Probiotics for Depression

Depression is challenging. It not only affects the person suffering it, but the treatment of depression is somewhat hit-and-miss.

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Only about one third of those with major depressive disorders respond to initial drug treatment.[2]

It is estimated that about 1 in 20 people will suffer from depression in their lifetimes, and almost 30% will experience an anxiety disorder. Sadly, these conditions appear to be higher in younger people and we are not getting better at preventing depression, nor at treating it, with numbers increasing over time.3  Given how common depression is, even small improvements in treatment are worth exploring.

Evidence is mounting, confirming that the gut microbiome affects brain function and depressive behaviours. Some ten years ago the renown Irish researchers John Cryan and Timothy Dinan first published their paper Mind-altering microorganisms: the impact of the gut microbiota on brain and behaviour.4  In 2013 Foster and Neufield reported that “bacteria, including commensal, probiotic, and pathogenic bacteria, in the gastrointestinal (GI) tract can activate neural pathways and central nervous system (CNS) signaling systems.”  They also suggested that “understanding the microbiota-gut-brain axis may provide novel approaches for prevention and treatment of mental illness, including anxiety and depression.”5

Research, published in the esteemed journal Translational Psychiatry, demonstrated that 4 weeks of high-dose probiotic supplementation reduced symptoms of depression when used in addition to regular treatment in people with major depressive disorder.

In addition to their regular medications, study participants took either Vivomixx® (a specific probiotic supplement made in Switzerland), or a placebo powder (indistinguishable from the active intervention), mixed into a cold, noncarbonated drink.

What did the results show?

Depressive symptoms decreased in all those who completed the study. Those taking the probiotic supplement had much greater improvements that those in the placebo group. This was backed up by chanes in the intestinal microbiota, with changes in lactic acid production correlating with the changes in symptoms of depression. Gut microbiota changes were sustained into the follow-up period (4-weeks after they stopped taking the supplement).

In this study, the participants also had assessments of their brain activity – measured by what is known as a functional MRI scan. When patients are shown images of neutral or fearful faces, there is a discernable difference in depressed patients on this scan. But taking probiotics changed the scan results – the depressed people in this study who took probiotics had a normalisation of their scan results. As well, they had increased in the volume of grey matter (that’s the part with a high concentration of neuronal cell bodies).

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In today’s world, that is big news.

The results of this study were significant. So much so, that the possibility of these being a chance findings was ruled out.

We still don’t know if the results were due to:

  • A specific strain in the probiotic mix (it contains 8 strains)
  • The specific mix itself (these 8 strains are unique)
  • The regularity of dosing
  • The dose used, which is much higher than any other probiotic on the market.

Unfortunately, the study was not big enough to test these things. As with all research, the conclusion “we need more research”.

The DownSide?

Vivomixx is an expensive probiotic. To take it at the dose recommended in the study would cost around $12-15 per day, which may seem out of reach for many people who need it. However, it is entirely possible that investing the cost of 1-2 cups of coffee a day into a good quality probiotic may do better for your depression than those 1-2 cups of coffee.

References

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References

  1. Schaub, AC, et al. Clinical, gut microbial and neural effects of a probiotic add-on therapy in depressed patients: a randomized controlled trial. Transl Psychiatry 12, 227 (2022).
  2. Rush AJ, Trivedi MH, Wisniewski SR, et al. Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. Am J Psychiatry. 2006;163(11):1905-1917.
  3. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):593-602.
  4. Cryan JF, Dinan TG. Mind-altering microorganisms: the impact of the gut microbiota on brain and behaviour. Nat Rev Neurosci. 2012;13(10):701-712.
  5. Foster JA, McVey Neufeld KA. Gut-brain axis: how the microbiome influences anxiety and depression. Trends Neurosci. 2013;36(5):305-312.
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