Effectiveness of probiotic/prebiotic/synbiotic treatments on anxiety: A systematic review and meta-analysis of randomized controlled trials

Zhao, Ziran; Xiao, Gui; Xia, Jieqiong; Guo, Honghua; Yang, Xiaoli; Jiang, Qian; Wang, Hu; Hu, Jiaji; Zhang, Caihong

doi:10.1016/j.jad.2023.09.018

Cited by 9 publications

(7 citation statements)

References 63 publications

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“…Inconsistencies among trials results may be explained, at least in part, by heterogeneity among studies as regards, e.g., probiotic strains and prebiotic substances, supplements dosage, and indices/scales adopted to measure the level of anxiety. Consistently with that, Zhao et al ( 180 ) found anxiety-scale specific effects, with positive interventional effect for STAI-S and BAI as compared to the DASS-A, the Hospitalized Anxiety Depression Scale, and others. They also reported that high-dose probiotics and multiple-strain supplements have a stronger effect on reducing anxiety scores compared to low-dose probiotics and sole/no-strain supplements, respectively.…”

Section: Diet Gut Microbiome and Anxiety: Integrating Available Evide...supporting

confidence: 78%

“…Out of five prebiotic studies, two found no significant effect, while three reported a decrease in the level of anxiety. More recently, Zhao et al ( 180 ) conducted a systematic review of randomized controlled trials assessing the anxiolytic effect of treatments involving probiotics, prebiotics, or synbiotics – a mixture of probiotics and prebiotics. This work revealed that both probiotics and synbiotics can significantly reduce anxiety scores, while prebiotics do not exert any significant effect compared to placebos.…”

Section: Diet Gut Microbiome and Anxiety: Integrating Available Evide...mentioning

confidence: 99%

“…They also reported that high-dose probiotics and multiple-strain supplements have a stronger effect on reducing anxiety scores compared to low-dose probiotics and sole/no-strain supplements, respectively. However, Zhao et al ( 180 ) could not determine the clinical efficacy of probiotic/prebiotic/synbiotic treatments in alleviating anxiety, due to the small combined effect size and the scarcity of studies addressing prebiotics and synbiotics.…”

Section: Diet Gut Microbiome and Anxiety: Integrating Available Evide...mentioning

confidence: 99%

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Diet quality and anxiety: a critical overview with focus on the gut microbiome

Basso,

Zorzan,

Johnstone

et al. 2024

Front. Nutr.

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Anxiety disorders disproportionally affect females and are frequently comorbid with eating disorders. With the emerging field of nutritional psychiatry, focus has been put on the impact of diet quality in anxiety pathophysiology and gut microbiome underlying mechanisms. While the relationship between diet and anxiety is bidirectional, improving dietary habits could better facilitate the actions of pharmacological and psychological therapies, or prevent their use. A better understanding of how gut bacteria mediate and moderate such relationship could further contribute to develop personalized programs and inform probiotics and prebiotics manufacturing. To date, studies that look simultaneously at diet, the gut microbiome, and anxiety are missing as only pairwise relationships among them have been investigated. Therefore, this study aims at summarizing and integrating the existing knowledge on the dietary effects on anxiety with focus on gut microbiome. Findings on the effects of diet on anxiety are critically summarized and reinterpreted in relation to findings on (i) the effects of diet on the gut microbiome composition, and (ii) the associations between the abundance of certain gut bacteria and anxiety. This novel interpretation suggests a theoretical model where the relationship between diet and anxiety is mediated and/or modulated by the gut microbiome through multiple mechanisms. In parallel, this study critically evaluates methodologies employed in the nutritional field to investigate the effects of diet on anxiety highlighting a lack of systematic operationalization and assessment strategies. Therefore, it ultimately proposes a novel evidence-based approach that can enhance studies validity, reliability, systematicity, and translation to clinical and community settings.

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Section: Diet Gut Microbiome and Anxiety: Integrating Available Evide...supporting

confidence: 78%

Section: Diet Gut Microbiome and Anxiety: Integrating Available Evide...mentioning

confidence: 99%

Section: Diet Gut Microbiome and Anxiety: Integrating Available Evide...mentioning

confidence: 99%

See 1 more Smart Citation

Diet quality and anxiety: a critical overview with focus on the gut microbiome

Basso,

Zorzan,

Johnstone

et al. 2024

Front. Nutr.

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“…Additionally, the anxiety-reducing effects of probiotics have been significantly documented in populations with anxiety disorders [ 109 ]. A meta-analysis revealed that both probiotics and synbiotics significantly reduced anxiety scores [ 110 ]. In a randomized controlled trial by Eskandarzadeh et al, a combination of probiotics and sertraline was superior to sertraline alone in reducing anxiety symptoms over 8 weeks in patients with Generalized Anxiety Disorder (GAD), suggesting an effectiveness in combined therapies [ 111 ].…”

Section: Prebiotics and Probiotics In The Treatment Of Psychopathologiesmentioning

confidence: 99%

Mind, Mood and Microbiota—Gut–Brain Axis in Psychiatric Disorders

Toader,

Dobrin,

Costea

et al. 2024

IJMS

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Psychiatric disorders represent a primary source of disability worldwide, manifesting as disturbances in individuals’ cognitive processes, emotional regulation, and behavioral patterns. In the quest to discover novel therapies and expand the boundaries of neuropharmacology, studies from the field have highlighted the gut microbiota’s role in modulating these disorders. These alterations may influence the brain’s processes through the brain–gut axis, a multifaceted bidirectional system that establishes a connection between the enteric and central nervous systems. Thus, probiotic and prebiotic supplements that are meant to influence overall gut health may play an insightful role in alleviating psychiatric symptoms, such as the cognitive templates of major depressive disorder, anxiety, or schizophrenia. Moreover, the administration of psychotropic drugs has been revealed to induce specific changes in a microbiome’s diversity, suggesting their potential utility in combating bacterial infections. This review emphasizes the intricate correlations between psychiatric disorders and the gut microbiota, mentioning the promising approaches in regard to the modulation of probiotic and prebiotic treatments, as well as the antimicrobial effects of psychotropic medication.

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“…The probable common etiopathogenesis of depression and MetS has led to a growing interest in interventions on the gut microbiota, including the use of probiotics and prebiotics as supplements that affect the microbiota-gut-brain axis and reduce the risk of depression [11], as well as metabolic syndrome and its sequelae [12]. The use of probiotics, defined as "microorganisms that, when administered in adequate amounts, confer a health benefit on the host" [13], may have the effect of reducing the intensity of anxiety symptoms [14]. Moreover, recent studies have reported that probiotics used as complementary treatments lead to better results in the management of depression [15,16].…”

Section: Introductionmentioning

confidence: 99%

Metabolic Status Influences Probiotic Efficacy for Depression—PRO-DEMET Randomized Clinical Trial Results

Gawlik-Kotelnicka,

Margulska,

Płeska

et al. 2024

Nutrients

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Probiotics may represent a safe and easy-to-use treatment option for depression or its metabolic comorbidities. However, it is not known whether metabolic features can influence the efficacy of probiotics treatments for depression. This trial involved a parallel-group, prospective, randomized, double-blind, controlled design. In total, 116 participants with depression received a probiotic preparation containing Lactobacillus helveticus Rosell®-52 and Bifidobacterium longum Rosell®-175 or placebo over 60 days. The psychometric data were assessed longitudinally at five time-points. Data for blood pressure, body weight, waist circumference, complete blood count, serum levels of C-reactive protein, cholesterol, triglycerides, and fasting glucose were measured at the beginning of the intervention period. There was no advantage of probiotics usage over placebo in the depression score overall (PRO vs. PLC: F(1.92) = 0.58; p = 0.45). However, we found a higher rate of minimum clinically important differences in patients supplemented with probiotics than those allocated to placebo generally (74.5 vs. 53.5%; X2(1,n = 94) = 4.53; p = 0.03; NNT = 4.03), as well as in the antidepressant-treated subgroup. Moreover, we found that the more advanced the pre-intervention metabolic abnormalities (such as overweight, excessive central adipose tissue, and liver steatosis), the lower the improvements in psychometric scores. A higher baseline stress level was correlated with better improvements. The current probiotic formulations may only be used as complementary treatments for depressive disorders. Metabolic abnormalities may require more complex treatments. ClinicalTrials.gov identifier: NCT04756544.

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Effectiveness of probiotic/prebiotic/synbiotic treatments on anxiety: A systematic review and meta-analysis of randomized controlled trials

Cited by 9 publications

References 63 publications

Diet quality and anxiety: a critical overview with focus on the gut microbiome

Diet quality and anxiety: a critical overview with focus on the gut microbiome

Mind, Mood and Microbiota—Gut–Brain Axis in Psychiatric Disorders

Metabolic Status Influences Probiotic Efficacy for Depression—PRO-DEMET Randomized Clinical Trial Results

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