Vasileva Svetlina S, Tucker Jack, Siskind Dan, Eyles Darryl
Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia.
Metro South Addiction and Mental Health Service, Metro South Health, Brisbane, Brisbane south, Australia.
Expert Opin Drug Saf. 2022 May;21(5):625-639. doi: 10.1080/14740338.2022.2042251. Epub 2022 Feb 28.
Second-generation antipsychotics (SGAs) are the most effective treatment for people with schizophrenia. Despite their effectiveness in treating psychotic symptoms, they have been linked to metabolic, cardiovascular and gastrointestinal side-effects. The gut microbiome has been implicated in potentiating symptoms of schizophrenia, response to treatment, and medication-induced side effects and thus presents a novel target mediating second-generation antipsychotic-induced side effects in patients.
This narrative review presents evidence from clinical and preclinical studies exploring the relationship between the gut microbiome, schizophrenia, second-generation antipsychotics, and antipsychotic-induced side-effects. It also covers evidence for psychobiotic treatment as a potential supplementary therapy for people with schizophrenia.
The gut microbiome has the potential to mediate antipsychotic-induced side-effects in people with schizophrenia. Microbiome-focused treatments should be considered in combination with standard therapy in order to ameliorate debilitating drug-induced side effects, increase quality of life, and potentially improve psychotic symptoms. Future studies should aim to collect not only microbiome data but also metabolomic measures, dietary information, and behavioral data.
第二代抗精神病药物（SGA）是治疗精神分裂症患者最有效的药物。尽管它们在治疗精神病症状方面有效，但与代谢、心血管和胃肠道副作用有关。肠道微生物群与精神分裂症症状的加剧、对治疗的反应以及药物引起的副作用有关，因此是介导第二代抗精神病药物在患者中引起副作用的一个新靶点。
本叙述性综述展示了临床和临床前研究的证据，这些研究探讨了肠道微生物群、精神分裂症、第二代抗精神病药物以及抗精神病药物引起的副作用之间的关系。它还涵盖了精神益生菌治疗作为精神分裂症患者潜在辅助治疗的证据。
肠道微生物群有可能介导精神分裂症患者抗精神病药物引起的副作用。应考虑将以微生物群为重点的治疗与标准治疗相结合，以改善使人衰弱的药物引起的副作用，提高生活质量，并有可能改善精神病症状。未来的研究不仅应旨在收集微生物群数据（而且还应收集代谢组学测量数据、饮食信息和行为数据）。
