Lactofem Probiotic May Boost SSRI Efficacy & Counteract Sexual Side Effects in Women with Depression (2024 Trial)

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Probiotics may help improve sexual function and reduce depression severity in women treated with SSRIs.

Highlights:

  1. Depression Prevalence: Approximately 5% of all adults will experience depressive disorder, often accompanied by reduced sexual desire and dysfunction.
  2. Study Design: The study was a double-blind randomized clinical trial involving 112 women with depressive disorder treated with SSRIs, comparing effects of SSRIs alone versus SSRIs plus a probiotic supplement (Lactofem).
  3. Results: After eight weeks, the group receiving SSRIs plus probiotics showed significant improvements in sexual function, sexual satisfaction, and depression severity compared to the group receiving SSRIs alone.
  4. Improvement Measures: Improvements were measured using the Female Sexual Function Index (FSFI), Hamilton Depression Rating Scale, and Larson’s Sexual Satisfaction Questionnaire, all showing significant positive changes in the probiotic group.

Source: BMC Psychiatry (2024)

Major Findings: Probiotic + SSRIs May Be Better for Women (2024 Trial)

1. Improvement in Sexual Function

Women in the probiotic (Lactofem) plus SSRIs group showed significant improvements in all domains of the Female Sexual Function Index (FSFI) compared to those in the SSRIs alone group.

  • Desire: The probiotic group had a marked increase in sexual desire scores.
  • Arousal: Arousal scores improved significantly in the probiotic group.
  • Lubrication: The probiotic group reported better lubrication.
  • Orgasm: There was a notable improvement in the ability to achieve orgasm.
  • Satisfaction: Sexual satisfaction scores were higher in the probiotic group.
  • Pain: Women in the probiotic group experienced less pain during intercourse.

2. Reduction in Depression Severity

Depression Scores: The Hamilton Depression Rating Scale (HDRS) scores showed a greater reduction in depression severity in the probiotic plus SSRIs group compared to the SSRIs alone group.

Before vs. After: Both groups saw improvements, but the probiotic group had a significantly greater reduction in HDRS scores after eight weeks.

3. Enhanced Sexual Satisfaction

Overall Satisfaction: Using Larson’s Sexual Satisfaction Questionnaire, the study found that women taking probiotics in addition to SSRIs reported higher levels of sexual satisfaction.

Scores: The probiotic group had significantly higher post-intervention satisfaction scores compared to the SSRIs alone group.

4. Probiotics May be Ideal Adjunct

The study concluded that adding probiotics to SSRI treatment can significantly improve sexual function, sexual satisfaction, and reduce the severity of depressive symptoms in women with depressive disorder.

This suggests that probiotics could be a valuable adjunct therapy for managing the side effects of SSRIs and improving overall wellbeing in this population.

Probiotics & Dosage Used in the Trial

Specific Probiotic

The probiotic supplement used in the trial was Lactofem, which included the following strains:

  • Lactobacillus acidophilus: 2 × 10^9 CFU/g
  • Bifidobacterium bifidus: 2 × 10^9 CFU/g
  • Lactobacillus rutri: 2 × 10^9 CFU/g
  • Lactobacillus fermentum: 2 × 10^9 CFU/g

Dosage

  • Administration: Each capsule contained 500 mg of the probiotic mixture.
  • Frequency: Participants in the probiotic group took one capsule daily for eight weeks.

Potential Mechanisms of Probiotic Efficacy in Depression (2024)

1. Gut-Brain Axis Modulation

Microbiome Influence: Probiotics can alter the gut microbiota composition, potentially leading to improved gut health and reduced inflammation.

Neurotransmitter Production: Some probiotic strains are known to produce neurotransmitters like GABA and serotonin, which can positively affect mood and reduce symptoms of depression.

2. Anti-Inflammatory Effects

Reduction in Cytokines: Probiotics can decrease systemic inflammation by reducing pro-inflammatory cytokines, which are often elevated in individuals with depression.

Barrier Protection: By strengthening the intestinal barrier, probiotics may prevent the translocation of harmful bacteria and their toxins into the bloodstream, thereby reducing systemic inflammation.

3. Hormonal Regulation

Stress Response: Probiotics can influence the hypothalamic-pituitary-adrenal (HPA) axis, potentially leading to a more balanced stress response and improved mood.

Oxidative Stress: By reducing oxidative stress, probiotics might help mitigate the impact of depression on sexual function and overall health.

4. Improvement in Sexual Function

Direct Impact: Enhanced gut health can lead to improved nutrient absorption and overall physical well-being, which may directly improve sexual function.

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Psychological Benefits: Reduction in depressive symptoms through probiotic use can lead to increased libido and sexual satisfaction as mood improves.

Trial Details: Probiotic Adjunct with SSRI in Women for Depression (2024)

The study aimed to evaluate the effects of oral probiotics on sexual function and depressive symptoms in women with depressive disorder who are treated with Selective Serotonin Reuptake Inhibitors (SSRIs).

Sample

  • Participants: 112 women aged 18-45 with diagnosed depressive disorder.
  • Groups: Participants were randomly assigned to two groups: one group received SSRIs plus a probiotic supplement (Lactofem), and the other group received SSRIs alone.
  • Duration: The intervention lasted for eight weeks.

Methods

  • Design: Double-blind randomized clinical trial.
  • Intervention: The probiotic supplement (Lactofem) contained Lactobacillus acidophilus, Bifidobacterium bifidus, Lactobacillus rutri, and Lactobacillus fermentum. It was administered daily.
  • Measurements:
    • Sexual Function: Evaluated using the Female Sexual Function Index (FSFI).
    • Depression Severity: Measured using the Hamilton Depression Rating Scale (HDRS).
    • Sexual Satisfaction: Assessed using Larson’s Sexual Satisfaction Questionnaire.
  • Statistical Analysis: Descriptive statistics and comparative tests were used to analyze the data before and after the intervention.

Limitations

  • Cultural Context: The study was conducted in Iran, where cultural factors might influence the results.
  • Placebo Control: The study did not include a placebo control group, making it difficult to attribute improvements solely to the probiotics.
  • Short Duration: The intervention period was limited to eight weeks, with no long-term follow-up to assess the lasting effects of the treatment.
  • Sample Homogeneity: Participants were from a single outpatient clinic and all were married, which might limit the generalizability of the findings.

Probiotics May Not be As Effective as Reported in this Study

Single Location: The study was conducted in Iran, where cultural, dietary, and lifestyle factors might influence the results. This context may limit the generalizability of the findings to other populations.

No Placebo Group: The study did not include a placebo control group, making it difficult to determine whether the observed benefits were specifically due to the probiotics or other factors such as a placebo effect or natural variations in symptoms.

8-Week Period: The intervention lasted only eight weeks, which may not be sufficient to observe long-term effects or determine the sustainability of the benefits.

Single Clinic & Marital Status: Participants were all from a single outpatient clinic and all were married, which may not reflect the diverse experiences of a broader population with depressive disorder.

Potential Psychotherapy & Counseling: Participants may have been receiving other forms of treatment, such as psychotherapy or counseling, which were not controlled for in the study. These treatments could have influenced the results, making it difficult to isolate the effects of the probiotics.

Younger & Healthier Participants: The study focused on younger women, who may experience fewer side effects from SSRIs and potentially have a more robust response to probiotics. This might not be representative of older adults or those with more severe health conditions.

Conclusion: Probiotics May Boost SSRI Efficacy

The study provides promising evidence that probiotics, when used alongside SSRIs, can significantly improve sexual function, sexual satisfaction, and reduce the severity of depressive symptoms in women with depressive disorder.

However, the findings should be interpreted with caution due to several limitations, including the lack of a placebo control group, a short intervention duration, and a homogenous sample population.

Despite these limitations, the positive results indicate that probiotics could be a valuable adjunct therapy, potentially offering a safer alternative to address the sexual dysfunction often associated with SSRI treatment.

Further research with more diverse populations and longer follow-up periods is necessary to confirm these findings and establish the long-term efficacy and safety of probiotics in managing depressive disorder and its associated symptoms.

References