Gut Microbiota in Depression: A Focus on Ketamine

Summary

Major depressive disorder is the leading cause of disability worldwide, and its pathophysiology remains incompletely understood. The gut microbiome, acting through the gut–microbiota–brain axis, is an increasingly recognized environmental factor in depression. Available treatments are insufficient, as 30% of patients are treatment-resistant, creating a need for novel strategies. Ketamine is an effective antidepressant in treatment-resistant patients, and its effects may be partially mediated by modification of gut microbiota. This review examines data on gut microbiota in depression, focusing on ketamine's effects on the microbiome in animal models. Earlier reports are preliminary and insufficient for firm conclusions, but further studies could clarify the gut–brain axis's role in depression treatment and lead to new strategies.

Study at a glance

Abstract

According to the WHO, major depressive disorder is the leading cause of disability worldwide, and it is a major contributor to the overall global burden of disease. The pathophysiology of this common and chronic disease is still not completely understood. The gut microbiome is an increasingly recognized environmental factor that can have a role in depression, acting through the gut–microbiota–brain axis. The available treatment for depression is still insufficient since 30% of patients are treatment-resistant. There is an unquestionable need for novel strategies. Ketamine is an effective antidepressant in treatment-resistant patients. It is suggested that the antidepressant effect of ketamine may be partially mediated by the modification of gut microbiota. In this study, we presented a review of data on gut microbiota in depression with special attention to the effect of ketamine on the microbiome in animal models of depression. Earlier reports are preliminary and are still insufficient to draw firm conclusion, but further studies in this field might help to understand the role of the gut–brain axis in the treatment of depression and might be the ground for developing new effective treatment strategies.