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Unravelling the role of the gut microbiome in antipsychotic-induced weight gain and metabolic dysfunction in humans and rodents: A systematic review
Second-generation antipsychotics are often associated with significant weight gain and metabolic dysfunction, yet the underlying mechanisms remain poorly understood. This systematic review investigates the potential role of the gut microbiome as a mediator of these adverse effects. A comprehensive search of PubMed and Embase yielded 24 relevant publications, encompassing both clinical and preclinical observational and intervention studies. The findings indicate a robust correlation between atypical antipsychotic use, weight gain, and alterations in gut microbiota, characterized by reduced microbial diversity, an increased Firmicutes/Bacteroidetes ratio, and a decrease in Akkermansia species. Despite these associations, consensus on the precise mechanisms linking the microbiome to antipsychotic-induced weight gain is lacking. Interventions targeting the microbiota have demonstrated limited efficacy in clinical populations; however, specific probiotic strains and microbiota metabolites have shown promise in preclinical research. Overall, while the interplay among antipsychotic-induced weight gain, metabolic dysfunction, and changes in the gut microbiome is evident, further investigations are essential to clarify causal relationships and facilitate the development of targeted microbiota interventions to mitigate these adverse effects. [NPID: Gut microbiome, antipsychotics, weight-gain, microbiota]
Year: 2026
