title: The effects of probiotics on depressive symptoms in humans: a systematic review.
abstract: BACKGROUND
  Patients suffering from depression experience significant mood, anxiety, and cognitive symptoms. Currently, most antidepressants work by altering neurotransmitter activity in the brain to improve these symptoms. However, in the last decade, research has revealed an extensive bidirectional communication network between the gastrointestinal tract and the central nervous system, referred to as the "gut-brain axis." Advances in this field have linked psychiatric disorders to changes in the microbiome, making it a potential target for novel antidepressant treatments. The aim of this review is to analyze the current body of research assessing the effects of probiotics, on symptoms of depression in humans.
  
  
  METHODS
  A systematic search of five databases was performed and study selection was completed using the preferred reporting items for systematic reviews and meta-analyses process.
  
  
  RESULTS
  Ten studies met criteria and were analyzed for effects on mood, anxiety, and cognition. Five studies assessed mood symptoms, seven studies assessed anxiety symptoms, and three studies assessed cognition. The majority of the studies found positive results on all measures of depressive symptoms; however, the strain of probiotic, the dosing, and duration of treatment varied widely and no studies assessed sleep.
  
  
  CONCLUSIONS
  The evidence for probiotics alleviating depressive symptoms is compelling but additional double-blind randomized control trials in clinical populations are warranted to further assess efficacy.
authors.affiliation: Department of Psychiatry, Queen's University, 752 King Street West, Kingston, ON K7L 4X3 Canada.
authors.forename: Caroline J K
authors.initials: CJK
authors.lastname: Wallace
authors.affiliation: Department of Psychiatry, Queen's University, 752 King Street West, Kingston, ON K7L 4X3 Canada.
authors.forename: Roumen
authors.initials: R
authors.lastname: Milev
keywords: Anxiety; Depression; Gut–brain axis; Microbiome; Probiotics; Systematic review