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<p>Objective. The gut–brain axis plays a key role in depression and anxiety, with biotics (probiotics, prebiotics, synbiotics) influencing gut microbiota and related pathways; however, their therapeutic effects remain unclear due to varied studies. This umbrella review evaluated existing systematic and meta-analysis reviews on the effectiveness of biotics in reducing depression and anxiety symptoms. Methods. A systematic search of English peer-reviewed literature up to August 6, 2025, identified 14 eligible reviews. Methodological quality and bias were assessed with AMSTAR-2 and ROBIS, and data were independently extracted by four reviewers following PRIOR guidelines. Results. Probiotics were associated with reductions in depressive symptoms, particularly in clinically diagnosed populations such as patients with major depressive disorder, while showing smaller or nonsignificant effects in general or non-clinical populations. Anxiety symptoms were also alleviated, with synbiotics appearing more effective than prebiotics or probiotics alone in some analyses. Prebiotics, however, generally showed limited or nonsignificant improvements in both depression and anxiety outcomes. Several reviews reported biological correlates of clinical improvement, including increased brain-derived neurotrophic factor (BDNF), elevated nitric oxide (NO), and reduced C-reactive protein (CRP), while changes in inflammatory cytokines such as IL-6 and TNF-α, as well as cortisol, were inconsistent or nonsignificant. Notably, one review also found moderate cognitive benefits from biotics. Despite these findings, study differences in populations, strains, duration, dosage, and measures limit broad conclusions. Conclusion. In short, probiotics—and to a lesser extent synbiotics—show promise for depression and anxiety, though more rigorous trials are needed to confirm their effectiveness.</p>

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The efficacy of probiotics, prebiotics, and synbiotics in depression and anxiety: an umbrella review of clinical trials

  • 期刊论文

  • 发表日期：

    2026年5月28日

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  • Ghaleb Oriquat,
  • Waleed K. Abdulsahib,
  • Wael Waleed Mustafa,
  • Jalpa R. Patel,
  • K. V. Jamuna,
  • Vandana Tripathi,
  • Samir Sahoo,
  • Neeraj Bainsal,
  • Nigina Khalikova

摘要

Objective. The gut–brain axis plays a key role in depression and anxiety, with biotics (probiotics, prebiotics, synbiotics) influencing gut microbiota and related pathways; however, their therapeutic effects remain unclear due to varied studies. This umbrella review evaluated existing systematic and meta-analysis reviews on the effectiveness of biotics in reducing depression and anxiety symptoms. Methods. A systematic search of English peer-reviewed literature up to August 6, 2025, identified 14 eligible reviews. Methodological quality and bias were assessed with AMSTAR-2 and ROBIS, and data were independently extracted by four reviewers following PRIOR guidelines. Results. Probiotics were associated with reductions in depressive symptoms, particularly in clinically diagnosed populations such as patients with major depressive disorder, while showing smaller or nonsignificant effects in general or non-clinical populations. Anxiety symptoms were also alleviated, with synbiotics appearing more effective than prebiotics or probiotics alone in some analyses. Prebiotics, however, generally showed limited or nonsignificant improvements in both depression and anxiety outcomes. Several reviews reported biological correlates of clinical improvement, including increased brain-derived neurotrophic factor (BDNF), elevated nitric oxide (NO), and reduced C-reactive protein (CRP), while changes in inflammatory cytokines such as IL-6 and TNF-α, as well as cortisol, were inconsistent or nonsignificant. Notably, one review also found moderate cognitive benefits from biotics. Despite these findings, study differences in populations, strains, duration, dosage, and measures limit broad conclusions. Conclusion. In short, probiotics—and to a lesser extent synbiotics—show promise for depression and anxiety, though more rigorous trials are needed to confirm their effectiveness.