Many commonly prescribed medications may leave long-lasting changes in the bacteria that live in the gut, according to new research. Researchers examined stool samples from more than 2,500 people in the Estonian Biobank, alongside their prescription records and data from participants in the Estonian Microbiome cohort. Their goal was to determine whether medication use was linked to differences in the gut microbiome, the community of bacteria and other microorganisms that lives in the digestive tract.
The researchers found that most of the medications they studied were associated with differences in the gut microbiome. Notably, for many drugs, these differences could still be detected years after a person had stopped taking the medication. The long-lasting associations were not limited to antibiotics, which are already known to affect gut bacteria.
Similar links were observed for antidepressants, beta-blockers, proton pump inhibitors (PPIs), and benzodiazepines. Each of these categories of medication was connected to its own distinctive microbial “fingerprint” in the gut. Oliver Aasmets, lead author of the study, said: "Most microbiome studies only consider current medications, but our results show that past drug use can be just as important as it is a surprisingly strong factor in explaining individual microbiome differences.” The results could have implications for future microbiome research.
If medications taken months or years earlier continue to influence the gut microbiome, researchers studying links between the microbiome and disease may need to take a person’s medication history into account. Lucy Hooper, a GP and co-founder of Coyne Medical in London, told Newsweek that certain groups may be more vulnerable to long-lasting microbiome changes than others. Babies and young children are still developing their gut microbiome, meaning disruptions during this period could have a greater impact.
She noted that research has previously linked early antibiotic use and microbiome changes in children to conditions including asthma, obesity and type 2 diabetes. Hooper added that older adults may also be at increased risk because microbiome diversity tends to decline with age, while many are more likely to require frequent or long-term medication use. One of the most striking findings involved benzodiazepines, a class of drugs commonly prescribed for anxiety and other disorders.
The researchers reported that the association between benzodiazepine use and changes in the gut microbiome was comparable to the associations seen with broad-spectrum antibiotics, which are designed to act against many different kinds of bacteria and are known to cause substantial changes in gut microbes. The study also showed that medications within the same drug class do not necessarily affect the microbiome in the same way. For example, diazepam and alprazolam, two benzodiazepines that may be prescribed for similar conditions, appeared to differ in how strongly they disrupted gut microbes.
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