• Home
  • Store
    • Newsletter Subscriptions
    • Multimedia
    • Books
    • eBooks
    • ABPN SA Courses
    • Social Work Courses
  • CME Center
  • Multimedia
    • Podcast
    • Webinars
    • Blog
    • Psychiatry News Videos
    • Medication Guide Videos
  • Newsletters
    • General Psychiatry
    • Child Psychiatry
    • Addiction Treatment
    • Hospital Psychiatry
    • Geriatric Psychiatry
    • Psychotherapy and Social Work
  • FAQs
  • Med Fact Book App
  • Log In
  • Register
  • Welcome
  • Sign Out
  • Subscribe
Home » Probiotics for Bipolar Disorder

Probiotics for Bipolar Disorder

November 1, 2018
Adam Strassberg, MD and Chris Aiken, MD
From The Carlat Psychiatry Report
Issue Links: Learning Objectives | Editorial Information | PDF of Issue
Adam Strassberg, MD Chris Aiken, MD Drs. Strassberg and Aiken have disclosed that they have no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Review of: Dickerson F et al, Bipolar Disord 2018. doi:10.1111/bdi.12652 [Epub ahead of print]

Type of study: Randomized double-blind placebo-controlled trial

Probiotics, the so-called “good” bacteria in the gut flora, have become popular as a natural treatment for various disorders. They are taken as capsules or through food sources like yogurt, vinegar, and fermented foods. Of relevance to psychiatry, some have theorized the existence of a “gut-brain axis,” in which probiotics influence mood and behavior through the vagus nerve and the endocrine and immune systems. Probiotics have shown promise in small studies of anxiety, depression, cognition, and weight loss, and this trial tested whether a daily probiotic could lower the rate of rehospitalization after a manic episode.

The authors randomized 66 patients to receive either a probiotic or placebo as an adjunct to their usual medications after discharge from a hospital stay for mania. The probiotic capsule contained two bacterial strains that are found in breast milk and thought to modulate immune function: Bifidobacterium lactis bb-12 and Lactobacillus rhamnosus GG.

After 6 months, the rate of rehospitalization was 3 times lower in patients who took probiotics (8 of 33, 24%) compared to those taking placebo (24 of 33, 73%). However, probiotics had no effect on manic and depressive symptoms (measured monthly using the YMRS, BPRS, and MADRS scales). No significant side effects were reported in this study.

TCPR’s Take
The study is small and needs replication, and while probiotics apparently reduced rehospitalization, the lack of benefit for actual mood symptoms reduces our confidence in the results.

Probiotics have potential benefits for medical conditions that often accompany bipolar disorder, like metabolic and irritable bowel syndromes. On the other hand, they may not be safe for everyone. While we await further confirmation of their risks and benefits, these “healthy bacteria” should be avoided in people who are pregnant, immunocompromised, or at high risk of infection, where probiotics pose known risks. The specific strains used in this study have a good safety record in humans, and they are available on Amazon as USANA-108 probiotic sticks and Culturelle Baby Grow and Thrive liquid.
General Psychiatry
KEYWORDS bipolar_disorder research-update
    Adam Strassberg, MD

    A Look at the Latest Antidepressant Meta-Analysis

    More from this author
    Aiken eic 150x150
    Chris Aiken, MD

    Ketamine Assisted Therapy Part I

    More from this author
    www.thecarlatreport.com
    Issue Date: November 1, 2018
    SUBSCRIBE NOW
    Table Of Contents
    CME Post-Test - Drug Metabolism, TCPR, November/December 2018
    New Approvals for TMS
    Is Clozapine the Next Step After a Single Failed Antipsychotic Trial?
    Does TMS Really Work in Depression?
    Probiotics for Bipolar Disorder
    Ask the Editor: Which Antipsychotic Is Best When Patients Complain of Akathisia?
    Effects of Drug Interactions
    Harnessing Beneficial Drug Interactions
    New Stimulants: From Remixed Amphetamines to Bedtime Ritalin
    DOWNLOAD NOW
    Featured Book
    • MFB7e_Print_App_Access.png

      Medication Fact Book for Psychiatric Practice, Seventh Edition (2024) - Regular Bound Book

      The updated 2024 reference guide covering the most commonly prescribed medications in psychiatry.
      READ MORE
    Featured Video
    • KarXT (Cobenfy)_ The Breakthrough Antipsychotic That Could Change Everything.jpg
      General Psychiatry

      KarXT (Cobenfy): The Breakthrough Antipsychotic That Could Change Everything

      Read More
    Featured Podcast
    • shutterstock_2622607431.jpg
      General Psychiatry

      Should You Test MTHFR?

      MTHFR is a...
      Listen now
    Recommended
    • Join Our Writing Team

      July 18, 2024
      WriteForUs.png
    • Insights About a Rare Transmissible Form of Alzheimer's Disease

      February 9, 2024
      shutterstock_2417738561_PeopleImages.com_Yuri A.png
    • How to Fulfill the DEA's One Time, 8-Hour Training Requirement for Registered Practitioners

      May 24, 2024
      DEA_Checkbox.png
    • Join Our Writing Team

      July 18, 2024
      WriteForUs.png
    • Insights About a Rare Transmissible Form of Alzheimer's Disease

      February 9, 2024
      shutterstock_2417738561_PeopleImages.com_Yuri A.png
    • How to Fulfill the DEA's One Time, 8-Hour Training Requirement for Registered Practitioners

      May 24, 2024
      DEA_Checkbox.png
    • Join Our Writing Team

      July 18, 2024
      WriteForUs.png
    • Insights About a Rare Transmissible Form of Alzheimer's Disease

      February 9, 2024
      shutterstock_2417738561_PeopleImages.com_Yuri A.png
    • How to Fulfill the DEA's One Time, 8-Hour Training Requirement for Registered Practitioners

      May 24, 2024
      DEA_Checkbox.png

    About

    • About Us
    • CME Center
    • FAQ
    • Contact Us

    Shop Online

    • Newsletters
    • Multimedia Subscriptions
    • Books
    • eBooks
    • ABPN Self-Assessment Courses

    Newsletters

    • The Carlat Psychiatry Report
    • The Carlat Child Psychiatry Report
    • The Carlat Addiction Treatment Report
    • The Carlat Hospital Psychiatry Report
    • The Carlat Geriatric Psychiatry Report
    • The Carlat Psychotherapy Report

    Contact

    carlat@thecarlatreport.com

    866-348-9279

    PO Box 626, Newburyport MA 01950

    Follow Us

    Please see our Terms and Conditions, Privacy Policy, Subscription Agreement, Use of Cookies, and Hardware/Software Requirements to view our website.

    © 2025 Carlat Publishing, LLC and Affiliates, All Rights Reserved.