Psychotropics and the Microbiome: a Chamber of Secrets…

Psychopharmacology (Berl). 2019 May;236(5):1411-1432. doi: 10.1007/s00213-019-5185-8. Epub 2019 Feb 26.

Abstract

The human gut contains trillions of symbiotic bacteria that play a key role in programming different aspects of host physiology in health and disease. Psychotropic medications act on the central nervous system (CNS) and are used in the treatment of various psychiatric disorders. There is increasing emphasis on the bidirectional interaction between drugs and the gut microbiome. An expanding body of evidence supports the notion that microbes can metabolise drugs and vice versa drugs can modify the gut microbiota composition. In this review, we will first give a comprehensive introduction about this bidirectional interaction, then we will take into consideration different classes of psychotropics including antipsychotics, antidepressants, antianxiety drugs, anticonvulsants/mood stabilisers, opioid analgesics, drugs of abuse, alcohol, nicotine and xanthines. The varying effects of these widely used medications on microorganisms are becoming apparent from in vivo and in vitro studies. This has important implications for the future of psychopharmacology pipelines that will routinely need to consider the host microbiome during drug discovery and development.

Keywords: Antidepressant; Antimicrobial; Antipsychotic; Gut microbiome; Psychotropic.

Publication types

  • Review

MeSH terms

  • Antidepressive Agents / pharmacology*
  • Antidepressive Agents / therapeutic use
  • Antipsychotic Agents / pharmacology*
  • Antipsychotic Agents / therapeutic use
  • Gastrointestinal Microbiome / drug effects*
  • Gastrointestinal Microbiome / physiology
  • Humans
  • Mental Disorders / drug therapy
  • Mental Disorders / psychology
  • Microbiota / drug effects
  • Microbiota / physiology
  • Psychotropic Drugs / pharmacology*
  • Psychotropic Drugs / therapeutic use

Substances

  • Antidepressive Agents
  • Antipsychotic Agents
  • Psychotropic Drugs