Abstract: The present study discusses the role of microbiota in
the metabolism of psychotropic drugs as well as the dysbiosis associated with
the antimicrobial properties of these agents. Psychotropic drugs are endowed
with antimicrobial properties and are known to alter the gut microbiome,
selectively depleting the Bacteroidetes phylum, and leading to obesity.
It is well-established that obesity has reached epidemic
proportions throughout the world, however, it is less known that its rates are
two to three times higher in mentally ill patients compared to the general
population. Both psychotropic drugs-induced dysmetabolism and high fat
diet-related weight gain present with a common enteric microbial pattern, and
depletion of the Bacteroidetes phylum, suggesting an overlapping pathology.
Others have opined that the loss of Bacteroidetes-generated metabolites is the
common denominator of weight gain induced either by an unhealthy diet or
psychotropic drugs.
Since germ-free animals exposed to psychotropics have not
demonstrated weight gain, altered commensal flora composition is believed to be
necessary and sufficient to induce dysmetabolism. Conversely, not only do
psychotropics disrupt the composition of gut microbiota but the latter alter
the metabolism of the former. For example, drug metabolism starts in the gut,
rather than the liver as it was construed in the past.
The potential biomarkers reflecting the status of the
Bacteroidetes phylum have been discussed and a closer look at nutritional
interventions, fecal microbiota transplantation, and transcranial magnetic
stimulation strategies has been taken that may lower obesity rates in chronic
psychiatric patients. Obesity is a modifiable risk factor of general morbidity,
therefore restoring the physiological levels of Bacteroidetes phylum by various
strategies may attenuate or reverse the excess weight in chronic psychiatric patients.
If validated, the biological markers described here may offer the clinician
additional feedback to estimate the imminence of weight-related complications.
Author
(s) Details
Adonis
Sfera
Department of Psychiatry, Loma Linda University, Loma Linda, CA,
United States and Department of Psychiatry, Patton State Hospital, San
Bernardino, CA, United States.
Carolina
Osorio
Department of Psychiatry, Loma Linda University, Loma Linda, CA,
United States.
Eddie
Lee Diaz
Department of Psychiatry, Patton State Hospital, San Bernardino,
CA, United States.
Gerald
Maguire
Department of Psychiatry, University of California, Riverside,
Riverside, CA, United States.
Michael
Cummings
Department of Psychiatry, Patton State Hospital, San Bernardino,
CA, United States.
Please see the book here:- https://doi.org/10.9734/bpi/dhrni/v5/2250
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