1 00:00:09,520 --> 00:00:13,440 Speaker 1: Hey, everybody, Welcome to another edition of Wisdom Wednesdays. This week, 2 00:00:13,600 --> 00:00:17,040 Speaker 1: I want to talk about a research paper that has 3 00:00:17,400 --> 00:00:21,960 Speaker 1: recently been published in the Journal and Nutritional Reviews, and 4 00:00:22,400 --> 00:00:26,560 Speaker 1: the title is Probiotics for Adults with Major Depressive Disorder 5 00:00:26,680 --> 00:00:32,879 Speaker 1: Compared with Antidepressants. A Systematic review and network meta Analysis. 6 00:00:32,960 --> 00:00:36,480 Speaker 1: So what they did for this was the researchers screened 7 00:00:36,680 --> 00:00:40,200 Speaker 1: a whole heap of published articles and they looked at 8 00:00:40,360 --> 00:00:46,160 Speaker 1: six different databases of publications for clinical trials that had 9 00:00:46,200 --> 00:00:50,800 Speaker 1: to be double blinded randomized control trials, so really good, 10 00:00:51,000 --> 00:00:55,120 Speaker 1: well designed studies were the individuals didn't know whether they 11 00:00:55,120 --> 00:00:58,000 Speaker 1: were having a placebo and the researchers didn't know where 12 00:00:58,040 --> 00:01:00,800 Speaker 1: they were having a placebo as well. Looking at published 13 00:01:00,880 --> 00:01:05,319 Speaker 1: articles between twenty fifteen and twenty twenty two, and they 14 00:01:05,440 --> 00:01:09,560 Speaker 1: ended up having at twenty two interventions that were identified 15 00:01:10,120 --> 00:01:13,959 Speaker 1: and sixteen of those find that there was effectiveness in 16 00:01:14,000 --> 00:01:19,440 Speaker 1: the treatment of major depressive disorders. But whenever they compared them, 17 00:01:19,959 --> 00:01:24,360 Speaker 1: what they find was that the probiotics, which I will 18 00:01:24,360 --> 00:01:26,920 Speaker 1: talk about in a second, but the probiotics had a 19 00:01:27,040 --> 00:01:32,080 Speaker 1: moderate effects size. So we know that antidepressants generally, when 20 00:01:32,080 --> 00:01:34,640 Speaker 1: you look at all of the studies, they tend to 21 00:01:34,720 --> 00:01:38,039 Speaker 1: have a small effects size. Now what that means is 22 00:01:38,080 --> 00:01:41,560 Speaker 1: that they are marginally more effective than placebo. Now that 23 00:01:41,560 --> 00:01:45,200 Speaker 1: doesn't mean they're not effective. It just means they're marginally 24 00:01:45,319 --> 00:01:47,960 Speaker 1: better than placebo. Because we know that when you give 25 00:01:47,960 --> 00:01:52,440 Speaker 1: people placebo, quite a few people respond, So a small. 26 00:01:52,160 --> 00:01:57,040 Speaker 2: Effects size generally is not great. But the probiotics in 27 00:01:57,080 --> 00:02:01,520 Speaker 2: this case had a moderate effects size, and they were 28 00:02:01,680 --> 00:02:07,120 Speaker 2: estimated to be more effective than about six different antidepressant medications, 29 00:02:07,200 --> 00:02:10,800 Speaker 2: as well as ketamine. And then there was one study 30 00:02:10,840 --> 00:02:14,760 Speaker 2: that had a combination of an SSRI and probiotics and 31 00:02:14,840 --> 00:02:19,000 Speaker 2: that was the most effective of all. Now, the limitations 32 00:02:19,320 --> 00:02:25,160 Speaker 2: here are that no studies actually comparerred the probiotics versus 33 00:02:25,200 --> 00:02:30,040 Speaker 2: the SSRI. They were all evaluated independently, and there's obviously 34 00:02:30,200 --> 00:02:33,280 Speaker 2: a bit of a risk of bias. But I think 35 00:02:33,320 --> 00:02:38,120 Speaker 2: this is pretty bloody good news because we know that 36 00:02:38,280 --> 00:02:43,639 Speaker 2: antidepressants have a long list of side effects and withdrawal effects. 37 00:02:43,639 --> 00:02:46,200 Speaker 2: And I'm about to read an article and will probably 38 00:02:46,240 --> 00:02:50,440 Speaker 2: do a podcast on this. Certainly when you survey people 39 00:02:50,440 --> 00:02:53,800 Speaker 2: who've been on them, and the list of side effects 40 00:02:53,840 --> 00:02:58,200 Speaker 2: and withdrawal syntomes are way way more than the published 41 00:02:58,320 --> 00:03:02,480 Speaker 2: data from the drug companies when they were originally produced, 42 00:03:02,520 --> 00:03:05,000 Speaker 2: because they didn't ask for a lot of these different 43 00:03:05,000 --> 00:03:07,320 Speaker 2: side effects. And if you don't ask, you don't see anything. 44 00:03:08,160 --> 00:03:11,840 Speaker 2: And we know that probiotics have no side effects are 45 00:03:12,040 --> 00:03:16,200 Speaker 2: very very little and potential side effects. And this just 46 00:03:16,240 --> 00:03:21,079 Speaker 2: goes to show the impact that the gut microbiome actually 47 00:03:21,120 --> 00:03:23,280 Speaker 2: has on our mental health. And this is through the 48 00:03:23,360 --> 00:03:26,320 Speaker 2: gut brain access and we are seeing more and more 49 00:03:27,040 --> 00:03:31,560 Speaker 2: that the health of our microbiome and particularly the composition 50 00:03:32,080 --> 00:03:35,480 Speaker 2: of that microbiome is pretty key for both our physical 51 00:03:35,520 --> 00:03:39,280 Speaker 2: health and our mental health. So the probiotics that were 52 00:03:39,720 --> 00:03:42,920 Speaker 2: used in these different studies there was different combinations. They 53 00:03:42,920 --> 00:03:50,920 Speaker 2: included Lactobacillus, Bifidobacterium, and Bacillus species, and the conclusion of 54 00:03:51,000 --> 00:03:55,560 Speaker 2: the researchers was that probiotics, compared with antidepressants and placebo, 55 00:03:55,800 --> 00:03:59,880 Speaker 2: may be efficacious as an adjunct or stand alone therapy 56 00:04:00,320 --> 00:04:04,040 Speaker 2: for treating major depressive disorder. Now, I think this is 57 00:04:04,200 --> 00:04:06,840 Speaker 2: really good news for all the people out there who 58 00:04:06,920 --> 00:04:10,640 Speaker 2: are struggling with their mental health, and hopefully we will 59 00:04:10,640 --> 00:04:13,640 Speaker 2: see a time not too far off where you will 60 00:04:13,640 --> 00:04:16,039 Speaker 2: go to the doctor or a psychiatrist and be given 61 00:04:16,080 --> 00:04:21,240 Speaker 2: the option of an antidepressant medication or one of these 62 00:04:21,440 --> 00:04:26,520 Speaker 2: different probiotics, and ideally you would also be advised of 63 00:04:26,640 --> 00:04:30,000 Speaker 2: the potential side effects and withdrawal effects of both of 64 00:04:30,000 --> 00:04:33,480 Speaker 2: these different treatment plants. So that's it for this week, folks, 65 00:04:34,000 --> 00:04:34,760 Speaker 2: catch you next time.