The effect of SSRI/SNRI antidepressant treatment on the gut microbiota of patients with major depressive disorder
BACKGROUND: The gut microbiome has been linked to major depressive disorder (MDD), yet it remains unclear whether antidepressant treatment influences these associations. This study aimed to clarify the role of serotonin reuptake inhibitors (SSRI/SNRI) in shaping gut microbiome changes observed in MDD. METHODS: We conducted cross-sectional analyses in two independent patient cohorts (total N = 1802) and a meta-analysis across both cohorts, comparing the gut microbiome of MDD patients with and without SSRI/SNRI treatment. RESULTS: Here we show that SSRI/SNRI treatment is consistently associated with reduced Clostridium sensu stricto 1 abundance. This effect is specific to SSRI/SNRI treatment and not observed with other psychotropic medications. Importantly, reductions in Clostridium sensu stricto 1 in MDD compared to unaffected controls are explained by SSRI/SNRI medication status. CONCLUSIONS: Antidepressant treatment is an important factor shaping gut microbiome alterations linked to MDD, underscoring the need to account for medication effects and potentially informing future microbiome-based strategies to improve treatment response.
Authors
- L. Fisch (ORCID: https://orcid.org/0000-0001-6424-7676)
- Andreas Jansen (ORCID: https://orcid.org/0000-0002-3140-8207)
- Corinna Bang (ORCID: https://orcid.org/0000-0001-6814-6151)
- Danique Mulder (ORCID: https://orcid.org/0000-0002-3927-4784)
- Janik Goltermann (ORCID: https://orcid.org/0000-0003-3087-1002)
- Elisabeth Johanna Leehr (ORCID: https://orcid.org/0000-0002-9264-5003)
- Marius Welzel (ORCID: https://orcid.org/0000-0002-4946-2156)
- Robert Nitsch (ORCID: https://orcid.org/0000-0002-6885-2555)
- Susanne L. Meinert (ORCID: https://orcid.org/0000-0003-2177-7161)
- Alejandro Arias Vásquez (ORCID: https://orcid.org/0000-0002-4786-0169)
- Sharmili Edwin Thanarajah (ORCID: https://orcid.org/0000-0003-3608-1474)
- Hamidreza Jamalabadi (ORCID: https://orcid.org/0000-0003-2485-2374)
- Andreas Lügering
- Andreas Reif (ORCID: https://orcid.org/0000-0002-0992-634X)
- Carsten Culmsee (ORCID: https://orcid.org/0000-0002-5121-5015)
- Silke Matura (ORCID: https://orcid.org/0000-0001-7666-9534)
- Tim Hahn (ORCID: https://orcid.org/0000-0001-6541-3795)
- Dominik Heider (ORCID: https://orcid.org/0000-0002-3108-8311)
- Tilo T. J. Kircher (ORCID: https://orcid.org/0000-0002-2514-2625)
- Indira Tendolkar (ORCID: https://orcid.org/0000-0003-3171-3671)
- André Franke (ORCID: https://orcid.org/0000-0003-1530-5811)
- Mirjam Bloemendaal (ORCID: https://orcid.org/0000-0001-5897-0649)
- Leon Fehse
- Janna N. Vrijsen (ORCID: https://orcid.org/0000-0003-0317-6696)
- Kira Flinkenflügel (ORCID: https://orcid.org/0000-0001-7738-5429)
- Eugenia Emile Natasha
- Philip van Eijndhoven
- Nina Alexander (ORCID: https://orcid.org/0000-0002-0106-1249)
- Benjamin Straube
- Nils R. Winter
- Paula Usemann
- Frederike Stein
- Udo Dannlowski
- Florian Thomas-Odenthal
- Tiana Borgers
- Igor Nenadic
- Lea Teutenberg
Institutions
- Goethe University Frankfurt (DE)
- Radboud University Nijmegen (NL)
- Philipps University of Marburg (DE)
- TU Dortmund University (DE)
- University of Münster (DE)
- Erasmus MC (NL)
- Radboud University Medical Center (NL)
- Fraunhofer Institute for Translational Medicine and Pharmacology (DE)
- Center for Behavioral Brain Sciences (DE)
- Center for HIV and Hepatogastroenterology (DE)
- University Hospital Frankfurt (DE)
- Pro Persona (NL)
- Leibniz Research Centre for Working Environment and Human Factors (DE)
- Bethel University (US)
Publication Details
- Journal
- Communications Medicine
- Published
- 2026-07-16
- DOI
- https://doi.org/10.1038/s43856-026-01782-5
- Primary Topic
- Gut microbiota and health
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- Horizon 2020 Framework Programme