Bile acid metabolites for diagnosing and treating depressive disorders

A method for stratifying and treating a subject having a depression, anxiety, mood disorders, or neuropsychiatric symptoms, or at risk of developing a neurological disorder, based on the subject's metabolic profile, the method comprising:

• analyzing a sample from a subject to determine concentration levels or ratios of one or more biomarker metabolites or gut microbiome-related biomarker metabolites related to bile acid anabolism, catabolism or homeostasis in the sample from the subject;
• determining if the subject has a metabolic defect related to disrupted bile acid anabolism, catabolism or homeostasis, or if the subject's gut microbiome has a defect related to disrupted bile acid anabolism, catabolism or homeostasis, or combinations thereof based on the measured concentration levels and calculated ratios of the one or more bile acid anabolism, catabolism or homeostasis biomarker metabolites in the sample as compared to a control sample;
• stratifying the subject into a subgroup of subjects, wherein an individual subgroup of subjects is defined by a unique and specific bile acid anabolism, catabolism or homeostasis profile based on the measured concentration levels and calculated ratios of the one or more biomarker metabolites or gut microbiome-related biomarker metabolites in the sample as compared to a control sample and the biomarker metabolite or gut microbiome-related biomarker metabolite defect determined for the subject.

A method for detecting depression or anxiety in a subject, the method comprising:

• analyzing a sample from a subject;
• determining concentration levels or ratios of one or more biomarker metabolites or gut microbiome-related biomarker metabolites in the sample from the subject;
• and
• determining the subject as having depression or anxiety or an increased risk of depression or anxiety when the concentration levels or ratios of the one or more biomarker metabolites or gut microbiome-related biomarker metabolites in the sample from the subject are different from (greater than or less than) the concentration levels or ratios of the one or more biomarker metabolites or gut microbiome-related biomarker metabolites in a control sample.

A method for treating depression, anxiety, mood disorders, or neuropsychiatric symptoms in a subject the method comprising:

• administering to the subject an effective amount sufficient to attenuate, reduce, or eliminate the symptoms of depression, anxiety, mood disorders, or neuropsychiatric symptoms of one or more of antidepressants, cognitive behavior therapy, exercise, dietary supplements, prebiotics, probiotics, dietary changes, or an elimination diet;
• analyzing sample from the subject;
• and
• measuring concentration levels or ratios in the subject's sample of one or more biomarker metabolites or gut microbiome-related biomarker metabolites comprising primary bile acids, secondary bile acids, or a combination thereof.