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TOPLINE:

The use of probiotics and prebiotics, alone or combined (synbiotics), was associated with a significantly greater decrease in symptoms of depression and anxiety in patients with depression compared to nonuse, a new meta-analysis showed.

METHODOLOGY:

• Researchers included 19 studies involving more than 1400 adults with mild-to-moderate depression or major depressive disorder, of whom 523 acted as the control group.
• In addition to assessing the effect of probiotics, prebiotics, and synbiotics on depression scores, the investigators also assed their effect on anxiety in seven of the included studies (n = 481).
• Risk for bias was evaluated using the Cochrane Collaboration’s tool.

TAKEAWAY:

• Compared with control individuals, participants receiving probiotics, prebiotics, or synbiotics had a significantly greater decrease in depression scores (standardized mean difference [SMD], -1.8; 95% CI, -2.4 to -1.1) and anxiety scores (SMD, -1.6; 95% CI, -2.8 to -0.4).
• Subgroup analyses indicated significant between-group differences for depression scores on the basis of nationality, intervention duration, disease severity, and BMI and for anxiety scores on the basis of nationality, age, assessment tool, and number of strains.
• However, six of the 19 studies showed some concerns for risk for bias.

IN PRACTICE:

Although the current analysis suggested a promising role for these substances, future studies “should focus on comparing probiotics, prebiotics, and synbiotics to standard treatments, identifying effective strains, and incorporating objective measures better to understand their impact on depression and anxiety symptoms,” the investigators wrote.

SOURCE:

This study was led by Reza Moshfeghinia, MD, MPH, Shiraz University of Medical Sciences, Shiraz, Iran. It was published online on May 24 in Journal of Psychiatric Research.

LIMITATIONS:

Significant heterogeneity existed in the diagnosis of depression among the included studies, with variation in diagnostic criteria and assessment tools potentially influencing the results. Additional limitations included the use of various strains and doses of probiotics, prebiotics, and synbiotics; reliance on self-reported measures; and the lack of objective data in some studies.

DISCLOSURES:

The investigators reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.