Skip to main content

Advertisement

Log in

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

  • Review
  • Published:
Psychopharmacology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  • Akkasheh G, Kashani-Poor Z, Tajabadi-Ebrahimi M et al (2016) Clinical and metabolic response to probiotic administration in patients with major depressive disorder: a randomized, double-blind, placebo-controlled trial. Nutrition 32:315–320. https://doi.org/10.1016/j.nut.2015.09.003

    Article  CAS  PubMed  Google Scholar 

  • Alshikh N, de Camargo AC, Shahidi F (2015) Phenolics of selected lentil cultivars: Antioxidant activities and inhibition of low-density lipoprotein and DNA damage. J Funct Foods 18:1022–1038

    Article  CAS  Google Scholar 

  • Asan E, Steinke M, Lesch K-P (2013) Serotonergic innervation of the amygdala: targets, receptors, and implications for stress and anxiety. Histochem Cell Biol 139:785–813. https://doi.org/10.1007/s00418-013-1081-1

    Article  CAS  PubMed  Google Scholar 

  • Åsberg M (1997) Neurotransmitters and suicidal behavior. Ann N Y Acad Sci 836:158–181

    Article  PubMed  Google Scholar 

  • Barbosa IG, Morato IB, de Miranda AS, Bauer ME, Soares JC, Teixeira AL (2014) A preliminary report of increased plasma levels of IL-33 in bipolar disorder: further evidence of pro-inflammatory status. J Affect Disord 157:41–44

    Article  CAS  PubMed  Google Scholar 

  • Barrett E, Ross RP, O'Toole PW, Fitzgerald GF, Stanton C (2012) γ-Aminobutyric acid production by culturable bacteria from the human intestine. J Appl Microbiol 113 (2):411–417

    Article  CAS  PubMed  Google Scholar 

  • Benros ME, Waltoft BL, Nordentoft M, Østergaard SD, Eaton WW, Krogh J, Mortensen PB (2013) Autoimmune diseases and severe infections as risk factors for mood disorders: a nationwide study. JAMA Psychiatry 70:812–820

    Article  PubMed  Google Scholar 

  • Benton D, Williams C, Brown A (2007) Impact of consuming a milk drink containing a probiotic on mood and cognition. Eur J Clin Nutr 61:355

    Article  CAS  PubMed  Google Scholar 

  • Bercik P, Park A, Sinclair D et al (2011) The anxiolytic effect of Bifidobacterium longum NCC3001 involves vagal pathways for gut–brain communication. Neurogastroenterol Motil 23:1132–1139

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Berk M, Kapczinski F, Andreazza A et al (2011) Pathways underlying neuroprogression in bipolar disorder: focus on inflammation, oxidative stress and neurotrophic factors. Neurosci Biobehav Rev 35:804–817

    Article  CAS  PubMed  Google Scholar 

  • Beydoun MA, Shroff MR, Beydoun HA, Zonderman AB (2010) Serum folate, vitamin B-12 and homocysteine and their association with depressive symptoms among US adults. Psychosom Med 72:862–873

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Bomba A, Nemcova R, Gancarcikova S, Herich R, Guba P, Mudronova D (2002) Improvement of the probiotic effect of micro-organisms by their combination with maltodextrins, fructo-oligosaccharides and polyunsaturated fatty acids. Br J Nutr 88:S95–S99

    Article  CAS  PubMed  Google Scholar 

  • Boufidou F, Nikolaou C, Alevizos B, Liappas IA, Christodoulou GN (2004) Cytokine production in bipolar affective disorder patients under lithium treatment. J Affect Disord 82:309–313

    Article  CAS  PubMed  Google Scholar 

  • Bravo JA, Forsythe P, Chew MV et al (2011) Ingestion of Lactobacillus strain regulates emotional behavior and central GABA receptor expression in a mouse via the vagus nerve. Proc Natl Acad Sci 108:16050–16055

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Cebra JJ (1999) Influences of microbiota on intestinal immune system development. Am J Clin Nutr 69:1046s–1051s. https://doi.org/10.1093/ajcn/69.5.1046s

    Article  CAS  PubMed  Google Scholar 

  • Collins SM (2014) A role for the gut microbiota in IBS. Nat Rev Gastroenterol Hepatol 11:497–505. https://doi.org/10.1038/nrgastro.2014.40

    Article  CAS  PubMed  Google Scholar 

  • Cryan JF, Dinan TG (2012) Mind-altering microorganisms: the impact of the gut microbiota on brain and behaviour. Nat Rev Neurosci 13:701–712. https://doi.org/10.1038/nrn3346

    Article  CAS  PubMed  Google Scholar 

  • Cunha AB, Andreazza AC, Gomes FA, Frey BN, Da Silveira LE, Gonçalves CA, Kapczinski F (2008) Investigation of serum high-sensitive C-reactive protein levels across all mood states in bipolar disorder. Eur Arch Psychiatry Clin Neurosci 258:300–304

    Article  PubMed  Google Scholar 

  • Cussotto S, Strain CR, Fouhy F et al (2018) Differential effects of psychotropic drugs on microbiome composition and gastrointestinal function. Psychopharmacology. https://doi.org/10.1007/s00213-018-5006-5

    Article  CAS  PubMed  Google Scholar 

  • Dargél AA, Godin O, Kapczinski F, Kupfer DJ, Leboyer M (2015) C-reactive protein alterations in bipolar disorder: a meta-analysis. J Clin Psychiatry: 76(2):142–150

    Article  PubMed  Google Scholar 

  • Davison KM, Kaplan BJ (2012) Nutrient intakes are correlated with overall psychiatric functioning in adults with mood disorders. Can J Psychiatry 57:85–92

    Article  PubMed  Google Scholar 

  • Dayan P, Huys QJ (2008) Serotonin, inhibition, and negative mood. PLoS Comput Biol 4:e4. https://doi.org/10.1371/journal.pcbi.0040004

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Dickerson F, Stallings C, Origoni A, Boronow J, Yolken R (2007) Elevated serum levels of C-reactive protein are associated with mania symptoms in outpatients with bipolar disorder. Prog Neuro-Psychopharmacol Biol Psychiatry 31:952–955

    Article  CAS  Google Scholar 

  • Dickerson F, Katsafanas E, Schweinfurth L et al (2015) Immune alterations in acute bipolar depression. Acta Psychiatr Scand 132:204–210

    Article  CAS  PubMed  Google Scholar 

  • Dickerson F, Adamos M, Katsafanas E et al (2018) Adjunctive probiotic microorganisms to prevent rehospitalization in patients with acute mania: a randomized controlled trial. Bipolar Disord 20:614–621. https://doi.org/10.1111/bdi.12652

    Article  CAS  PubMed  Google Scholar 

  • Drexhage RC, Knijff EM, Padmos RC, Heul-Nieuwenhuijzen L, Beumer W, Versnel MA, Drexhage HA (2010) The mononuclear phagocyte system and its cytokine inflammatory networks in schizophrenia and bipolar disorder. Expert Rev Neurother 10:59–76

    Article  CAS  PubMed  Google Scholar 

  • Engeland CG, Kavaliers M, Ossenkopp K-P (2003) Sex differences in the effects of muramyl dipeptide and lipopolysaccharide on locomotor activity and the development of behavioral tolerance in rats. Pharmacol Biochem Behav 74:433–447

    Article  CAS  PubMed  Google Scholar 

  • Evans SJ, Bassis CM, Hein R, Assari S, Flowers SA, Kelly MB, Young VB, Ellingrod VE, McInnis MG (2017) The gut microbiome composition associates with bipolar disorder and illness severity. J Psychiatr Res 87:23–29. https://doi.org/10.1016/j.jpsychires.2016.12.007

    Article  PubMed  Google Scholar 

  • Fond G, Loundou A, Hamdani N, Boukouaci W, Dargel A, Oliveira J, Roger M, Tamouza R, Leboyer M, Boyer L (2014) Anxiety and depression comorbidities in irritable bowel syndrome (IBS): a systematic review and meta-analysis. Eur Arch Psychiatry Clin Neurosci 264:651–660

    Article  PubMed  Google Scholar 

  • Frangou S, Lewis M, McCrone P (2006) Efficacy of ethyl-eicosapentaenoic acid in bipolar depression: randomised double-blind placebo-controlled study. Br J Psychiatry 188:46–50

    Article  PubMed  Google Scholar 

  • Gao J (2013) Correlation between anxiety-depression status and cytokines in diarrhea-predominant irritable bowel syndrome. Exp Ther Med 6:93–96

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Garud S, Leffler D, Dennis M et al (2009) Interaction between psychiatric and autoimmune disorders in coeliac disease patients in the Northeastern United States. Aliment Pharmacol Ther 29:898–905

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Geddes JR, Miklowitz DJ (2013) Treatment of bipolar disorder. Lancet 381:1672–1682

    Article  CAS  PubMed  Google Scholar 

  • Gerner RH, Post RM, Bunney WE (1976) A dopaminergic mechanism in mania. Am J Psychiatry 133(10):1177–1180

  • Gershon A, Eidelman P (2015) Inter-episode affective intensity and instability: predictors of depression and functional impairment in bipolar disorder. J Behav Ther Exp Psychiatry 46:14–18

    Article  PubMed  Google Scholar 

  • Gitlin MJ, Swendsen J, Heller TL, Hammen C (1995) Relapse and impairment in bipolar disorder. Am J Psychiatry 152:1635

    Article  CAS  PubMed  Google Scholar 

  • Goehler LE, Park SM, Opitz N, Lyte M, Gaykema RP (2008) Campylobacter jejuni infection increases anxiety-like behavior in the holeboard: possible anatomical substrates for viscerosensory modulation of exploratory behavior. Brain Behav Immun 22:354–366

    Article  CAS  PubMed  Google Scholar 

  • Goldstein BI, Kemp DE, Soczynska JK, McIntyre RS (2009) Inflammation and the phenomenology, pathophysiology, comorbidity, and treatment of bipolar disorder: a systematic review of the literature. J Clin Psychiatry 70:1078, 1090

    Google Scholar 

  • Goldstein BI, Collinger KA, Lotrich F, Marsland AL, Gill M-K, Axelson DA, Birmaher B (2011) Preliminary findings regarding proinflammatory markers and brain-derived neurotrophic factor among adolescents with bipolar spectrum disorders. J Child Adolesc Psychopharmacol 21:479–484

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Gomez de Agüero M, Ganal-Vonarburg SC, Fuhrer T et al (2016) The maternal microbiota drives early postnatal innate immune development. Science 351:1296–1302. https://doi.org/10.1126/science.aad2571

    Article  CAS  PubMed  Google Scholar 

  • Gracious BL, Chirieac MC, Costescu S, Finucane TL, Youngstrom EA, Hibbeln JR (2010) Randomized, placebo-controlled trial of flax oil in pediatric bipolar disorder. Bipolar Disord 12:142–154

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Hamdani N, Doukhan R, Kurtlucan O, Tamouza R, Leboyer M (2013) Immunity, inflammation, and bipolar disorder: diagnostic and therapeutic implications. Curr Psychiatry Rep 15:387

    Article  PubMed  Google Scholar 

  • Hamdani N, Boukouaci W, Hallouche MR, Charron D, Krishnamoorthy R, Leboyer M, Tamouza R (2015) Resolution of a manic episode treated with activated charcoal: Evidence for a brain–gut axis in bipolar disorder. Aust N Z J Psychiatry 49:1221–1223

    Article  PubMed  Google Scholar 

  • Hope S, Dieset I, Agartz I et al (2011) Affective symptoms are associated with markers of inflammation and immune activation in bipolar disorders but not in schizophrenia. J Psychiatr Res 45:1608–1616

    Article  PubMed  Google Scholar 

  • Ismail NA, Ragab SH, ElBaky AA, Shoeib AR, Alhosary Y, Fekry D (2011) Frequency of Firmicutes and Bacteroidetes in gut microbiota in obese and normal weight Egyptian children and adults. Arch Med Sci 7:501

    Article  CAS  Google Scholar 

  • Jacka FN, Pasco JA, Mykletun A et al (2010) Association of Western and traditional diets with depression and anxiety in women. Am J Psychiatr 167:305–311

    Article  PubMed  Google Scholar 

  • Jacka FN, Pasco JA, Mykletun A, Williams LJ, Nicholson GC, Kotowicz MA, Berk M (2011) Diet quality in bipolar disorder in a population-based sample of women. J Affect Disord 129:332–337

    Article  PubMed  Google Scholar 

  • Jacka FN, O’Neil A, Opie R et al (2017) A randomised controlled trial of dietary improvement for adults with major depression (the ‘SMILES’ trial). BMC Med 15:23

    Article  PubMed  PubMed Central  Google Scholar 

  • Jacobs D, Silverstone T (1986) Dextroamphetamine-induced arousal in human subjects as a model for mania. Psychol Med 16:323–329

    Article  CAS  PubMed  Google Scholar 

  • Kapczinski F, Dal-Pizzol F, Teixeira AL et al (2011) Peripheral biomarkers and illness activity in bipolar disorder. J Psychiatr Res 45:156–161

    Article  PubMed  Google Scholar 

  • Kim Y-K, Jung H-G, Myint A-M, Kim H, Park S-H (2007) Imbalance between pro-inflammatory and anti-inflammatory cytokines in bipolar disorder. J Affect Disord 104:91–95

    Article  CAS  PubMed  Google Scholar 

  • Köhler O, Petersen L, Mors O, Mortensen P, Yolken R, Gasse C, Benros M (2017) Infections and exposure to anti-infective agents and the risk of severe mental disorders: a nationwide study. Acta Psychiatr Scand 135:97–105

    Article  PubMed  CAS  Google Scholar 

  • Koo J, Marangell LB, Nakamura M, Armstrong A, Jeon C, Bhutani T, Wu JJ (2017) Depression and suicidality in psoriasis: review of the literature including the cytokine theory of depression. J Eur Acad Dermatol Venereol 31:1999–2009. https://doi.org/10.1111/jdv.14460

    Article  CAS  PubMed  Google Scholar 

  • Ladabaum U, Boyd E, Zhao WK, Mannalithara A, Sharabidze A, Singh G, Chung E, Levin TR (2012) Diagnosis, comorbidities, and management of irritable bowel syndrome in patients in a large health maintenance organization. Clin Gastroenterol Hepatol 10:37–45

    Article  PubMed  Google Scholar 

  • Leboyer M, Soreca I, Scott J, Frye M, Henry C, Tamouza R, Kupfer DJ (2012) Can bipolar disorder be viewed as a multi-system inflammatory disease? J Affect Disord 141:1–10

    Article  PubMed  PubMed Central  Google Scholar 

  • Lee Y-T, Hu L-Y, Shen C-C et al (2015) Risk of psychiatric disorders following irritable bowel syndrome: a nationwide population-based cohort study. PLoS One 10:e0133283

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Legendre T, Boudebesse C, Henry C, Etain B (2017) Antibiomania: think of the manic syndrome secondary to antibiotic therapy. Encephale 43:183–186

    Article  CAS  PubMed  Google Scholar 

  • Leonard B, Maes M (2012) Mechanistic explanations how cell-mediated immune activation, inflammation and oxidative and nitrosative stress pathways and their sequels and concomitants play a role in the pathophysiology of unipolar depression. Neurosci Biobehav Rev 36:764–785

    Article  CAS  PubMed  Google Scholar 

  • Liu C-J, Hu L-Y, Yeh C-M, Hu Y-W, Chen P-M, Chen T-J, Lu T (2015) Irritable brain caused by irritable bowel? A nationwide analysis for irritable bowel syndrome and risk of bipolar disorder. PLoS One 10:e0118209

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Lopresti AL, Jacka FN (2015) Diet and bipolar disorder: a review of its relationship and potential therapeutic mechanisms of action. J Altern Complement Med 21:733–739

    Article  PubMed  Google Scholar 

  • Lyte M (2011) Probiotics function mechanistically as delivery vehicles for neuroactive compounds: Microbial endocrinology in the design and use of probiotics. BioEssays 33(8):574–581

    Article  CAS  PubMed  Google Scholar 

  • Maes M (2008) The cytokine hypothesis of depression: inflammation, oxidative & nitrosative stress (IO&NS) and leaky gut as new targets for adjunctive treatments in depression. Neuro Endocrinol Lett 29:287–291

    CAS  PubMed  Google Scholar 

  • Magalhaes P, Kapczinski F, Nierenberg A, Deckersbach T, Weisinger D, Dodd S, Berk M (2012) Illness burden and medical comorbidity in the Systematic Treatment Enhancement Program for Bipolar Disorder. Acta Psychiatr Scand 125:303–308

    Article  CAS  PubMed  Google Scholar 

  • Mass M, Kubera M, Leunis J-C (2008) The gut-brain barrier in major depression: intestinal mucosal dysfunction with an increased translocation of LPS from gram negative enterobacteria (leaky gut) plays a role in the inflammatory pathophysiology of depression. Neuroendocrinol Lett 29:117–124

    Google Scholar 

  • Mayer EA, Tillisch K, Gupta A (2015) Gut/brain axis and the microbiota. J Clin Invest 125:926–938. https://doi.org/10.1172/JCI76304

    Article  PubMed  PubMed Central  Google Scholar 

  • McNamara RK (2015) Mitigation of inflammation-induced mood dysregulation by long-chain omega-3 fatty acids. J Am Coll Nutr 34:48–55

    Article  PubMed  PubMed Central  Google Scholar 

  • Meador-Woodruff JH, Hogg AJ Jr, Smith RE (2001) Striatal ionotropic glutamate receptor expression in schizophrenia, bipolar disorder, and major depressive disorder. Brain Res Bull 55:631–640

    Article  CAS  PubMed  Google Scholar 

  • Molteni R, Barnard RJ, Ying Z, Roberts CK, Gomez-Pinilla F (2002) A high-fat, refined sugar diet reduces hippocampal brain-derived neurotrophic factor, neuronal plasticity, and learning. Neuroscience 112(4):803–814

    Article  CAS  PubMed  Google Scholar 

  • Mueller HT, Meador-Woodruff JH (2004) NR3A NMDA receptor subunit mRNA expression in schizophrenia, depression and bipolar disorder. Schizophr Res 71:361–370

    Article  PubMed  Google Scholar 

  • Munkholm K, Vinberg M, Kessing LV (2013) Cytokines in bipolar disorder: a systematic review and meta-analysis. J Affect Disord 144:16–27

    Article  CAS  PubMed  Google Scholar 

  • Murphy BL, Stoll AL, Harris PQ, Ravichandran C, Babb SM, Carlezon WA Jr, Cohen BM (2012) Omega-3 fatty acid treatment, with or without cytidine, fails to show therapeutic properties in bipolar disorder: a double-blind, randomized add-on clinical trial. J Clin Psychopharmacol 32:699–703

    Article  CAS  PubMed  Google Scholar 

  • Myint AM, Kim Y-K, Verkerk R, Park SH, Scharpé S, Steinbusch HWM, Leonard BE (2007) Tryptophan breakdown pathway in bipolar mania. J Affect Disord 102:65–72. https://doi.org/10.1016/j.jad.2006.12.008

    Article  CAS  PubMed  Google Scholar 

  • Mykletun A, Jacka F, Williams L et al (2010) Prevalence of mood and anxiety disorder in self reported irritable bowel syndrome (IBS). An epidemiological population based study of women. BMC Gastroenterol 10:88

    Article  PubMed  PubMed Central  Google Scholar 

  • Nielsen PR, Benros ME, Mortensen PB (2013) Hospital contacts with infection and risk of schizophrenia: a population-based cohort study with linkage of Danish national registers. Schizophr Bull 40:1526–1532

    Article  PubMed  PubMed Central  Google Scholar 

  • O’Mahony SM, Clarke G, Borre YE, Dinan TG, Cryan JF (2015) Serotonin, tryptophan metabolism and the brain-gut-microbiome axis. Behav Brain Res 277:32–48. https://doi.org/10.1016/j.bbr.2014.07.027

    Article  CAS  PubMed  Google Scholar 

  • O’Neil A, Berk M, Itsiopoulos C et al (2013) A randomised, controlled trial of a dietary intervention for adults with major depression (the “SMILES” trial): study protocol. BMC Psychiatry 13:114

    Article  PubMed  PubMed Central  Google Scholar 

  • Painold A, Mörkl S, Kashofer K et al (2018) A step ahead: exploring the gut microbiota in inpatients with bipolar disorder during a depressive episode. Bipolar Disord. https://doi.org/10.1111/bdi.12682

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Parkinson L, Keast R (2014) Oleocanthal, a phenolic derived from virgin olive oil: a review of the beneficial effects on inflammatory disease. Int J Mol Sci 15:12323–12334

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Perlis RH, Ostacher MJ, Patel JK et al (2006) Predictors of recurrence in bipolar disorder: primary outcomes from the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Am J Psychiatr 163:217–224

    Article  PubMed  Google Scholar 

  • Pinto-Sanchez MI, Hall GB, Ghajar K et al (2017) Probiotic Bifidobacterium longum NCC3001 reduces depression scores and alters brain activity: a pilot study in patients with irritable bowel syndrome. Gastroenterology 153:448–459 e448. https://doi.org/10.1053/j.gastro.2017.05.003

    Article  PubMed  Google Scholar 

  • Pompili M, Gonda X, Serafini G et al (2013) Epidemiology of suicide in bipolar disorders: a systematic review of the literature. Bipolar Disord 15:457–490

    Article  PubMed  Google Scholar 

  • Post RM (2007) Role of BDNF in bipolar and unipolar disorder: clinical and theoretical implications. J Psychiatr Res 41:979–990

    Article  PubMed  Google Scholar 

  • Rahe C, Unrath M, Berger K (2014) Dietary patterns and the risk of depression in adults: a systematic review of observational studies. Eur J Nutr 53:997–1013

    Article  CAS  PubMed  Google Scholar 

  • Reedy J, Krebs-Smith SM, Miller PE, Liese AD, Kahle LL, Park Y, Subar AF (2014) Higher diet quality is associated with decreased risk of all-cause, cardiovascular disease, and cancer mortality among older adults. J Nutr 144:881–889

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Reininghaus EZ, Wetzlmair LC, Fellendorf FT et al (2018) The impact of probiotic supplements on cognitive parameters in euthymic individuals with bipolar disorder: a pilot study. Neuropsychobiology:1–8. https://doi.org/10.1159/000492537

  • Romijn AR, Rucklidge JJ, Kuijer RG, Frampton C (2017) A double-blind, randomized, placebo-controlled trial of Lactobacillus helveticus and Bifidobacterium longum for the symptoms of depression. Aust N Z J Psychiatry 51:810–821. https://doi.org/10.1177/0004867416686694

    Article  PubMed  PubMed Central  Google Scholar 

  • Ron Sender, Shai Fuchs, Ron Milo, (2016) Revised estimates for the number of human and bacteria cells in the body. PLOS Biology 14 (8):e1002533

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Rosenberg E, Sharon G, Atad I, Zilber-Rosenberg I (2010) The evolution of animals and plants via symbiosis with microorganisms. Environ Microbiol Rep 2:500–506. https://doi.org/10.1111/j.1758-2229.2010.00177.x

    Article  PubMed  Google Scholar 

  • Rosenblat JD, Kakar R, Berk M et al (2016) Anti-inflammatory agents in the treatment of bipolar depression: a systematic review and meta-analysis. Bipolar Disord 18:89–101. https://doi.org/10.1111/bdi.12373

    Article  CAS  PubMed  Google Scholar 

  • Roshanaei-Moghaddam B, Katon W (2009) Premature mortality from general medical illnesses among persons with bipolar disorder: a review. Psychiatr Serv 60:147–156

    Article  PubMed  Google Scholar 

  • Round JL, Mazmanian SK (2009) The gut microbiota shapes intestinal immune responses during health and disease. Nat Rev Immunol 9:313–323. https://doi.org/10.1038/nri2515

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Sachs GS, Printz DJ, Kahn DA, Carpenter D, Docherty JP (2000) The expert consensus guideline series: medication treatment of bipolar disorder. Postgrad Med 1:1–104

    Google Scholar 

  • Sampson TR, Mazmanian SK (2015) Control of brain development, function, and behavior by the microbiome. Cell Host Microbe 17:565–576. https://doi.org/10.1016/j.chom.2015.04.011

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Sánchez-Villegas A, Delgado-Rodríguez M, Alonso A, Schlatter J, Lahortiga F, Majem LS, Martínez-González MA (2009) Association of the Mediterranean dietary pattern with the incidence of depression: the Seguimiento Universidad de Navarra/University of Navarra follow-up (SUN) cohort. Arch Gen Psychiatry 66:1090–1098

    Article  PubMed  Google Scholar 

  • Sánchez-Villegas A, Galbete C, Martinez-González MÁ et al (2011) The effect of the Mediterranean diet on plasma brain-derived neurotrophic factor (BDNF) levels: the PREDIMED-NAVARRA randomized trial. Nutr Neurosci 14:195–201

    Article  PubMed  CAS  Google Scholar 

  • Saraf MK, Piccolo BD, Bowlin AK, Mercer KE, LeRoith T, Chintapalli SV, Shankar K, Badger TM, Yeruva L (2017) Formula diet driven microbiota shifts tryptophan metabolism from serotonin to tryptamine in neonatal porcine colon. Microbiome 5:77. https://doi.org/10.1186/s40168-017-0297-z

    Article  PubMed  PubMed Central  Google Scholar 

  • Sarris J, Logan AC, Akbaraly TN et al (2015a) Nutritional medicine as mainstream in psychiatry. Lancet Psychiatry 2:271–274

    Article  PubMed  Google Scholar 

  • Sarris J, Logan AC, Akbaraly TN et al (2015b) International Society for Nutritional Psychiatry Research consensus position statement: nutritional medicine in modern psychiatry. World Psychiatry 14:370–371

    Article  PubMed  PubMed Central  Google Scholar 

  • Schmidt K, Cowen PJ, Harmer CJ, Tzortzis G, Errington S, Burnet PW (2015) Prebiotic intake reduces the waking cortisol response and alters emotional bias in healthy volunteers. Psychopharmacology 232:1793–1801. https://doi.org/10.1007/s00213-014-3810-0

    Article  CAS  PubMed  Google Scholar 

  • Scholey A (2018) Nutrients for neurocognition in health and disease: measures, methodologies and mechanisms. Proc Nutr Soc 77:73–83

    Article  PubMed  Google Scholar 

  • Scott KA, Ida M, Peterson VL et al (2017) Revisiting Metchnikoff: age-related alterations in microbiota-gut-brain axis in the mouse. Brain Behav Immun 65:20–32

    Article  PubMed  Google Scholar 

  • Sender R, Fuchs S, Milo R (2016) Revised estimates for the number of human and bacteria cells in the body. PLOS Biology 14(8): e1002533

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Severance EG, Gressitt KL, Stallings CR et al (2013) Discordant patterns of bacterial translocation markers and implications for innate immune imbalances in schizophrenia. Schizophr Res 148:130–137

    Article  PubMed  PubMed Central  Google Scholar 

  • Severance EG, Yolken RH, Eaton WW (2016) Autoimmune diseases, gastrointestinal disorders and the microbiome in schizophrenia: more than a gut feeling. Schizophr Res 176:23–35

    Article  PubMed  Google Scholar 

  • Sokol H, Seksik P, Furet JP et al (2009) Low counts of Faecalibacterium prausnitzii in colitis microbiota. Inflamm Bowel Dis 15:1183–1189. https://doi.org/10.1002/ibd.20903

    Article  CAS  PubMed  Google Scholar 

  • Steenbergen L, Sellaro R, van Hemert S, Bosch JA, Colzato LS (2015) A randomized controlled trial to test the effect of multispecies probiotics on cognitive reactivity to sad mood. Brain Behav Immun 48:258–264

    Article  PubMed  Google Scholar 

  • Sudo N, Chida Y, Aiba Y, Sonoda J, Oyama N, Yu XN, Kubo C, Koga Y (2004) Postnatal microbial colonization programs the hypothalamic–pituitary–adrenal system for stress response in mice. J Physiol 558:263–275

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Sun Y, Geng W, Pan Y, Wang J, Xiao P, Wang Y (2019) Supplementation with Lactobacillus kefiranofaciens ZW3 from Tibetan Kefir improves depression-like behavior in stressed mice by modulating the gut microbiota. Food Funct. https://doi.org/10.1039/C8FO02096E

    Article  CAS  Google Scholar 

  • Suppes T, Dennehy EB, Swann AC et al (2002) Report of the Texas Consensus Conference Panel on medication treatment of bipolar disorder 2000. J Clin Psychiatry 63(4):288–299. https://doi.org/10.4088/JCP.v63n0404

    Article  PubMed  Google Scholar 

  • Swidsinski A, Loening-Baucke V, Vaneechoutte M, Doerffel Y (2008) Active Crohn’s disease and ulcerative colitis can be specifically diagnosed and monitored based on the biostructure of the fecal flora. Inflamm Bowel Dis 14:147–161. https://doi.org/10.1002/ibd.20330

    Article  PubMed  Google Scholar 

  • Sylvia LG, Peters AT, Deckersbach T, Nierenberg AA (2013) Nutrient-based therapies for bipolar disorder: a systematic review. Psychother Psychosom 82:10–19

    Article  PubMed  Google Scholar 

  • Tannock GW, Savage DC (1974) Influences of dietary and environmental stress on microbial populations in the murine gastrointestinal tract. Infect Immun 9:591–598

    CAS  PubMed  PubMed Central  Google Scholar 

  • Tseng P-T, Zeng B-S, Chen Y-W, Wu M-K, Wu C-K, Lin P-Y (2016) A meta-analysis and systematic review of the comorbidity between irritable bowel syndrome and bipolar disorder. Medicine (Baltimore) 95(33):e4617. https://doi.org/10.1097/MD.0000000000004617

    Article  PubMed  PubMed Central  Google Scholar 

  • Turnbaugh PJ, Ley RE, Mahowald MA, Magrini V, Mardis ER, Gordon JI (2006) An obesity-associated gut microbiome with increased capacity for energy harvest. Nature 444:1027

    Article  PubMed  Google Scholar 

  • Walker JR, Graff LA, Bernstein CN (2009) Depression and anxiety in inflammatory bowel disease: a review of comorbidity and management. Inflamm Bowel Dis 15:1105–1118. https://doi.org/10.1002/ibd.20873

    Article  PubMed  Google Scholar 

  • Weinberg DS, Smalley W, Heidelbaugh JJ, Sultan S, Association AG (2014) American Gastroenterological Association Institute guideline on the pharmacological management of irritable bowel syndrome. Gastroenterology 147:1146

    Article  PubMed  Google Scholar 

  • Wiest R, Garcia-Tsao G (2005) Bacterial translocation (BT) in cirrhosis. Hepatology 41:422–433

    Article  CAS  PubMed  Google Scholar 

  • Wozniak J, Biederman J, Mick E, Waxmonsky J, Hantsoo L, Best C, Cluette-Brown JE, Laposata M (2007) Omega-3 fatty acid monotherapy for pediatric bipolar disorder: a prospective open-label trial. Eur Neuropsychopharmacol 17:440–447

    Article  CAS  PubMed  Google Scholar 

  • Yatham LN (2005) Diagnosis and management of patients with bipolar II disorder. J Clin Psychiatry 66:13–17

    PubMed  Google Scholar 

  • Yolken R, Adamos M, Katsafanas E et al (2016) Individuals hospitalized with acute mania have increased exposure to antimicrobial medications. Bipolar Disord 18:404–409

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Shakuntla Gondalia.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article belongs to a Special Issue on Microbiome in Psychiatry & Psychopharmacology

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gondalia, S., Parkinson, L., Stough, C. et al. Gut microbiota and bipolar disorder: a review of mechanisms and potential targets for adjunctive therapy. Psychopharmacology 236, 1433–1443 (2019). https://doi.org/10.1007/s00213-019-05248-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00213-019-05248-6

Keywords

Navigation