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Gut feeling: randomized controlled trials of probiotics for the treatment of clinical depression: Systematic review and meta-analysis

BACKGROUND: Recently the gut microbiota has attracted significant interest in psychiatric research due to the observed bidirectional gut–brain communication. A growing body of evidence from preclinical work has suggested that probiotics may be effective in reducing stress and anxiety and alleviating...

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Detalles Bibliográficos
Autores principales: Nikolova, Viktoriya, Zaidi, Syed Yawar, Young, Allan H., Cleare, Anthony J., Stone, James M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6595633/
https://www.ncbi.nlm.nih.gov/pubmed/31263542
http://dx.doi.org/10.1177/2045125319859963
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author Nikolova, Viktoriya
Zaidi, Syed Yawar
Young, Allan H.
Cleare, Anthony J.
Stone, James M.
author_facet Nikolova, Viktoriya
Zaidi, Syed Yawar
Young, Allan H.
Cleare, Anthony J.
Stone, James M.
author_sort Nikolova, Viktoriya
collection PubMed
description BACKGROUND: Recently the gut microbiota has attracted significant interest in psychiatric research due to the observed bidirectional gut–brain communication. A growing body of evidence from preclinical work has suggested that probiotics may be effective in reducing stress and anxiety and alleviating low mood. It is unclear to what extent these effects are seen in clinical populations. We aimed to identify all published evidence on the efficacy of probiotics as treatment for depression in clinically depressed populations. METHODS: Randomized controlled trials of patients with depression where probiotics were used as supplementary or standalone treatment were considered eligible. A literature search with the terms (probiotic* OR bacteria OR Lactobacillus OR Bifidobacterium) AND depress* was performed in PubMed and Web of Science. Data on study population characteristics, treatment effectiveness, tolerability and risk of bias were extracted from eligible studies. A random effects model was used for meta-analyses. RESULTS: Only three studies met inclusion criteria (229 individuals randomized), two of which administered probiotics as a supplementary treatment to antidepressants and one as a standalone treatment. Upon removal of the latter study from the meta-analysis due to clinical heterogeneity, there was an overall positive effect of probiotics on depressive symptoms (standardized mean difference = 1.371, 95% confidence interval 0.130–2.613). CONCLUSIONS: There is limited evidence for the efficacy of probiotics in depression at present, although there may be a beneficial effect of probiotics on depressive symptoms when administered in addition to antidepressants. Further studies are required to investigate this and explore potential mechanisms.
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spelling pubmed-65956332019-07-01 Gut feeling: randomized controlled trials of probiotics for the treatment of clinical depression: Systematic review and meta-analysis Nikolova, Viktoriya Zaidi, Syed Yawar Young, Allan H. Cleare, Anthony J. Stone, James M. Ther Adv Psychopharmacol Novel Strategies for the Treatment of Depression BACKGROUND: Recently the gut microbiota has attracted significant interest in psychiatric research due to the observed bidirectional gut–brain communication. A growing body of evidence from preclinical work has suggested that probiotics may be effective in reducing stress and anxiety and alleviating low mood. It is unclear to what extent these effects are seen in clinical populations. We aimed to identify all published evidence on the efficacy of probiotics as treatment for depression in clinically depressed populations. METHODS: Randomized controlled trials of patients with depression where probiotics were used as supplementary or standalone treatment were considered eligible. A literature search with the terms (probiotic* OR bacteria OR Lactobacillus OR Bifidobacterium) AND depress* was performed in PubMed and Web of Science. Data on study population characteristics, treatment effectiveness, tolerability and risk of bias were extracted from eligible studies. A random effects model was used for meta-analyses. RESULTS: Only three studies met inclusion criteria (229 individuals randomized), two of which administered probiotics as a supplementary treatment to antidepressants and one as a standalone treatment. Upon removal of the latter study from the meta-analysis due to clinical heterogeneity, there was an overall positive effect of probiotics on depressive symptoms (standardized mean difference = 1.371, 95% confidence interval 0.130–2.613). CONCLUSIONS: There is limited evidence for the efficacy of probiotics in depression at present, although there may be a beneficial effect of probiotics on depressive symptoms when administered in addition to antidepressants. Further studies are required to investigate this and explore potential mechanisms. SAGE Publications 2019-06-26 /pmc/articles/PMC6595633/ /pubmed/31263542 http://dx.doi.org/10.1177/2045125319859963 Text en © The Author(s), 2019 http://creativecommons.org/licenses/by/4.0/ This article is distributed under the terms of the Creative Commons Attribution 4.0 License (http://www.creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Novel Strategies for the Treatment of Depression
Nikolova, Viktoriya
Zaidi, Syed Yawar
Young, Allan H.
Cleare, Anthony J.
Stone, James M.
Gut feeling: randomized controlled trials of probiotics for the treatment of clinical depression: Systematic review and meta-analysis
title Gut feeling: randomized controlled trials of probiotics for the treatment of clinical depression: Systematic review and meta-analysis
title_full Gut feeling: randomized controlled trials of probiotics for the treatment of clinical depression: Systematic review and meta-analysis
title_fullStr Gut feeling: randomized controlled trials of probiotics for the treatment of clinical depression: Systematic review and meta-analysis
title_full_unstemmed Gut feeling: randomized controlled trials of probiotics for the treatment of clinical depression: Systematic review and meta-analysis
title_short Gut feeling: randomized controlled trials of probiotics for the treatment of clinical depression: Systematic review and meta-analysis
title_sort gut feeling: randomized controlled trials of probiotics for the treatment of clinical depression: systematic review and meta-analysis
topic Novel Strategies for the Treatment of Depression
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6595633/
https://www.ncbi.nlm.nih.gov/pubmed/31263542
http://dx.doi.org/10.1177/2045125319859963
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