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Depression is a common and severe mood disorder that affects approximately 280 million people worldwide. Suicidal thoughts are more common in patients with moderate to severe depression. Psychotherapy and medication are the main treatments for depression, but medication is not a complete cure, especially in moderate to severe depression, and is often accompanied by multiple adverse reactions.
SAMe, as a dietary supplement, has been extensively studied for its antidepressant effects over the past few decades. Probiotics have attracted attention for their potential in a variety of clinical applications, and several studies have explored the link between probiotics and mood disorders. Gut flora dysbiosis is one of the risk factors for depression and affects depression by inducing systemic inflammation and imbalance in neurotransmitter production.
Transmethylation pathway: SAMe is the main methyl donor and affects the central nervous system through the cellular transmethylation pathway. The transmethylation pathway of SAMe involves the methylation of neurotransmitters, epigenetic targets (DNA, RNA, and histones), and protein phosphatase 2A.
Monoamine neurotransmitters: SAMe may enhance neurotransmitter levels by acting as a methyl donor for the synthesis of monoamine neurotransmitters such as norepinephrine, dopamine, and serotonin.
SAMe is an endogenous molecule that participates in multiple biochemical pathways, including the synthesis and metabolism of neurotransmitters and potential epigenetic pathways. SAMe supplementation can increase SAMe levels in cerebrospinal fluid and has a mitigating effect on different types of depression.
Probiotics are live microorganisms that, when consumed in adequate amounts, can provide health benefits by improving or restoring the intestinal flora. The health benefits of probiotics in psychiatric patients are called psychobiotics, and they act on the gut-brain axis by producing and transmitting neuroactive substances, potentially acting as antidepressants.
Anti-inflammatory, antioxidant, and immunomodulatory: Probiotics increase BDNF levels, reduce inflammatory and immune-mediated signals, reduce overactivation of the HPA axis, and increase the production of neurotransmitters (GABA, serotonin, norepinephrine, and dopamine) through these mechanisms.
Affecting neurotransmitter synthesis: Certain probiotic strains can increase the secretion of neurotransmitters such as GABA, serotonin, norepinephrine, and histamine.
Studies have suggested that the combined use of SAMe and probiotics may be an effective strategy for the treatment of depression, especially in refractory cases. This combination therapy may work by improving intestinal flora dysbiosis, reducing systemic inflammatory responses, and enhancing the therapeutic effects of SAMe.
[1] Ullah, H.; Khan, A.; Rengasamy, K.R.R.; Di Minno, A.; Sacchi, R.; Daglia, M. The Efficacy of S-Adenosyl Methionine and Probiotic Supplementation on Depression: A Synergistic Approach. Nutrients 2022, 14, 2751.
*Special note - This article is for informational purposes only and cannot replace a doctor's treatment diagnosis and advice. It should not be regarded as a recommendation or proof of efficacy of the medical products involved. If it involves disease diagnosis, treatment, and rehabilitation, please be sure to go to a professional medical institution to seek professional advice.
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