Is a "Mitochondrial Psychiatry" in the Future? A Review

Abstract

The field of "mitochondrial medicine" has advanced rapidly since the first patient with a mitochondrial disorder, a concept primarily used for defects of the respiratory chain, was described in 1962 and the first mitochondrial DNA (mtDNA) mutations were described in 1988. Because of the ubiquitous requirement for energy and unique aspects of mtDNA genetics, mtDNA mutations are known to cause a bewildering spectrum of clinical manifestations. However, because of its high-energy requirement, brain is the primary tissue affected in mitochondrial disorders. Using a variety of approaches, mitochondrial function has been shown in numerous studies to be abnormal in patients with schizophrenia and depression. Although less studied, an increase of psychiatric symptoms and disorders, in particular depression, are likely present in patients with mitochondrial disorders. The major categories of drugs used to treat schizophrenia and depression have been demonstrated to exert effects on mitochondria. The authors conclude that an association between energy metabolism and the mental disorders of schizophrenia and depression has been well documented, but that no conclusive evidence as yet demonstrates a causal relationship. A "mitochondrial psychiatry" model is proposed in which a moderate reduction in mitochondrial energy metabolism, genetically determined and/or acquired, is one predisposing factor in the multi-factorial development of certain chronic mental disorders. Clinical implications of our hypothesis, present and future, include the presence of co-morbid somatic symptoms/conditions, and specific treatment at least in highly-selected cases.

Micronutrients Versus Standard Medication Management in Autism: A Naturalistic Case–Control Study

“…It is possible that all of these mechanisms converge on a single, fundamental pathway, for which mitochondrial function is the likely candidate. It has been proposed that some psychiatric disorders, for instance, are actually mitochondrial diseases (Young 2007), because of demonstrated energy imbalance and mitochondrial dysfunction in schizophrenia and mood disorders (Kato and Kato 2000;Konradi et al 2004;Gardner and Boles 2005).…”

Efficacy and cost of micronutrient treatment of childhood psychosis

“…Much has been written lately about the role of proinflammatory effects and impaired mitochondrial function in fostering neurological and mental impairments 29 30. Enhancement of micronutrient intake would be expected to augment mitochondrial function; as well, many nutrients are powerful antioxidants and exert anti-inflammatory effects.…”

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“…18 An alternative model for explaining underlying mechanisms involves energy metabolism: for instance, it has been proposed that some mood symptoms represent a mitochondrial disease associated with decreased mitochondrial energy metabolism. 19,20 Perhaps micronutrients compensate for inadequate levels of mitochondrial activity.…”