Antipsychotic meds show promise in treating meningitis


French scientists find common mental health drugs combat rapid and sometimes deadly brain infection. Andrew Masterson reports.


A computer illustration of a pair of Neisseria meningitidis bacteria, showing clearly the Type IV pili they use to attach to the inside of blood vessels.

KATERYNA KON/SCIENCE PHOTO LIBRARY/Getty Images

The serious and sometimes lethal effects of bacterial meningitis can be successfully treated using a commonly prescribed anti-psychotic medication – at least in mice – researchers in France have shown.

Meningitis is a term used to encompass several different forms of illness, all of which involve the inflammation of the meninges, or membranes, surrounding the brain and spinal cord. The most common cause is viral – resulting in cases that are generally mild – but more serious versions can be triggered by certain species bacteria, fungi and parasites.

One of the most worst forms is caused by a species of bacterium known as Neisseria meningitidis. Infection is swift and, in about 10% of cases, deadly. Symptoms include sudden onset high fever, stiff neck and headache.

N. meningitidis operates by using tiny hairlike appendages, known as Type IV pili, to attach to the insides of blood vessels, forming clumps. Existing antibiotics are not generally able to dissolve these formations.

Now, using mice as a model, a team headed by Kevin Denis, from France’s Institut Cochin in Paris, has shown that a class of anti-psychotic meds known as phenothiazines work very efficiently as clump-busters.

In a paper published in the journal Nature Microbiology, the scientists report that the drugs interrupt the function of the Type IV pili, breaking up existing N. meningitidis clusters and preventing the formation of new ones.

“These compounds exert a strong protective effect,” the authors write.

“They reduce meningococcal colonisation of the human vessels and prevent subsequent vascular dysfunctions, intravascular coagulation and overwhelming inflammation, the hallmarks of invasive meningococcal infections. Finally, they reduce lethality.”

Phenothiazines don’t actually kill the bacteria, but by disrupting the clumps they allow antibiotics to increase their own effect. The researchers thus report a two-pronged attack as optimal.

Denis and colleagues describe their work as “proof of concept”, and at this stage it remains to be determined whether the treatment strategy produces similar results in humans.

N. meningitidis is not the only pathogen that uses Type IV to induce infection, however, and the researchers suggest that deploying phenothiazines may be useful against other bacterial species that use the same method.

  1. https://www.nature.com/articles/s41564-019-0395-8
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