According to a recent study that was released in PNAS, antidepressants are linked to the rise in superbugs. With a few days of exposure, bacteria develop drug resistance, not only against one antibiotic but multiple antibiotics.
The phrase “superbug” conjures up pictures of super-strong bacteria that can resist the effects of the drugs used to kill them. The widespread use of antibiotics is regarded to be the root of the problem. As a result of bacterial adaptability in a struggle for survival, more and more bacterial illnesses are becoming resistant to antibiotic treatment.
According to a recent study that was released in PNAS on January 23, antidepressants, some of the most often prescribed drugs in the world, can become lethal superbugs due to the development of antibiotic resistance.
“Even after a few days exposure, bacteria develop drug resistance, not only against one but multiple antibiotics,” Jianhua Guo, one of the study’s authors and a professor at the University of Queensland’s Australian Centre for Water and Environmental Biotechnology, told Nature. “This is both interesting and scary.”
In the study, scientists exposed Escherichia coli, or E. coli, bacteria to 13 antibiotics from six different drug classes after exposing the bacteria to five common antidepressants, including sertraline (Zoloft), duloxetine (Cymbalta), bupropion (Wellbutrin), escitalopram (Lexapro), and agomelatine (Valdoxan).
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Every antidepressant contributed to the development of antibiotic resistance in E. coli, however, sertraline (Zoloft) and duloxetine (Cymbalta) had the strongest effects and generated the most resistant bacterial cells.
When Guo’s lab found that domestic wastewater had more antibiotic-resistant genes than hospital wastewater—where more antibiotics are used—in 2014, this sparked his interest in non-antibiotic substances causing antibiotic resistance.
This led to the discovery by his team and others that antidepressants were able to kill or slow the growth of particular bacteria. According to Guo, this causes the bacteria to go into “an SOS response,” which sets off defence mechanisms that help them survive and subsequently resist antibiotic treatments.
Guo and his team conducted the current study to determine whether antidepressants could lead to bacteria developing antibiotic resistance in response to these findings.
In addition to showing that antidepressants contribute to antibiotic resistance, the study discovered that the faster the E. coli bacteria gained resistance and the more antibiotics they could resist over the two-month study frame, the higher the dose of antidepressants.
It’s interesting to note that bacteria in high-oxygen environments evolved resistance faster than those in low-oxygen lab settings. A low-oxygen environment more closely resembles the human intestine, where the E. coli bacteria develops in the body, which may be good news for humans.
The study also showed that at least one of the antidepressants, sertraline, marketed under the brand name Zoloft, promoted the propagation of resistance genes among bacterial cells. These transfers can take place between many bacterial species, allowing resistance to cross species boundaries and transform from infectious to harmless bacteria.
The Prolific Use of Antidepressants
Antibiotic resistance poses a severe threat to public health globally. Antibiotic resistance is thought to have directly caused the deaths of 1.2 million people worldwide in 2019; this number is anticipated to rise in the coming years.
Over 200,000 people’s data were examined as part of an extensive epidemiological study conducted by the University of Bristol and published in the British Journal of Psychiatry Open. The goal of the study was to determine whether long-term antidepressant use (over five and ten years) was linked to the onset of six health issues, including diabetes, high blood pressure, coronary heart disease, stroke (and related syndromes), as well as two mortality outcomes, such as death from cardiovascular disease or from any cause.
The Pharmaceutical Journal reports that the number of antidepressant prescriptions written in the U.K. has climbed by 35 per cent over the last six years, and that number increased by 5.1 per cent in 2021–2022, marking the sixth consecutive year of growth. These figures show both the worrying increase in antidepressant use as well as the ramifications of these medications’ propensity for developing antibiotic resistance.
The top 20 antidepressants by prescription volume in the US were compiled by Definitive Healthcare, a company that gathers and analyses healthcare data. The top three antidepressants recommended by doctors in 2021 were:
- Zoloft (sertraline hydrochloride)–18,337,255 prescriptions
- Desyrel/Oleptro (trazodone hydrochloride)–15,175,105 prescriptions
- Wellbutrin (bupropion hydrochloride)–14,849,887 prescriptions
In the United States alone, almost 130.5 million prescriptions for the 20 antidepressants on the list were written in 2021.
How Dangerous Is Antibiotic Resistance?
Antibiotic resistance is one of the largest dangers to world health, food security, and development, according to the World Health Organization. They point out that as antibiotics lose their effectiveness, a rising number of infections, such as pneumonia, TB, blood poisoning, gonorrhoea, and foodborne diseases, become difficult and occasionally impossible to cure.
Without immediate action, the WHO warns that “ordinary diseases and mild injuries can once again kill” in a post-antibiotic world.
Tuberculosis, anthrax, tetanus, pneumonia, cholera, botulism, and pseudomonas diseases are a few of the most deadly bacterial infections. One of the most prevalent infections that are now resistant to medications is MRSA (pdf below), or methicillin-resistant Staphylococcus aureus, and its symptoms typically start as painful, swollen red lumps on the skin that resemble pimples or spider bites. Many cases are minor, but some might result in infections that are more serious and potentially fatal. MRSA is frequently referred to as a “superbug” because of how challenging it is to treat and how resistant it is to medications.
According to the PNAS study, the necessity to reevaluate the antibiotic-like side effects of antidepressants is highlighted by the fact that the United States consumes a large number of antibiotics (16,850 kilos annually in the United States alone).
Implications for Humans
More investigation is required to determine whether antidepressants may contribute to the emergence of superbugs in the environment or in human bodies given that these effects were only seen in Petri dishes.
The researchers found that sertraline and duloxetine, the two antidepressants that had the most dramatic effects and resistance, had effects after just one day of exposure. The ramifications for humans are difficult to anticipate, however. Simply noted, there may be enough antidepressants in the colon in clinically relevant quantities to cause resistance (e.g., 50 mg/L).
Another worry is whether the presence of antidepressants in wastewater is enabling bacteria to become resistant, which might result in a public health emergency. To completely comprehend what concentrations might be important and their long-term ramifications, more research is required.
According to a new study published in Nature, depression may not be caused by a serotonin imbalance in the brain as previously assumed.
The latest research connecting antidepressants to superbugs provides another incentive to look into alternative depression treatments, especially in light of the tremendous challenges the globe has experienced recently and the rising use of antidepressants.
**Do not quit taking antidepressants suddenly if you are currently on them. The safest course of action is to gradually decrease the quantity over several weeks or months. Please get advice from a medical expert you can trust to guide you through the process if you’re interested in reducing your dosage or eliminating antidepressants altogether.
Read the study given below: