Probiotics may complement antidepressant treatment

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Research has linked gut microbiota to depression. VICTOR TORRES/Stocksy
  • Depression affects millions of people in the United States alone.
  • Treatment for depression is often complex and may involve a combination of several therapies.
  • New research suggests that probiotics may be a useful complementary treatment for improving depressive symptoms.

With approximately 21 million adults in the United States experiencing one or more major depressive episodes in 2020, according to the National Institute of Mental Health (NIMH), the search for improved treatment options, aside from standard drugs, continues.

A recent study Posted in Translational psychiatry found that probiotics may be a useful complementary treatment for people with depression.

The study adds to current evidence showing a link between gut health and mental health.

According to the NIMH, a major depressive episode is defined as:

“A period of at least two weeks during which a person experienced depressed mood or loss of interest or pleasure in daily activities, and exhibited a majority of the specified symptoms, such as problems sleeping, nutrition, energy, focus or self-esteem.”

Depression treatment is often different for each person because the symptoms and severity are different for everyone. Treatment may include a combination of the following:

  • Support from groups, friends and family members
  • Cognitive-behavioral therapy, which involves learning to change thought patterns and actions to help manage symptoms
  • Medications such as the use of antidepressants

Improving other areas of health and supporting general well-being can also help treat depression. For example, the use of relaxation and exercise techniques can be beneficial for people with depression.

However, researchers are still struggling to understand how best to help people with depression, including using additional treatments.

The study in question was a randomized controlled trial that delved into the relationship between the gut’s natural bacteria and its connection to the brain. The study authors note that previous research has shown that in people with depression, there are also changes in the composition of bacteria in the gut.

The participants included in the study were adults who currently suffered from depression. The researchers used the Hamilton Depression Rating Scale to assess participants’ depression.

The participants belonged to one of two groups: one group received probiotics for four weeks while the other received a placebo.

Probiotics, according to the National Institutes of Health, are “live microorganisms (such as bacteria and yeast) that provide health benefits when you consume them.” They can impact bacteria in the gut, and people can catch them through supplements or certain types of food.

Researchers found that participants who received the probiotic had a greater reduction in their depressive symptoms. They also found an increase in a group of bacteria called Lactobacillus among the intestinal flora of participants who received the probiotic.

Study author and neuroscientist Dr. André Schmidt noted that among the study’s highlights was the supportive effect of probiotics on antidepressants in patients with major depressive disorder.

“A 4-week intervention period further facilitated clinical decision-making, i.e. deciding whether the combination of antidepressants [and] whether the probiotics worked or not. The improvement in depressive symptoms was accompanied [an] increased abundance of Lactobacillus,” he explained to Medical News Today.

Dr. Schmidt said these findings could help develop better, more effective and personalized probiotics for the treatment of depression.

The study provides valuable data and indicates that the use of probiotics may be helpful in the treatment of depression. However, the study also had several limitations.

First, the study included a limited number of participants. The authors also note that participants’ compliance with taking the probiotic or the placebo was not perfect, which may have impacted the results. Further research may include longer follow-up and more participants.

Additionally, results can be influenced by many probiotic strains and their interaction with the body, so studying the specifics will be important in future research. Another area researchers can work to understand is the distinct interaction between antidepressants and probiotics.

Dr. Schmidt said DTM that further research could focus on “identifying biomarkers for treatment orientation”. that is, knowing which patient benefits from which treatment, based on specific biomarkers.

Dr Graham Rook, Emeritus Professor of Medical Microbiology at University College London, who was not involved in the study, found the results encouraging.

“[There was] modest evidence of reduced depression symptoms at least in a high compliance subgroup (55% remission rate) compared to a 40% remission rate in the placebo group,” he pointed out.

Dr. Rook noted that researchers could work to understand why these particular findings occurred.

[I]It seems likely that probiotics may be beneficial in depression, but there are many candidate mechanisms. Perhaps if we could identify the mechanism, we would be able to improve the effect to a more useful level.
— Dr. Graham Rook

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