Why antidepressants like Prozac, sertalin and cipralex can make antibiotics less effective

According to the study, popular antidepressants such as sertraline and cipralex may promote the growth of antibiotic-resistant superbugs.

Antimicrobial or antibiotic resistance occurs when bacteria and viruses evolve to resist drugs, making it difficult to treat infections, and the World Health Organization has called it one of the top global health threats facing humanity.

Traditionally, it has been associated with the overuse of antibiotics in humans and animals.

While it’s still thought to be the main cause of antimicrobial resistance, new research suggests that anti-anxiety and antidepressants may also play a role, though it’s too early to tell for sure and there’s no evidence that people should stop taking the medication, the researchers say.

Researchers at the University of Queensland conducted a series of laboratory tests on antibiotic-susceptible E. coli and found that five commonly prescribed medications for anxiety and depression significantly increased antibiotic resistance in bacteria after only a few days of exposure.

This is the most comprehensive study of superbugs and antidepressants. It is based on a 2018 study led by the same researcher, Professor Jianhua Guo, who found that fluoxetine, better known as Prozac, causes antibiotic resistance in laboratory experiments.

The new study looked at five other commonly used antidepressants and 13 antibiotics from six classes of antibiotics, and looked at the development of resistance in E. coli.

The drugs tested by the investigators included sertraline (Zoloft), escitalopram (Lexapro and Cipralex), bupropion (Wellbutrin and Zyban), duloxetine (Cymbalta), and agomelatine (Valdoxan and Timanax).

“Our results are both interesting and frightening – they have somewhat changed our understanding of antibiotic resistance,” said Prof Guo. I. “Sertraline, duloxetine and fluoxetine had the strongest effect on antibiotic resistance in bacteria of the drugs we tested.

“Our study showed a significant increase in antibiotic resistance from these three, even at very low doses.

Professor Guo believes that resistance is a response to the stress that antidepressants put on bacteria that produce chemicals to protect themselves, in other words, antibiotic resistance.

“We found that these drugs induce a ‘SOS response’ and activate cellular defense mechanisms, which in turn cause E. coli bacteria to develop resistance to several classes of antibiotics,” he explained. “We cannot ignore the contribution of antidepressants to the spread of antibiotic resistance.”

He added that he is now working to confirm his results in mice in the lab before testing in humans.

This is what experts who did not participate in the study say. I They considered the results significant. “This study is an important addition to new evidence pointing to the role of non-antibiotic drugs in antibiotic resistance,” said Kiran Patil, a bacterial expert at the University of Cambridge.

“The main conclusion that antibiotic resistance can arise in response to antidepressants is well founded. The study is an important step in confirming a mechanistic link between non-antibiotic drugs and antibiotic resistance.”

However, he warned that much more research is needed to determine what effect those substances that have been identified in the laboratory have on living people.

He argued that most of the research was carried out under aerobic conditions, that is, in the presence of oxygen, while E. coli is most often found in the large intestine, where conditions are anaerobic. This means that a process identified in the laboratory may not be the same in humans.

“The study concerns E. coli, which, although common, is not a common microbe in the gastrointestinal tract. In addition, most of the research is done under aerobic conditions, meaning that the mechanisms identified are likely to be less relevant in an in vivo environment. [living animals and humans] context, the doctor said. patil.

Aimee Murray, an antimicrobial expert at the University of Exeter, said: “These results are important as they suggest that the use of antidepressants may have unforeseen consequences in terms of developing and increasing the transmission of antibiotic resistance.

“However, much more research is needed to fully characterize, understand and put into context these findings, as well as any implications for human health.”

“Based on this study, we would definitely not advise people to stop taking any prescription medication, including antidepressants. Much more research is needed before a change in clinical practice can occur,” the doctor said. Murray

The study was published in the journal PLUS ONE.