Adjunctive fecal microbiota transplantation for major depressive disorder: A randomized, double-blind, placebo-controlled trial - PubMed
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- FMT as adjunct to escitalopram did not significantly improve remission rates at week 8 compared to placebo.
- FMT led to greater reductions in HAMD-17 depression scores at weeks 2 and 8, with a comparable safety profile.
- FMT resulted in durable donor microbial engraftment, enriching beneficial taxa like Lachnospiraceae and Oscillospiraceae.
- Microbial changes were associated with increased serum bile acids, which correlated with symptom alleviation.
- Mediation analysis suggests bile acids suppress inflammatory pathways, linking microbiota changes to antidepressant effects.
- FMT may enhance escitalopram efficacy by modulating bile-acid metabolism and inflammation via the gut microbiota.