Persistent sadness, hopelessness, and a loss of interest or pleasure in daily activities characterize MDD.

There has been growing interest in exploring alternative treatment approaches in recent years. These tools include probiotic supplementation to alleviate anxiety and depression symptoms.

A pilot randomized trial published in JAMA Psychiatry provides valuable insights into the potential benefits of probiotic supplementation as an adjunctive treatment for individuals with a major depressive disorder who do not achieve a complete remission with antidepressants.

We will examine the study findings and discuss the implications for clinical practice.

Depression is Common

Major depression is quite common, with around 264 million people globally experiencing this debilitating disorder, according to the World Health Organization.

According to The National Institute of Mental Health, 17.3 million (7.1 percent of adults) have had at least one major depressive episode in the United States.

The National Institute of Mental Health explains that of adults, 17.3 million (7.1 percent of the adult population) have had at least one major depressive episode in the United States.

The prevalence of major depression varies across different countries and populations, but it is a significant public health concern.

Major depression affects individuals from all walks of life, irrespective of age, gender, socioeconomic status, or cultural background. It is not limited to a specific demographic group and can occur in children, adolescents, adults, and older adults.

Women may be more likely to experience major depression than men. The reasons for this gender difference are not fully understood.

Despite its commonality, major depression is often underdiagnosed and undertreated. Many individuals suffering from depression do not seek professional. Reasons include stigma, lack of awareness, and limited access to mental health services.

Addressing the prevalence of major depression requires increased awareness. We also need improved mental health literacy and enhanced accessibility to appropriate treatments and support systems for those affected.

Depression (major depressive disorder) – Symptoms and causes

www.mayoclinic.org

Anxiety is common

Anxiety disorders are among the most common mental health conditions worldwide, affecting a significant portion of the global population. The condition is the most common mental illness globally and has a striking impact on the global disease burden.

Anxiety is a normal and adaptive response to stress or danger, but it can be classified as an anxiety disorder when it becomes chronic, excessive, and interferes with daily functioning.

Approximately 284 million individuals experience an anxiety disorder, making it a widespread concern.

It is important to note that anxiety disorders are not exclusive to any particular demographic group and can affect people from all backgrounds and age groups.

Anxiety disorders can manifest in various forms, such as generalized anxiety disorder (GAD), panic disorder, social anxiety disorder, specific phobias, and post-traumatic stress disorder (PTSD).

Anxiety-related conditions can significantly impact an individual’s quality of life, relationships, and overall well-being.

Similar to major depression, anxiety disorders are often underdiagnosed and undertreated. Many anxious individuals don’t seek professional help due to stigma, lack of awareness, or fear of judgment.

Furthermore, some individuals may not recognize that their distressing symptoms indicate an anxiety disorder. Addressing the prevalence of anxiety requires promoting mental health awareness, reducing stigma, and ensuring access to appropriate diagnosis, treatment, and support services for those in need.

Anxiety disorders – Symptoms and causes

www.mayoclinic.org

Probiotics, Anxiety, and Depression

The randomized trial investigated the effects of probiotic supplementation as an adjunctive treatment for anxiety and depression symptoms in patients with MDD.

The study included 120 participants already receiving treatment with antidepressant medication but had not achieved full remission.

They were randomly assigned to receive either a widely-available, 14-strain probiotic supplement or a placebo. Subjects took the supplement or placebo four times daily for eight weeks.

Researchers assessed the severity of anxiety and depression symptoms using standardized measures at the beginning and end of the study.

The trial results revealed:

A significant drop in anxiety and depression symptoms among those who received probiotic supplementation (versus a placebo).

This finding suggests that probiotic supplementation may benefit mental health outcomes in individuals with MDD who do not experience complete relief from antidepressants alone.

Importantly, the use of probiotics as an adjunctive treatment did not interfere with the efficacy of the antidepressant medication, emphasizing its potential as a complementary therapeutic approach.

Probiotics mechanism

The mechanisms underlying the observed effects of probiotic supplementation on anxiety and depression symptoms are not yet fully understood.

However, there are several plausible explanations based on current scientific understanding. One hypothesis is that probiotics may modulate the gut-brain axis, bidirectional communication between the gastrointestinal and central nervous systems.

Emerging evidence suggests that alterations in gut microbiota composition and function are associated with mood disorders. Probiotics help restore a healthy balance of gut bacteria, improving mental well-being.

Furthermore, probiotics exert anti-inflammatory effects and regulate the production of neurotransmitters, such as serotonin, which play a crucial role in mood regulation.

Dysfunction in the serotonergic system is implicated in the pathophysiology of anxiety and depression. By influencing serotonin levels, probiotics may help alleviate depressive symptoms and promote a more positive mood state.

Probiotics: What is it, Benefits, Side Effects, Food & Types

Probiotics are a mixture of live bacteria or yeast in your body.

my.clevelandclinic.org

Clinical Trial Implications

The findings of this pilot trial have important implications for clinical practice, particularly for individuals with MDD who do not achieve full remission with antidepressants alone.

Adding probiotic supplementation as an adjunctive treatment may offer a valuable and safe option to enhance therapeutic outcomes. Given probiotics’ relatively low cost and minimal side effects, it could be a feasible and accessible intervention for many patients.

Study Limitations

However, it is essential to recognize the limitations of this study. First, the trial had a relatively small sample size, and we need to interpret the findings cautiously until replicated in larger, more diverse populations.

Secondly, the specific probiotic strain, dosage, and treatment duration used in this trial may not be generalizable to all available probiotic products. We need additional research to identify the most effective probiotic strains and optimal treatment protocols for managing anxiety and depression symptoms in patients with MDD.

Third, adherence was evaluated through capsule count, which, while the most commonly used method in clinical trials, can lead to overreporting.

In conclusion, the pilot randomized trial published in JAMA Psychiatry suggests that probiotic supplementation used as an adjunctive treatment holds promise in reducing anxiety and depression symptoms in patients with a Major Depressive Disorder (MDD) who do not experience full relief from antidepressants alone.

Gut-Brain Axis

The study’s findings support the hypothesis that probiotics may positively influence the gut-brain axis and modulate key neurochemical pathways involved in mood regulation.

Sugar, the Gut, and Obesity: Revealing Findings You Should Know About.

medium.com

We need more study

Although further research is warranted, these results provide a stepping stone for future investigations in larger populations to establish the efficacy and safety of probiotics as adjunctive treatments for anxiety and depression in MDD.

Incorporating probiotics into the treatment landscape may broaden the options available to clinicians and improve outcomes for individuals struggling with MDD.

The randomized clinical trial used the equivalent colony-forming unit of a single serving of kombucha.

Conflicts of Interest

The Medical Research Council Industrial CASE Ph.D. funded the study. Studentship with ADM Protexin (supplier of the probiotics) as the industry partner and additional support from Freya Green.

Study author Dr. Nikolova has received grants from the Medical Research Council and ADM Protexin during the conduct of the study as well as personal fees from Janssen outside the submitted work.

The post Surprising Link Between Probiotics, Anxiety, and Depression appeared first on Medika Life.

Approximately one in five individuals who take antibiotics develop antibiotic-associated diarrhea. Antibiotic-associated diarrhea is likely to start a week or so after antibiotic initiation. Occasionally, diarrhea and other symptoms do not emerge until days or weeks after the completion of the antibiotic course.

Fortunately, diarrhea is typically mild, self-limited, and requires no treatment. Fortunately, the gastrointestinal upset usually resolves within a few days of discontinuing the antibiotic. The antibiotic may need to be switched or discontinued for those with more serious GI problems.

Antibiotic-associated diarrhea is likely to begin about a week after you start taking an antibiotic. However, diarrhea and other symptoms sometimes don’t appear until days or weeks after you’ve finished antibiotic treatment.

Clostridioides difficile (C. diff) infection

I would be remiss if I did not mention C. difficile. These toxin-making bacteria can cause serious antibiotic-related diarrhea or more frequent bowel movements. In addition to causing loose stools and more-frequent bowel movements, C. difficile infection can cause:

• Severe diarrhea and dehydration
• Lower abdominal pain and cramping
• Low-grade fever
• Nausea
• Loss of appetite

Most cases of C. diff occur when someone has been taking antibiotics (or not long after completing an antibiotic course). While the infection can affect anyone, risk factors include:

• Age 65 or older
• A recent hospital or nursing home stay
• A weakened immune system (for example, in those with HIV/AIDS, cancer, or organ transplant patients taking immunosuppressive drugs)
• Prior infection with C. diff or known exposure to the germs

Here are some disturbing statistics from the US Centers for Disease Control (CDC): C. diff causes nearly half a million infections in the United States annually. Of those who get an infection, one in six will get it again in the subsequent two to eight weeks. One in 11 over 65 will die of symptoms related to a C. diff infection within one month.

Those with C. diff are contagious, so please wash your hands with soap and water each time you use the bathroom and before you eat. If you have diarrhea, use a separate bathroom if possible. Finally, take showers and wash with soap.

Please call your healthcare provider immediately if you have serious symptoms of antibiotic-associated diarrhea. These symptoms are common to several conditions, so you may need tests — for example, stool or blood— to determine the cause.

While antibiotics are an important tool for battling potentially life-threatening bacteria, the drugs can disrupt the composition and function of the gut microbiome. More specifically, antibiotics can drop the abundance and diversity of gut bacteria, opening the door to infection by bad, pathogenic bacteria.

What is the microbiome?

Here is what I previously wrote about the microbiome:

“The microbiome, the collection of bacteria, fungi, and viruses that live in and on our bodies, is a component of our immune system. The microbiome is essential to the defense systems of our bodies.

We have approximately 100 trillion microbes — including bacteria, fungi, and viruses — primarily found in the gastrointestinal system, our skin, and other body parts.

I have a new word for you: Dysbiosis, a change in the microbiome’s composition, diversity, or metabolites from a healthy pattern to one associated with a disease. Antibiotics can be a cause. Replacing microorganisms (via fecal transplants) can be an effective management option for some problems, such as inflammatory bowel disease and certain recurrent infections associated with antibiotic use.

What does this have to do with you? Dysbiosis plays a role in diverse conditions, including type 2 diabetes, obesity, asthma, food allergy, and atopic dermatitis. The gut microbiome is thus an attractive target for intervention. Some have found success in managing type 2 diabetes with gut microbiome manipulation.

I’ll bet you didn’t know that the microbiota can weigh upwards of two kilograms. A growing body of evidence points to the microbiome as essential to metabolic function, digestion, and resisting infection. Your genes, environment, and medicines can influence gut microbiota.”

Antibiotics and the microbiome

Some have hailed antibiotics as miracle drugs that have revolutionized medicine since their introduction more than a hundred years ago. By effectively treating infectious bacterial diseases, these drugs have ushered in an era with far fewer medical issues and deaths.

With antibiotic use has come increasing threats, including antibiotic resistance and potential direct harm to human health. Animal studies remind us that gut microbiome disruption (secondary to antibiotics) can have long-lasting harmful effects, including a higher risk of allergies and obesity.

Diet and Weight Loss: How Calorie Restriction Affects Your Weight and Gut

DIET IS IMPORTANT in shaping our gut microbiome. Today, we look at microbiome basics before pivoting to new research…

medium.com.

In addition, the microbiome may influence long COVID-19 risk.

Long Covid and Your Gut

DO YOU HAVE LONG COVID SYMPTOMS? It might be because of gut microbes.

medium.com.

Probiotics with antibiotics

Can probiotics alleviate some of the gut microbiome disruption induced by antibiotics? And can probiotics reduce antibiotic-induced diarrhea? According to a new systematic review published in the Journal of Medical Microbiology, the answer appears to be yes.

We may be on our way to co-prescribing probiotics with antibiotic treatments.

What are probiotics?

Probiotics are live bacteria and yeasts that are good for you, especially your gastrointestinal system. While we initially think of bacteria as “bad” and disease-causing, your bodies are full of microbes such as bacteria, both good and bad. Some refer to probiotics as “good” bacteria because they help keep the gut healthy.

Probiotics are living microorganisms, usually belonging to the genera Lactobacillus, Bifidobacterium, and Saccharomyces. You can find probiotics in some foods (such as yogurt) and supplements.

Historical research shows that combining probiotics and antibiotics can reduce the risk of antibiotic-associated diarrhea. Probiotics help in several ways: They suppress harmful bacteria, change the immune system, and help to protect the gut lining.

Part of my reluctance to always prescribe probiotics with antibiotics is concern that the probiotics can alter the gut microbiome composition for a long time. Moreover, the available studies looking at taking probiotics and antibiotics are mixed.

To clarify the role of probiotic supplementation on the gut microbiome, Texas Christian University (USA) researchers did a systematic review of the available clinical literature.

Their review included 22 studies that either used antibiotics or probiotics alone and seven studies looking at probiotics in conjunction with antibiotics. All 11 antibiotic studies showed changes in the gut microbiome composition, including a drop in the microbe diversity; antibiotics led to few microbe species in the gut.

Here are the findings for the seven studies involving probiotics in combination with antibiotics:

• Gastrointestinal symptoms. Five (of the seven) studies showed improvements in symptoms such as diarrhea.
• Microbe diversity. Four (of the seven) studies showed probiotics prevented antibiotic-induced declines in microbe diversity. Of the three negative studies, two had a short duration of antibiotics (potentially causing only limited changes in the gut microbiome).
• Microbiome composition. All four studies that had information on gut microbiota showed that the simultaneous use of probiotics and antibiotics helped restore the baseline (pre-antibiotic) microbiome composition.

Most studies showing the benefits of adding probiotics to antibiotics continued the probiotics for about one week after the completion of the antibiotics.

My take

I am delighted with the review. Still, we know little about the long-term safety of probiotic supplements. Could the use of high amounts of probiotics with the same bacterial species facilitate the transfer of resistant genes to infectious pathogens? Could introducing pathogens via probiotics increase opportunistic infections, especially among those with weakened immune systems?

Probiotics: If It Does Not Help, It Does Not Harm. Really?

Microorganisms. 2019 Apr; 7(4): 104.

www.ncbi.nlm.nih.gov

Many of the available studies looking at probiotics are poorly designed or underpowered. And there is this concern: Probiotic companies often fund these studies. We don’t know much about probiotic effectiveness or safety, even though the study I presented today signals the potential promise of probiotic use.

Alas, probiotics in the United States are not regulated or treated as drugs, rather than dietary supplements. For now, if you are immuno-compromised, you should dodge probiotics unless used under the guidance of a qualified healthcare professional.

We need more research to understand better how to integrate probiotics into an antibiotic course. What is the optimal dose? Frequency? Probiotic choice? Nevertheless, I am delighted that probiotics may play a larger file in the future.

Now, if we can minimize the use of unnecessary antibiotics, but that is a topic for another day. Thank you for joining me for this look at probiotics and antibiotic-induced gut damage. Oh, one more thing:

How you Can use a Psychobiotic Diet to Lower Stress

EATING A DIET RICH IN FERMENTED AND PREBIOTIC foods may help us to feel less stressed, according to a new study from…

medium.com

The post Do Probiotics Repair Antibiotic-Induced Gut Damage? appeared first on Medika Life.