Advertisement

Can probiotics reduce bipolar symptoms?: A systematic review

Published:December 09, 2022DOI:https://doi.org/10.1016/j.pmip.2022.100098

      Highlights

      • Evidence suggests dysbiosis of the gut microbiome plays a role in the pathogenesis of psychiatric diseases, including bipolar disorder.
      • Preliminary studies show probiotics improve symptoms of bipolar disorder, particularly mania.
      • Probiotics are a potentially effective treatment for bipolar patients with a very limited side effect profile.

      Abstract

      Background

      There is growing evidence suggesting a connection between gut dysbiosis and the development of psychiatric disorders. A number of studies have shown that probiotics contribute to symptom reduction in major depressive disorder, but very few such studies have been conducted on bipolar disorder. The present study is a systematic review of such studies.

      Methods

      Systematic review following PRISMA guidelines of studies published in the past ten years which involve the use of probiotics in patients with bipolar disorder.

      Results

      Of 4717 articles screened, 5 were included in this review [n = 193]. Collectively, the studies measured the effects of probiotics on the symptoms of bipolar disorder as well as rehospitalization rates.

      Conclusion

      Despite the limited number of studies done on this topic, there is evidence that probiotics improve symptoms of bipolar disorder, particularly manic symptoms, with no significant negative effects.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Personalized Medicine in Psychiatry
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Sidhu M.
        • van der Poorten D.
        The gut microbiome.
        Aust Fam Physician. 2017; 46: 206-211
        • Williams N.T.
        Probiotics.
        Am J Health Syst Pharm. 2010; 67: 449-458https://doi.org/10.2146/ajhp090168
        • Cryan J.F.
        • O’Riordan K.
        • Cowan C.S.M.
        • Sandhu K.V.
        • Bastiaanssen T.F.S.
        • Boehme M.
        • et al.
        The Microbiota-Gut-Brain Axis.
        Physiol Rev. 2019; 99: 1877-2013https://doi.org/10.1152/physrev.00018.2018
        • Shanahan F.
        • Ghosh T.S.
        • O’Toole P.W.
        The Health Microbiome – What is the Definition of a Healthy Gut Microbiome?.
        Gastroenterology. 2021; 160: 483-494https://doi.org/10.1053/j.gastro.2020.09.057
        • Valdes A.M.
        • Walter J.
        • Segal E.
        • Spector T.D.
        Role of the gut microbiota in nutrition and health.
        BMJ. 2018; 361k2179https://doi.org/10.1136/bmj.k2179
        • Gupta V.
        • Garg R.
        Probiotics.
        Indian J Med Microbiol. 2009; 27: 202-209https://doi.org/10.4103/0255-0857.53201
        • Smith D.
        • Whitham E.
        • Ghaemi S.N.
        Bipolar Disorder.
        Handb Clin Neurol. 2012; 106: 251-263https://doi.org/10.1016/B978-0-444-52002-9.00015-2
        • Flowers S.A.
        • Ward K.M.
        • Clark C.T.
        The gut microbiome in bipolar disorder and pharmacotherapy management.
        Neuropsychobiology. 2020; 79: 43-49https://doi.org/10.1159/000504496
        • Sublette M.E.
        • Cheung S.
        • Lieberman E.
        • Hu S.
        • Mann J.J.
        • Uhlemann A.C.
        • et al.
        Bipolar disorder and the gut microbiome: A systematic review.
        Bipolar Disord. 2021; 23: 544-564https://doi.org/10.1111/bdi.13049
        • Evans S.J.
        • Bassis C.M.
        • Hein R.
        • Assari S.
        • Flowers S.A.
        • Kelly M.B.
        • et al.
        The gut microbiome composition associates with bipolar disorder and illness severity.
        J Psychiatr Res. 2017; 87: 23-29https://doi.org/10.1016/j.jpsychires.2016.12.007
        • Dash S.
        • Syed Y.Y.A.
        • Khan M.R.
        Understanding the role of the gut microbiome in brain development and its association with neurodevelopment psychiatric disorders.
        Front Cell Dev Biol. 2022; 10880544https://doi.org/10.3389/fcell.2022.880544
        • Bauer M.E.
        • Teixeira A.L.
        Inflammation in psychiatric disorders: what comes first?.
        Ann N Y Acad Sci. 2019; 1437: 57-67https://doi.org/10.1111/nyas.13712
        • Huang R.
        • Wang K.
        • Jianan H.u.
        Effect of Probiotics on Depression: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
        Nutrients. 2016; 8: 483https://doi.org/10.3390/nu8080483
        • Shahrbabaki M.E.
        • Sabouri S.
        • Sabahi A.
        • Barfeh D.
        • Divsalar P.
        • Esmailzadeh M.
        • et al.
        The Efficacy of probiotics for treatment of bipolar disorder-type 1: A randomized, double-blind, placebo controlled trial.
        Iran J Psychiatry. 2020; 15: 10-16
        • Zeng C.
        • Qui Y.
        • Li S.
        • Teng Z.
        • Xiang H.
        • Chen J.
        • et al.
        Effects of probiotic supplements on oxidative stress biomarkers in first-episode bipolar disorder patients: A randomized, placebo-controlled trial.
        Front Pharmacol. 2022; 13829815https://doi.org/10.3389/fphar.2022.829815
        • Dickerson F.
        • Adamos M.
        • Katsafanas E.
        • Khushalani S.
        • Origoni A.
        • Savage C.
        Adjunctive probiotic microorganisms to prevent rehospitalization in patients with acute mania: A randomized controlled trial.
        Bipolar Disord. 2018; 20: 614-621https://doi.org/10.1111/bdi.12652
        • Reininghause E.Z.
        • Wetzlmair L.C.
        • Fellendorf F.T.
        • Platzer M.
        • Queissner R.
        • Birner A.
        • et al.
        Probiotic treatment in individuals with euthymic bipolar disorder: A pilot-study on clinical changes and compliance.
        Neuropsychobiology. 2020; 79: 71-79https://doi.org/10.1159/000493867
        • Reininghaus E.Z.
        • Wetlmair L.C.
        • Fellendorf F.
        • Platzer M.
        • Queissner R.
        • Birner A.
        • et al.
        The impact of probiotic supplements on cognitive parameters in euthymic individuals with bipolar disorder: A pilot study.
        Neuropsychobiology. 2018; : 1-8https://doi.org/10.1159/000492537