Charles L Raison, MD: What's Next for the Study of Microbiota?

Charles L Raison, MD:

I think the next step in this case involves more research, because a lot of these things run the risk of being a fad. We always gotta worry about that, because one of the challenges in psychiatry is because the brain is such a complex place, because these disorders are sometimes so intractable and chronic, we're a profession that's often overwhelmed by hope. That hope sometimes is what makes us run prematurely to things ahead of the data.

So many things in psychiatry have been near miracle cures, until they were tested. The power of hope and placebo is very powerful in our field.

What really needs to be done here are studies looking at this question of can we identify interventions that are targeted at the microbiota, targeted at the gut? And maybe not just the gut. There's the story of the lungs, but the gut is really the main focus.

Can we devise interventions that actually show a signal? At this point, I think in general the field will continue to probably overpromise around probiotics and things like this. They don't seem to have huge risks and downsides, but to really rigorously go forward we need a lot of research.

Right now the National Institutes of Health is invested very heavily in trying to understand these microbial-human interactions and there are increasing grants in the field of mental health. Again, it's still in its infancy, but it's coming.

The microbiota is like a tidal wave, it's like a tsunami. I mean, it started in these very simple places in the gut and now it's gone into Parkinson's Disease and dementia - it's gonna affect everything.

The technology is advancing so rapidly, it's hard actually to say even when it's coming because things are coming so quickly there. But it's something that mental health practitioners should keep an eye on, because I think increasingly we're going to begin to see evidence-based treatments that are targeted at the microbiota.