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The Microbiota-Gut-Brain Axis in Mental Health and Medication Response: Parsing Directionality and Causality
Thomaz F S Bastiaanssen1, John F Cryan1
1Department of Anatomy and Neuroscience, School of Medicine, College of Medicine & Health, and APC Microbiome Ireland, University College Cork, Cork, Ireland.
Abstract:
There is increasing evidence for the role of the microbiome in various mental health disorders. Moreover, there has been a growing understanding of the importance of the microbiome in mediating both the efficacy and side effects of various medications, including psychotropics. In this issue, Tomizawa and colleagues report on the effect of psychotropic drugs on the gut microbiome of 40 patients with depression and/or anxiety disorders. In their longitudinal cohort, the authors find that antipsychotics, but not anxiolytics, decrease microbiome alpha diversity. They further find that antipsychotics dosage was negatively correlated with alpha diversity in these patients. The health consequences of these microbiome alterations remain to be fully understood. In this commentary, we will discuss such findings through the lens of several recent studies on the microbiota-gut-brain axis. We also use the paper as a backdrop to discuss directionality and, by extension, causality in relation to microbiota-gut-brain-brain signaling.
Insights
Antipsychotic medications significantly reduced gut microbiome diversity in patients with depression and anxiety. Higher antipsychotic doses correlated with lower microbiome diversity, suggesting a potential impact on the microbiota-gut-brain axis.
Area of Science:
- Neuroscience
- Microbiology
- Psychiatry
Background:
- Growing evidence links the microbiome to mental health disorders.
- The microbiome influences the efficacy and side effects of psychotropic medications.
Purpose of the Study:
- To investigate the impact of psychotropic drugs on the gut microbiome in patients with depression and/or anxiety disorders.
- To explore the relationship between psychotropic drug dosage and microbiome alterations.
Main Methods:
- Longitudinal cohort study of 40 patients with depression and/or anxiety disorders.
- Analysis of gut microbiome alpha diversity in relation to psychotropic medication use.
- Correlation analysis between antipsychotic dosage and microbiome diversity.
Main Results:
- Antipsychotics, unlike anxiolytics, were found to decrease microbiome alpha diversity.
- A negative correlation was observed between antipsychotic dosage and microbiome alpha diversity.
Conclusions:
- Antipsychotic use is associated with reduced gut microbiome diversity in patients with depression and anxiety.
- Further research is needed to understand the health consequences of these microbiome alterations and their role in the microbiota-gut-brain axis.
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