A stool transplant could have a positive effect on mental illness. This is demonstrated by a case study published in the specialist journal “Bipolar Disorders”. In it, researchers from the University of New South Wales (UNSW Sydney) in Australia describe their observations. It has long been known that mental illness is linked to the microbiome in the gut. However, the recent observation could represent a new therapeutic approach.
The case study describes the treatment of a 28-year-old man diagnosed with bipolar disorder. When researchers first looked at him in 2014, he said he had suffered from severe anxiety since he was 10 years old. For the researchers, he met the criteria for “generalized anxiety and panic disorder”.
Fecal transplant as a means of fighting mental illness
As part of the treatment, the man was given feces, after which his symptoms improved markedly. A year after the transplant, the patient said he no longer needed almost any medication and eventually stopped taking it completely after another four months.
The so-called “stool transplant” had positively influenced the microbiome in her gut. Previously, the patient had manic phases alternating with depressive phases treated with multiple drugs. According to the researchers, however, the effect of the drugs was “unsatisfactory”. Hence the decision to undergo a stool transplant.
Stool transplants have long been used for intestinal diseases so that the intestinal flora can be regenerated. The feces of a healthy person, for example in the form of capsules, are transported to the patient’s intestines. The microorganisms it contains are then deposited in the diseased intestine. Transplantation via an enema is also possible. The possible side effects of the transfer are so far very rare, provided that a stool transplant is under medical supervision. In theory, it is also possible to transmit pathogens, bacteria or viruses through the faeces.
Researchers rule out the placebo effect in the case study
As for treatment success, the researchers noted that single case studies always have “obvious and well-recognized risks”, such as the possibility of a placebo reaction. In the case of observation of the young, the researchers describe, however, a placebo reaction can be ruled out. Because with a placebo reaction, there would only be a short-lived improvement. The sharp improvement in symptoms over a period of over a year also surprised scientists. In retrospect, they describe the stool transplant process as “time consuming”. However, there are other approaches to improve the microbiome in the gut. In a Canadian study, subjects were fed a small dose on a daily basis, with stool samples taken at 12 and 24 weeks.
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Previous experiments in the field of faecal transplantation with animals have already shown promising results. Mice fed on the feces of depressed humans also appeared to become depressed. Something similar was also observed in mice treated with feces of schizophrenics.
This is made possible by the so-called “intestinal brain”. Humans have millions of nerve cells between the intestinal wall and muscle layers. The messenger substances serotonin and dopamine are also produced there. They are transmitted to the brain via the vagus nerve. With a modified microbiome, for example in mental illness, it is possible that the intestinal mucosa is damaged. This can cause inflammation. As a result, happiness hormones, for example, can no longer be transmitted to the brain without interference. If the microbiome stabilizes during the transplant, the interruption would be reversed. However, research in this regard is still in its infancy. It is unclear when a stool transplant can be used to treat mental illness. The verdict of the study from Australia is similar.
Further studies are needed
“Although our patient’s bipolar disorder was very severe, he was able to attend college, work part-time, travel overseas, and have close partners and relationships,” writes the study’s author. For a small percentage of people with bipolar disorder who are unresponsive to multiple medications and are therefore at high risk of suicide, as the side effects of many medications can shorten life, he believes a stool transplant may make sense. Much more clinical trials are needed.
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