ADVERTORIAL
The efficacy of saffron and psychobiotics in anxiety and depression
By Laura Dwyer | BHSc ( Naturopathy )
Depression and anxiety
Mood disorders are one of the most prevalent psychiatric disorders worldwide and currently represent a leading cause of disability .
Depressive disorders are viewed as a collection of different symptom domains , including anxious and somatic symptoms , and as such , many individuals experience both depression and anxiety simultaneously . 1 Patients with anxiety and concomitant depression appear to have a lower response and remission rate , longer illness duration and greater disruption of social , work and family life than non-anxious depressed individuals . 2 Treatment options have primarily focused on pharmaceuticals that target neurotransmitters ; however , recent reviews and meta-analyses have questioned their efficacy . 3-5 As the pathophysiology of mood disorders involves complex biological pathways , alternative therapeutic options that address neuroinflammation , the HPAaxis , and microbiome development may provide more favourable outcomes .
Saffron
Safr ' Inside™ is a clinically trialled saffron extract containing at least 2 % safranal and 3 % crocins . While not completely understood , the effects of saffron on mental health may result from a synergistic function of these specific constituents . 6 Saffron inhibits the reuptake of monoamine neurotransmitters , 6 , 7 reduces proinflammatory cytokines , 8 , 9 and decreases corticosterone levels , 10 which all contribute to disease development . 11 Increased oxidative stress also accelerates inflammatory and immune responses and disrupts neurotransmitter balance , further influencing the development of mental health conditions . 12-14 Consequently , the beneficial effects of saffron may be attributed to its ability to defend cells against oxidative stress .
Clinical Evidence
Nine meta-analyses have demonstrated the efficacy of saffron in the treatment of major depressive disorder ( MDD ), mild-to-moderate depression and low mood . 15-23 Several studies have found saffron to be equally effective as antidepressants and superior to placebo at improving depressive symptoms . Furthermore , results of five clinical trials have conclusively demonstrated significant improvements in symptoms of anxiety and comorbid depression . 24-28 Most significantly , saffron for six weeks ( 30mg / day ) was as effective as citalopram in improving symptoms of anxiety and depression in patients with MDD and anxious distress . 25
Psychobiotics
A plethora of evidence indicates that pathophysiological pathways involved in mood disorders are associated with increased intestinal permeability and inflammatory activation . 29 Proinflammatory cytokines are associated with neuroendocrine changes , induce depression and elicit behavioural changes . 30 , 31 Exposure to proinflammatory cytokines also decreases epithelial barrier function and may contribute to chronic inflammation associated with mood disorders . Cerebiome ® ( Lactobacillus helveticus R0052 and Bifidobacterium longum R0175 ) has been shown to reduce proinflammatory cytokines 32 , 33 and mitigate the effects of chronic stress by decreasing corticosterone and increasing levels of brain-derived neurotrophic factor ( BDNF ). 34
Clinical Evidence
Cerebiome ® alongside conventional antidepressant therapy significantly decreased depression scores compared to placebo in patients with mild-to-moderate depression , 35 and increased serum BDNF levels compared to prebiotics in patients with low-to-moderate depression . 36 These
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results suggest probiotics may influence the gut-brain axis and alter the expression of BDNF . Moreover , Cerebiome ® statistically reduced stress-induced gastrointestinal symptoms in adults , 37 and alleviated psychological distress as measured by anxiety and depression scales . 38 A decrease in urinary free cortisol was also observed , suggesting HPA-axis modulation .
Summary
Natural medicine practitioners are in an ideal position to help patients with anxiety and depression , particularly where medications may be contraindicated , such as children , pregnant and breastfeeding women , and those cautious of drug interactions . Accumulating evidence supports the use of saffron and specific probiotic formulations to address all facets of mood disorder development , including brain dysfunction , neuroinflammation , the HPA-axis and the gut-brain axis .
* References available on request
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Disclaimer : The views and opinions expressed in these advertorials are those of the authors and do not necessarily reflect the opinions of ATMS or its Directors .
116 | vol28 | no2 | JATMS