Could taking poop pills help improve the health of those suffering from certain mental health disorders?
The University of Calgary’s Cumming School of Medicine is currently recruiting for two studies to find out whether fecal microbiota transplantation (FMT) can reduce symptoms of major depression disorder (MDD) and obsessive-compulsive disorder (OCD).
FMT is a medical procedure where a pill prepared from the stool (poop) of a healthy person is transferred into a patient’s gut. The procedure has been successful in treating C. difficile, a bacterium that causes an infection of the colon.
“Poop pills” are one way the gut microbiome can be manipulated by bringing in beneficial bacteria and reducing the number of “harmful” bacteria. According to researchers at the U of C, there is compelling evidence of an interaction between one’s gut and the central nervous system.
“Underlying our whole research is the concept that we believe that your gut bacteria via the gut-brain axis – the connection between your GI system and your brain – impact mental illness and that this is a very viable target for treatment, that mental illness is not just a brain disease, that it actually has strong links to your GI system,” explained Dr. Valerie Taylor, head of the psychiatry department at the U of C.
Taylor said there is a strong body of research identifying the fact that gut microbiome is different in people who have mental illness and those who don’t.
“Essentially what we’re doing is putting back things that should normally be there,” she said.
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The study for patients with MDD will take about 13 weeks and will include 18 visits to Foothills Medical Centre in Calgary. Researchers are looking for 25 more people to fulfill this study. Participants have a 50/50 chance of receiving placebo capsules or FMT capsules.
“Depression is one of the most prevalent psychiatric illnesses and there’s been probably the most research done on this illness and links between the gut microbiome or your gut-brain axis,” Taylor said.
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The study for people with OCD will take four months. Researchers are looking for 15 more patients for this study. All participants will receive FMT from a healthy donor.
“OCD is quite interesting in that it’s actually one of the only illnesses for which there is a documented link between types of OCD and actually specific bacterial — in this case streptococcal infection — which causes a form of OCD in children,” Taylor said.
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“The fact that there might potentially be a link between other forms of OCD and your gut bacteria really seemed intriguing to us.”
Taylor said psychiatric medications are some of the most prescribed classes of medication worldwide, but that only about 50 per cent of people respond to the first treatment and many people do not respond to treatment at all. On top of that, she said many people who do respond to treatment have “such significant side effects that they can’t tolerate the treatment.”
“We know that there is a large segment of the population that is really suffering from these illnesses and what’s currently available is simply not working,” Taylor said.
“What else can be offer people?”
Taylor hopes FMT may also result in fewer side effects than treatments such as anti-depressants.
“For us it was go big or go home,” she explained of the research.
“For sure for some there’s an ick factor, but I think for many they haven’t responded to conventional treatment, they feel so rotten and so desperate, and this really makes sense to them.”
The studies will follow patients for one year after the treatments end, and look at things like how long their wellness journey is maintained.
“Can depression and OCD be safely treated with this type of treatment? And if so, how long is that remission maintained?” Taylor explained.
“Is this something that you have one course of treatment and that’s it? Or is this something that, people are going to get well but at a certain point your system wants to revert to the bacteria that it likes despite the fact that that bacterial pattern or ecosystem results in illnesses like depression?”
Safety in the studies is paramount. Dr. Thomas Louie, a clinical professor of medicine at the U of C, is a physician collaborator working with Taylor on the studies. He has been providing fecal transplants to patients in Calgary and across Canada for over 20 years.
Louie said all stool donors in these studies are screened as per Health Canada and Canadian Blood Services guidelines. He said all donors are generally in their 20s or 30s, with active lifestyles and are taking no medication.
“The stool samples are tested with 30 different tests to exclude possible pathogens,” Louie explained.
“Even these days we test donors for COVID as well as monkeypox.”
Taylor said results of the research will be used to help identify exactly which bacteria may be leading to the illnesses in hopes of creating a microbial therapeutic or “supercharged probiotic, for want of a better description.”
Anyone interested in taking part in the studies can find out more information on the University of Calgary’s Taylor Lab website.
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