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The Effect of Probiotic Supplementation on Depressive Symptoms and Quality of Life in Patients After Myocardial Infarction

Results of a Preliminary Double-Blind Clinical Trial

Moludi, Jalal PhD; Alizadeh, Mohammad MD, PhD; Mohammadzad, Mir Hossein Seyed MD; Davari, Mina PhD

doi: 10.1097/PSY.0000000000000749

Objective Evidence indicates that probiotic supplements may improve or prevent depression. Little is known about the effects of probiotic supplementation on symptoms of depression and quality of life (QOL) in patients with myocardial infarction (MI).

Methods This randomized, double-blind, and placebo-controlled clinical trial was performed in 44 patients with a recent diagnosis of MI who underwent percutaneous coronary intervention. Patients were randomly assigned to receive either capsules containing 1.6 × 109 colony-forming units of Lactobacillus rhamnosus capsules with their lunch (the active intervention group) or capsules that contained maltodextrin (the placebo control group) for 12 weeks. The Beck Depression Inventory, QOL, and biomarkers of oxidative stress (serum total antioxidant capacity), and malondialdehyde), and high-sensitivity C-reactive protein (hs-CRP) as inflammation marker were assessed. These measures were obtained at baseline and at 12 weeks’ follow-up.

Results The total Beck Depression Inventory score decreased significantly in patients who received probiotic supplements compared with the placebo group (−5.57 [6.1] versus −0.51 [2.8], p = .045). Improvements in the mean QOL score were also stronger in the probiotic versus the placebo group (23.6 [39.1] versus 0.44 [42.6], p = .023). In addition, increases in total antioxidant capacity (93.7 [88.4] versus 27.54 [64.7] mmol/l, p = .009) and decreases in malondialdehyde (−40.7 [63.73] versus −4.2 [67.6] nmol/ml, p = .033) and high-sensitivity C-reactive protein (−1.74 [0.70] versus 0.67 [1.27] mg/l, p = .040) levels were stronger in patients receiving probiotic supplementation than the placebo group.

Conclusion These data provide preliminary evidence that probiotic supplementation in patients with percutaneous coronary intervention post-MI has beneficial effects on depressive symptoms and markers of oxidative stress and inflammation. Multicenter studies with larger sample sizes are needed to replicate these findings and identify patient subgroups with the most benefit from probiotic supplementation.

Trial identifier: IRCT20121028011288N15.

Patients with myocardial infarction are predisposed to experience several challenges including increased risk of depression and poor quality of life. Moludi et al. examined whether probiotic supplementation can influence the depression in patients with myocardial infarction. Results showed that probiotic supplementation has beneficial effects on depressive symptoms, quality of life, and markers of oxidative stress and inflammation.

From the School of Nutrition Sciences and Food Technology (Moludi), Kermanshah University of Medical Sciences, Kermanshah, Iran; Nutrition Research Center, Faculty of Nutrition (Alizadeh, Davari), Tabriz University of Medical Sciences, Tabriz, Iran; and Department of Cardiology, Shohada Hospital (Mohammadzad), Urmia University of Medical Sciences, Urmia, Iran.

Address correspondence to Mohammad Alizadeh, MD, PhD, Nutrition Research Center, Department of Biochemistry and Diet Therapy, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran. E-mail:

Received for publication November 20, 2018; revision received July 28, 2019.

Online date: October 8, 2019

Copyright © 2019 by American Psychosomatic Society
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