Clinical significance of microbiota changes under the influence of psychotropic drugs. An updated narrative review

Abstract

Relationship between drugs and microbiota is bilateral. Proper composition thus function of microbiota is a key to some medications used in modern medicine. However, there is also the other side of the coin. Pharmacotherapeutic agents can modify the microbiota significantly, which consequently affects its function. A recently published study showed that nearly 25% of drugs administered to humans have antimicrobial effects. Multiple antidepressants are antimicrobials,. and antibiotics with proven antidepressant effects do exist. On the other hand, antibiotics (e.g., isoniaside, minocycline) confer mental phenotype changes, and adverse effects caused by some antibiotics include neurological and psychological symptoms which further supports the hypothesis that intestinal microbiota may affect the function of the central nervous system. Here we gathered comprehensively data on drugs used in psychiatry regarding their antimicrobial properties. We believe our data has strong implications for the treatment of psychiatric entities. Nevertheless the study of ours highlights the need for more well-designed trials aimed at analysis of gut microbiota function.

Clinical Relevance of Gut Microbiota Alterations under the Influence of Selected Drugs—Updated Review

“…In addition to external factors, it is drugs and their metabolites that have the ability to remodel the human microbiota. As evidenced in our last study [ 8 ], psychotropic drugs can affect the microbiota’s composition to a large extent. However, this is not always associated with a negative effect.…”

Pharmacomicrobiomics of cell-cycle specific anti-cancer drugs – is it a new perspective for personalized treatment of cancer patients?

“…There is also a bunch of evidence pointing to the interaction between psychotropic drugs and the microbiome. 16 , 17 Nevertheless, recent data indicate that bidirectional interactions between some chemotherapeutic agents and the gut microbiome may affect the response and efficiency of anti-cancer treatment. 18 Therefore, in the present review, we mainly concentrate on three main aspects: (1) interaction between the most significant cell-cycle specific anti-cancer drugs ( Figure 1 ) and gut microbiome, (2) mapping of drug metabolism by gut microbiome, and (3) limitations and future perspectives by mentioning key points with their specialist’s justifications and presenting trials that are under investigation.…”

Microbiome: The Next Frontier in Psychedelic Renaissance

“…The paradigm of mental health treatment is undergoing a significant shift characterized by a resurgent interest in the therapeutic potential of psychedelic substances [ 1 , 2 , 3 ]. Concurrently, the role of the gut microbiome in mental health has emerged as a prominent field of study [ 4 , 5 ]. The intersection of these two fields has given rise to an exciting frontier of research in the psychedelic renaissance, investigating the interaction between the gut microbiome and psychedelics.…”

“…Furthermore, the individual variability in gut microbiome composition may influence the bioavailability and effects of psychedelic substances, emphasizing the potential for a personalized approach in psychedelic therapy. In Figure 1 , Misera et al illustrate how the gut microbiota influences psychiatric treatment efficacy [ 4 ]. Antipsychotic drugs alter the microbiota composition, which can mitigate psychiatric symptoms and potentially induce metabolic disorders—a common reason for treatment discontinuation.…”