A glimpse into future therapies addressing mental disorders: Could a poo transplant be the answer for patients fighting depression?

Dr. Jeremy Lim, MBBS

Co-founder and CEO of AMILI

SINGAPORE: In recent years, Singapore has been struggling with a distressing surge in the number of individuals taking their own lives due to mental health issues. As the nation grapples with this heartbreaking trend, unconventional approaches to addressing the root causes of these mental health problems are being explored. One such innovative solution gaining attention is the potential use of faecal microbiota transplantation (FMT), commonly known as faecal transplant or poo transplant, a potentially groundbreaking medical procedure that has shown promising results in treating certain mental health disorders. Given the urgency to tackle this rising crisis, could this unconventional therapy provide a glimmer of hope in reshaping the landscape of mental health treatment in Singapore?

In a groundbreaking study conducted by researchers at the University of New South Wales, two patients suffering from bipolar disorder underwent a faecal transplant. The results were astounding, with both patients experiencing significant symptomatic improvements. One patient, who had previously tried multiple medications without success, became symptom-free and stopped taking all medications, experiencing a remarkable transformation in quality of life. The other patient, who had developed an intolerance to the side effects of medication, experienced a decrease in mood swings as well as improvements in anxiety and attention deficit hyperactivity disorder (ADHD). AMILI, a local company and Southeast Asia’s first precision gut microbiome company, also discovered a similar finding through its study, where a patient showed an improvement in ADHD symptoms with the use of FMT. The company was established by doctors and scientists in Singapore to bridge the gap in gut health research and provide accessibility to microbiome services.

Another two case studies conducted by researchers at the University of Basel in Switzerland explored the use of faecal transplantation in major depressive disorder (MDD) patients. These patients had previously received treatment for their depression but continued to experience symptoms. After undergoing oral frozen FMT-capsule interventions, both patients’ depressive symptoms improved. One of the patients experienced a decrease in Hamilton Depression Rating Scale (HAMD) scores from 21 to 9 points after 4 weeks, while the other patient’s scores decreased from 31 to 10 points. Gastrointestinal symptoms also improved in both patients.

However, it is important to note that these results came from only a handful of cases, and while the scientific community holds great optimism for the future of faecal transplantation in mental health treatment, further research is needed to determine the effectiveness of faecal transplantation in treating depression and other mental health problems.

The gut microbiome, comprised of trillions of bacteria residing in our digestive system, is now recognised for its profound influence on overall health, including brain health. This complex ecosystem of bacteria, viruses, and fungi plays a crucial role in numerous physiological processes, including the production of neurotransmitters, immune system modulation, and the regulation of inflammation. Imbalances or disruptions in the gut microbiome, known as dysbiosis, have been linked to conditions such as depression, anxiety, and even neurodevelopmental disorders. The potential impact of the gut microbiome on mental health highlights the interconnectedness of our bodily systems and opens up new therapeutic avenues for restoring microbial equilibrium and promoting mental health. While caution must be exercised, these preliminary findings suggest that faecal transplantation could be a promising avenue for future research and treatment to establish its efficacy and rule out other contributing factors.

Cordlife, a homegrown stem cell cryopreservation company, now offers individuals the option to cryopreserve their healthy poo in case they or a family member require a faecal transplant in the future. Known as gut microbiome banking, this emerging practice allows healthy individuals to store their own healthy gut microbiome-rich faeces to potentially address future gastrointestinal conditions or other health issues. By preserving a sample of their own healthy poo, individuals are essentially preserving a unique resource that could potentially be used to restore microbial balance in their gut if necessary. This first-of-its-kind service is provided in partnership with AMILI to provide transformative healthcare solutions to patients in Singapore and the Southeast Asia region. Despite the unconventional nature of this concept, it reflects the growing interest in the therapeutic potential of faecal transplants and the desire to explore innovative approaches to address health challenges using our own natural resources. It is important to note, however, that cryopreservation of faeces should only be performed under the guidance of medical professionals and in accordance with proper safety protocols.

Although still in its early stages, the potential of faecal transplants to revolutionise treatment approaches in mental health is an area of growing interest. The scientific community emphasises that faecal transplantation should not be viewed a standalone treatment for mental disorders, but rather as a potential addition to current therapeutic methods. Collaborations between researchers, clinicians, and policymakers are necessary to advance this field of study and navigate the complexities of regulatory approval and implementation. It is crucial that medical professionals regulate and supervise the procedure, and home-based attempts should be avoided. As research continues and larger-scale trials are conducted, we will gain a better understanding of the effectiveness of faecal transplants in treating conditions such as bipolar disorder, depression, and other mental health issues.

If you would like to find out more about Gut Microbiome Banking, please visit https://cordlifetech.com/gutmicrobiome/why-bank or contact us at +65 6238 0808 / gutmicrobiome@cordlife.com.

Disclaimer: The information presented in this commentary is based on recent scientific studies and should not substitute medical advice. Individuals should consult healthcare professionals for personalised guidance and treatment options related to mental health disorders.

References:

¹ Parker G, Spoelma MJ, Rhodes N. Faecal microbiota transplantation for bipolar disorder: A detailed case study. Bipolar Disord. 2022;24(5):559-563.

² Hooi SL, Dwiyanto J, Haikel R, Toh KY, Wong RKM, Lee JWJ. A case report of improvement on ADHD symptoms after fecal microbiota transplantation with gut microbiome profiling pre- and post-procedure. Curr Med Res Opin. 2022;38(11):1977-1982.

³ Doll J, Vazquez-Castellanos JF, Schaub AC, et al. Fecal Microbiota Transplantation (FMT) as an Adjunctive Therapy for Depression—Case Report. Front Psychiatry. 2022;13:815422.

4 Clapp M, Aurora N, Herrera L, et al. Gut microbiota’s effect on mental health: The gut-brain axis. Clin Pract. 2017;7(4):987.