2020 Volume 11 Pages 67-78
Generalised anxiety disorder (GAD) displays a variety of psychological and physical symptoms. These are difficult to rapidly control with currently available pharmacological options. This review summarises the evidence for an acute use of microbiological modification drugs targeting vagal nerve stimulation.
A systematic search was conducted in Medline, Pubmed, and PschInfo for all pre-clinical and human studies concerning the use of Lactobacillus and Bifidobacterium in the treatment of GAD.
Twenty-five studies were eligible for inclusion. In mice, modification therapy resulted in improved behaviour that was at least non-inferior to standard therapy (antidepressants). Brain histopathology revealed further anti-inflammatory and neuroprotective benefits. Vagotomy abolished the anti-GAD properties of the treatment.
In humans, several species demonstrated significant reductions in palpitations, shortness of breath, headaches, flu-like symptoms, and abdominal pains vs. placebo within 4 to 12 weeks. B. bifidum, B. lactis, L. acidophilus and S. thermophiles showed alleviation of physical symptoms to population baseline when added to an antidepressant. No significant side effects were reported in the studies.
As physical symptoms are typically the presenting medical complaint of GAD, there is potential to control the disease with the administration of bacteria-containing pharmaceutical agents as an adjunct to current antidepressant options.