Table 3.

Antimicrobial properties of psychotropic medications on the gut microbiota.

Class	Medication	Type of study	Proposed mechanism of action	Reference
Antidepressant	Amitriptyline	In vitro	Inhibits growth of Staphylococcus spp., Bacillus spp., Vibrio cholerae, Cryptococcus spp. and Candida albicans	Mandal et al. 2010 [180]
		In vivo	Protects mice from Salmonella typhimurium	Mandal et al. 2010 [180]
	Clomipramine	In vitro	Cytotoxic to Leishmania donovani and Leishmania major	Zilberstein and Dwyer 1984 [181]
	Desipramine	In vitro	Antimicrobial effect on Plasmodium falciparum	Basco and Le Bras 1990 [182]
				Salama and Facer 1990 [183]
		In vivo	Antimicrobial effect of Ruminococcus flavefaciens and Adlercreutzia. equolifaciens	Lukić et al. 2019 [148]
	Duloxetine	In vivo	Antimicrobial effect of R. flavefaciens and A. equolifaciens	Lukić et al. 2019 [148]
	Escitalopram	In vitro	Antimicrobial effect on E. coli	Cussotto et al. 2019 [129]
		In vivo	Antimicrobial effect of R. flavefaciens and A. equolifaciens	Lukić et al. 2019 [148]
	Fluoxetine	In vitro	Antimicrobial activity against E. coli and L. rhamnosus	Cussotto et al. 2019 [129]
		In vivo	Antimicrobial effect of R. flavefaciens and A. equolifaciens	Lukić et al. 2019 148
		In vivo	In rats, inhibits the growth of Succinivibrio and Prevotella	Cussotto et al. 2019 [129]
	Imipramine	In vitro	Cytotoxic against L. donovani and Leishmania major	Zilberstein and Dwyer 1984 [181]
		In vitro	Inhibits growth of E. coli, Yersinia enterocolitica, and Giardia lamblia	Csiszar and Molnar 1992 [184]
				Molnar 1988 [146]
				Weinbach et al. 1992 [185]
	Sertraline	In vitro	Antimicrobial activity against E. coli	Bohnert et al. 2011 [144]
		In vitro	Inhibition of S. aureus, E. coli, and P. aeruginosa growth and antibiotic synergy	Ayaz et al. 2015 [145]
	Venlafaxine	In vivo	Antimicrobial effect of R. flavefaciens and A. equolifaciens	Lukić et al. 2019 [148]
Antipsychotics	Aripiprazole	In vivo	Increases abundance of Clostridium, Ruminiclostridium, Intestinibacter, and Eubacterium coprostanoligens	Cussotto et al. 2019 [129]
		Human	Alteration of Lachnospiraceae, Akkermansia, and Sutterella between controls and patients treated with atypical antipsychotics	Flowers et al. 2017 [135]
	Chlorpromazine	In vitro	Inhibits S. aureus and E. coli growth.	Csisizar and Molnar 1992 [184]
				Amaral and Lorin 1991 [186]
				Ordway et al. 2002 [187]
	Olanzapine	In vitro	Inhibits growth of E. coli and Enterococcus faecalis	Morgan et al. 2014 [155]
		In vivo	Alters the microbiota profile in rats over a 3-week treatment	Davey et al. 2013 [188]
			Causes weight gain in mice over 4-week treatment. This is absent in germ-free mice	Morgan et al. 2014 [155]
			If treated with a probiotic (B-GOS) the weight gain caused by olanzapine is attenuated in female rats	Kao et al. 2018 [156]
		Human	Alteration of Lachnospiraceae, Akkermansia, and Sutterella between controls and patients treated with atypical antipsychotics	Flowers et al. 2017 [135]
	Risperidone	Humans	Alteration of Lachnospiraceae, Akkermansia, and Sutterella between controls and patients treated with atypical antipsychotics	Flower et al. 2017 [135]
Anxiolytics	Propranolol	In vitro	Inhibits E. coli growth with mixed evidence of S. aureus growth inhibition	Kruszewska et al. 2004 [149]
				Hadera et al. 2018 [150]
				Jerwood and Cohen 2008 [151]
Mood stabilisers	Lamotrigine	In vitro	Antibacterial activity against the Gram-positive bacteria B. subtilis, S. aureus, and S. faecalis	Qian et al. 2009 [152]
	Lithium	In vivo	After 4 weeks of treatment there is a change in the caecal microbiome in rats	Cussotto et al. 2019 [129]
	Valproate	In vivo	After 4 weeks of treatment there is a change in the caecal microbiome in rats	Cussotto et al. 2019 [129]