Psychosis Resolves After Cancer Treatment in Rare Case — Could Autoimmunity Be the Key?

A rare report of a woman who recovered from schizophrenia symptoms has drawn attention in the psychiatric community. Some researchers believe that a small number of people diagnosed with psychosis may actually have an autoimmune condition that affects the brain.

An article published in The New Yorker focused on a person named Mary who’d been diagnosed with schizophrenia at the age of 55. Mary lived with psychosis for 20 years. She experienced a complete remission — her psychotic symptoms disappeared — after receiving chemotherapy and an immune-targeting drug called rituximab to treat lymphoma.

The case study prompted some researchers to wonder whether Mary had a type of autoimmune psychosis rather than schizophrenia.

What Is Autoimmune Psychosis?

“Autoimmune psychosis” is a term some researchers use to describe cases where the body’s immune system mistakenly attacks the brain, causing symptoms that resemble schizophrenia — such as delusions, hallucinations, or disorganized thinking. In some of these cases, treating the immune system (rather than using standard antipsychotic drugs) may lead to improvement.

Scientists have already identified several antibodies that can trigger symptoms resembling psychosis. One of the most studied is a condition called anti-NMDA receptor encephalitis, which can mimic schizophrenia but responds well to immunotherapy in many cases.

Although these cases are thought to be rare, some health experts believe they are sometimes missed — especially in people with long-term or treatment-resistant psychosis.

Clinical Trials Are Testing Immune-Based Treatments

Although Mary’s case isn’t included in any published medical study, it’s not the only instance where psychosis seemed to improve with immune-based treatment. A small Swedish study using rituximab — the same drug Mary received — found improvement in people with treatment-resistant schizophrenia. Researchers have since started a randomized controlled trial to see whether a single infusion of rituximab can reduce symptoms in adults with schizophrenia spectrum disorders.

Additionally, a trial is underway in the United Kingdom to test whether a combination of immune therapies can help people who have psychosis and show signs of autoimmune activity.

Researchers at Columbia University’s Stavros Niarchos Foundation Center for Precision Psychiatry & Mental Health are also launching a large screening effort this year to identify people in psychiatric hospitals who may have treatable autoimmune conditions — including undiagnosed cases of autoimmune psychosis.

What This Means for People Living With Schizophrenia

Cases like Mary’s appear to be extremely rare, and most people with schizophrenia do not have an autoimmune cause. But the idea of autoimmune psychosis is gaining interest in the psychiatric community because it may help explain a small number of hard-to-treat cases.

For now, there’s no routine test to check for autoimmune psychosis, and rituximab is not an approved treatment for schizophrenia. However, if someone is experiencing new or treatment-resistant symptoms, especially with neurological changes (like seizures, confusion, or rapid decline), a doctor may consider testing for autoimmune causes.

If you or someone you care for is living with schizophrenia and not seeing improvements with current treatment, it may be worth starting a conversation with your doctor. In some cases, additional testing or referral to a neurologist may help rule out other potential causes — including rare autoimmune conditions. While these situations are uncommon, continuing to ask questions and explore options can be an important part of advocating for your care.

Learn about six treatment options for schizophrenia.

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