe they just have better access to care or something. Using other antibiotics as the comparison group controls for that. Other differences were adjusted statistically.
The new study uses Finland's national health database. They looked at 52,786 adolescents who had at least one psychiatric visit and received antibiotics.
About a third got doxycycline, the rest got other antibiotics.
Link: buff.ly/l9UUhQS
About a third got doxycycline, the rest got other antibiotics.
Link: buff.ly/l9UUhQS
November 6, 2025 at 6:41 PM
The new study uses Finland's national health database. They looked at 52,786 adolescents who had at least one psychiatric visit and received antibiotics.
About a third got doxycycline, the rest got other antibiotics.
Link: buff.ly/l9UUhQS
About a third got doxycycline, the rest got other antibiotics.
Link: buff.ly/l9UUhQS
Maybe schizophrenia is caused by an infection? This was actually a popular theory in the early 1900s. The bug most linked to schizophrenia (still weakly) is Toxoplasma.
But here's the problem: doxycycline doesn't work against Toxoplasma. So we need another explanation.
But here's the problem: doxycycline doesn't work against Toxoplasma. So we need another explanation.
November 6, 2025 at 6:41 PM
Maybe schizophrenia is caused by an infection? This was actually a popular theory in the early 1900s. The bug most linked to schizophrenia (still weakly) is Toxoplasma.
But here's the problem: doxycycline doesn't work against Toxoplasma. So we need another explanation.
But here's the problem: doxycycline doesn't work against Toxoplasma. So we need another explanation.
The use of doxycycline in childhood may protect against the future development of schizophrenia.
Wait... what?
This is one of those studies that makes you say "that can't be right." But maybe it is?
Let me walk you through this weird one.
Wait... what?
This is one of those studies that makes you say "that can't be right." But maybe it is?
Let me walk you through this weird one.
November 6, 2025 at 6:41 PM
The use of doxycycline in childhood may protect against the future development of schizophrenia.
Wait... what?
This is one of those studies that makes you say "that can't be right." But maybe it is?
Let me walk you through this weird one.
Wait... what?
This is one of those studies that makes you say "that can't be right." But maybe it is?
Let me walk you through this weird one.
Here's how that would mess things up:
Some kids who wouldn't normally need psychiatric care get pushed over that edge by doxycycline. Now they're in the study group, but they're actually the HEALTHIEST kids in that group.
Some kids who wouldn't normally need psychiatric care get pushed over that edge by doxycycline. Now they're in the study group, but they're actually the HEALTHIEST kids in that group.
November 6, 2025 at 6:39 PM
Here's how that would mess things up:
Some kids who wouldn't normally need psychiatric care get pushed over that edge by doxycycline. Now they're in the study group, but they're actually the HEALTHIEST kids in that group.
Some kids who wouldn't normally need psychiatric care get pushed over that edge by doxycycline. Now they're in the study group, but they're actually the HEALTHIEST kids in that group.
But I have doubts.
First, there's no clear dose-response effect. Higher doses should show stronger effects if this is causal. The medium dose looks best here, which is... odd.
First, there's no clear dose-response effect. Higher doses should show stronger effects if this is causal. The medium dose looks best here, which is... odd.
November 6, 2025 at 6:39 PM
But I have doubts.
First, there's no clear dose-response effect. Higher doses should show stronger effects if this is causal. The medium dose looks best here, which is... odd.
First, there's no clear dose-response effect. Higher doses should show stronger effects if this is causal. The medium dose looks best here, which is... odd.
The researchers did good work ruling out some obvious confounders. The main one? Acne. That's probably why these teens got doxycycline.
But when they looked at non-tetracycline acne drugs, no protective effect. So it's not just treating acne that helps.
But when they looked at non-tetracycline acne drugs, no protective effect. So it's not just treating acne that helps.
November 6, 2025 at 6:39 PM
The researchers did good work ruling out some obvious confounders. The main one? Acne. That's probably why these teens got doxycycline.
But when they looked at non-tetracycline acne drugs, no protective effect. So it's not just treating acne that helps.
But when they looked at non-tetracycline acne drugs, no protective effect. So it's not just treating acne that helps.
The results over 15 years:
- No doxycycline: 2.74% developed schizophrenia
- Low exposure: 2.22%
- Medium exposure: 1.42%
- High exposure: 2.0%
That's a 20-50% reduction. If real, this would be the first preventative treatment for schizophrenia.
- No doxycycline: 2.74% developed schizophrenia
- Low exposure: 2.22%
- Medium exposure: 1.42%
- High exposure: 2.0%
That's a 20-50% reduction. If real, this would be the first preventative treatment for schizophrenia.
November 6, 2025 at 6:39 PM
The results over 15 years:
- No doxycycline: 2.74% developed schizophrenia
- Low exposure: 2.22%
- Medium exposure: 1.42%
- High exposure: 2.0%
That's a 20-50% reduction. If real, this would be the first preventative treatment for schizophrenia.
- No doxycycline: 2.74% developed schizophrenia
- Low exposure: 2.22%
- Medium exposure: 1.42%
- High exposure: 2.0%
That's a 20-50% reduction. If real, this would be the first preventative treatment for schizophrenia.
The design choice here is smart. Comparing doxycycline users to ALL non-users would be messy. Maybe they just have better access to care or something. Using other antibiotics as the comparison group controls for that. Other differences were adjusted statistically.
November 6, 2025 at 6:39 PM
The design choice here is smart. Comparing doxycycline users to ALL non-users would be messy. Maybe they just have better access to care or something. Using other antibiotics as the comparison group controls for that. Other differences were adjusted statistically.
The new study uses Finland's national health database. They looked at 52,786 adolescents who had at least one psychiatric visit and received antibiotics.
About a third got doxycycline, the rest got other antibiotics.
Link: buff.ly/l9UUhQS
About a third got doxycycline, the rest got other antibiotics.
Link: buff.ly/l9UUhQS
November 6, 2025 at 6:39 PM
The new study uses Finland's national health database. They looked at 52,786 adolescents who had at least one psychiatric visit and received antibiotics.
About a third got doxycycline, the rest got other antibiotics.
Link: buff.ly/l9UUhQS
About a third got doxycycline, the rest got other antibiotics.
Link: buff.ly/l9UUhQS
Maybe schizophrenia is caused by an infection? This was actually a popular theory in the early 1900s. The bug most linked to schizophrenia (still weakly) is Toxoplasma.
But here's the problem: doxycycline doesn't work against Toxoplasma. So we need another explanation.
But here's the problem: doxycycline doesn't work against Toxoplasma. So we need another explanation.
November 6, 2025 at 6:39 PM
Maybe schizophrenia is caused by an infection? This was actually a popular theory in the early 1900s. The bug most linked to schizophrenia (still weakly) is Toxoplasma.
But here's the problem: doxycycline doesn't work against Toxoplasma. So we need another explanation.
But here's the problem: doxycycline doesn't work against Toxoplasma. So we need another explanation.
So what actually killed them? Primarily Salmonella enterica paratyphi - the agent of paratyphoid fever. Think supercharged food poisoning from fecal-contaminated food and water. Not glamorous, but those camp conditions were perfect for it.
October 29, 2025 at 9:07 PM
So what actually killed them? Primarily Salmonella enterica paratyphi - the agent of paratyphoid fever. Think supercharged food poisoning from fecal-contaminated food and water. Not glamorous, but those camp conditions were perfect for it.
In 2006, researchers (yes, THAT Didier Raoult) used PCR on body lice from soldiers' graves in Lithuania. They found Rickettsia prowazekii, the agent of epidemic typhus. Case closed, right?
Not so fast.
Not so fast.
October 29, 2025 at 9:07 PM
In 2006, researchers (yes, THAT Didier Raoult) used PCR on body lice from soldiers' graves in Lithuania. They found Rickettsia prowazekii, the agent of epidemic typhus. Case closed, right?
Not so fast.
Not so fast.
The classic explanation has always been epidemic typhus—spread by body lice in the unsanitary camps. The symptoms matched: fever, delirium, diarrhea. Physicians at the time documented it. And yes, there were definitely lice. Lots of them.
October 29, 2025 at 9:07 PM
The classic explanation has always been epidemic typhus—spread by body lice in the unsanitary camps. The symptoms matched: fever, delirium, diarrhea. Physicians at the time documented it. And yes, there were definitely lice. Lots of them.
Picture this: 1812. You're marching east with 600,000 soldiers in the Grande Armée. You think you're invincible. What you don't know? Only 3-4 out of every 100 of you will make it home.
October 29, 2025 at 9:07 PM
Picture this: 1812. You're marching east with 600,000 soldiers in the Grande Armée. You think you're invincible. What you don't know? Only 3-4 out of every 100 of you will make it home.
So what actually killed them? Primarily Salmonella enterica paratyphi - the agent of paratyphoid fever. Think supercharged food poisoning from fecal-contaminated food and water. Not glamorous, but those camp conditions were perfect for it.
October 29, 2025 at 9:06 PM
So what actually killed them? Primarily Salmonella enterica paratyphi - the agent of paratyphoid fever. Think supercharged food poisoning from fecal-contaminated food and water. Not glamorous, but those camp conditions were perfect for it.
In 2006, researchers (yes, THAT Didier Raoult) used PCR on body lice from soldiers' graves in Lithuania. They found Rickettsia prowazekii, the agent of epidemic typhus. Case closed, right?
Not so fast.
Not so fast.
October 29, 2025 at 9:06 PM
In 2006, researchers (yes, THAT Didier Raoult) used PCR on body lice from soldiers' graves in Lithuania. They found Rickettsia prowazekii, the agent of epidemic typhus. Case closed, right?
Not so fast.
Not so fast.
The classic explanation has always been epidemic typhus—spread by body lice in the unsanitary camps. The symptoms matched: fever, delirium, diarrhea. Physicians at the time documented it. And yes, there were definitely lice. Lots of them.
October 29, 2025 at 9:06 PM
The classic explanation has always been epidemic typhus—spread by body lice in the unsanitary camps. The symptoms matched: fever, delirium, diarrhea. Physicians at the time documented it. And yes, there were definitely lice. Lots of them.
Picture this: 1812. You're marching east with 600,000 soldiers in the Grande Armée. You think you're invincible. What you don't know? Only 3-4 out of every 100 of you will make it home.
October 29, 2025 at 9:06 PM
Picture this: 1812. You're marching east with 600,000 soldiers in the Grande Armée. You think you're invincible. What you don't know? Only 3-4 out of every 100 of you will make it home.
So what we may be seeing is a revival of a very old idea.
In 1891, William Coley noticed that some cancer patients recovered after bacterial infections. He suspected the infection jolted the immune system awake, and devoted his life to testing that theory.
In 1891, William Coley noticed that some cancer patients recovered after bacterial infections. He suspected the infection jolted the immune system awake, and devoted his life to testing that theory.
October 22, 2025 at 3:26 PM
So what we may be seeing is a revival of a very old idea.
In 1891, William Coley noticed that some cancer patients recovered after bacterial infections. He suspected the infection jolted the immune system awake, and devoted his life to testing that theory.
In 1891, William Coley noticed that some cancer patients recovered after bacterial infections. He suspected the infection jolted the immune system awake, and devoted his life to testing that theory.
Mechanistically, mRNA seems to “wake up” the innate immune system, the body’s first-responder defense, amplifying the effect of checkpoint inhibitors.
When the researchers used unmodified uridine vaccines (more immunogenic, more side effects), tumors shrank even more.
When the researchers used unmodified uridine vaccines (more immunogenic, more side effects), tumors shrank even more.
October 22, 2025 at 3:26 PM
Mechanistically, mRNA seems to “wake up” the innate immune system, the body’s first-responder defense, amplifying the effect of checkpoint inhibitors.
When the researchers used unmodified uridine vaccines (more immunogenic, more side effects), tumors shrank even more.
When the researchers used unmodified uridine vaccines (more immunogenic, more side effects), tumors shrank even more.