Anti-inflammatory and psychobiotic augmentation (experimental)

Domain IX · Biomedical, neuro & digital · Dinan, Stanton, Cryan · 2013

What it is

This is not a psychotherapy and not an approved treatment. It is an experimental research area testing whether adding ("augmenting") an anti-inflammatory drug, or a gut-targeted product (probiotic, so-called "psychobiotic", or faecal microbiota transplant), to standard psychiatric treatment…

Format

• Stratification by inflammation. Newer designs measure CRP or IL-6 to test whether only inflamed patients benefit; in MINDEP, patients with higher CRP improved more on minocycline, while the whole-group comparison showed similar improvement on both arms.
• Notice and elicit. Goal: know what the client is taking or considering (prescribed, over the counter, supplements, "gut health" regimes). Ongoing, inside routine sessions. Move on when you have a clear picture or the client has raised a question.

Evidence status, as the guide reports it

• Current status in brief. A review of 20 meta-analyses found the strongest pooled evidence for celecoxib, mixed and heterogeneous evidence for minocycline, and the weakest for omega-3, and concluded that "no clear clinical recommendations" can be made. The largest minocycline trial in…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• notes that read as prescribing advice.
• weight change, rigidity, distress around food.
• therapy being put "on hold" while waiting for a biological fix.
• hopelessness after a null result; increased risk after trial exit.
• consent driven by hopelessness; capacity concerns, which you raise with the team.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.