A combination of probiotics and magnesium orotate attenuate depression in a small SSRI resistant cohort: an intestinal anti-inflammatory response is suggested

Abstract

Approximately, one-third of those who develop major depression will have a poor response to treatment and over time can become treatment resistant. Intestinal dysbiosis has been implicated in depression with systemic inflammation and vagal and enteric nerve impairment. We report on a sequel pilot study (n = 12) with a combination probiotics/magnesium orotate formulation adjuvant administered with SSRIs for treatment resistant depression. At the end of an 8-week intervention mean changes for depression scores and quality of life in the group was clinically significantly improved (p < 0.001) with all but 4 participants experiencing a benefit. An intestinal anti-inflammatory response was suggested. At 16-weeks follow-up while still on SSRI medications, the group had relapsed after cessation of the test intervention.

The Microbiota‐Inflammasome Hypothesis of Major Depression

“…In a study with treatment resistant MDD patients, 8 weeks supplementation with Lactobacillus acidophilus , Bifidobacterium bifidum , Streptoccocus thermophiles and magnesium orotate reduced depression scores and improved life quality . Similarly, the administration of Lactobacillus acidophilus , Lactobacillus casei , and Bifidobacterium bifidum decreased depression scores, and high sensitivity CRP, while increasing glutathione levels .…”

Antidepressive Mechanisms of Probiotics and Their Therapeutic Potential

“…Therefore, certain probiotics may serve as an adjuvant or alternative treatment for MDD and its subtypes. A pilot study showed that MSP, together with a magnesium supplement, decreased depression in SSRI treatment-resistant patients (Bambling et al, 2017). A clinical trial also reported that the combination of B. longum and L. helveticus decreased depression in MDD patients with prior use of standard antidepressants (Kazemi et al, 2019).…”

“…However, MSPs may have higher potency in humans. In MDD patients, SSP (L. plantarum) did not reduce depression but improved cognition (Lew et al, 2018), whereas MSPs had repeatedly shown antidepressive efficacy (Akkasheh et al, 2016;Bambling et al, 2017;Ghorbani et al, 2018;Kazemi et al, 2019). MSPs often gave better therapeutic efficacy compared to that of SSPs in gut-related disorders and pathogen infections, which could be explained by an overall higher dosage (Chapman et al, 2011(Chapman et al, , 2012.…”

Mitochondria could be a potential key mediator linking the intestinal microbiota to depression

“…Although mild depression can be treated with various medicines, major depressive disorder (MDD) is difficult to treat. 5 Additional pharmacotherapy prescriptions include anti-psychiatric agents that can produce severe side-effects. 1 The severity of MDD is caused by physical illnesses such as cardiovascular disorders, stroke, metabolic syndromes, and psychiatric conditions such as anxiety.…”

“…[10][11][12] For example, it has been shown that the Bacteroides genus in patients with MDD was increased, while the Lachnospiraceae genus was decreased. 5,14,15 Further consideration on the mechanisms central to the role that gut microorganisms may have on the pathogenesis of MDD is of significant importance. Emerging evidence with the administration of probiotics has demonstrated a decrease in neuroinflammation, a pathogenic characteristic of depression.…”