Although we have data on the reproductive safety of various medications used to treat anxiety, many women would understandably prefer to avoid medications when possible. Many women ask about alternative treatments, including dietary supplements, herbal remedies and probiotics. While these treatments are often considered to be “safer” because they are natural, it is important to recognize that their production is not regulated by the Food and Drug Administration, and often we have very minimal data regarding the use of these medications during pregnancy. Another challenge in advising women regarding these alternative treatments is the lack of data regarding their efficacy; few clinical trials have assessed the efficacy of these treatments.
Given increased interest in the microbiome as a moderator of disease and health, there has been considerable excitement surrounding the use of probiotics as a treatment for a wide array of common complaints, as well as psychiatric disorders including anxiety and depression. A recent double-blind randomized controlled trial looks at the use of probiotics for the treatment of prenatal anxiety and depression.
This study included 40 pregnant women with elevated depressive symptoms and/or anxiety. Participants received either an orally consumed probiotic (Ecologic Barrier) or placebo from 26 to 30 weeks gestation until delivery.
After 8 weeks of intervention, there was no significant difference between the probiotic and placebo groups on measures of depression, anxiety, overall stress, and maternal bonding.
While many women would prefer to avoid the use of medications during pregnancy, we must ensure that pregnant women with depression and and/or anxiety are using alternatives that are safe and effective. At this point, we do not have information to support the efficacy of probiotics in this setting. In general, data indicating the effectiveness of probiotics for the treatment of anxiety and depression is sparse (Noonan et al, 2020). While there are some studies which suggest beneficial effects, well-conducted, randomized controlled trials in larger populations are necessary.
Ruta Nonacs, MD PhD
Browne PD, Bolte AC, Besseling-van der Vaart I, Claassen E, de Weerth C. Probiotics as a treatment for prenatal maternal anxiety and depression: a double-blind randomized pilot trial. Sci Rep. 2021 Feb 4;11(1):3051. Free text available.
Elias J, Bozzo P, Einarson A. Are probiotics safe for use during pregnancy and lactation? Can Fam Physician. 2011 Mar;57(3):299-301. Free text available.
Noonan S, Zaveri M, Macaninch E, Martyn K. Food & mood: a review of supplementary prebiotic and probiotic interventions in the treatment of anxiety and depression in adults. BMJ Nutr Prev Health. 2020 Jul 6;3(2):351-362. Free text available.