Gut microbiota and bipolar disorder: a review of mechanisms and potential targets for adjunctive therapy

Psychopharmacology (Berl). 2019 May;236(5):1433-1443. doi: 10.1007/s00213-019-05248-6. Epub 2019 Apr 30.

Abstract

There is increasing evidence that connections formed between microbiome, the gut, and the brain play a role in health and well-being. Non-pharmaceutical targets for management of mood disorders, such as bipolar disorder, are relatively under-researched. At the same time, it is clear that there is an intimate connection between psychiatry and gastrointestinal health. Here, we have discussed various comorbid conditions associated with bipolar disorders such as inflammation, irritable bowel disease and antibiotic induced mania with importance to demonstrate possible involvement of the gut microbiota. Gut microbiota-targeted preclinical and clinical interventions have demonstrated enhancement in various psychological conditions. Further in this review, we explore links between bipolar disorder, inflammation and gut microbiome with a focus on dietary, pro- and pre-biotic interventions as potential adjuvant therapies for use in the management of mood disorders such as bipolar disorder.

Keywords: Adjuvant therapy; Antibiomania; Antibiotic; Bipolar disorder; Gut microbiome; Immunity; Inflammation; Probiotics.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / adverse effects
  • Bipolar Disorder / diet therapy
  • Bipolar Disorder / drug therapy*
  • Bipolar Disorder / metabolism
  • Brain / drug effects*
  • Brain / metabolism
  • Drug Therapy, Combination
  • Gastrointestinal Microbiome / drug effects*
  • Gastrointestinal Microbiome / physiology
  • Humans
  • Inflammation Mediators / antagonists & inhibitors
  • Inflammation Mediators / metabolism
  • Microbiota / drug effects
  • Microbiota / physiology
  • Prebiotics / administration & dosage*
  • Probiotics / administration & dosage*

Substances

  • Anti-Bacterial Agents
  • Inflammation Mediators
  • Prebiotics