Role of Gut Microbiota in Patients with Depression on Antidepressants: An Umbrella Review

Background: Major depressive disorder (MDD) is linked to gut microbiota alterations, which may play a role in its pathophysiology.Emerging evidence suggests that gut microbiota can influence antidepressant responses, offering new insights into depression management.Objective: This review summarizes the role of these alterations in patients with depression, focusing on their impact on treatment outcomes and therapeutic efficacy.Materials and methods: A comprehensive systematic search was conducted across PubMed, Scopus, and Google Scholar.Duplicate records were removed using Zotero, and the remaining studies were imported into Rayyan for title, abstract, and full-text screening.Two reviewers independently screened the studies, with any conflicts resolved by a third reviewer.The Joanna Briggs Institute (JBI) critical evaluation checklist was followed during the quality assessment and data extraction process.The study included systematic reviews assessing the changes in gut microbiota.Results: Three suitable systematic reviews were included.Two reviews indicated moderate evidence, and one review indicated strong evidence, showing the credibility of the findings.Using the JBI critical appraisal checklist for systematic reviews, all 3 reviews were considered high quality (scores: 9-11).Findings on the gut microbiota-brain axis suggest that modulating the gut microbiota could serve as a potential therapeutic target for the treatment and/or prevention of mood and anxiety disorders. Conclusion:This umbrella review offers a comprehensive synthesis of the role of gut microbiota in relation to antidepressant use.Despite the heterogeneity among the included studies, the findings highlight a clear interaction between the gut microbiota and antidepressants.This review serves as a valuable resource for educators, healthcare professionals, and policymakers aiming to enhance patient outcomes.