What is the significance of the impact of antipsychotics on the gut microbiome?

The Underlying Neurobiological Mechanisms of Psychosis: Focus on Neurotransmission Dysregulation, Neuroinflammation, Oxidative Stress, and Mitochondrial Dysfunction

“…Where possible, approaches using multiple techniques should be used and the findings should be related to specific symptoms [ 104 , 167 , 168 , 172 , 177 ]. It is very important to compare biomarkers over the clinical course of schizophrenia [ 45 , 119 , 166 ]. Many preclinical and clinical studies have been conducted on the GBA in recent years.…”

“…More extensive longitudinal studies on prebiotics and probiotics need to be conducted before they can be considered as routine compositions to be given in conjunction with antipsychotics. Such studies should be combined with metabolomic investigations and consider factors such as nutritional status, sex, and stage of the illness [ 96 , 117 , 119 , 121 , 178 ]. There have been increasing studies on connectomics, neuroimaging, and the use of artificial intelligence and machine learning in investigations on psychosis in recent years, and these will no doubt continue to expand in the future.…”

“…There is also evidence to demonstrate that several antipsychotics have antibiotic properties and can affect the composition of the gut microbiome [ 118 , 119 ]. The gut microbiome has also been identified as a factor mediating metabolic side effects of second-generation antipsychotics [ 120 , 121 ].…”

“…The gut microbiome has also been identified as a factor mediating metabolic side effects of second-generation antipsychotics [ 120 , 121 ]. The chronic use of antipsychotics can cause dysbiosis of the gut microbiome, with resulting dysregulation of the neurotransmitters dopamine, glutamate, serotonin, and noradrenaline; increases in inflammation pathways; oxidative stress; and mitochondrial dysfunction [ 119 ]. The consequences may include resistance to treatment and increased severity of metabolic irregularities [ 122 ].…”

Women with Schizophrenia Have Difficulty Maintaining Healthy Diets for Themselves and Their Children: A Narrative Review

“…Additional variables are the drug's effect on gut microbiota and the brain areas that regulate food intake. All antipsychotics change the balance of gut bacteria [48] and it may be this indirect route that leads to various metabolic disturbances. The research groups of both Mukherjee et al and Sankaranarayanan et al [44,45] conclude their reviews of the effects of 2nd generation antipsychotics on disordered eating in schizophrenia by detailing the consequences of their use on a number of dietary and nutritional parameters, namely hunger, food cravings and addiction, dietary restraint and disinhibition, satiety, caloric intake, eating habits, and dietary composition.…”