Ocrelizumab for Psychosis by Autoimmunity

Inclusion criteria

• Individuals of either sex, 18-35 years of age.
• Having an active psychotic disorder meeting DSM-5 criteria, including a duration of at least six months, for Schizophrenia Spectrum Disorder, as defined by the Mini International Neuropsychiatric Interview (MINI).
• A total PANSS ≥ 60 and a score ≥ 4 on at least 2 of the PANSS positive symptoms.
• Normal academic performance at least until the age of 15 years and absence of psychiatric symptoms before the same age.
• Ability to assent or consent to the performance of the study and participate in testing procedures.

Exclusion criteria

• The dose of antipsychotic medication (if they are on one) has been changed less than two weeks prior to baseline PANSS testing (Visit 2, see below).
• Patient treated with a medication designed to suppress the immune system, other than standard analgesics or antipyretics, in the six months prior to randomization.
• Vaccinated with a live-attenuated vaccine less than 4 weeks before ocrelizumab infusion or with a non-live vaccine less than 2 weeks before infusion.
• Active infection, or history of or known presence of recurrent or chronic infection (for example, hepatitis B or C, Human Immunodeficiency Virus, syphilis, tuberculosis, PML).
• History of brain tumor, stroke, severe head trauma or multiple sclerosis.
• Active cancer, metabolic encephalopathy, severe cardiovascular or renal disease.
• In the judgment of the PI, psychosis related to substance abuse or metabolic disorders.
• Pregnancy or lactation.
• Requirement for chronic treatment with systemic corticosteroids or immunosuppressants during the course of the study.
• History of or currently active primary or secondary immunodeficiency.
• History of severe allergic or anaphylactic reactions to humanized or murine monoclonal antibodies.
• Contraindications to or intolerance of oral or IV corticosteroids.