An explosion of research is expanding our knowledge of the impact of the microbiome across all body systems. There is truly no system not being impacted by the microbiome. Antibiotic treatment profoundly alters the microbiome in a detrimental manner, with no good data existing regarding what timeline is required for it to recover, if it ever does. Probiotic treatment has proven instrumental in helping restore balance to the microbiome when administered during or following antibiotic treatment.
The microbiome has been clearly linked to mental health, with multiple human trials showing probiotic supplementation benefiting multiple parameters of mental health. Recent evidence has examined a critical question: can a course of antibiotics induce depression?
Evidence on this topic remains in its infancy. All subsequent information has been derived from a review (Dinan and Dinan 2022).
A 2010 case report presented a 75-year-old man with no history of psychiatric illness prescribed antibiotics for treatment of a post operative wound. He became acutely depressed and committed suicide. The coroner credited antibiotic treatment as the cause of the suicide.
A series of case control studies between 2005 and 2013 found associations between antibiotic use and increased risk of depression and anxiety. Risk of depression and anxiety increased with repeat exposure to antibiotics.
A clinical study surveyed 94 patients that had been prescribed fluoroquinolones. Seventy-two percent of participants reported experiencing anxiety, 62% reported experiencing depression, 48% reported experiencing insomnia, 37% reported experiencing panic attacks, and 33% reported cognitive impairment.
While in its infancy, this appears to be a research front worthy of following. Clinically, colleagues are encouraged to screen for new or altering mental health concerns in relation to antibiotic administration.
Reference:
Dinan K, Dinan T. Antibiotics and mental health: The good, the bad and the ugly. J Intern Med. 2022 Dec;292(6):858-869.
