UCalgary researcher investigates fecal microbiota transplantation as a treatment for mental illness

Dr. Valerie Taylor, MD, PhD, psychiatrist, professor and researcher at the Cumming School of Medicine (CSM) is recruiting people for two studies using fecal microbiota transplantation (FMT), often called poop pills, as a potential treatment for two mental health illnesses, major depressive disorder and obsessive-compulsive disorder. 

Taylor is one of only a few funded researchers in the world examining the therapeutic effects of fecal transplant in a clinical population. 

“We are tapping into the gut-brain axis and power of the microbiome as a way to improve life and unlock new treatment options for individuals struggling with a variety of psychiatric conditions,” says Taylor, a member of the Hotchkiss Brain Institute and the Snyder Institute for Chronic Diseases at the CSM. 

We had a chance to sit down with Taylor to find out more about the science behind poop pills for mental health. We also had a chance to visit the lab of Dr. Thomas Louie, MD, and take photos of how the poop pills are made. Louie did his first fecal transplant in 1996 and says it is a safe and effective treatment for clostridium difficile (C. difficile) infections. He’s excited to see Taylor explore the science of FMT further.

Q: Dr. Taylor, which studies are you recruiting for?
A: We are recruiting for two studies. In both we are investigating whether FMT can improve life for people with major depressive disorder, and for people with obsessive-compulsive disorder.

In the study for individuals diagnosed with Major Depressive Disorder (MDD) we want to find out whether FMT can reduce symptoms of depression they are experiencing. The study will take about 13 weeks to complete and will include 18 visits to Foothills Medical Centre. Participants have a fifty-fifty chance of receiving placebo capsules or FMT capsules.

In the study involving individuals diagnosed with obsessive-compulsive disorder (OCD) we want to find out whether FMT can reduce symptoms associated with OCD and we are investigating a new way to collect gut samples. The study will take four months to complete. All participants will be receiving FMT from healthy individuals (active FMT). 

Q: There are many psychiatric disorders. Why are these studies focusing on major depressive disorder?
A: The microbiome’s impact on mental health is a new and promising area of research. In the Taylor lab we are expanding our clinical studies to examine how the human microbiome can improve mental health. There are well-developed diagnostic and assessment tools around depression, which helps us with recruitment and assessment to determine whether this therapy is effective.

Q: Why are we looking to the gut microbiome for answers related to mental illness?
A: There now exists compelling evidence of an interaction between our intestinal microbiota (the gut), and the central nervous system. We believe that understanding the bacteria in your digestive system — the gut microbiome — holds tremendous potential for diagnosing and treating various psychiatric conditions. What we’ve also learned from early studies, is that targeting the microbiome is essentially side-effect free and that changing the microbiome improves signalling between the gut and the brain.

Q: What is the gut-brain axis?
A: The gut-brain axis is a bidirectional communication link between the gut and its contents (transmitter-producing bacteria and their by-products) and the brain. Evidence suggests that manipulation of this system may offer new treatment options for mental illness. Early studies indicate that changing the microbiome can improve signalling between the gut and the brain.

Q: Why would poop pills be effective as a treatment for mental illness?
A: Poop pills are one way we can manipulate the gut microbiome by bringing in beneficial bacteria and reducing the number of harmful bacteria. This mechanism has been very successful in treating C. difficile infections and has been permitted by Health Canada for that condition. Our research program focuses on achieving the same results in mental health illnesses.

Q: How do poop pills work?
A: A pill prepared from stool of a healthy person is transferred into the gut of a person with a disease. This is already used for people suffering from severe stomach disorders such as C. difficile infections.

Q: Where do you get the poop from?
A: Poop is provided by donors registered with UCalgary’s FMT program. These donors have been carefully screened by undergoing a full history and physical exam specifically screening for any risk factors or active infections. Poop provided by these donors undergoes strict testing before being used in our participants. The pills are made in Dr. Thomas Louie’s lab at UCalgary.

Q: What side-effects could be caused by a poop pill?
A: Participants are provided with a full list of all possible side effects from the poop pill during the consenting process. These can include abdominal discomfort, nausea, bloating, diarrhea, constipation and gas. Fortunately, there has been no reports of serious adverse events in any of our trials related to poop pills.

Q: How are you monitoring the differences/success?
A: Clinical differences are measured by a series of validated clinical assessment tools that participants complete at various timepoints during the participation.

Q: How many poop pills would you have to take to experience a difference, and is it something you would take for life?
A: The optimal dose is part of the research objectives of our clinical trials design. Currently we are using the same dose prescribed to C. difficile-infected patients — 60 capsules (over three days) as a loading dose, followed by a booster dose of 20 capsules (in one day) a month later and another booster dose of 20 capsules (in one day) a month after that.

Q: Where can someone get more information about the studies and research being done in the Taylor lab?
A: Email Asem Bala, senior research program lead, at: taylorlab@ucalgary.ca
Learn more about the Major Depressive Disorder study
Learn more about the Obsessive Compulsive Disorder study