Probiotics as an Adjuvant Treatment for Psychiatric Disorders

Introduction: Many psychiatric illnesses have been linked to the gut microbiome, with supplements such as probiotics showing some efficacy in alleviating the symptoms of some psychiatric illnesses. There is a well-established, bidirectional connection between the gut microbiome and the brain, known as the gut-brain-axis. Research suggests that the gut-brain-axis may influence a variety of neurological functions, including the pathology of psychiatric disorders. The aim of this chapter is to evaluate the current literature investigating the effects of adjuvant probiotic or synbiotic administration in combination with first-line treatments for psychiatric illnesses.

Methods: This review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic search of four databases was conducted using key terms related to treatments for psychiatric illnesses, the gut microbiome, and probiotics.

All results were then evaluated based on specific eligibility criteria.

Results: Ten studies met eligibility criteria and were analysed for reported changes in outcome measures used to assess the symptoms of psychiatric illness and the tolerability of treatment. All Major Depressive Disorder (MDD) (n=7) and Generalized Anxiety Disorder (GAD) (n=1) studies found adjuvant probiotic or synbiotic treatment to be more efficacious in improving the symptoms of psychiatric illness than the first-line treatment alone or with placebo. The schizophrenia studies (n=2) found adjuvant probiotic treatment to have no significant difference in clinical outcomes, but it was found to improve the tolerability of first-line antipsychotics.

Discussion and Conclusion: The findings of the studies included in this chapter suggest the use of adjuvant probiotic treatment with selective serotonin reuptake inhibitors (SSRIs) for MDD and GAD to be superior to SSRI treatment alone. Probiotic adjuvant treatment with antipsychotics could be beneficial for improving the tolerability of the antipsychotics, but these findings do not suggest that adjuvant probiotic treatment would result in improved clinical outcomes for symptoms of schizophrenia. Finally, it is said that the gut microbiome and the brain are clearly linked, and reviewed studies show that combining treatments that target both areas respectively is a viable and efficacious way to combat the symptoms and treat psychiatric illnesses.