COMMENTARY

Probiotics May Reduce Rehospitalization in Bipolar Disorder

Drew Ramsey, MD

Disclosures

April 15, 2019

This transcript has been edited for clarity.

Hello. I'm Dr Drew Ramsey, an assistant clinical professor of psychiatry at Columbia University in New York City. Welcome back to the Brain Food Blog.

I'm excited to share a new piece of science linking the microbiome and the use of probiotics with the treatment of bipolar disorder. In a 2018 study[1] from a team at the Sheppard Pratt Health System and Johns Hopkins University School of Medicine in Baltimore, Maryland, researchers looked at 66 patients hospitalized for mania. These patients completed a randomized clinical trial looking at two types of probiotic bacteria (Lactobacillus rhamnosus strain GG and Bifidobacterium animalis subspecies lactis strain Bb12) or placebo, which were added on to treatment as usual.

After being followed for 6 months, the results were quite striking. Patients receiving the probiotic had a significantly decreased risk of being hospitalized. About 24% of patients were rehospitalized in the treatment group, compared with approximately 73% in the placebo group. Also, individuals receiving the probiotic were rehospitalized for much shorter periods of time (2.8 vs 8.3 days).

Another part of this study that was quite interesting, which I haven't really seen in a lot of trials to date, was that the researchers looked at a number of biomarkers to establish what's called a neuroinflammatory index. They looked at a group of antigens to things like gliadin, toxoplasmosis, or the Mason‐Pfizer monkey virus. They stratified their sample and found that individuals with high neuroinflammatory markers who received the probiotic had a 90% reduced risk of being rehospitalized for mania.

This study adds to the growing interest and science surrounding the microbiome, which is a subject we're going to focus on in future blog posts. I'm interested in how you're seeing this affect clinical care. Many patients are asking about this, and although we currently don't have strand-specific or patient-specific data to really guide them, I'm wondering how the use of probiotics and the new science about the microbiome is influencing your clinical practice.

I'm Dr Drew Ramsey, and this has been the Brain Food Blog.

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