Antipsychotics miss important symptoms, and yoga helps fill the gap
STUDY: Mullapudi T et al, Behavioral Medicine 2026
STUDY TYPE: Randomized controlled trial
FUNDING: DBT-Wellcome Trust India Alliance
Background
Yoga has shown benefits in prior trials on mood, social functioning, and quality of life in schizophrenia. This small trial tested whether it also shifts immune markers thought to drive the illness.
The Study
- 66 patients with schizophrenia on stable antipsychotics, randomized to yoga therapy (n=33) or treatment as usual (n=33); 59 completed three months.
- The yoga group received 20 supervised 60-minute sessions over four weeks, then continued home practice three times weekly for eight weeks.
- Primary outcomes included clinical scales and immune biomarkers (cytokines and complement proteins).
Results
The yoga group improved on positive symptoms (Positive Symptoms scale (SAPS)), negative symptoms (Negative Symptoms scale (SANS)), and global illness severity (Clinical Global Impression (CGI)) compared to the treatment-as-usual group. Verbal fluency and social functioning also improved with yoga. Quality of life scores (WHOQOL-BREF) favored yoga in the psychological and environmental domains.
On the biological side, the yoga group showed reductions in plasma IL-1β, an inflammatory cytokine consistently elevated in schizophrenia. Gene expression of two pro-inflammatory markers (IL-1b, IL-6) also fell, while expression of C4 — a complement protein linked to synaptic pruning — rose. The authors interpret these as signals that yoga may work partly through immune modulation, though these findings are exploratory and shouldn’t be over-interpreted.
Limitations
Small sample, no active control group, participants not blinded to treatment, and home practice was tracked by self-report only.
Practice Implications
- If your patient is open to yoga, encourage it as an add-on to antipsychotics for mood, cognition, and negative symptoms in schizophrenia.
—Chris Aiken, MD
Director, Psych Partners
Editor in Chief, Carlat Psychiatry Report
