Psychotropics and the Microbiome: a Chamber of Secrets

• Published in: Psychopharmacology 2019-05, Vol.236 (5), p.1411-1432
• Main Authors: Cussotto, Sofia, Clarke, Gerard, Dinan, Timothy G., Cryan, John F.
• Format: Article
• Language: English
• Subjects: Alcohols; Analgesics; Antianxiety agents; Anticonvulsants; Antidepressants; Antidepressive Agents - pharmacology; Antidepressive Agents - therapeutic use; Antimicrobial agents; Antipsychotic agents; Antipsychotic Agents - pharmacology; Antipsychotic Agents - therapeutic use; Antipsychotics; Bacteria; Biomedical and Life Sciences; Biomedicine; Central nervous system; Digestive system; Drug abuse; Drug discovery; Drug interaction; Drug interactions; Drugs; Gastrointestinal Microbiome - drug effects; Gastrointestinal Microbiome - physiology; Health; Humans; Illegal drugs; Intestinal microflora; Medical law; Mental disorders; Mental Disorders - drug therapy; Mental Disorders - psychology; Microbiomes; Microbiota; Microbiota (Symbiotic organisms); Microbiota - drug effects; Microbiota - physiology; Microorganisms; Mood; Neurosciences; Nicotine; Opioids; Pharmacology/Toxicology; Physiological aspects; Psychiatry; Psychotropic drugs; Psychotropic Drugs - pharmacology; Psychotropic Drugs - therapeutic use; Review; Tricyclic antidepressants; Xanthine; Xanthines
• ISSN: 0033-3158; 1432-2072; 1432-2072
• DOI: 10.1007/s00213-019-5185-8

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.