Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland.
Transl Psychiatry. 2024 Jan 15;14(1):26. doi: 10.1038/s41398-024-02735-z.
The psychopharmacological treatment of patients with schizophrenia or depression is often accompanied by serious side effects. In particular, the clinical findings of weight gain are worrying, as this side effect can lead to various medical sequelae in the future. However, the treatment of metabolic changes in psychiatric patients is often neglected or unsuccessful. An improved knowledge of possible therapeutic approaches is needed. The aim of this study was to provide an overview of the utilisation and effectiveness of probiotics in reducing weight gain in patients with severe mental illness. A scoping review of studies published until 15 June 2022 was conducted to identify studies using probiotics in people with schizophrenia or depression. We systematically searched the databases EMBASE, PubMed (MEDLINE), Web of Science and SCOPUS with a predefined search string. In addition, reference lists of relevant publications were examined for additional studies. The studies were assessed by two reviewers. The primary outcomes were weight-related measurements. The secondary outcomes were metabolic blood parameters and gut microbiota. Four studies ultimately met the inclusion criteria. Two studies in which probiotics were administered did not find significant effects on pharmacologically induced weight gain. The other two studies examined the effects of synbiotics (a combination of probiotics and prebiotics). Interestingly, less weight gain was observed in individuals with this combined intervention. Adjustments in diet can be helpful and are generally well-accepted interventions in the fight against pharmacologically induced weight gain. The clinical use of probiotics and prebiotics (or synbiotics) as dietary interventions may represent a promising additional strategy in this regard. However, the few studies available showed no clear conclusions.
精神分裂症或抑郁症患者的精神药理学治疗常伴有严重的副作用。特别是，体重增加的临床发现令人担忧，因为这种副作用可能会导致未来出现各种医疗后遗症。然而，精神科患者代谢变化的治疗往往被忽视或不成功。需要更好地了解可能的治疗方法。本研究旨在综述益生菌在减少严重精神疾病患者体重增加方面的应用和效果。我们对截至 2022 年 6 月 15 日发表的研究进行了范围综述，以确定使用益生菌治疗精神分裂症或抑郁症患者的研究。我们使用预定义的搜索字符串系统地搜索了 EMBASE、PubMed（MEDLINE）、Web of Science 和 SCOPUS 数据库。此外，还检查了相关出版物的参考文献列表以获取其他研究。研究由两名评审员进行评估。主要结果是与体重相关的测量。次要结果是代谢血液参数和肠道微生物群。最终有四项研究符合纳入标准。两项给予益生菌的研究没有发现益生菌对药物引起的体重增加有显著影响。另外两项研究检查了合生元（益生菌和益生元的组合）的效果。有趣的是，联合干预的个体体重增加较少。饮食调整可能会有所帮助，并且通常是对抗药物引起的体重增加的可接受的干预措施。益生菌和益生元（或合生元）作为饮食干预的临床应用可能是这方面有前途的额外策略。然而，现有少数研究没有得出明确的结论。
