Efektivitas probiotik terhadap gejala depresi ditinjau dari durasi pengobatan: Sebuah tinjauan sistematis
DOI: https://doi.org/10.33024/hjk.v20i1.2159
Durasi Pengobatan Gejala Depresi Probiotik Sumbu Usus–Otak
Abstract
Background: Depression is a major global health problem that significantly impacts quality of life and productivity. Changes or disruptions in the composition of the gut microbiota, known as dysbiosis, are believed to play a role in influencing depressive symptoms through the gut-brain axis. Probiotics have the potential to alleviate depression by modulating the gut microbiota and inflammatory signaling pathways, but the influence of intervention duration on their effectiveness remains unclear.
Purpose: To assess the effectiveness of probiotics on depressive symptoms in terms of treatment duration.
Method: A systematic review was conducted in PubMed, Scopus, Google Scholar, and ScienceDirect databases to identify randomized controlled trials (RCTs) published between 2015 and 2025. Eligible studies included adult subjects (≥18 years) with a diagnosis of major depressive disorder (MDD) or measurable depressive symptoms who received single-strain or multi-strain probiotics as monotherapy or adjunct therapy. Outcomes were assessed using validated depression scales, such as the Hamilton Depression Rating Scale (HAM-D), the Montgomery–Åsberg Depression Rating Scale (MADRS), and the Beck Depression Inventory (BDI). Twelve RCTs met inclusion criteria.
Results: Probiotic administration demonstrated the greatest antidepressant effect in medium-term interventions (4–8 weeks). Short-term therapy (<4 weeks) produced only minimal improvement, while long-term use (>12 weeks) tended to reach a plateau, with biological benefits persisting but without further significant symptom reduction. Multi-strain therapy and adjunctive use demonstrated greater effectiveness.
Conclusion: Probiotics are most effective when administered over a 4–8-week period and are a safe and promising adjunctive therapy for mild to moderate depression.
Keywords: Depressive Symptoms; Gut-Brain Axis; Probiotics; Treatment Duration.
Pendahuluan: Depresi merupakan masalah kesehatan global utama yang berdampak signifikan terhadap kualitas hidup dan produktivitas. Perubahan atau gangguan komposisi mikrobiota usus yang dikenal sebagai disbiosis, diyakini berperan dalam memengaruhi gejala depresi melalui sumbu usus–otak. Probiotik berpotensi meredakan depresi dengan memodulasi mikrobiota usus dan jalur sinyal inflamasi, namun pengaruh durasi intervensi terhadap efektivitasnya masih belum jelas.
Tujuan: Untuk menilai efektivitas probiotik terhadap gejala depresi ditinjau dari durasi pengobatan.
Metode: Penelitian tinjuan sistematis dilakukan pada basis data PubMed, Scopus, Google Scholar, dan ScienceDirect untuk mengidentifikasi uji klinis acak terkontrol (randomized controlled trials/RCT) yang dipublikasikan antara tahun 2015-2025. Studi yang memenuhi kriteria melibatkan subjek dewasa (≥18 tahun) dengan diagnosis gangguan depresi mayor (major depressive disorder/MDD) atau gejala depresi yang terukur, yang menerima probiotik strain tunggal atau multi-strain sebagai terapi tunggal maupun tambahan. Luaran dinilai menggunakan skala depresi tervalidasi, seperti Hamilton Depression Rating Scale (HAM-D), Montgomery–Åsberg Depression Rating Scale (MADRS), dan Beck Depression Inventory (BDI). Sebanyak 12 RCT memenuhi kriteria inklusi.
Hasil: Pemberian probiotik menunjukkan efek antidepresan terbesar pada intervensi jangka menengah (4–8 minggu). Terapi jangka pendek (<4 minggu) hanya menghasilkan perbaikan minimal, sedangkan penggunaan jangka panjang (>12 minggu) cenderung mencapai plateau, dengan manfaat biologis yang tetap bertahan namun tanpa penurunan gejala yang bermakna lebih lanjut. Terapi multi-strain dan penggunaan sebagai terapi tambahan menunjukkan efektivitas yang lebih tinggi.
Simpulan: Probiotik paling efektif diberikan dalam rentang waktu 4–8 minggu dan merupakan terapi tambahan yang aman serta menjanjikan untuk depresi ringan hingga sedang.
Kata Kunci: Durasi Pengobatan; Gejala Depresi; Probiotik; Sumbu Usus–Otak.
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