The effect and safety of probiotics on depression: a systematic review and meta-analysis of randomized controlled trials

• Published in: European journal of nutrition 2023-10, Vol.62 (7), p.2709-2721
• Main Authors: Lin, Junjie, Zhang, Yu, Wang, Kunyi, Wang, Junping, Kou, Shuo, Chen, Kan, Zheng, Weijun, Chen, Rucheng
• Format: Article
• Language: English
• Subjects: Chemistry; Chemistry and Materials Science; Clinical trials; Depression - therapy; Humans; Interleukin 6; Mental depression; Meta-analysis; Nutrition; Patients; Probiotics; Probiotics - therapeutic use; Randomized Controlled Trials as Topic; Review; Systematic review; Tumor Necrosis Factor-alpha; Tumor necrosis factor-α
• ISSN: 1436-6207; 1436-6215; 1436-6215
• DOI: 10.1007/s00394-023-03184-y

Purpose With the escalating social pressures, there has been a continuous rise in the prevalence of depression among the population, leading to substantial healthcare burdens. Moreover, conventional pharmacological interventions still exhibit certain limitations. Therefore, the primary objective of this study is to systematically evaluate the clinical efficacy of probiotics in the treatment of depression. Methods Randomized controlled trials of probiotics in treating depressive symptoms were retrieved from Pubmed, Cochrane Library, Web of Science, Wan Fang database, and CNKI between the establishment of the database and March 2022. The primary outcome was Beck’s depression rating scale (BDI) scores, while the secondary outcomes were depression scores on the DASS-21 scale, biochemical indicators (IL-6, NO, and TNF-α levels), and adverse events. In addition, Revman 5.3 was used for Meta-analysis and quality evaluation, and Stata 17 was used for the Egger test and Begg’s test. A total of 776 patients, including 397 and 379 patients in the experimental and control groups, respectively, were included. Results The total BDI score of the experimental group was lower than that of the control group (MD = − 1.98, 95%CI − 3.14 to − 0.82), and the score of DASS (MD = 0.90, 95%CI − 1.17 to 2.98), the IL-6 level (SMD = − 0.55, 95%CI − 0.88 to − 0.23), the NO level (MD = 5.27, 95% CI 2.51 to 8.03), and the TNF-α level (SMD = 0.19, 95% CI − 0.25 to 0.63). Conclusion The findings substantiate the therapeutic potential of probiotics in mitigating depressive symptoms by significantly reducing Beck's Depression Inventory (BDI) scores and alleviating the overall manifestation of depression.