The Robert Koch Institute in Berlin (remember Koch’s Postulates?) earlier this year cancelled its research into Borna Disease Virus (BDV). That is really regrettable, because BDV, a neurotropic virus, may cause depression and bipolar disorder. BDV may be transmitted by blood transfusions; research on this is being carried out in Australia. There may even be an effective cure; an antiviral drug, amantadine sulfate, approved for use against the common flu.
Given the prevalence of depression and bipolar disorder, you should have thought that a decent randomized trial would have been carried out. A small trial would not cost more that a couple of hundred thousand dollars. But amantadine is a 30 year old drug, no longer covered by patents. There is practically no incentive for pharmaceutical firms to finance such a study. So far there has been none. Given the potential huge benefits and the low cost, that is a tragedy.
In the meantime, German and Austrian doctors are using amantadine and reportedly getting good results. However, we still need the solid evidence we would get from a well-designed randomized controlled trial.
Borna disease virus and the evidence for human pathogenicity: a systematic review. Authors: Chalmers, R.M.; Thomas, D.Rh.; Salmon, R.L.
Background: Borna disease is a neurological viral disease of veterinary importance in central Europe, although Borna Disease virus (BDV) has been reported to be present in animals in most continents. The hypothesis that BDV is associated with human illness is controversial. However, should even a small fraction of mental illness be attributable to infection with BDV, this would be an important finding, not least because illness in that sub-population would, theoretically, be preventable…
Discussion: Although agreed gold standard tests and evidence for test specificity are lacking, there is evidence that humans are exposed to the virus. Further epidemiological studies are required to establish whether there are associations with disease.
For a possible cure, see e.g.
Objective: Originally introduced into pharmacotherapy as an antiviral compound, amantadine was shown to also have multiple pharmacological effects on the central nervous system. In addition, only a few studies reported on certain antidepressive properties of amantadine. This effect was highlighted by the discovery of its antiviral effect on Borna disease virus (BDV), which is hypothesized to be an etiopathogenetic factor to subtypes of affective disorders. Therefore, the therapeutical use of amantadine in BDV-infected depressive patients was investigated…
Conclusion: Amantadine appears to show a remarkable antidepressive efficacy in BDV-infected depressive patients. The antidepressive effect in this open trial appeared to be comparable to standard antidepressives, possibly being a result of its antiviral effect against BDV as a potentially relevant etiopathogenetic factor in these disorders.