Menni Alexandra-Eleftheria, Theodorou Helen, Tzikos Georgios, Theodorou Ioannis M, Semertzidou Eleni, Stelmach Veroniki, Shrewsbury Anne D, Stavrou George, Kotzampassi Katerina
Department of Surgery, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece.
Department of Sociology, School of Social Sciences, University of Crete, 74100 Rethymno, Greece.
Nutrients. 2025 Jun 17;17(12):2022. doi: 10.3390/nu17122022.
Depression is a leading contributor to global disability, with a large proportion of patients showing inadequate responses to conventional antidepressants. Probiotic bacteria with psychotropic potential seem to be an emerging treatment option, either alone or in conjunction with depression symptom management. To critically review the Randomized Clinical Trials (RCTs) whose primary focus was to evaluate the efficacy of probiotics/psychobiotics to ameliorate depression status, quantified via validated psychometric tools. A comprehensive literature search of the PubMed and Scopus databases (January 2014-January 2025) was conducted to identify RCTs with the primary aim of improving depression status in adults taking probiotics in comparison to those taking a well-defined placebo. Nineteen RCTs met the inclusion criteria, with all demonstrating a significant amelioration of depression status after probiotic/psychobiotic treatment, taken either as a stand-alone treatment [ = 5] or as an adjunctive treatment to antidepressant therapy [ = 10]. However, only in 14 studies was a significant improvement achieved at the end of treatment over a placebo, which also showed an improvement against the baseline. In total, 7 out of 10 studies with probiotics as an add-on therapy and 7 out of the 9 with probiotics, either as a monotherapy or with a different percentage also taking antidepressants, exhibited a significant amelioration of depression status against placebo treatment. Probiotics, particularly multi-strain preparations and certain well-characterized single strains, seem to be noticeably beneficial in alleviating depressive symptoms in adults. However, there is an urgent need for large-scale randomized clinical trials with well-defined specific psychobiotic strains in order to confirm the most effective strains.
抑郁症是导致全球残疾的主要因素，很大一部分患者对传统抗抑郁药反应不佳。具有精神调节潜力的益生菌似乎是一种新兴的治疗选择，可单独使用或与抑郁症症状管理相结合。为了严格审查那些主要关注评估益生菌/精神益生菌改善抑郁状态疗效的随机临床试验（RCT），通过经过验证的心理测量工具进行量化。对PubMed和Scopus数据库（2014年1月至2025年1月）进行了全面的文献检索，以确定主要目的是改善服用益生菌的成年人与服用明确安慰剂的成年人相比的抑郁状态的RCT。19项RCT符合纳入标准，所有这些试验都表明益生菌/精神益生菌治疗后抑郁状态有显著改善，治疗方式为单独治疗[ = 5]或作为抗抑郁治疗的辅助治疗[ = 10]。然而，只有14项研究在治疗结束时相对于安慰剂取得了显著改善，安慰剂相对于基线也有改善。总的来说，10项将益生菌作为附加疗法的研究中有7项，以及9项将益生菌作为单一疗法或不同比例同时服用抗抑郁药的研究中有7项，相对于安慰剂治疗，抑郁状态有显著改善。益生菌，特别是多菌株制剂和某些特征明确的单一菌株，似乎在缓解成年人的抑郁症状方面明显有益。然而，迫切需要进行大规模的随机临床试验，使用明确的特定精神益生菌菌株，以确认最有效的菌株。
