{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T10:07:27Z","timestamp":1790158047742,"version":"4.1.0"},"reference-count":71,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Medicine and Pharmacy Carol Davila"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int. J. Mol. Sci.","IJMS"],"abstract":"<jats:p>Antipsychotic drugs are essential for the treatment of schizophrenia-spectrum disorders and other severe psychiatric conditions, but several agents produce clinically important metabolic and gastrointestinal adverse effects. Increasing evidence suggests that these outcomes may involve bidirectional interactions between antipsychotics and the gut microbiota. This structured narrative review integrates human, animal, gnotobiotic, in vitro, pharmacokinetic, and multi-omic evidence to examine drug-specific microbiome effects and microbiota-dependent modulation of host responses. Olanzapine has the strongest mechanistic evidence, with germ-free, antibiotic-depletion, colonization, and vagotomy studies supporting a contributory role of the microbiota in weight gain, adiposity, inflammation, altered microbial metabolites, and lipid dysregulation. Risperidone also shows microbiota-dependent metabolic and neurobiological effects, whereas findings for clozapine, quetiapine, aripiprazole, lurasidone, and amisulpride remain more heterogeneous or limited. Across agents, no universal taxonomic pattern has emerged. Functional pathways involving short-chain fatty acids, bile acids, epithelial barrier integrity, immune and neuroendocrine signaling, vagal pathways, and microbial drug metabolism appear more informative than individual taxa or the Firmicutes\/Bacteroidota ratio. Current evidence remains limited by methodological heterogeneity, small cohorts, confounding, and predominantly preclinical mechanistic data. Prospective, treatment-naive, drug-specific longitudinal multi-omic studies are required.<\/jats:p>","DOI":"10.3390\/ijms27198471","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T09:20:46Z","timestamp":1790155246000},"page":"8471","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Antipsychotic-Induced Remodeling of the Gut Microbiota: Drug-Specific Patterns and Molecular Links to Metabolic Adverse Effects"],"prefix":"10.3390","volume":"27","author":[{"given":"R\u0103zvan-Ioan","family":"Papacocea","sequence":"first","affiliation":[{"name":"Department of Psychiatry II, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"\u201cDr. Carol Davila\u201d Central Military Emergency University Hospital, 010825 Bucharest, Romania"},{"name":"Center for Innovation and eHealth, Carol Davila University of Medicine and Pharmacy, 030167 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miculescu","family":"Adina Gabriela","sequence":"additional","affiliation":[{"name":"Center for Innovation and eHealth, Carol Davila University of Medicine and Pharmacy, 030167 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volosin","family":"Radu-\u0218tefan","sequence":"additional","affiliation":[{"name":"Center for Innovation and eHealth, Carol Davila University of Medicine and Pharmacy, 030167 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1633-4449","authenticated-orcid":false,"given":"Thais","family":"Russomano","sequence":"additional","affiliation":[{"name":"Center for Aerospace Medicine Studies (CEMA), University of Lisbon, 1649-004 Lisbon, Portugal"},{"name":"Space Technology Center, AGH University of Krak\u00f3w, 30-054 Krak\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioana Raluca","family":"Papacocea","sequence":"additional","affiliation":[{"name":"Center for Innovation and eHealth, Carol Davila University of Medicine and Pharmacy, 030167 Bucharest, Romania"},{"name":"Discipline of Medical Physiology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1002\/wps.21036","article-title":"Metabolic Side Effects in Persons with Schizophrenia during Mid- to Long-Term Treatment with Antipsychotics: A Network Meta-Analysis of Randomized Controlled Trials","volume":"22","author":"Burschinski","year":"2023","journal-title":"World Psychiatry"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.bbi.2021.09.014","article-title":"Antipsychotic-Induced Gastrointestinal Hypomotility and the Alteration in Gut Microbiota in Patients with Schizophrenia","volume":"99","author":"Xu","year":"2022","journal-title":"Brain Behav. Immun."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"20451253221096525","DOI":"10.1177\/20451253221096525","article-title":"Gut Microbiome in Schizophrenia and Antipsychotic-Induced Metabolic Alterations: A Scoping Review","volume":"12","author":"Singh","year":"2022","journal-title":"Ther. Adv. Psychopharmacol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"107561","DOI":"10.1016\/j.phrs.2024.107561","article-title":"IUPHAR Themed Review: The Gut Microbiome in Schizophrenia","volume":"211","author":"Kamath","year":"2025","journal-title":"Pharmacol. Res."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Papacocea, R.-I., and Ciobanu, A.-M. (2026). A Taxon-Centered Review of Bacterial Shifts in Psychiatric Disorders. Front. Psychiatry, 17.","DOI":"10.3389\/fpsyt.2026.1702172"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.jpsychires.2025.05.046","article-title":"Systematic Examination of Off-Target Effects of Antipsychotic Medications Associated with Microbiome Disruption and Heightened Bacterial Infection Risks","volume":"189","author":"McDonagh","year":"2025","journal-title":"J. Psychiatr. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1671","DOI":"10.1007\/s00213-018-5006-5","article-title":"Differential Effects of Psychotropic Drugs on Microbiome Composition and Gastrointestinal Function","volume":"236","author":"Cussotto","year":"2019","journal-title":"Psychopharmacology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1016\/j.biopsych.2023.07.019","article-title":"Psycho-Pharmacomicrobiomics: A Systematic Review and Meta-Analysis","volume":"95","author":"Minichino","year":"2024","journal-title":"Biol. Psychiatry"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"103307","DOI":"10.1016\/j.ebiom.2021.103307","article-title":"The Gut Microbiome Influences the Bioavailability of Olanzapine in Rats","volume":"66","author":"Cussotto","year":"2021","journal-title":"eBioMedicine"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/j.schres.2024.07.053","article-title":"Schizophrenia and Antipsychotic Medications Present Distinct and Shared Gut Microbial Composition: A Meta-Analysis","volume":"274","author":"Cheng","year":"2024","journal-title":"Schizophr. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1612","DOI":"10.1038\/s41467-020-15457-9","article-title":"Metagenome-Wide Association of Gut Microbiome Features for Schizophrenia","volume":"11","author":"Zhu","year":"2020","journal-title":"Nat. Commun."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"106167","DOI":"10.1016\/j.neubiorev.2025.106167","article-title":"Gut Microbiome Characteristics in Individuals across Different Stages of Schizophrenia Spectrum Disorders: A Systematic Review and Meta-Analysis","volume":"173","author":"Kong","year":"2025","journal-title":"Neurosci. Biobehav. Rev."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Papacocea, R.-I., Iliu\u021b\u0103, F.P., and Papacocea, I.R. (2026). Gut Microbiome Dysregulation Across Schizophrenia Spectrum Disorders: Bacteria-, Fungi- and Virome-Level Alterations with Molecular and Immunological Implications. Int. J. Mol. Sci., 27.","DOI":"10.3390\/ijms27083372"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"eaau8317","DOI":"10.1126\/sciadv.aau8317","article-title":"The Gut Microbiome from Patients with Schizophrenia Modulates the Glutamate-Glutamine-GABA Cycle and Schizophrenia-Relevant Behaviors in Mice","volume":"5","author":"Zheng","year":"2019","journal-title":"Sci. Adv."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2905","DOI":"10.1038\/s41380-019-0475-4","article-title":"Transplantation of Microbiota from Drug-Free Patients with Schizophrenia Causes Schizophrenia-Like Abnormal Behaviors and Dysregulated Kynurenine Metabolism in Mice","volume":"25","author":"Zhu","year":"2020","journal-title":"Mol. Psychiatry"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1016\/j.schres.2024.06.040","article-title":"Multi-Omics Analysis Reveals the Impact of Gut Microbiota on Antipsychotic-Induced Weight Gain in Schizophrenia","volume":"270","author":"Liu","year":"2024","journal-title":"Schizophr. Res."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Morgan, A.P., Crowley, J.J., Nonneman, R.J., Quackenbush, C.R., Miller, C.N., Ryan, A.K., Bogue, M.A., Paredes, S.H., Yourstone, S., and Carroll, I.M. (2014). The Antipsychotic Olanzapine Interacts with the Gut Microbiome to Cause Weight Gain in Mouse. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0115225"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e00058-23","DOI":"10.1128\/spectrum.00058-23","article-title":"Longitudinal Gut Microbiota Dysbiosis Underlies Olanzapine-Induced Weight Gain","volume":"11","author":"Qian","year":"2023","journal-title":"Microbiol. Spectr."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e309","DOI":"10.1038\/tp.2013.83","article-title":"Antipsychotics and the Gut Microbiome: Olanzapine-Induced Metabolic Dysfunction Is Attenuated by Antibiotic Administration in the Rat","volume":"3","author":"Davey","year":"2013","journal-title":"Transl. Psychiatry"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Zhu, Z., Gu, Y., Zeng, C., Yang, M., Yu, H., Chen, H., Zhang, B., and Cai, H. (2022). Olanzapine-Induced Lipid Disturbances: A Potential Mechanism through the Gut Microbiota-Brain Axis. Front. Pharmacol., 13.","DOI":"10.3389\/fphar.2022.897926"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Pe\u0142ka-Wysiecka, J., Kaczmarczyk, M., B\u0105ba-Kubi\u015b, A., Li\u015bkiewicz, P., Wro\u0144ski, M., Skonieczna-\u017bydecka, K., Marlicz, W., Misiak, B., Starzy\u0144ska, T., and Kucharska-Mazur, J. (2019). Analysis of Gut Microbiota and Their Metabolic Potential in Patients with Schizophrenia Treated with Olanzapine: Results from a Six-Week Observational Prospective Cohort Study. J. Clin. Med., 8.","DOI":"10.3390\/jcm8101605"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1038\/s41398-018-0116-8","article-title":"Prebiotic Attenuation of Olanzapine-Induced Weight Gain in Rats: Analysis of Central and Peripheral Biomarkers and Gut Microbiota","volume":"8","author":"Kao","year":"2018","journal-title":"Transl. Psychiatry"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2449","DOI":"10.1007\/s00213-021-05866-z","article-title":"Effect of Bifidobacterium on Olanzapine-Induced Body Weight and Appetite Changes in Patients with Psychosis","volume":"238","author":"Yang","year":"2021","journal-title":"Psychopharmacology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1093\/schbul\/sbac044","article-title":"Probiotics Plus Dietary Fiber Supplements Attenuate Olanzapine-Induced Weight Gain in Drug-Naive First-Episode Schizophrenia Patients: Two Randomized Clinical Trials","volume":"48","author":"Huang","year":"2022","journal-title":"Schizophr. Bull."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1038\/s41398-022-01958-2","article-title":"The Effects of Probiotics Plus Dietary Fiber on Antipsychotic-Induced Weight Gain: A Randomized Clinical Trial","volume":"12","author":"Huang","year":"2022","journal-title":"Transl. Psychiatry"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"4531","DOI":"10.1111\/bph.16507","article-title":"The Atypical Antipsychotics Lurasidone and Olanzapine Exert Contrasting Effects on the Gut Microbiome and Metabolic Function of Rats","volume":"181","author":"Kamath","year":"2024","journal-title":"Br. J. Pharmacol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"115914","DOI":"10.1016\/j.psychres.2024.115914","article-title":"Effects of Antipsychotics on the Gastrointestinal Microbiota: A Systematic Review","volume":"336","author":"Dias","year":"2024","journal-title":"Psychiatry Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1007\/s00213-018-5102-6","article-title":"Second-Generation Antipsychotics and Metabolism Alterations: A Systematic Review of the Role of the Gut Microbiome","volume":"236","author":"Misera","year":"2019","journal-title":"Psychopharmacology"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Chen, H., Cao, T., Zhang, B., and Cai, H. (2023). The Regulatory Effects of Second-Generation Antipsychotics on Lipid Metabolism: Potential Mechanisms Mediated by the Gut Microbiota and Therapeutic Implications. Front. Pharmacol., 14.","DOI":"10.3389\/fphar.2023.1097284"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1080\/14740338.2022.2042251","article-title":"Does the Gut Microbiome Mediate Antipsychotic-Induced Metabolic Side Effects in Schizophrenia?","volume":"21","author":"Vasileva","year":"2022","journal-title":"Expert Opin. Drug Saf."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1725","DOI":"10.1016\/j.ebiom.2015.10.018","article-title":"Risperidone-Induced Weight Gain Is Mediated through Shifts in the Gut Microbiome and Suppression of Energy Expenditure","volume":"2","author":"Bahr","year":"2015","journal-title":"eBioMedicine"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1186\/s40168-026-02358-0","article-title":"Early Risperidone Exposure Impairs Cognitive Function by Perturbation of the Gut Microbiome and Bile Acids\/Tyrosine-PTP1B Axis","volume":"14","author":"Ye","year":"2026","journal-title":"Microbiome"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/j.schres.2018.05.017","article-title":"Changes in Metabolism and Microbiota after 24-Week Risperidone Treatment in Drug-Naive, Normal Weight Patients with First-Episode Schizophrenia","volume":"201","author":"Yuan","year":"2018","journal-title":"Schizophr. Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1038\/s41398-021-01531-3","article-title":"Gut Microbial Biomarkers for the Treatment Response in First-Episode, Drug-Naive Schizophrenia: A 24-Week Follow-Up Study","volume":"11","author":"Yuan","year":"2021","journal-title":"Transl. Psychiatry"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Xiang, M., Zheng, L., Pu, D., Lin, F., Ma, X., Ye, H., Pu, D., Zhang, Y., Wang, D., and Wang, X. (2022). Intestinal Microbes in Patients with Schizophrenia Undergoing Short-Term Treatment: Core Species Identification Based on Co-Occurrence Networks and Regression Analysis. Front. Microbiol., 13.","DOI":"10.3389\/fmicb.2022.909729"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1002\/phar.1890","article-title":"Interaction Between Atypical Antipsychotics and the Gut Microbiome in a Bipolar Disease Cohort","volume":"37","author":"Flowers","year":"2017","journal-title":"Pharmacotherapy"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Yin, F., Shi, Z., Ma, X., Ding, K., Zhang, Y., and Ma, S. (2023). Impact of Clozapine Monotherapy on Gut Microbiota and Metabolism in People with Schizophrenia. Front. Microbiol., 14.","DOI":"10.3389\/fmicb.2023.1253156"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1001\/jamapsychiatry.2023.5371","article-title":"Associations of the Gut Microbiome with Treatment Resistance in Schizophrenia","volume":"81","author":"Vasileva","year":"2024","journal-title":"JAMA Psychiatry"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Manchia, M., Fontana, A., Panebianco, C., Paribello, P., Arzedi, C., Cossu, E., Garzilli, M., Montis, M.A., Mura, A., and Pisanu, C. (2021). Involvement of Gut Microbiota in Schizophrenia and Treatment Resistance to Antipsychotics. Biomedicines, 9.","DOI":"10.3390\/biomedicines9080875"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1038\/s41398-026-04077-4","article-title":"Clozapine Disrupts the Gut-Lung Microbiota Axis, Linking Gastrointestinal Hypomotility to Increased Respiratory Vulnerability","volume":"16","author":"Cai","year":"2026","journal-title":"Transl. Psychiatry"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"114326","DOI":"10.1016\/j.psychres.2021.114326","article-title":"Metagenomic Analysis Reveals Gut Bacterial Signatures for Diagnosis and Treatment Outcome Prediction in Bipolar Depression","volume":"307","author":"Lai","year":"2022","journal-title":"Psychiatry Res."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e00102-22","DOI":"10.1128\/jb.00102-22","article-title":"The Atypical Antipsychotic Quetiapine Promotes Multiple Antibiotic Resistance in Escherichia coli","volume":"204","author":"Kyono","year":"2022","journal-title":"J. Bacteriol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"001568","DOI":"10.1099\/mic.0.001568","article-title":"Pharmaco-Psychiatry and Gut Microbiome: A Systematic Review of Effects of Psychotropic Drugs for Bipolar Disorder","volume":"171","author":"Bui","year":"2025","journal-title":"Microbiology"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1900752","DOI":"10.1002\/advs.201900752","article-title":"Gut Microbiota Changes in Patients with Bipolar Depression","volume":"6","author":"Hu","year":"2019","journal-title":"Adv. Sci."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"17878","DOI":"10.1038\/s41598-020-74934-9","article-title":"Unravelling the Antimicrobial Action of Antidepressants on Gut Commensal Microbes","volume":"10","author":"Mottawea","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"2403914","DOI":"10.1002\/adfm.202403914","article-title":"Inulin-Lipid Core-Shell Microcapsules Target the Gut Microbiota and Mimic the Pharmaceutical Food Effect for Improved Oral Antipsychotic Delivery","volume":"34","author":"Meola","year":"2024","journal-title":"Adv. Funct. Mater."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"114453","DOI":"10.1016\/j.ejpb.2024.114453","article-title":"Contrasting the Pharmacokinetic Performance and Gut Microbiota Effects of an Amorphous Solid Dispersion and Lipid Nanoemulsion for a Poorly Water-Soluble Antipsychotic","volume":"203","author":"Meola","year":"2024","journal-title":"Eur. J. Pharm. Biopharm."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Nita, I.-B., Ilie, O.-D., Ciobica, A., Hritcu, L.-D., Dobrin, I., Doroftei, B., and Dobrin, R. (2022). Reviewing the Potential Therapeutic Approaches Targeting the Modulation of Gastrointestinal Microflora in Schizophrenia. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms232416129"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1002\/phar.2214","article-title":"Effects of Atypical Antipsychotic Treatment and Resistant Starch Supplementation on Gut Microbiome Composition in a Cohort of Patients with Bipolar Disorder or Schizophrenia","volume":"39","author":"Flowers","year":"2019","journal-title":"Pharmacotherapy"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1038\/nature25979","article-title":"Extensive Impact of Non-Antibiotic Drugs on Human Gut Bacteria","volume":"555","author":"Maier","year":"2018","journal-title":"Nature"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1016\/j.jpsychires.2020.02.005","article-title":"Alteration of the Gut Microbiome in First-Episode Drug-Naive and Chronic Medicated Schizophrenia Correlate with Regional Brain Volumes","volume":"123","author":"Ma","year":"2020","journal-title":"J. Psychiatr. Res."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Nita, I.-B., V\u0103c\u0103rean-Trandafir, I.-C., Am\u0103randi, R.-M., Ilie, O.-D., Dobrin, P.-R., Bejenariu, A.-C., Ivanov, I.-C., and Doroftei, B. (2025). Exploring Gut Microbiota Profile Induced by Antipsychotics in Schizophrenic Patients: Insights from an Eastern European Pilot Study. BMC Psychiatry, 25.","DOI":"10.1186\/s12888-025-07461-4"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1093\/ijnp\/pyaa070","article-title":"Effects of Psychotropics on the Microbiome in Patients with Depression and Anxiety: Considerations in a Naturalistic Clinical Setting","volume":"24","author":"Tomizawa","year":"2021","journal-title":"Int. J. Neuropsychopharmacol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"115463","DOI":"10.1016\/j.psychres.2023.115463","article-title":"The Role of the Gut Microbiome in Weight-Gain in Schizophrenia Patients Treated with Atypical Antipsychotics: Evidence Based on Altered Composition and Function in a Cross-Sectional Study","volume":"328","author":"Fang","year":"2023","journal-title":"Psychiatry Res."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Wu, Y., Zang, S., Wu, Z., and Huang, J. (2025). First Exposure to Second-Generation Antipsychotics Alters Gut Microbiota and Metabolic Profiles in Patients with Glucose-Lipid Metabolism Disorders. Front. Psychiatry, 16.","DOI":"10.3389\/fpsyt.2025.1722760"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1186\/s12967-025-06923-3","article-title":"Metagenome-Based Characterization of the Gut Virome in Patients with Schizophrenia","volume":"23","author":"Ren","year":"2025","journal-title":"J. Transl. Med."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1016\/j.bbi.2024.01.218","article-title":"Differences in the Gut Microbiome of Young Adults with Schizophrenia Spectrum Disorder: Using Machine Learning to Distinguish Cases from Controls","volume":"117","author":"Stiernborg","year":"2024","journal-title":"Brain Behav. Immun."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1093\/schbul\/sbad049","article-title":"Compositional and Functional Alterations in Intestinal Microbiota in Patients with Psychosis or Schizophrenia: A Systematic Review and Meta-Analysis","volume":"49","author":"Murray","year":"2023","journal-title":"Schizophr. Bull."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1001\/jamapsychiatry.2021.2573","article-title":"Perturbations in Gut Microbiota Composition in Psychiatric Disorders: A Review and Meta-Analysis","volume":"78","author":"Nikolova","year":"2021","journal-title":"JAMA Psychiatry"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.schres.2023.03.005","article-title":"Shotgun Metagenomics Reveals Abnormal Short-Chain Fatty Acid-Producing Bacteria and Glucose and Lipid Metabolism of the Gut Microbiota in Patients with Schizophrenia","volume":"255","author":"Li","year":"2023","journal-title":"Schizophr. Res."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1038\/nature24460","article-title":"Quantitative Microbiome Profiling Links Gut Community Variation to Microbial Load","volume":"551","author":"Vandeputte","year":"2017","journal-title":"Nature"},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Hao, S., Zhou, Y., Zhang, X., and Jiang, H. (2023). Gut Microbiome Profiles May Be Related to Atypical Antipsychotic Associated Overweight in Asian Children with Psychiatric Disorder: A Preliminary Study. Front. Cell. Infect. Microbiol., 13.","DOI":"10.3389\/fcimb.2023.1124846"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1016\/j.jpsychires.2023.05.021","article-title":"Comparison of Gut Microbiome Profile in Patients with Schizophrenia and Healthy Controls-A Plausible Non-Invasive Biomarker?","volume":"162","author":"Gokulakrishnan","year":"2023","journal-title":"J. Psychiatr. Res."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"e9574","DOI":"10.7717\/peerj.9574","article-title":"Altered Gut Microbiota Associated with Symptom Severity in Schizophrenia","volume":"8","author":"Li","year":"2020","journal-title":"PeerJ"},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Militaru, A.-M., Pietreanu, A.C., Trifu, S., and Popa, G.L. (2026). Gut Microbiota in Schizophrenia: Taxonomic Shifts, Beta-Diversity Alterations, and Biomarker Potential: A Systematic Review. Int. J. Mol. Sci., 27.","DOI":"10.3390\/ijms27104606"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1679","DOI":"10.1093\/schbul\/sbaf028","article-title":"Microbiome-Gut-Brain Profiles in Schizophrenia and Their Potential Link to Cognitive Performance: Findings from a Case-Control Study","volume":"51","author":"Wu","year":"2025","journal-title":"Schizophr. Bull."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1186\/s12967-025-07152-4","article-title":"Gut Microbiota Remodeling and Sensory-Emotional Functional Disruption in Adolescents with Bipolar Depression","volume":"23","author":"Tang","year":"2025","journal-title":"J. Transl. Med."},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Liu, J.C.W., Gorbovskaya, I., Hahn, M.K., and M\u00fcller, D.J. (2021). The Gut Microbiome in Schizophrenia and the Potential Benefits of Prebiotic and Probiotic Treatment. Nutrients, 13.","DOI":"10.3390\/nu13041152"},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Munawar, N., Ahmad, A., Anwar, M.A., and Muhammad, K. (2022). Modulation of Gut Microbial Diversity through Non-Pharmaceutical Approaches to Treat Schizophrenia. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23052625"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"100923","DOI":"10.1016\/j.bbih.2024.100923","article-title":"Should We Consider Microbiota-Based Interventions as a Novel Therapeutic Strategy for Schizophrenia? A Systematic Review and Meta-Analysis","volume":"43","author":"Hassib","year":"2025","journal-title":"Brain Behav. Immun. Health"},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Ye, N., Song, X., Yu, J., Bao, X., Ye, M., and Jiang, L. (2025). Effects of Gut Microbiota Interventions on Patients with Schizophrenia: A Systematic Review and Meta-Analysis. Front. Microbiol., 16, Correction in Front. Microbiol.\u00a02026, 16, 1744519.","DOI":"10.3389\/fmicb.2025.1744519"}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/19\/8471\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T09:25:38Z","timestamp":1790155538000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/19\/8471"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,23]]},"references-count":71,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2026,10]]}},"alternative-id":["ijms27198471"],"URL":"https:\/\/doi.org\/10.3390\/ijms27198471","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,23]]}}}