Mental Health -Exploring the Relationship with Antidepressants and Gut Microbiota
Mental Health As a specialist dietitian, I continually raise awareness about the impact and importance of diet on mental health. The recent Panorama programme regarding the difficulty of antidepressant withdrawal has highlighted the vast numbers of dependants, the need for alternatives, and if possible, avoiding them in the first place. This blog hopes to shed light on the important need and connection between diet and mental well-being exploring the intricate relationship between diet, mental health, antidepressants, and gut microbiota. The Significance of Diet in Mental Health The saying “you are what you eat” holds true when it comes to mental health. We have understood for many years there is a gut-brain axis, and know the complex communication network between the gut and the brain plays a vital role in mental well-being. Numerous pathways have been identified through which diet could plausibly affect mental health. These include modulation of pathways involved in inflammation, oxidative stress, epigenetics, mitochondrial dysfunction, the gut microbiota, tryptophan–kynurenine metabolism, the HPA axis, neurogenesis and BDNF (brain-derived neurotrophic factor), epigenetics, and risks with obesity. Mental Health – The Role of Nutrients We know multiple nutrients have been linked to improved mental health. I have spent the past 15 yrs of my 26 yr career, working with my patients to perfect their diets not only to be optimal for their physical wellbeing but mental health too. One group of well-known and researched nutrients are the omega-3s. These fatty acids can be found in fatty fish, walnuts, and flaxseeds but also consumed by the gallon by people in supplement form as our bodies can’t make them. (YouTube Video). Omega 3’s have good and bad press with research finding that high dose supplementation may cause atrial fibrillation and increase risk of bleeding. Consumed in their natural form is the best option as they have a known potential in reducing symptoms of depression and anxiety when consumed as part of a bigger nutrient selection. If needing a supplement using a plant based option is ideal (see below). Another well-known group of nutrients are B vitamins, found in whole grains, leafy greens, and legumes, are important for brain function and mood regulation. I see hundreds of patients take these in high doses either in singles like high dose B12 or high dose B6 believing “more is better” whilst continuing a poor quality diet. This is not recommended and can actually be at best making expensive urine and at worst cause toxic neuropathy, insomnia, headache, palpitations, anxiety and acne…. Understanding Antidepressants Antidepressant medications are commonly prescribed to manage mental health conditions such as depression and anxiety. Common ones include: citalopram (Cipramil) dapoxetine (Priligy) escitalopram (Cipralex) fluoxetine (Prozac or Oxactin) fluvoxamine (Faverin) paroxetine (Seroxat) sertraline (Lustral) vortioxetine (Brintellix) These medications work by increasing neurotransmitters in the brain, such as serotonin and noradrenaline. Whilst the exact mechanism of how these chemicals affect mood is not fully understood, it is believed that they help to regulate emotions and improve overall well-being. In the UK, around one in seven now take an antidepressant. Globally they have made the pharmaceutical industry billions. When the current generation of drugs was launched 35 years ago, they promised a safe and effective treatment, free from the side effects of older medicines. But have they lived up to those claims? While many people say they have benefited from taking antidepressants. Panorama revealed evidence of some companies trying to conceal concerns about their drugs, following patients who have suffered serious side effects as they continue their fight to be heard. The Panorama programme highlighted they are not a standalone solution and should be used in conjunction with other therapeutic approaches. Diet and Antidepressants: Interactions and Considerations It’s important to remember that what we eat can also play a significant role in how our bodies respond to antidepressant medications if they are taken. Certain foods and supplements can interact with these drugs, potentially reducing their effectiveness or causing unwanted side effects. Therefore, it’s essential for individuals taking antidepressants to be mindful of their diet and speak with their healthcare provider about any potential interactions that may occur. One example Grapefruit, is a nutritious and delicious fruit that is commonly consumed as part of a healthy diet. However, many people are unaware that grapefruit and its juice can interact with certain medications, impacting their effectiveness and potentially causing harmful side effects. Mental Health and Gut Microbiota The gut microbiota, the trillions of microorganisms residing in our digestive tract, have gained significant attention for their influence on mental well-being. Emerging research suggests that imbalances in the gut microbiota, known as dysbiosis, may contribute to mental health disorders. A healthy, diverse gut microbiome is associated with improved mood and cognitive function. Research suggests that the neurochemicals produced by the gut microbiome can have a direct impact on mental health and behaviour. One such example is serotonin, which plays a crucial role as a signalling molecule in the gastrointestinal tract. Enterochromaffin (EC) cells utilize serotonin to activate afferent neurons that transmit signals to the central nervous system, making it an important sensory transducer. Research suggests that the gut is responsible for producing a large portion of the body’s serotonin (over 90%) and roughly half of its dopamine (Berger et al., 2009). Studies conducted on germ-free mice have shown that serum levels of serotonin decrease and tryptophan increase without the presence of gut microbes, further highlighting the important role the gut plays in neurotransmitter production.(Wikoff et al, 2009) The Impact of Diet on Gut Microbiota Diet plays a pivotal role in shaping the composition and diversity of our gut microbiota. A diet rich in fibre, found in fruits, vegetables, whole grains, and legumes, provides nourishment for beneficial bacteria in the gut. On the other hand, diets high in processed foods added sugars, and unhealthy fats can negatively impact the gut microbiota. Mental Health – Probiotics Probiotics, beneficial live bacteria and yeasts, have shown promise in promoting mental well-being. Specific strains of probiotics, such as Lactobacillus and Bifidobacterium, have
