Gut Microbiota Modulation in CNS Disorders: Therapeutic Strategies and Implications for Drug Efficacy

Various central nervous system (CNS) disorders, including neurodegenerative diseases, depression, schizophrenia, epilepsy, and anxiety, present significant obstacles to public health because of their intricate causes and the scarcity of effective treatments. Recent studies have shown that gut microbiota (GM) and CNS communicate bidirectionally. Modulation of immune system, neurotransmitters, and neuroactive metabolites are only a few examples of how GM can significantly influence CNS. Dysbiosis or changes in composition and function of gut microbes play a contributing role in various CNS disorders. In these disorders, probiotics, prebiotics, fecal microbiota transplantation, antibiotics use, and interventions based on microbial metabolites have demonstrated beneficial effects in animal models and some clinical studies. By restoring microbial equilibrium, increasing microbial diversity, and promoting the generation of beneficial metabolites, these approaches can improve the efficacy of traditional medications while minimizing their side effects and the disease itself, based on preclinical evidence and emerging clinical studies. Nevertheless, several obstacles should be overcome before the clinical translation of these approaches, such as using of standardized methods for modulating GM, identifying specific microbial signatures linked to various CNS illnesses, and understanding the exact mechanisms of gut-brain communication. This review provides a novel integrated perspective by comprehensively clarifying the bidirectional interactions between CNS pharmacological agents and microbiota-based therapeutic strategies in different neurological and psychiatric disorders, offering a unified framework to improve traditional pharmacological therapies. Importantly, future studies should concentrate on exploring the mechanisms and the exact interconnections between GM and CNS problems to elaborate targeted therapies for these disorders.