IUPHAR themed review: The gut microbiome in schizophrenia

Gut microbial dysbiosis or altered gut microbial consortium, in schizophrenia suggests a pathogenic role through the gut-brain axis, influencing neuroinflammatory and neurotransmitter pathways critical to psychotic, affective, and cognitive symptoms. Paradoxically, conventional psychotropic interven...

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Main Authors: Srinivas Kamath, Elysia Sokolenko, Kate Collins, Nicole S.L. Chan, Natalie Mills, Scott R. Clark, Francine Z. Marques, Paul Joyce
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Pharmacological Research
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Online Access:http://www.sciencedirect.com/science/article/pii/S1043661824005061
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author Srinivas Kamath
Elysia Sokolenko
Kate Collins
Nicole S.L. Chan
Natalie Mills
Scott R. Clark
Francine Z. Marques
Paul Joyce
author_facet Srinivas Kamath
Elysia Sokolenko
Kate Collins
Nicole S.L. Chan
Natalie Mills
Scott R. Clark
Francine Z. Marques
Paul Joyce
author_sort Srinivas Kamath
collection DOAJ
description Gut microbial dysbiosis or altered gut microbial consortium, in schizophrenia suggests a pathogenic role through the gut-brain axis, influencing neuroinflammatory and neurotransmitter pathways critical to psychotic, affective, and cognitive symptoms. Paradoxically, conventional psychotropic interventions may exacerbate this dysbiosis, with antipsychotics, particularly olanzapine, demonstrating profound effects on microbial architecture through disruption of bacterial phyla ratios, diminished taxonomic diversity, and attenuated short-chain fatty acid synthesis. To address these challenges, novel therapeutic strategies targeting the gut microbiome, encompassing probiotic supplementation, prebiotic compounds, faecal microbiota transplantation, and rationalised co-pharmacotherapy, show promise in attenuating antipsychotic-induced metabolic disruptions while enhancing therapeutic efficacy. Harnessing such insights, precision medicine approaches promise to transform antipsychotic prescribing practices by identifying patients at risk of metabolic side effects based on their microbial profiles. This IUPHAR review collates the current literature landscape of the gut-brain axis and its intricate relationship with schizophrenia while advocating for integrating microbiome assessments and therapeutic management. Such a fundamental shift in proposing microbiome-informed psychotropic prescriptions to optimise therapeutic efficacy and reduce adverse metabolic impacts would align antipsychotic treatments with microbiome safety, prioritising 'gut-neutral' or gut-favourable drugs to safeguard long-term patient outcomes in schizophrenia therapy.
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spelling doaj-art-30a44007a4f2407ead18a20a098090e52025-08-20T02:44:24ZengElsevierPharmacological Research1096-11862025-01-0121110756110.1016/j.phrs.2024.107561IUPHAR themed review: The gut microbiome in schizophreniaSrinivas Kamath0Elysia Sokolenko1Kate Collins2Nicole S.L. Chan3Natalie Mills4Scott R. Clark5Francine Z. Marques6Paul Joyce7UniSA Clinical & Health Sciences, University of South Australia, Adelaide, South Australia 5000, AustraliaDiscipline of Anatomy and Pathology, School of Biomedicine, University of Adelaide, Adelaide, South Australia 5005, AustraliaUniSA Clinical & Health Sciences, University of South Australia, Adelaide, South Australia 5000, AustraliaUniSA Clinical & Health Sciences, University of South Australia, Adelaide, South Australia 5000, AustraliaDiscipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, South Australia 5000, AustraliaDiscipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, South Australia 5000, AustraliaBaker Heart and Diabetes Institute, Melbourne, VIC, Australia; Hypertension Research Laboratory, School of Biological Sciences and Victorian Heart Institute, Monash University, Melbourne, VIC, AustraliaUniSA Clinical & Health Sciences, University of South Australia, Adelaide, South Australia 5000, Australia; Correspondence to: University of South Australia, Clinical & Health Sciences, Bradley Building, Adelaide, South Australia 5000, Australia.Gut microbial dysbiosis or altered gut microbial consortium, in schizophrenia suggests a pathogenic role through the gut-brain axis, influencing neuroinflammatory and neurotransmitter pathways critical to psychotic, affective, and cognitive symptoms. Paradoxically, conventional psychotropic interventions may exacerbate this dysbiosis, with antipsychotics, particularly olanzapine, demonstrating profound effects on microbial architecture through disruption of bacterial phyla ratios, diminished taxonomic diversity, and attenuated short-chain fatty acid synthesis. To address these challenges, novel therapeutic strategies targeting the gut microbiome, encompassing probiotic supplementation, prebiotic compounds, faecal microbiota transplantation, and rationalised co-pharmacotherapy, show promise in attenuating antipsychotic-induced metabolic disruptions while enhancing therapeutic efficacy. Harnessing such insights, precision medicine approaches promise to transform antipsychotic prescribing practices by identifying patients at risk of metabolic side effects based on their microbial profiles. This IUPHAR review collates the current literature landscape of the gut-brain axis and its intricate relationship with schizophrenia while advocating for integrating microbiome assessments and therapeutic management. Such a fundamental shift in proposing microbiome-informed psychotropic prescriptions to optimise therapeutic efficacy and reduce adverse metabolic impacts would align antipsychotic treatments with microbiome safety, prioritising 'gut-neutral' or gut-favourable drugs to safeguard long-term patient outcomes in schizophrenia therapy.http://www.sciencedirect.com/science/article/pii/S1043661824005061SchizophreniaPersonalised therapyAntipsychoticsGut brain axisDysbiosisPsychotropics
spellingShingle Srinivas Kamath
Elysia Sokolenko
Kate Collins
Nicole S.L. Chan
Natalie Mills
Scott R. Clark
Francine Z. Marques
Paul Joyce
IUPHAR themed review: The gut microbiome in schizophrenia
Pharmacological Research
Schizophrenia
Personalised therapy
Antipsychotics
Gut brain axis
Dysbiosis
Psychotropics
title IUPHAR themed review: The gut microbiome in schizophrenia
title_full IUPHAR themed review: The gut microbiome in schizophrenia
title_fullStr IUPHAR themed review: The gut microbiome in schizophrenia
title_full_unstemmed IUPHAR themed review: The gut microbiome in schizophrenia
title_short IUPHAR themed review: The gut microbiome in schizophrenia
title_sort iuphar themed review the gut microbiome in schizophrenia
topic Schizophrenia
Personalised therapy
Antipsychotics
Gut brain axis
Dysbiosis
Psychotropics
url http://www.sciencedirect.com/science/article/pii/S1043661824005061
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