# Prucalopride, a serotonin type 4 receptor agonist, induces fast anxiolytic/antidepressant effects and concomitant changes in the gut microbiota

**Authors:** Sofia Cussotto, Salma R. Abdennebi, Isabelle Etting, Christine A. Denny, René Hen, Romain Colle, Emmanuelle Corruble, Jean-Claude Alvarez, Denis J. David, Indira Mendez-David

PMC · DOI: 10.1038/s41522-026-00928-6 · NPJ Biofilms and Microbiomes · 2026-02-04

## TL;DR

Prucalopride, a drug for constipation, shows fast anxiolytic and antidepressant effects in mice and alters gut microbiota.

## Contribution

The study demonstrates prucalopride's rapid efficacy in treating stress-related behaviors and its impact on gut microbiota.

## Key findings

- Prucalopride improved emotionality scores faster than fluoxetine in stressed mice.
- Prucalopride restored Ruminococcus levels in the gut microbiota depleted by stress.
- The drug showed significant behavioral improvements within 7 days of treatment.

## Abstract

Major Depressive Disorder (MDD) affects around 20% of people globally and is often comorbid with anxiety. This study investigates prucalopride, a serotonin type 4 receptor (5-HT4R) agonist approved for constipation, as a fast-acting anxiolytic/antidepressant using a mouse model of stress, based on corticosterone (CORT) administration. Behavioral effects of prucalopride (0.5 and 1.5 mg/kg/day) were compared to fluoxetine, a common SSRI, over 7 (subchronic) and 28 (chronic) days. Prucalopride showed faster and more significant improvements in emotionality scores than fluoxetine, reversing CORT-induced behavioral changes within 7 days. Gut microbiota analysis revealed CORT-induced changes at the subchronic timepoint. While chronic prucalopride did not alter microbial alpha diversity, it significantly shifted microbial composition (beta-diversity). Notably, prucalopride restored levels of the genus Ruminococcus, which were depleted by CORT. Our findings highlight prucalopride’s rapid anxiolytic and antidepressant-like effects and its impact on gut microbiota, supporting the potential of 5-HT4R-targeting molecules as therapeutic options for psychiatric disorders.

## Linked entities

- **Proteins:** HTR4 (5-hydroxytryptamine receptor 4)
- **Chemicals:** prucalopride (PubChem CID 3052762), corticosterone (PubChem CID 5753), fluoxetine (PubChem CID 3386)
- **Diseases:** Major Depressive Disorder (MONDO:0002009), anxiety (MONDO:0005618)
- **Species:** Mus musculus (taxon 10090)

## Full-text entities

- **Genes:** HTR4 (5-hydroxytryptamine receptor 4) [NCBI Gene 3360] {aka 5-HT4, 5-HT4R}
- **Diseases:** anxiety (MESH:D001007), constipation (MESH:D003248), MDD (MESH:D003865), psychiatric disorders (MESH:D001523)
- **Chemicals:** fluoxetine (MESH:D005473), CORT (MESH:D003345), Prucalopride (MESH:C406662)
- **Species:** Ruminococcus (genus) [taxon 1263], Mus musculus (house mouse, species) [taxon 10090]

## Full text

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## Figures

3 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12979823/full.md

## References

5 references — full list in the complete paper: https://tomesphere.com/paper/PMC12979823/full.md

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Source: https://tomesphere.com/paper/PMC12979823