New antipsychotic formula reduces weight gain and increases serotonin levels

970 million people struggle with mental illness worldwide. However, when the recommended treatment includes antipsychotic drugs, side effects often include extra pounds, complicating an already difficult diagnosis.

Now, a study published in the journal Advanced Functional Materials by the University of South Australia shows that antipsychotics can be redesigned with a specially designed coating that not only reduces unwanted weight gain, but also increases serotonin levels by more than 250%.

The researchers specifically tested Lurasidone, a drug used to treat schizophrenia and bipolar depression, finding that the new coatings target the gut microbiome to improve drug absorption by 8-fold while overcoming common side effects like weight gain.

The coatings are created from tiny core-shell particles made from the dietary fiber inulin and bioactive medium-chain triglycerides. The inulin coating improves the gut microbiome by providing an energy source for gut bacteria, while the medium-chain triglycerides help the drug be absorbed into the blood.

This is a breakthrough discovery that has the potential to change the lives of millions of people around the world.

Lead researcher Dr Paul Joyce from the University of South Australia says that microbiota-targeting microcapsules could improve treatment outcomes for mental illnesses.

"Most patients with schizophrenia or bipolar disorder are prescribed a variety of antipsychotic drugs, which cause significant side effects by disrupting the gut microbiome - the microbial ecosystem that naturally colonizes the gut," says Dr Joyce.

"The most noticeable side effect is weight gain, with many patients often seeing a 10% to 15% increase in body weight after just three months treatment.

"Because the gut microbiome plays an important role in regulating overall health, especially mood and cognition, the negative impact of these drugs on the microbiome often makes them counterproductive.

"Instead of improving mood and cognition, the medications lead to a cascading cycle of worsening mental and metabolic health as patients now struggle with weight gain and mental health issues.

"To make matters worse, most antipsychotics need to be taken with food to be effective. But for a very vulnerable group of patients, this can be difficult to achieve, leaving most patients with suboptimal blood levels of the drugs.

"Clearly, new strategies are needed to address the side effects and the need to take these drugs with food – and that’s exactly what we’ve achieved with Lurasidone.

"This study shows that when antipsychotic drugs are formulated with our new smart core-shell microparticles, drug absorption is increased, eliminating the need to take it with food, while increasing the diversity and abundance of the gut microbiome to overcome common side effects such as weight gain.

"It's important to note that because we are not developing new drugs but redeveloping existing ones, new treatments can be brought into clinical practice quickly and we can expect them to be available within the next few years rather than the 10-15 years required for regulatory approval of new drug molecules."

Next steps include testing the effectiveness of these reformulated drugs in patients, with long-term goals to expand these technologies to all mental health therapies, including antidepressants, to mitigate any side effects.