Section - Quick Takes

05. Probiotics and Prebiotics for Depression and Anxiety: Can the Gut Heal the Mind?

Published on July 1, 2025 Certification expiration date: July 1, 2028

Derick E. Vergne, M.D.

Assistant Professor - Tufts University School of Medicine

Key Points

Biotics show positive effects on depression, anxiety, and cognition as adjunctive treatments in mild to moderate cases. Their role in severe disorders remains unclear.
Biotics may influence brain function via the gut-brain axis, potentially regulating the immune system and reducing inflammation.
Evidence is limited by small sample sizes, self-reports, and inconsistent methodologies, suggesting cautious clinical application pending more research.

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Biotics’ Impact on Mental Health

Today, I’m reviewing a study published in the journal Brain and Behavior by a group from Iran, which explores how prebiotics and probiotics might affect depression, anxiety, and cognition.

The authors highlight the rising prevalence of these conditions, driven by neurochemical imbalances, genetic predispositions, and environmental factors. As we often see in clinical practice, cognitive impairments frequently accompany psychiatric disorders.

Gut-Brain Axis Basics

Emerging evidence points to the gut-brain axis playing a significant role in mental health.

Probiotics are live microorganisms that confer health benefits to the host.
Prebiotics are compounds that promote the growth of beneficial gut bacteria.
Synbiotics represent the combination of pre- and probiotics.

There is mounting evidence that microbiota could be influencing brain function indirectly by way of the gut-brain axis. In their meta-analysis, the authors’ objective was to find out whether prebiotics, probiotics and synbiotics have an effect on depression,

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Table of Contents

Learning Objectives:

After completing this activity, the learner will be able to:

Evaluate the efficacy and safety profile of lumateperone for treating major depressive episodes with mixed features in both MDD and bipolar patients.
Assess the clinical utility of GLP-1 agonists in managing antipsychotic-induced weight gain.
Compare the effectiveness of quetiapine versus lithium as augmentation strategies in treatment-resistant depression.
Interpret the relationship between antidepressant use and cognitive decline in patients with dementia while considering potential indication bias.
Evaluate the potential of biotic interventions (prebiotics, probiotics, and synbiotics) as adjunctive treatments for depression, anxiety, and cognitive impairment.

Original Release Date: July 1, 2025
Expiration Date: July 1, 2028

Experts: Scott Beach, M.D., Paul Zarkowski, M.D., Kristin Raj, M.D., Oliver Freudenreich, M.D. & Derick Vergne, M.D.

Medical Editors: Flavio Guzmán, M.D. & Sebastián Malleza M.D.

Relevant Financial Disclosures:
Oliver Freudenreich declares the following interests:
– Karuna: Research grant to institution, advisory board
– Vida: Consultant
– American Psychiatric Association: Consultant
– Medscape: Speaker
– Wolters-Kluwer: Royalties, editor
– National Council for Wellbeing: Consultant

All of the relevant financial relationships listed above have been mitigated by Medical Academy and the Psychopharmacology Institute.

None of the other faculty, planners, and reviewers for this educational activity have relevant financial relationships to disclose during the last 24 months with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Contact Information: For questions regarding the content or access to this activity, contact us at support@psychopharmacologyinstitute.com

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This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medical Academy LLC and the Psychopharmacology Institute. Medical Academy is accredited by the ACCME to provide continuing medical education for physicians

Credit Designation Statement

Medical Academy designates this enduring activity for a maximum of 0.75 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.