Including Probiotics in Major Depression Treatment Shows Promise

[Nelson Vergel]

The study was published in JAMA Psychiatry recently. It was a single-center, double-blind, placebo-controlled pilot randomized clinical trial, and it aimed to evaluate the acceptability, tolerability, and potential efficacy of probiotics as an adjunctive treatment for patients with major depressive disorder (MDD). The participants were adults aged 18 to 55 years with MDD who were taking antidepressant medication but experiencing an incomplete response to treatment. They were given a multistrain probiotic (8 billion colony-forming units per day) or a placebo daily for 8 weeks in addition to their ongoing antidepressant medication.

The trial reported no serious adverse reactions, high adherence to the treatment protocol, and low attrition. Furthermore, the study found that the probiotic group showed greater improvements in depressive symptoms according to the Hamilton Depression Rating Scale (HAMD-17) and the Inventory of Depressive Symptomatology (IDS) scores, as well as greater improvements in anxiety symptoms according to the Hamilton Anxiety Rating Scale (HAMA) scores, compared with the placebo group.

However, the study authors stressed that these results are preliminary, and a definitive efficacy trial is needed to further investigate the potential of probiotics as an add-on treatment for people with MDD1.

Acceptability, Tolerability, and Treatment Effects of Probiotics as Adjunctive Treatment in Depression

This pilot randomized clinical trial evaluates acceptability and tolerability data and estimates of intervention effect size for probiotics as adjunctive treatment for patients with major depressive disorder.

jamanetwork.com

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[Nelson Vergel]

Recent years have seen a rapid increase in the use of gut microbiota-targeting interventions, such as probiotics, for the treatment of psychiatric disorders. The objective of this update review was to evaluate all randomised controlled clinical trial evidence on the efficacy of probiotics for clinical depression. Cochrane guidelines for updated reviews were followed. By searching PubMed and Web of Science databases, we identified 546 new records since our previous review. A total of seven studies met selection criteria, capturing 404 people with depression. A random effects meta-analysis using treatment type (stand-alone vs. adjunctive) as subgroup was performed. The results demonstrated that probiotics are effective in reducing depressive symptoms when administered in addition to antidepressants (SMD = 0.83, 95%CI 0.49–1.17), however, they do not seem to offer significant benefits when used as stand-alone treatment (SMD = −0.02, 95%CI −0.34–0.30). Potential mechanisms of action may be via increases in brain-derived neurotrophic factor (BDNF) and decreases in C-reactive protein (CRP), although limited evidence is available at present. This review offers stronger evidence to support the clinical use of probiotics in depressed populations and provides an insight into the mode of administration more likely to yield antidepressant effects.

Updated Review and Meta-Analysis of Probiotics for the Treatment of Clinical Depression: Adjunctive vs. Stand-Alone Treatment

Recent years have seen a rapid increase in the use of gut microbiota-targeting interventions, such as probiotics, for the treatment of psychiatric disorders. The objective of this update review was to evaluate all randomised controlled clinical trial evidence on the efficacy of probiotics for...

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