Investigation of the Gut Microbiome in Patients with Schizophrenia and Clozapine-Induced Weight Gain: Protocol and Clinical Characteristics of First Patient Cohorts

Gorbovskaya, Ilona; Kanji, Sarah; Liu, Jonathan C.W.; MacKenzie, Nicole E.; Agarwal, Sri Mahavir; Marshe, Victoria S.; Sriretnakumar, Venuja; Verdú, Elena F.; Berčík, Přemysl; Palma, Giada De; Hahn, Margaret; Müller, Daniel J.

doi:10.1159/000494696

Cited by 14 publications

(11 citation statements)

References 45 publications

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“…Antipsychotics can disrupt mitochondria function, related enzyme activity and ATP levels through downregulation in genes encoding subunits of the electron transport chain [53]. Our groups initiated a pilot study examining the effects of antipsychotics in patients with early psychosis, as well as in patients starting clozapine and in patients being chronically treated with clozapine in order to better understand the potential causal roles of antipsychotic medications and induced metabolic abnormalities [54].…”

Section: Antipsychotic-induced Metabolic Side Effectsmentioning

confidence: 99%

The Gut Microbiome in Schizophrenia and the Potential Benefits of Prebiotic and Probiotic Treatment

et al. 2021

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The gut microbiome (GMB) plays an important role in developmental processes and has been implicated in the etiology of psychiatric disorders. However, the relationship between GMB and schizophrenia remains unclear. In this article, we review the existing evidence surrounding the gut microbiome in schizophrenia and the potential for antipsychotics to cause adverse metabolic events by altering the gut microbiome. We also evaluate the current evidence for the clinical use of probiotic and prebiotic treatment in schizophrenia. The current data on microbiome alteration in schizophrenia remain conflicting. Longitudinal and larger studies will help elucidate the confounding effect on the microbiome. Current studies help lay the groundwork for further investigations into the role of the GMB in the development, presentation, progression and potential treatment of schizophrenia.

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Section: Antipsychotic-induced Metabolic Side Effectsmentioning

confidence: 99%

The Gut Microbiome in Schizophrenia and the Potential Benefits of Prebiotic and Probiotic Treatment

et al. 2021

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“…Despite interest in microbiome manipulation for schizophrenia, there are no results from FMT related trials to date, 64 with studies underway to characterize the microbiome signatures in more detail. 65 A single case report of dramatic improvement in cognition after FMT for rCDI in a patient with Alzheimer's disease 66 correlates with results from a mouse model. 67 For multiple sclerosis (MS), there have been case reports of arrest of secondary progressive MS 68 and relapsing remitting MS. 69 Studies on the impact of FMT on anxiety and depression are largely limited to patients with IBS, and reported improvements must be considered in light of small, low-quality studies.…”

Section: The Gut-brain Axis: Neurological and Psychiatric Conditionsmentioning

confidence: 72%

An update on fecal microbiota transplantation for the treatment of gastrointestinal diseases

Waller

Leong

Paramsothy

2021

J of Gastro and Hepatol

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Our understanding of the microbiome and its implications for human health and disease continues to develop. Fecal microbiota transplantation (FMT) is now an established treatment for recurrent Clostridioides difficile infection. There is also increasing evidence for the efficacy of FMT in inducing remission for mild-moderate ulcerative colitis. However, for other indications, data for FMT are limited, with randomized controlled trials rare, typically small and often conflicting. Studies are continuing to explore the role of FMT for many other conditions, including Crohn's disease, functional gut disorders, metabolic syndrome, modulating responses to chemotherapy, eradication of multidrug resistant organisms, and the gut-brain axis. In light of safety, logistical, and regulatory challenges, there is a move to standardized products including narrow spectrum consortia. However, the mechanisms underpinning FMT remain incompletely understood, including the role of non-bacterial components, which may limit success of novel microbial approaches.

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“…Gorbovskaya et al [50] designed a two-phase protocol, currently underway, regarding chronic clozapine (200/252.3 mg) treatment to deepen understanding of the underlying mechanisms of antipsychotic medications and metabolic abnormalities and possibly the transplantation of human samples.…”

Section: Clozapinementioning

confidence: 99%

Reviewing the Potential Therapeutic Approaches Targeting the Modulation of Gastrointestinal Microflora in Schizophrenia

Nita

Ilie

Ciobîcă

et al. 2022

IJMS

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Schizophrenia (SCZ) is a severe brain disorder characterized by an intriguing clinical panel that has begun to gain interest due to its particular phenotype. Having considered the role of gut microflora in psychiatry, the latest discoveries might offer further insight into the underlying mechanisms. Thus, we aimed to offer an updated overview of the therapeutic potential of microorganism-derived supplements alongside dedicated protocols that target the re-establishment of the host’s eubiosis. Based on combinations of specific keywords, we performed searches in four databases (PubMed/Medline, ISI Web of Knowledge, Scopus, and ScienceDirect) for the established interval (2018–2022) and identified twenty two eligible cases, restricted only to human patients’ experiences. Up until the writing of this manuscript, it has been revealed that the administration of specific lactic acid bacteria strains (Lactobacillus and Bifidobacterium), or those combined with vitamin D and selenium, maintain the integrity of the gut flora, preventing antagonistic effects including inflammation, antipsychotic-related body weight gain (olanzapine) and other metabolic dysfunctionalities. However, there are multiple antipsychotics that exert a potent effect upon gut flora, influencing a plethora of pathways and creating a dysbalance ratio between beneficial and opportunistic pathogens. Risperidone, amisulpride, and clozapine are just a few examples, but the current literature is unfortunately inconsistent and reported data is contradictory, which is why we support additional studies in this context. Moreover, we further argue the utility of studying how distinct controlled substances influence microbial communities, considering that ketamine is proved to alleviate depressive-like behavior as opposed to amphetamine and phencyclidine, which are known substances to trigger SCZ-like symptoms in experimental models. Probiotics may be regarded as the most consequential vehicle through which the gut flora can be successfully influenced, in adequate doses exerting a beneficial role as an alternative approach to alleviate SCZ symptoms.

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Investigation of the Gut Microbiome in Patients with Schizophrenia and Clozapine-Induced Weight Gain: Protocol and Clinical Characteristics of First Patient Cohorts

Cited by 14 publications

References 45 publications

The Gut Microbiome in Schizophrenia and the Potential Benefits of Prebiotic and Probiotic Treatment

The Gut Microbiome in Schizophrenia and the Potential Benefits of Prebiotic and Probiotic Treatment

An update on fecal microbiota transplantation for the treatment of gastrointestinal diseases

Reviewing the Potential Therapeutic Approaches Targeting the Modulation of Gastrointestinal Microflora in Schizophrenia

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