Antidepressants, antimicrobials or both? Gut microbiota dysbiosis in depression and possible implications of the antimicrobial effects of antidepressant drugs for antidepressant effectiveness

• Published in: Journal of affective disorders Vol. 208; pp. 22 - 32
• Main Authors: Macedo, Danielle, Filho, Adriano José Maia Chaves, Soares de Sousa, Caren Nádia, Quevedo, João, Barichello, Tatiana, Júnior, Hélio Vitoriano Nobre, Freitas de Lucena, David
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 15.01.2017
• Subjects: Anti-Infective Agents - administration & dosage; Anti-Infective Agents - adverse effects; Antidepressants; Antidepressive Agents - administration & dosage; Antidepressive Agents - adverse effects; Antimicrobials; Depression; Depressive Disorder, Major - drug therapy; Depressive Disorder, Major - microbiology; Dysbiosis; Dysbiosis - microbiology; Gastrointestinal Microbiome - drug effects; Gut microbiota; Humans; Psychiatry; Gut microbiota; ACTH; SPF; MDD; Dysbiosis; adrenocorticotropic hormone; Major depressive disorder; Monoamine-oxidase inhibitor; IFN-γ; mTOR; iNOS; Chemokine (C-C Motif) Ligand 2; chronic mild stress; GLT1; minimum inhibitory concentrations; MIC; CMS; prostaglandin 2; gamma-aminobutyric acid; COX 2; central nervous system; germ-free; MMP; TCA; GABA; HPA; MAO; specific pathogen free; lipopolysaccharide; TLR4; toll-like receptor 4; glutamate transporter 1; Immunoglobulin M; IgA; gamma interferon; CNS; Immunoglobulin A; lactobacillus rhamnosus; MAOI; IgM; LPS; mammalian target of rapamycin; tumor necrosis factor alpha; Antidepressants; NMDA; CCL2; inducible nitric oxide synthase (iNOS); healthy controls; GF; tricyclic antidepressants; hypothalamic-pituitary-adrenal; Monoamine-oxidase; PGE2; BDNF; Antimicrobials; Depression; N-methyl – d- aspartate; Brain-derived neurotrophic factor; TNF-α; matrix metalloproteinase; cyclooxygenase 2; HC; JB-1
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2016.09.012

Abstract Objectives The first drug repurposed for the treatment of depression was the tuberculostatic iproniazid. At present, drugs belonging to new classes of antidepressants still have antimicrobial effects. Dysbiosis of gut microbiota was implicated in the development or exacerbation of mental disorders, such as major depressive disorder (MDD). Based on the current interest in the gut-brain axis, the focus of this narrative review is to compile the available studies regarding the influences of gut microbiota in behavior and depression and to show the antimicrobial effect of antidepressant drugs. A discussion regarding the possible contribution of the antimicrobial effect of antidepressant drugs to its effectiveness/resistance is included. Methods The search included relevant articles from PubMed, SciELO, LILACS, PsycINFO, and ISI Web of Knowledge. Results MDD is associated with changes in gut permeability and microbiota composition. In this respect, antidepressant drugs present antimicrobial effects that could also be related to the effectiveness of these drugs for MDD treatment. Conversely, some antimicrobials present antidepressant effects. Conclusion Both antidepressants and antimicrobials present neuroprotective/antidepressant and antimicrobial effects. Further studies are needed to evaluate the participation of antimicrobial mechanisms of antidepressants in MDD treatment as well as to determine the contribution of this effect to antidepressant resistance.