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Efficacy of probiotic supplements in improving the symptoms of psychosis, anxiety, insomnia, and anorexia due to amphetamine and methamphetamine use: a randomized clinical trial

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Abstract

Rationale

Changes in the density and diversity of gut microbiota in chronic use of methamphetamine have been mentioned as contributors to psychotic and anxiety symptoms, sleep problems, and loss of appetite.

Objective

In this placebo-controlled clinical trial, we investigated the effect of the probiotic Lactobacillus Acidophilus in improving psychiatric symptoms among hospitalized patients with chronic methamphetamine use along with psychotic symptoms.

Methods

60 inpatients with a history of more than 3 years of methamphetamine use, were randomly assigned to one of two groups receiving either a probiotic capsule or placebo along with risperidone for 8 weeks based on a simple randomization method. In weeks 0, 4, and 8, patients were evaluated using the Brief Psychiatric Rating Scale (BPRS), Beck Anxiety Inventory (BAI), Pittsburgh Sleep Quality Index (PSQI), Simple Appetite Nutritional Questionnaire (SANQ), and Body Mass Index (BMI).

Results

Compared to the control group, patients receiving probiotics had better sleep quality, greater appetite, and higher body mass index (there were significant interaction effects of group and time at Week 8 in these variables (t = -3.32, B = -1.83, p = .001, d = 0.89), (t = 10.50, B = 2.65, p <.001, d = 1.25) and (t = 3.40, B = 0.76, p <.001, d = 0.30), respectively. In terms of the improvement of psychotic and anxiety symptoms, there was no statistically significant difference between the two groups.

Conclusions

The use of probiotics was associated with improved sleep quality, increased appetite, and increased body mass index in patients with chronic methamphetamine use. Conducting more definitive clinical trials with larger sample sizes and longer-term follow-up of cases is recommended.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgement

We express our gratitude to the patients and their caregivers who made this study possible. We also thank all the nurses and staff of Imam Hossein Hospital who cooperated with us in conducting the study.

Funding

Alborz University of Medical Sciences (Grant No: IR.ABZUMS.REC.1400.302)

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Authors and Affiliations

  1. Department of Psychiatry, Imam Hossein Hospital, School of Medicine, Alborz University of Medical Sciences, Karaj, Alborz, Iran

    Rahim Badrfam & Atefeh Zandifar

  2. Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran

    Atefeh Zandifar

  3. Alborz Office of Universal Scientific Education and Research Network (USERN), Alborz University of Medical Sciences, Karaj, Iran

    Amirhossein Hajialigol & Maryam Rashidian

  4. Department of Psychology, Florida State University, Tallahassee, Florida, USA

    Norman Brad Schmidt & Danielle Morabito

  5. Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran

    Rahim Badrfam, Mostafa Qorbani & Ehsan Shahrestanaki

  6. Evidence-Based Phytotherapy and Complementary Medicine Research Center, Alborz University of Medical Sciences, Karaj, Iran

    Mahboobeh Mehrabani Natanzi

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  1. Rahim Badrfam
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Contributions

RB, AZ: Conceptualization, Methodology, Investigation, Project administration, Data curation, Writing- Original draft, Preparation, Supervision, Writing- Reviewing and Editing, AH, MR: Methodology, Investigation, Data curation, Writing- Original draft, NBS: Writing- Reviewing and Editing, DM: Data curation, Formal Analysis, Editing, MQ: Methodology, Data curation, Formal Analysis, ES: Data curation, Formal Analysis, MMN: Conceptualization, Methodology. All the authors have read and approved the final version of the manuscript.

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Correspondence to Atefeh Zandifar.

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Badrfam, R., Zandifar, A., Hajialigol, A. et al. Efficacy of probiotic supplements in improving the symptoms of psychosis, anxiety, insomnia, and anorexia due to amphetamine and methamphetamine use: a randomized clinical trial. Psychopharmacology (2024). https://doi.org/10.1007/s00213-024-06577-x

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