- The gut microbiome, comprised of bacteria, fungi, and yeast, plays an important role in human health.
- Disruption of the microbiome has been linked to numerous chronic health conditions.
- It has long been known that antibiotics affect the gut microbiome, killing both beneficial and pathogenic bacteria.
- Now, a study has found that other prescription medications also have negative effects on the microbiome, and that the effects can persist for years after the drugs are stopped.
Recent studies have found that many prescription medications have lasting effects on the gut microbiome that can last for years.
research, Published in the Journal of the American Society for Microbiology m systemIn addition to antibiotics, antidepressants, beta blockers, stomach acid reducers, and Substances such as anti-anxiety medications may continue to disrupt the microbiome long after use.
Babak Firuji, MDThe gastroenterologist at MemorialCare Orange Coast Medical Center in Fountain Valley, California, welcomed the study but urged caution when interpreting the results.
“The methodology was powerful and convincingly linked changes in the gut microbiome to drug use, but this was not a controlled trial. There are too many unexplained variables, including environmental factors, diet, and geographic location. The most surprising finding is how many different types of drugs appear to affect the gut microbiome.”
researchers We used data from 2,509 adults from the Estonian microbiome population. Estonia Biobank — A population-based databank on volunteers in Estonia.
The volunteers, aged between 23 and 89, provided blood, cheek swabs and stool samples. The researchers then used:
They accessed details about participants’ current and past prescription drug use from their electronic health records.
At the time of the first sample, participants were using a total of 433 prescription drugs, and over the previous five years, participants had used 507 prescription drugs. Just over a third of the participants (857) were not taking drugs at the time of the first sample, and those who were taking drugs were using an average of three types of drugs.
Because the researchers did not evaluate the effect of antibiotics at the first time point, they excluded people who took antibiotics within 90 days of collecting the first sample, but evaluated the effect of antibiotics at the second sample.
In total, the researchers analyzed the effects of 186 drugs. Of these, 167 affected the microbiome in some way, and 78 showed long-term effects on microbiome composition.
Measurable changes in the microbiome were seen in people who took the following drugs:
- Antibiotics — Drugs that treat bacterial infections by killing the bacteria or preventing their growth.
- Antidepressants – relieve symptoms of depression by increasing neurotransmitters in the brain.
- Antipsychotics – Drugs that treat psychosis associated with some mental health conditions, such as schizophrenia and bipolar disorder.
- Beta blockers – medications used to treat cardiovascular conditions such as angina and high blood pressure.
- Biguanides — metformin used to treat type 2 diabetes
- Proton pump inhibitors (PPIs) treat acid reflux, heartburn, and stomach ulcers by reducing stomach acid.
- Benzodiazepines prescribed for anxiety and sleep disorders.
Antibiotics, beta-blockers, benzodiazepine derivatives, glucocorticoids, PPIs, biguanides, and antidepressants all affected the microbiome that appeared years after previous drug intake.
Researchers found that the longer people took drugs and the more drugs they took, the greater the impact on their microbiome. Several drugs were shown to interact and have a greater impact on the microbiome, but when it came to individual drugs, it was benzodiazepines that seemed to have the most negative effects.
In the paper, the authors warn:
“The physiological effects of drugs targeting humans can be even greater in that they are often taken continuously throughout one’s life, rather than being taken for a short period of time like antibiotics,” he said.
“Our findings highlight that even past drug use can leave a lasting mark. At the same time, we found that even within the same class of drugs, individual drugs can affect the microbiome in very different ways. If two drugs are equally effective, doctors can choose the drug that has less effect on the gut microbiome.”
— Elin Οrg, PhDStudy co-author, head of the microbiome research group at the University of Tartu
Even within drug classes, drugs had different effects. Among benzodiazepines commonly prescribed as anti-anxiety medications, alprazolam, sold as Xanax, was found to have a much more widespread effect on the microbiome than diazepam (Valium).
“The notable differences in the effects of alprazolam and diazepam on the microbiome may provide valuable input to future treatment decisions and warrant further investigation,” the authors noted.
since
A healthy microbiome is a stable community with a diversity of microorganisms and an abundance of microbial genes that live in balance with the human host. However, factors such as diet, antibiotics, and age You can change your gut microbiomeIt often has negative health effects.
The microbial community is destroyed bacterial imbalanceIt has been linked to diseases such as inflammatory bowel disease (IBD), obesity, allergic diseases and asthma, type 2 diabetes, cardiovascular disease, and autoimmune diseases.
Antibiotics, especially broad-spectrum antibiotics, kill not only the beneficial bacteria in your gut, but also the bacteria you are trying to destroy to get rid of the infection.
But as Firoozi explains, different drugs work in different ways.
“In a broader sense, drugs such as antidepressants, beta-blockers and benzodiazepines can affect gut motility, which can affect gut bacteria by slowing their movement through the intestines. Proton pump inhibitors have long been associated with affecting the gut microbiome, primarily by removing the main defense against bacterial growth, namely stomach acid.”
He suggested that benzodiazepines may affect a person’s gut microbiome by altering their eating habits, and that diet is closely linked to the health of the microbiome.
Firoozi stressed that people should follow their doctor’s instructions and recommended taking medications only as prescribed and for as long as needed.
He advised, “Particularly in the case of benzodiazepines, long-term use is strongly discouraged because they easily cause dependence and are associated with cognitive decline. In the case of PPI drugs, the need to continue the drug should be discussed at least every two months and efforts should be made to discontinue the drug.”
He also recommended following a diet high in fiber and low in fat, minimizing red and processed meats, reducing your intake of processed foods, and promoting overall gut health through regular exercise.
