The Role of Probiotics in Depression Therapy: Current State of Knowledge and Therapeutic Perspectives
DOI:
https://doi.org/10.12775/QS.2025.40.59858Keywords
depression, gut microbiota, probiotics, gut-brain axis, supplementation, neurotransmitters, inflammation, mental disordersAbstract
Depression is one of the most common mental disorders worldwide, leading to a significant reduction in quality of life and an increased risk of suicide. The pathogenesis of major depressive disorder (MDD) remains complex and not fully understood, involving neurotransmitter disturbances, excessive activation of the hypothalamic-pituitary-adrenal (HPA) axis, and reduced levels of brain-derived neurotrophic factor (BDNF). In recent years, an increasing number of studies have highlighted the role of gut microbiota and the gut-brain axis as key elements in the pathogenesis of depression. This review aimed to analyze the current evidence on the impact of probiotic supplementation on depressive symptoms. A PubMed database search was conducted, including randomized clinical trials, meta-analyses, and systematic reviews from the last five years. The results of the analyzed studies suggest that probiotics, particularly Lactobacillus and Bifidobacterium strains, may reduce depressive symptoms, regulate neurotransmitter levels, and decrease inflammation. However, the effectiveness of probiotic supplementation varied depending on the strain used, intervention duration, and the study population. Despite promising results, further research is needed to determine optimal probiotic therapy protocols in depression.
References
Akkasheh, G., Kashani-Poor, Z., Tajabadi-Ebrahimi, M., Jafari, P., Akbari, H., Taghizadeh, M., Memarzadeh, M. R., Asemi, Z., & Esmaillzadeh, A. (2016). Clinical and metabolic response to probiotic administration in patients with major depressive disorder: A randomized, double-blind, placebo-controlled trial. Nutrition, 32(3), 315–320. https://doi.org/10.1016/j.nut.2015.09.003
Alli, S. R., Gorbovskaya, I., Liu, J. C. W., Kolla, N. J., Brown, L., & Müller, D. J. (2022). The gut microbiome in depression and potential benefit of prebiotics, probiotics, and synbiotics: A systematic review of clinical trials and observational studies. International Journal of Molecular Sciences, 23(9), 4494. https://doi.org/10.3390/ijms23094494
Bercik, P., Denou, E., Collins, J., Jackson, W., Lu, J., Jury, J., Deng, Y., Blennerhassett, P., Macri, J., McCoy, K. D., Verdu, E. F., & Collins, S. M. (2011). The intestinal microbiota affect central levels of brain-derived neurotropic factor and behavior in mice. Gastroenterology, 141(2), 599-609, 609.e1-3. https://doi.org/10.1053/j.gastro.2011.04.052
Bercik, P., Verdu, E. F., Foster, J. A., Macri, J., Potter, M., Huang, X., Malinowski, P., Jackson, W., Blennerhassett, P., Neufeld, K. A., Lu, J., Khan, W. I., Corthesy-Theulaz, I., Cherbut, C., Bergonzelli, G. E., & Collins, S. M. (2010). Chronic gastrointestinal inflammation induces anxiety-like behavior and alters central nervous system biochemistry in mice. Gastroenterology, 139(6), 2102-2112.e1. https://doi.org/10.1053/j.gastro.2010.06.063
Doroszkiewicz, J., Groblewska, M., & Mroczko, B. (2021). The role of gut microbiota and gut-brain interplay in selected diseases of the central nervous system. International Journal of Molecular Sciences, 22(18), 10028. https://doi.org/10.3390/ijms221810028
Ferenchick, E. K., Ramanuj, P., & Pincus, H. A. (2019). Depression in primary care: Part 1—Screening and diagnosis. BMJ, 365, l794. https://doi.org/10.1136/bmj.l794
Foster, J. A., & Neufeld, K.-A. M. (2013). Gut–brain axis: How the microbiome influences anxiety and depression. Trends in Neurosciences, 36(5), 305–312. https://doi.org/10.1016/j.tins.2013.01.005
Gutiérrez-Rojas, L., Porras-Segovia, A., Dunne, H., Andrade-González, N., & Cervilla, J. A. (2020). Prevalence and correlates of major depressive disorder: A systematic review. Brazilian Journal of Psychiatry, 42(6), 657–672. https://doi.org/10.1590/1516-4446-2020-0650
He, J., Chang, L., Zhang, L., Wu, W., & Zhuo, D. (2023). Effect of probiotic supplementation on cognition and depressive symptoms in patients with depression: A systematic review and meta-analysis. Medicine (Baltimore), 102(47), e36005. https://doi.org/10.1097/MD.0000000000036005
Hofmeister, M., Clement, F., Patten, S., Li, J., Dowsett, L. E., Farkas, B., Mastikhina, L., Egunsola, O., Diaz, R., Cooke, N. C. A., & Taylor, V. H. (2021). The effect of interventions targeting gut microbiota on depressive symptoms: A systematic review and meta-analysis. CMAJ Open, 9(4), E1195–E1204. https://doi.org/10.9778/cmajo.20200283
Kelly, J. R., Minuto, C., Cryan, J. F., Clarke, G., & Dinan, T. G. (2017). Cross talk: The microbiota and neurodevelopmental disorders. Frontiers in Neuroscience, 11, 490. https://doi.org/10.3389/fnins.2017.00490
Kumar, A., Pramanik, J., Goyal, N., Chauhan, D., Sivamaruthi, B. S., Prajapati, B. G., & Chaiyasut, C. (2023). Gut microbiota in anxiety and depression: Unveiling the relationships and management options. Pharmaceuticals, 16(4), 565. https://doi.org/10.3390/ph16040565
Liu, Y., Zhang, L., Wang, X., Wang, Z., Zhang, J., Jiang, R., Wang, X., Wang, K., Liu, Z., Xia, Z., Xu, Z., Nie, Y., Lv, X., Wu, X., Zhu, H., & Duan, L. (2016). Similar fecal microbiota signatures in patients with diarrhea-predominant irritable bowel syndrome and patients with depression. Clinical Gastroenterology and Hepatology, 14(11), 1602–1611.e5. https://doi.org/10.1016/j.cgh.2016.05.033
Liu, P., Liu, Z., Wang, J., Wang, J., Gao, M., Zhang, Y., Yang, C., Zhang, A., Li, G., Li, X., Liu, S., Liu, L., Sun, N., Zhang, K. (2024). Immunoregulatory role of the gut microbiota in inflammatory depression. Nature Communications, 15(1), 3003. https://doi.org/10.1038/s41467-024-47273-w
Ray, K. (2017). IBS: Mindful of probiotics for psychiatric comorbidities in IBS. Nature Reviews Gastroenterology & Hepatology, 14(7), 386-387. https://doi.org/10.1038/nrgastro.2017.70
Reininghaus, E. Z., Platzer, M., Kohlhammer-Dohr, A., Hamm, C., Mörkl, S., Bengesser, S. A., Fellendorf, F. T., Lahousen-Luxenberger, T., Leitner-Afschar, B., Schöggl, H., Amberger-Otti, D., Wurm, W., Queissner, R., Birner, A., Falzberger, V. S., Painold, A., Fitz, W., Wagner-Skacel, J., Brunnmayr, M., Rieger, A., Maget, A., Unterweger, R., Schwalsberger, K., Reininghaus, B., Lenger, M., Bastiaanssen, T. F. S., & Dalkner, N. (2020). PROVIT: Supplementary probiotic treatment and vitamin B7 in depression—a randomized controlled trial. Nutrients, 12(11), 3422. https://doi.org/10.3390/nu12113422
Schaub, A.-C., Schneider, E., Vazquez-Castellanos, J. F., Schweinfurth, N., Kettelhack, C., Doll, J. P. K., Yamanbaeva, G., Mählmann, L., Brand, S., Beglinger, C., Borgwardt, S., Raes, J., Schmidt, A., Lang, U. E. (2022). Clinical, gut microbial and neural effects of a probiotic add-on therapy in depressed patients: A randomized controlled trial. Translational Psychiatry, 12(1), 227. https://doi.org/10.1038/s41398-022-01977-z
Schneider, E., Doll, J. P. K., Schweinfurth, N., Kettelhack, C., Schaub, A. C., Yamanbaeva, G., Varghese, N., Mählmann, L., Brand, S., Eckert, A., Borgwardt, S., Lang, U. E., Schmidt, A. (2023). Effect of short-term, high-dose probiotic supplementation on cognition, related brain functions and BDNF in patients with depression: A secondary analysis of a randomized controlled trial. Journal of Psychiatry & Neuroscience, 48(1), E23–E33. https://doi.org/10.1503/jpn.220117
Simpson, C. A., Diaz-Arteche, C., Eliby, D., Schwartz, O. S., Simmons, J. G., & Cowan, C. S. M. (2021). The gut microbiota in anxiety and depression: A systematic review. Clinical Psychology Review, 83, 101943. https://doi.org/10.1016/j.cpr.2020.101943
Sonali, S., Ray, B., Ahmed, T. H., Rathipriya, A. G., Sunanda, T., Mahalakshmi, A. M., Rungratanawanich, W., Essa, M. M., Qoronfleh, M. W., Chidambaram, S. B., Song, B. J. (2022). Mechanistic insights into the link between gut dysbiosis and major depression: An extensive review. Cells, 11(8), 1362. https://doi.org/10.3390/cells11081362
Wallace, C. J. K., & Milev, R. (2017). The effects of probiotics on depressive symptoms in humans: A systematic review. Annals of General Psychiatry, 16, 14. https://doi.org/10.1186/s12991-017-0138-2
World Health Organization. (2023). Depression. Retrieved from https://www.who.int/news-room/fact-sheets/detail/depression
Vuotto, C., Battistini, L., Caltagirone, C., & Borsellino, G. (2020). Gut microbiota and disorders of the central nervous system. Neuroscientist, 26(5-6), 487–502. https://doi.org/10.1177/1073858420918826
Xiong, R.-G., Li, J., Cheng, J., Zhou, D. D., Wu, S. X., Huang, S. Y., Saimaiti, A., Yang, Z. J., Gan, R. Y., Li, H. B. (2023). The role of gut microbiota in anxiety, depression, and other mental disorders as well as the protective effects of dietary components. Nutrients, 15(14), 3258. https://doi.org/10.3390/nu15143258
Zhu, F., Tu, H., & Chen, T. (2022). The microbiota-gut-brain axis in depression: The potential pathophysiological mechanisms and microbiota combined antidepression effect. Nutrients, 14(10), 2081. https://doi.org/10.3390/nu14102081
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Copyright (c) 2025 Weronika Cyrkler, Jakub Robak, Stanisław Telega, Paweł Bollin, Urszula Szymczak, Wojciech Wiesław Lachór, Monika Barbara Solarz, Julia Piekarska, Justyna Maria Solarz, Jakub Tomasz Wawrzyńców

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