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The Stanley Research Center at Sheppard Pratt

Sheppard Pratt is the site of one of several research centers established by the Stanley Medical Research Institute of Bethesda, Maryland. The mission of the Institute, a not-for-profit medical foundation, is to support research on the causes and treatment of schizophrenia and bipolar disorder. Heading the Stanley Research Center at Sheppard Pratt is Faith Dickerson, Ph.D. Dr. Dickerson and her colleagues have just published in the Archives of General Psychiatry a study of 229 schizophrenia patients which shows that serum antibodies to a Herpes Simplex Virus (Type 1) are associated with relative cognitive impairments.

If validated, the study has large implications, including the possibility that some day antiviral agents could be used to treat schizophrenia. The idea that schizophrenia might be somehow caused by an environmental agent such as a virus has existed for some time. The evidence for this idea is tantalizing but not conclusive. For example, data have recently been analyzed from a large perinatal study that was started in the 1950’s and 60’s. Results indicate that among mothers who had antibodies to Herpes Simplex Virus (Type 2) an unexpectedly high number of offspring developed schizophrenia. Infectious agents, Dr. Dickerson explains, are but one way of looking at the etiology of this difficult disease, the causes of which remain unknown. Other conceptual etiologies include aberrant neurodevelopmental processes, neurotransmitter defects and deficiencies, structural brain alterations, and genetic factors. But the etiology of schizophrenia may not be unitary. For example, environmental agents or infections may simply sow the seeds for the ultimate development of a schizophrenia disease. It is only recently, she relates, that sophisticated immunoassay techniques have allowed this attempted detection of viral antibodies in blood from historical samples and from current patients.

Dr. Dickerson and her colleagues are conducting studies on the benefits of adjunctive anti-viral and antibiotic medications for persons with schizophrenia. Participants in these studies have at least moderate residual symptoms despite state-of-the-art medication treatment. A current double blind study is underway using Zithromax, versus a placebo, as an add-on medication. The Stanley group recently finished an open label study of Valtrex and is beginning a double blind placebo-controlled trial with the same compound. In the past the group performed a study with investigators at Chestnut Lodge on the efficacy of supplementation with omega three fatty acids (fish oil). This work, published in The American Journal of Psychiatry in 2001, showed there to be no specific benefit for patients taking the omega-3 fatty acids compared to patients who received a placebo, thus dispelling a popular belief about the efficacy of fish oil agents. Discussing these findings, the authors emphasize that available treatments for schizophrenia are often not adequate; reports of new drugs evoke great hope and even placebo responses. It is only through placebo-controlled trials that agents can be properly evaluated.

While the Stanley Medical Research Institute has generously funded studies at its Sheppard Pratt location, it is of note that Sheppard Pratt itself has a tradition of research and has historically encouraged its faculty to pursue investigations. Under the auspices of Sheppard Pratt, Dr. Dickerson had authored works on the stigma of mental illness and on the problem of insight in schizophrenia. At the current time, she is collaborating with researchers at the University of Maryland on studies about medical comorbidity in persons with serious mental illness. Dr. Dickerson relates that Sheppard Pratt has a large and diverse patient population and also wonderful staff that are helpful in carrying out research studies. Dr. Dickerson also considers herself fortunate in having excellent collaborators, including John Boronow, M.D., service chief of the Psychotic Disorders Program and medical director for adult services; Cassie Stallings, RNC, senior clinical research nurse; Andrea Origoni, database manager; and Sara Cole, assistant research project coordinator.

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Last modified: Monday, April 21, 2014

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