Is there a link between Schizophrenia and Fibromyalgia and ME/CFS?

[pattismith]

three articles released in 2020 and 2021 deal with Fibro and CFS symptoms in Schizophrenia patients.

Let's see if there is anything interesting we may learn from it:

Chronic fatigue and fibromyalgia symptoms are key components of deficit schizophrenia and are strongly associated with activated immune-inflammatory pathways - ScienceDirect

Chronic fatigue syndrome and fibromyalgia-like symptoms are an integral component of the phenome of schizophrenia: neuro-immune and opioid system correlates | SpringerLink

In schizophrenia, chronic fatigue syndrome- and fibromyalgia-like symptoms are driven by breakdown of the paracellular pathway with increased zonulin and immune activation-associated neurotoxicity | medRxiv

 

[pattismith]

@Hip , they studied CCL11 in this patient cohort:

There is now evidence that schizophrenia and especially deficit schizophrenia (DefSCZ) (a phenotype characterized by negative symptoms) is accompanied by activated immune-inflammatory pathways.

A subset of patients with schizophrenia and DefSCZ experience physiosomatic symptoms reminiscent of chronic fatigue and fibromyalgia.

However, there are no data whether, in DefSCZ, physiosomatic symptoms are associated with increased levels of cytokines/chemokines.

This study examined the associations between physiosomatic symptoms, as assessed with the FibroFatigue (FF) scale, and symptoms of DefSCZ as well as interleukin IL-1β, IL-1 receptor antagonist (sIL-1RA), tumor necrosis factor (TNF)-α and CCL11 (eotaxin) in 120 DefSCZ patients (as defined by the Schedule for Deficit Schizophrenia) and 54 healthy controls.
...

Interleukin IL-1β, IL-1RA, TNF-α and CCL11 explained 59.4% of the variance in the LV extracted from the FF and DefSCZ symptoms.

In conclusion, these data show that physiosomatic symptoms are a core component of DefSCZ phenomenology and are strongly associated with activated immune pathways, which have neurotoxic effects.

 

[pattismith]

Same cohort?

We measured neuro-immune markers including plasma CCL11 (eotaxin), interleukin-(IL)-6, IL-10, Dickkopf protein 1 (DKK1), high mobility group box 1 protein (HMGB1) and endogenous opioid system (EOS) markers including κ-opioid receptor (KOR), μ-opioid receptor (MOR), endomorphin-2 (EM2) and β-endorphin.

Patients with an increased FF score display increased ratings of psychosis, hostility, excitement, formal though disorders, psycho-motor retardation and negative symptoms as compared with patients with lower FF scores.

A large part of the variance in the FF score (55.1%) is explained by the regression on digit sequencing task, token motor task, list learning, IL-10, age (all inversely) and IL-6 (positively).

Neural network analysis shows that the top-6 predictors of the FF score are (in descending order): IL-6, HMGB1, education, MOR, KOR and IL-10.

We found that 45.1% of the variance in a latent vector extracted from cognitive test scores, schizophrenia symptoms and the FF score was explained by HMGB1, MOR, EM2, DKK1, and CCL11.

Physiosomatic symptoms are an integral part of the phenome of schizophrenia.

Neurotoxic immune pathways and lowered immune regulation coupled with alterations in the EOS appear to drive the physiosomatic symptoms of schizophrenia.

 

[Springbok1988]

I have been wondering about this for the last several weeks based on my own symptoms (negative symptoms only, no positive symptoms like hallucinations). Based on this idea I tried taking sarcosine, a supplement that has been shown to help people with schizophrenia. I felt large improvements in my symptoms. I felt connected to my body again and had more energy. I still experienced emotional blunting but I felt alive again. The problem with sarcosine is that it keeps me awake for the following two nights after taking it.
I also feel some improvement from taking glycine which has also been shown to help those with schizophrenia. I might try D-serine next but it’s harder to find.
I find that medications and supplements that lower NMDA activity (like memantine, oxaloacetate, and agmatine) make me feel very depressed. Ones that increase activity make me feel better but more emotionally blunted.
Thank you for this information! It backs up what I’ve been thinking already.

 

[pattismith]

I have been wondering about this for the last several weeks based on my own symptoms (negative symptoms only, no positive symptoms like hallucinations). Based on this idea I tried taking sarcosine, a supplement that has been shown to help people with schizophrenia. I felt large improvements in my symptoms. I felt connected to my body again and had more energy. I still experienced emotional blunting but I felt alive again. The problem with sarcosine is that it keeps me awake for the following two nights after taking it.
I also feel some improvement from taking glycine which has also been shown to help those with schizophrenia. I might try D-serine next but it’s harder to find.
I find that medications and supplements that lower NMDA activity (like memantine, oxaloacetate, and agmatine) make me feel very depressed. Ones that increase activity make me feel better but more emotionally blunted.
Thank you for this information! It backs up what I’ve been thinking already.

Thank you too for sharing your experimentations!
You make me feel sarcosine might help me, I will try it

 

[Hip]

I've researched possible treatments for the negative symptoms of schizophrenia quite a bit, because some of my mental symptoms I have with my ME/CFS are negative symptoms.

The negative symptoms of schizophrenia are:

1. Apathy

The person may have a lack of interest in activities that previously were important to them such as their work or studies or recreational activities such as sports. They may also stop looking after themselves properly and their personal hygiene and appearance may suffer noticeably. They may be reluctant to leave the house or even their bedroom and may lie in bed for the larger part of the day.

2. Absent, blunted or incongruous emotional responses

People with schizophrenia experiencing negative symptoms may appear to display no reaction to good or bad news or to react inappropriately for instance laughing at sad news or appearing to become unhappy when hearing good news.

3. Reductions in speech

People with negative symptoms of schizophrenia may appear to have little interest in conversation and may give only very brief responses to questions. Their speech may be disrupted or there may be long pauses in the flow of their speech or in responding to conversation (known as poverty of speech). The ability to make small talk is often completely lost and this loss of vital communication skills can impact seriously on the person’s ability to take part in social activities or find employment7. This is also called alogia by doctors. In extreme cases the person may become completely mute.

4. Social withdrawal

The person may shun social contact and may prefer to spend the larger part of the day and night by themselves. There is a general lack of will to interact with the world around them. This is called avolition by doctors

5. Impaired attention

There may be an obvious difficulty in concentrating during conversation and an inability to concentrate on even simple tasks.

6. Anhedonia

This describes an inability to experience pleasure. People with schizophrenia who experience this often describe life as being grey or empty, devoid of the normal emotional ups and downs that we all take for granted7. Others have described it as feeling empty or hollow10.

7. Sexual problems

There may be a significant reduction or total absence of libido (sex drive), men may experience problems in achieving erections and both men and women may have problems achieving an orgasm (anorgasmia).

8. Lethargy

People with schizophrenia experiencing negative symptoms will often have a profound lack of energy and find it difficult to do any more than light activity. This may lead to them spending a large part of the day in bed or watching television.

Source: here

My symptoms are anhedonia, blunted emotions, social withdrawal (and of course lethargy, like most ME/CFS patients). The only thing I have found to improve these symptoms is low-dose amisulpride, which helps the social withdrawal. I have a thread on this here.


Schizophrenia in which there are only the negative symptoms, but no positive symptoms, is sometimes called simple schizophrenia.

Some treatment for simple schizophrenia symptoms that I found are listed below. But I have not noticed much benefit from these, apart from amisulpride.



Treatments for Negative Schizophrenia Symptoms

Good summary of treatments: Treating Negative Symptoms in Schizophrenia: an Update

Statins may reduce negative symptoms of schizophrenia. 1

Carnosine reduces negative symptoms, but not positive. 1

Maprotiline improves the negative symptoms of schizophrenia by a noradrenaline potentiating action. 1

Low doses of amisulpride (100 to 300 mg) or olanzapine (10 to 20 mg) beneficial for the negative symptoms of schizophrenia. 1

Sarcosine 1 to 2 grams daily beneficial for the negative symptoms of schizophrenia. 1

Agomelatine effective for negative symptoms. 1

Galantamine may be effective for negative symptoms. 1

Piracetam for negative symptoms? 1

Oxytocin has shown particular promise in its potential to treat the intractable negative symptoms and social cognitive deficits. 1

Pregnenolone and DHEA improve negative symptoms. 1

Pregnenolone plus L-theanine for negative symptoms and anxiety. 1

5-HT3 antagonists (ondansetron, tropisetron, granisetron) help negative symptoms. 1 2 Lemon essential oil is a potent 5-HT3 antagonist (beta-pinene content of this oil is a 5-HT3 antagonist).

5-HT2 antagonists (ritanserin) help negative symptoms. 1

List of 5-HT2 antagonists, includes mirtazapine.

N-acetyl-cysteine improves negative symptoms. 1

COX-2 inhibitors like celecoxib help negative symptoms. 1

MIN-101 for negative symptoms. 1



I also now and then get days when I have these very mild psychosis symptoms (which I find very unpleasant). I found the drug amiloride (a diuretic) really effective for these. Other substances which help my mild psychosis listed at the bottom of this post.

 

[Springbok1988]

Low doses of amisulpride (100 to 300 mg) or olanzapine (10 to 20 mg) beneficial for the negative symptoms of schizophrenia. 1

@Hip, where do you source amisulpride?

 

[Hip]

@Hip, where do you source amisulpride?

It's available in Europe, but not the US. But you can buy from any of the prescription-free pharmacies listed a the bottom of the first post in this thread .

 

[wastwater]

Complement immune system maybe a link to both

 

[pattismith]

@Hip , did you try Minocycline?

Possible antipsychotic effects of minocycline in patients with schizophrenia

doi:10.1016/j.pnpbp.2006.08.013 (medicinabiomolecular.com.br)

 

[Hip]

@Hip , did you try Minocycline?

Yes, after just one pill, it caused a sharp pain within the bone or the joint of one of my toes. I stopped taking minocycline immediately, but even then, the pain persisted for months.

I never experienced such a pain previously or since.

 

[pattismith]

Yes, after just one pill, it caused a sharp pain within the bone or the joint of one of my toes. I stopped taking minocycline immediately, but even then, the pain persisted for months.

I never experienced such a pain previously or since.

That's interesting,
I took minocycline when I was young in the heighties for acne but never experienced pain reaction at that time.

In 2011, I took it again for skin purpose and then was hit by a burning spine, which stopped only after I stopped minocycline;

Then some years later, in 2017 this burning spine came back spontaneously, and I got rid of it only weeks later, after taking Azithromycin (I had this antibiotic prescription for respiratory disease)!

 

[Gmorl69]

I've researched possible treatments for the negative symptoms of schizophrenia quite a bit, because some of my mental symptoms I have with my ME/CFS are negative symptoms.

The negative symptoms of schizophrenia are:

Source: here

My symptoms are anhedonia, blunted emotions, social withdrawal (and of course lethargy, like most ME/CFS patients). The only thing I have found to improve these symptoms is low-dose amisulpride, which helps the social withdrawal. I have a thread on this here.


Schizophrenia in which there are only the negative symptoms, but no positive symptoms, is sometimes called simple schizophrenia.

Some treatment for simple schizophrenia symptoms that I found are listed below. But I have not noticed much benefit from these, apart from amisulpride.



Treatments for Negative Schizophrenia Symptoms

Good summary of treatments: Treating Negative Symptoms in Schizophrenia: an Update

Statins may reduce negative symptoms of schizophrenia. 1

Carnosine reduces negative symptoms, but not positive. 1

Maprotiline improves the negative symptoms of schizophrenia by a noradrenaline potentiating action. 1

Low doses of amisulpride (100 to 300 mg) or olanzapine (10 to 20 mg) beneficial for the negative symptoms of schizophrenia. 1

Sarcosine 1 to 2 grams daily beneficial for the negative symptoms of schizophrenia. 1

Agomelatine effective for negative symptoms. 1

Galantamine may be effective for negative symptoms. 1

Piracetam for negative symptoms? 1

Oxytocin has shown particular promise in its potential to treat the intractable negative symptoms and social cognitive deficits. 1

Pregnenolone and DHEA improve negative symptoms. 1

Pregnenolone plus L-theanine for negative symptoms and anxiety. 1

5-HT3 antagonists (ondansetron, tropisetron, granisetron) help negative symptoms. 1 2 Lemon essential oil is a potent 5-HT3 antagonist (beta-pinene content of this oil is a 5-HT3 antagonist).

5-HT2 antagonists (ritanserin) help negative symptoms. 1

List of 5-HT2 antagonists, includes mirtazapine.

N-acetyl-cysteine improves negative symptoms. 1

COX-2 inhibitors like celecoxib help negative symptoms. 1

MIN-101 for negative symptoms. 1



I also now and then get days when I have these very mild psychosis symptoms (which I find very unpleasant). I found the drug amiloride (a diuretic) really effective for these. Other substances which help my mild psychosis listed at the bottom of this post.

 

[Gmorl69]

HI HIP,
I followed up on your advice about KAVA, and managed to get some from a pet supplier in uk (bulk powder form that strained after mixing with warm water) as a drink.
Yes this stuff actually works.
I have got a replacement for alcohol now.
It lets me relax in a similar way to alcohol but non of the bad affects or hangover.
I’m a bit concerned about using it with the medication I’m on
Trifluroperazine and clozapine but am able to get my liver checked each month.
Thankyou for telling me about it.

Can I ask you one thing that’s very important to me.
I want to get off the low dose of clozapine 20mg I’m on and many people have said that Perphenazine (Trilafon)is a good one to replace it with as it’s similar to trifluroperazine but has sedation for sleep.
It used to be prescribed as a tablet with amitriptline included

https://en.m.wikipedia.org/wiki/Amitriptyline/perphenazine

Unfortunately it’s no longer prescribed in uk as it’s an old drug and has been superseded by the newer atypicals that I’ve never got on with.
Do you have a list of online reputable pharmacies (I think you listed them in one of your posts)
I’ve used buy-pharma and United pharmacies before but they don’t stock it.
Perphenazine is still prescribed in the USA and Canada but not in Europe or even India. So I’m looking for a reputable Canadian or USA pharmacist.
Thanks
Greg morley

 

[Hip]

Do you have a list of online reputable pharmacies (I think you listed them in one of your posts)
I’ve used buy-pharma and United pharmacies before but they don’t stock it.

The list of reputable pharmacies is here.

From that list, the following pharmacies stock clozapine:
https://www.buy-pharma.md/Products/search?keyword=clozapine
https://www.generics.greencrosspharmacy.online/search-results?q=clozapine
https://otc-online-store.com/azaleptin-buy-online-clozapine
http://www.schickersunichem.co.nz/buy-clozaril-in-nz.html
https://www.indianpharma.co/buy_clozaril_us.html

 

[Shanti1]

Sarcosine 1 to 2 grams daily beneficial for the negative symptoms of schizophrenia

Thank you for posting the list above on treatments for the negative symptoms of schizophrenia. The sarcosine has been a winner for me. I found it helps me feel more at ease socially, less irritable, and lessens the aversion to social interaction. This is similar to the help I get from amisulpride, but I can't take amisulpride every day (I use it as a rescue medication - also helps with sound sensitivity). So far, I've been able to take sarcosine daily. I'm on week two, so early days.... not sure how long the benefit will last, but fingers crossed.

I've been combining it with a small dose of magnesium L-threonate for cognition, and that has been working well.

 

[bob800]

The sarcosine has been a winner for me.

Hi @Shanti1, thanks for reporting on this. I'm curious if you have noticed any adverse effects on sleep quality or initiation - these seem to be commonly mentioned elsewhere on the Internet.

Does you find the sarcosine improves your energy and/or alertness? (curious as these are my main issues)

 

[Shanti1]

Hi @bob800 ,
The sarcosine also helps my energy, alertness, and focus as well. I'm on week 3 now and if anything, it seems to be more effective than when I first started, which is unusual. I also have been experiencing a feeling of relief and sometimes plain happiness to not dread social interaction and to feel more natural relating.

I'm really sensitive to things, so I am only using 250mg in the morning, but I understand most people need around 1-3g. I'm using this brand: https://nootropicsdepot.com/sarcosi...SXMfo3RXsKbWcGSJSpk_K-O-gYzCZTtTKY8dL6RYoTBzU

I have noticed that I am more likely now to wake up at 3am and be up for an hour, but I still fall asleep ok. I've always tended toward hypersomnia instead of insomnia, so it hasn't really been an issue for me.

Hope all of this lasts. Three weeks is still to early to know if my body will continue to accept sarcosine and respond well.

 

[Dysfunkion]

Hi @bob800 ,
The sarcosine also helps my energy, alertness, and focus as well. I'm on week 3 now and if anything, it seems to be more effective than when I first started, which is unusual. I also have been experiencing a feeling of relief and sometimes plain happiness to not dread social interaction and to feel more natural relating.

I'm really sensitive to things, so I am only using 250mg in the morning, but I understand most people need around 1-3g. I'm using this brand: https://nootropicsdepot.com/sarcosi...SXMfo3RXsKbWcGSJSpk_K-O-gYzCZTtTKY8dL6RYoTBzU

I have noticed that I am more likely now to wake up at 3am and be up for an hour, but I still fall asleep ok. I've always tended toward hypersomnia instead of insomnia, so it hasn't really been an issue for me.

Hope all of this lasts. Three weeks is still to early to know if my body will continue to accept sarcosine and respond well.

Not sure if your still around but around that does as I only the 500 mg capsules is what I'm going to try tomorrow. I was considering that brand but every time I divide up tablets it never goes well so I went for the capsules, there wasn't too many options out there. Doesn't appear to be as widely trialed but from what I was able to dig up this stuff tends to go a few ways with people. They feel great at high doses and are able to stay there with no issues. Have one amazing day with it but if they repeat the dose another day it all goes south and gets worse with every next day they use it. They immediately have an a ridiculous spike in anxiety and get very rage-y. Or they don't respond at all to it. I'm planning on if it works out trying every 3 days since that seems safest if I decide to continue taking it.

I first heard of it when I was browsing the POIS subreddit from someone who had success with it in resolving a lot of their symptoms. The same exact symptoms a couple other found relief from in the autism subreddit. The other forums I can find on autism aren't very medically focused in finding relief so there's no results on there for anything like this. I also saw a lot of posts on the schizophrenia sub for this with some people who had success in it negating the neggative symptoms which I need help with, some other had not so great experiences with it general spiking anxiety levels through the roof but this happening was almost always 1000 mg+ doses.

 

[Shanti1]

Hi @Dysfunkion, Sadly, like most things, the sarcosine wore off about three weeks after writing the post you responded to and I haven't been able to get the same response on reintroduction. The story of almost anything that helps, but at least I get temporary responses to things.

I actually have had some improvements lately, but is related to discovering and getting rid of mold in the house... another story for another thread.