Longitudinal Influence of Prescribed Antidepressants on Fecal and Oral Microbiomes Among Veterans With Major Depressive Disorder
Publication: The Journal of Neuropsychiatry and Clinical Neurosciences
Abstract
Objective:
The purpose of this study was to evaluate the influence of a new course of antidepressant monotherapy on gut and oral microbiomes and the relationship to depressive symptoms.
Methods:
Longitudinal microbiome samples obtained from 10 U.S. veterans were analyzed. Baseline samples were taken before a new course of antidepressant monotherapy (either switching from a previous treatment or starting a new treatment). Targeted genomic sequencing of the microbiome samples was used to analyze changes in taxonomy and diversity across participants, medications, and medication class. Associations between these changes and Patient Health Questionnaire–9 (PHQ-9) scores were analyzed.
Results:
Taxonomic variability was observed across participants, with the individual being the main microbial community driver. In terms of the fecal microbiome, antidepressants were associated with shifts toward Bacteroides being less abundant and Blautia, Pseudomonas, or Faecalibacterium being more abundant. Likewise, the composition of the oral microbiome was variable, with individual participants being the primary drivers of community composition. In the oral samples, the relative abundance of Haemophilus decreased after antidepressants were started. Increases in Blautia and decreases in Bacteroides were associated with lower PHQ-9 scores.
Conclusions:
Antidepressants were found to influence fecal and oral microbiomes such that a new course of antidepressant monotherapy was associated with taxonomic alterations toward healthier states in both fecal and oral microbiomes, which were associated with decreases in depressive symptoms. Additional longitudinal research is required to increase understanding of microbiomes and symptom-based changes, with a particular focus on potential differences between medication classes and underlying mechanisms.
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Published In
History
Received: 21 December 2022
Revision received: 11 August 2023
Accepted: 14 September 2023
Published online: 23 January 2024
Published in print: Spring 2024
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Competing Interests
Dr. Brenner has received editorial remuneration from Wolters Kluwer and the Rand Corporation, she has received royalties from the American Psychological Association and Oxford University Press, and she has served as a consultant with sports leagues via her university affiliation. The other authors report no financial relationships with commercial interests.
Funding Information
Supported by a Merit Review Award (1P1 HX002375-01/SDR 16–348) from the U.S. Department of Veterans Affairs, Health Services Research and Development Service. Some data were collected with the Research Electronic Data Capture tool, which was developed and maintained with support from the Vanderbilt Institute for Clinical and Translational Research (NIH grant UL1TR000445 from the National Center for Advancing Translational Sciences), and with the Behavioral Health Laboratory software program (supported by Capital Solution Design). Additional support was provided by the U.S. Department of Veterans Affairs, through the Rocky Mountain MIRECC and the Veterans Integrated Services Network 5 MIRECC, and the Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora.The views expressed in this study are those of the authors and do not necessarily represent the views or policy of the U.S. Department of Veterans Health Affairs or the U.S. Department of Defense and do not imply endorsement by the U.S. government. Staff from the Veterans Health Administration Office of Research and Development and the Office of Mental Health and Suicide Prevention at the Department of Veterans Affairs were involved in the design and conduct of the parent study; they did not participate in the collection, management, and analysis of the data but did assist with interpretation of the data; they participated in preparation, review, and approval of the manuscript. They did not have the right to veto submission of the results or to control the journal to which the results were submitted.
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