Probiotic Therapy Linked to Reduced Rehospitalization for Patients with Acute Mania

By Josh Garcia
Friday, January 18, 2019

A recent study further explores interrelationships among inflammation, probiotics and mental health.

Multiple studies have examined connections between inflammation and mental health conditions, as well as the use of probiotics to treat these conditions. For example, a 2017 meta-analysis in Annals of General Psychiatry found compelling evidence that probiotics could help alleviate symptoms of depression.

Probiotics and Mania

Faith Dickerson, PhD, MPH, psychologist, Director of Psychology and Head of the Stanley Research Program at Sheppard Pratt Health System in Baltimore, is a leader in this field, having published papers on the link between the microbiome and conditions such as bipolar disorder. One such study, in PLOS One, found that the level of inflammation was a predictor of rehospitalization for patients with mania in the six-month period after hospital discharge.

Dickerson built on these findings in another recent study, published in Bipolar Disorders, in which she and her team examined 66 patients who had been hospitalized for mania. In addition to conventional treatment, half of the study participants received probiotics while the other half received placebos following hospitalization. The groups were observed for 24 weeks.

There were 24 rehospitalizations in the placebo group, whereas the probiotic group had only eight. The average length of stay for rehospitalizations from the placebo group was 8.3 days, compared with 2.8 days for the probiotic group.

In addition, there was a 90 percent reduction of rehospitalization risk for individuals with relatively high rates of systemic inflammation who underwent adjunctive probiotic treatment.

“This particular subset was a relatively small number of individuals, but it suggests that the effect [of adjunctive probiotic therapy] is occurring through inflammatory processes,” Dickerson says.

“No matter what we measured — the percentage of people rehospitalized or the number of days spent in the hospital — the results were in favor of probiotic therapy.”
— Faith Dickerson, PhD, MPH, psychologist, Director of Psychology and Head of the Stanley Research Program at Sheppard Pratt Health System

Convenience and Cost

Though Dickerson says it’s too early to recommend probiotics be added to clinical guidelines for treating mania, potential advantages of probiotics include their relatively low cost, wide availability and acceptance among the general population.

“As far as studies go, probiotics were such an acceptable compound for patients because they have minimal side effects,” Dickerson says.

She hopes to study the administration of probiotics in patients over a longer period, as mental health conditions are often lifelong. She also hopes to determine the mechanisms of probiotic therapy and what types, combinations and dosages of microorganisms work best for certain symptoms.

Drew Ramsey, MD, Assistant Clinical Professor of Psychiatry at Columbia University College of Physicians and Surgeons, author of Eat Complete and co-author of The Happiness Diet, is excited about advances in this area.

“Are fermented foods and plant-based diets adequate, or do individuals need to take probiotic supplements?” asks Dr. Ramsey, who was not involved in Dickerson’s research. “I hope studies like these are replicated very soon, since the results can have profound impacts on patients and their families.”