Therapeutic Implications of the Microbial Hypothesis of Mental Illness

Jonathan Savitz, Robert H. Yolken

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

There is increasingly compelling evidence that microorganisms may play an etiological role in the emergence of mental illness in a subset of the population. Historically, most work has focused on the neurotrophic herpesviruses, herpes simplex virus type 1 (HSV-1), cytomegalovirus (CMV), and Epstein–Barr virus (EBV) as well as the protozoan, Toxoplasma gondii. In this chapter, we provide an umbrella review of this literature and additionally highlight prospective studies that allow more mechanistic conclusions to be drawn. Next, we focus on clinical trials of anti-microbial medications for the treatment of psychiatric disorders. We critically evaluate six trials that tested the impact of anti-herpes medications on inflammatory outcomes in the context of a medical disorder, nine clinical trials utilizing anti-herpetic medications for the treatment of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) or schizophrenia, and four clinical trials utilizing anti-parasitic medications for the treatment of schizophrenia. We then turn our attention to evidence for a gut dysbiosis and altered microbiome in psychiatric disorders, and the potential therapeutic effects of probiotics, including an analysis of more than 10 randomized controlled trials of probiotics in the context of schizophrenia, bipolar disorder (BD), and major depressive disorder (MDD).

Original languageEnglish (US)
Title of host publicationCurrent Topics in Behavioral Neurosciences
PublisherSpringer Science and Business Media Deutschland GmbH
Pages315-351
Number of pages37
DOIs
StatePublished - 2023

Publication series

NameCurrent Topics in Behavioral Neurosciences
Volume61
ISSN (Print)1866-3370
ISSN (Electronic)1866-3389

Keywords

  • Bipolar disorder
  • Clinical trial
  • Cytomegalovirus
  • Epstein–Barr virus
  • Herpes simplex virus
  • Major depressive disorder
  • Microbiome
  • Schizophrenia
  • Toxoplasma gondii

ASJC Scopus subject areas

  • Behavioral Neuroscience

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