Australian breakthrough could reduce antipsychotic side effects

Key points:

• Antipsychotic medications are used to manage psychotic symptoms, such as hallucinations, delusions and disordered thinking

• Approximately 10 percent of mental health-related prescriptions filled in 2022 – 2023 were antipsychotics

• About 18 percent of the Australian population were dispensed a mental health-related prescription in 2022 – ‘23

Researchers from the University of South Australia have shown that antipsychotics can be reformulated with a strategically engineered coating that not only reduces unwanted weight gain but also boosts serotonin levels by more than 250 percent.

For many with conditions such as schizophrenia or bipolar disorder, antipsychotic medications can lead to a range of side effects, including:

• loss of menstrual period;
• dryness of the mouth;
• blurred vision;
• sedation;
• weight gain, leading to diabetes and obesity.

One study found that patients who are obese are approximately 13 times more likely to discontinue medication because of weight gain compared to those who are non-obese.

UniSA researchers tested Lurasidone, a drug used in the treatment of schizophrenia and bipolar depression, finding that the new coatings target the gut microbiome to improve drug absorption by eight-fold while reducing weight gain.

Lead researcher UniSA’s Dr Paul Joyce said microbiota-targeting microcapsules have the potential to improve treatment outcomes of mental health medications.

“Most patients suffering from schizophrenia or bipolar disorder are prescribed a range of antipsychotic medications, which trigger significant adverse effects by disrupting the gut microbiome — the microbial ecosystem that naturally colonises the gut,” Dr Joyce said.

“The most notable side effect is weight gain, with many patients often seeing increases of between 10 – 15 percent of their body weight after just three months of treatment.

“Because the gut microbiome plays a major role in regulating overall health, especially mood and cognition, the detrimental impact of these medications on the microbiome often makes them counterproductive.

“Instead of improving mood and cognition, the medication leads to a cascading cycle of poor mental and metabolic health as patients now struggle with excess weight and mental health issues.”

Dr Joyce explained that most antipsychotics needed to be taken with food and it can often be difficult for vulnerable patients to reach optimal drug levels.

“Clearly, new strategies are needed to eliminate side effects and the need for these medications to be taken with food — and that’s exactly what we’ve achieved with the drug Lurasidone,” he continued.

“Importantly, because we are not developing new drugs, rather reformulating them, the new therapies can be fast-tracked for clinical use, so we could expect them within the next few years rather than the 10 – 15 years needed for new drug molecules to be approved by regulatory bodies.”

People with schizophrenia and bipolar disorder may be eligible for psychosocial disability support under the National Disability Insurance Scheme.

Although not all mental health conditions are eligible for NDIS support, researchers hope that this breakthrough could extend these technologies across all mental health therapies, including anti-depressants, to mitigate any adverse effects.

Approximately 36 percent of people with severe or profound disability self-reported that they had mood disorders, such as depression, compared with 32 percent of people with other forms of disability and 8.7 percent of people without disability.

Do you experience any side effects from your medication? Let the team at Talking Disability know and subscribe to the newsletter for more information, news and industry updates.

Related content:

What is schizophrenia?

Psychosocial disabilities

Mental health and the NDIS