Atlas›Domain IX · Biomedical, neuro & digital›Guide 013
Guide IX-013

Anti-inflammatory and psychobiotic augmentation (experimental)

Dinan, Stanton, Cryan2013
A 28 · L 65 · M 716 interventions in the Trinity explorer2 described for recognition only
Client cardCompare
[source: …] where a claim comes from[uncertain] not confirmed in a primary source[synthesis] the writer's reconstruction

1. Introduction

Version followed: the research literature as it stood when checked (October 2026), anchored on the Simon et al. (2023) systematic review of meta-analyses of anti-inflammatory agents in major depression, named randomised trials (MINDEP, Hellmann-Regen et al. 2022, BeneMin, Nikolova et al. 2023, Green et al. 2023), the Dinan, Stanton and Cryan (2013) definition of "psychobiotics", the US prescribing information for celecoxib (revised 11/2024) and an extended-release minocycline label, and NCCIH consumer guidance on probiotics.

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 improves outcomes. The agents most studied in depression are celecoxib (a COX-2-selective NSAID), minocycline (a tetracycline antibiotic with anti-inflammatory and microglial effects) and omega-3 fatty acids [source: Simon et al. 2023]. None of these has a psychiatric indication in the labelling: celecoxib's US label lists only arthritis, pain and dysmenorrhoea indications [source: Celebrex prescribing information via Drugs.com]. The FDA has not approved any health claims for probiotics [source: NCCIH].

Core idea of how change would happen (hypothesis, not established). A subgroup of people with depression or psychosis show low-grade inflammation (e.g. raised C-reactive protein, CRP); the hypothesis is that damping inflammation, or altering gut bacteria that signal to the brain via the vagus nerve, immune and neuroendocrine routes, would relieve symptoms in that subgroup [source: KCL MINDEP release; Dinan et al. 2013]. Dinan and colleagues defined a psychobiotic as a live organism that, ingested in adequate amounts, produces a health benefit in people with psychiatric illness, and noted that the antidepressant and anxiolytic effects had then been shown mainly in rodents [source: Dinan et al. 2013, UCC record].

Who delivers it. Any use of celecoxib or minocycline is a prescriber decision (both are prescription medicines under US labelling) and, for psychiatric purposes, is off-label or within a research trial [source: Celebrex and minocycline labels; inference for "off-label" from absence of a psychiatric indication] [uncertain: prescription status outside the US not checked]. Probiotics are sold over the counter as foods and supplements [source: NCCIH]. Faecal microbiota transplant for depression has only been tested in pilot research [source: Green et al. 2023]. The psychotherapist's role is not to recommend, supply or adjust any of these, but to respond well when clients ask about them or have started them, to route interaction and safety questions to the prescriber or pharmacist, and to avoid overclaiming.

2. Framework

There is no treatment protocol for psychotherapists to follow. What follows is (a) how the research is structured, so you can describe it accurately, and (b) a working framework for the therapist's role [synthesis].

(a) How the research is structured [source: trial reports listed below]

  • Adjunctive design. In the depression trials, the agent was added to the client's ongoing antidepressant, compared against placebo, over short periods: four weeks (MINDEP, 39 patients), six weeks (Hellmann-Regen et al., 173 patients, nine German university hospitals), eight weeks (Nikolova et al. probiotic pilot, 49 patients). BeneMin added minocycline or placebo to routine care for 207 people with recent-onset schizophrenia-spectrum disorder across 12 NHS trusts [source: KCL MINDEP; HealthDay; KCL Nikolova; BeneMin record].
  • 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 [source: KCL MINDEP].
  • 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 [source: Simon et al. 2023]. The largest minocycline trial in treatment-resistant depression found no benefit over placebo [source: HealthDay on Hellmann-Regen et al. 2022]. BeneMin found no benefit for negative symptoms in early psychosis [source: BeneMin record]. Probiotic and FMT studies in depression are pilots [source: KCL Nikolova; Green et al. 2023].

(b) The therapist's working framework [synthesis]

  1. 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.
  2. Inform and route. Goal: give an accurate, brief research-status picture and hand medical questions to the prescriber or pharmacist. Usually part of one or two sessions. Move on once the client knows who to ask and has a plan to ask.
  3. Collaborate during any prescribed or trial use. Goal: support informed consent, monitor and pass on warning signs, keep psychological treatment going. Lasts as long as the medical treatment. Move on when the prescriber or trial ends it.
  4. Review and close. Goal: help the client make sense of the result (including no effect) without blame, and keep the overall treatment plan intact.

No session count applies; this is embedded in whatever psychotherapy you are already providing.

3. Guiding principles

[source: NCCIH for principles 3 and 5; labels for principle 4; Simon et al. 2023 for principle 2; remainder synthesis]

  • Stay in your lane on medicines. Never advise starting, stopping, continuing or changing any medicine or supplement; your action is always to route to the prescriber or pharmacist. [synthesis]
  • Describe research status, not promise. Say "being studied", "mixed results", "no clear recommendation"; never "works for depression". [source: Simon et al. 2023]
  • Proven treatment stays in place. NCCIH advises not replacing scientifically proven treatments with unproven products; frame any experimental option as discussed alongside, not instead of, current care. [source: NCCIH]
  • "Natural" or "over the counter" does not mean risk-free. Celecoxib carries a boxed warning; NSAIDs interact with SSRIs/SNRIs and lithium; probiotics have limited long-term safety data. [source: labels; NCCIH]
  • Encourage disclosure to prescribers. NCCIH advises talking to a health care provider before taking a probiotic supplement; extend this to all self-started products. [source: NCCIH; extension is synthesis]
  • Non-judgemental curiosity. Self-starting is usually a sign of hope or frustration with treatment; explore it rather than correct it. [synthesis]
  • Attribute claims. When citing a finding, name the study type and size ("a 49-person pilot") so the client can weigh it. [synthesis]
  • Watch for industry and media framing. Some trials are industry-supported (the Nikolova probiotic pilot was co-funded by the probiotic's manufacturer) and press releases often omit caveats. [source: KCL Nikolova]
  • Inflammation is one hypothesis, not a diagnosis you make. Blood tests and their interpretation belong to the medical team. [synthesis]
  • Keep the psychological formulation whole. A biological hypothesis does not replace attention to stressors, relationships and meaning. [synthesis]

4. Intervention inventory

Part A describes the medical side at a descriptive level only, as labelling and trial reports give it; doses, schedules and product choices are deliberately left out and belong to the prescriber. Part B gives the psychotherapist's own interventions.

Part A. How the experimental treatments are delivered (descriptive)

A1. Anti-inflammatory augmentation in trials (celecoxib, minocycline)

  • Purpose: to test whether an anti-inflammatory drug added to an antidepressant (or to antipsychotic care) improves symptoms, especially in people with raised inflammatory markers [source: KCL MINDEP; Simon et al. 2023].
  • Steps (as trials describe them): a research or prescribing clinician screens eligibility; in stratified designs, blood CRP and/or IL-6 is measured; the client continues routine treatment and is randomised to the agent or a placebo, both tablets or capsules; symptoms are rated on standard clinician scales (e.g. HAM-D, MADRS, PANSS) over several weeks; adverse events are recorded [source: KCL MINDEP; HealthDay; BeneMin record].
  • Findings to describe accurately: celecoxib has the most consistent pooled signal; minocycline results are heterogeneous, with the largest trial in treatment-resistant depression (Hellmann-Regen et al., JAMA Network Open, 2022) "robustly demonstrating" no advantage over placebo; MINDEP suggested a benefit only in higher-CRP patients and its authors said replication in larger samples is needed; BeneMin found no benefit on negative symptoms in early psychosis and advised against further such trials without clear evidence of the targeted inflammatory process [source: Simon et al. 2023; HealthDay; KCL MINDEP; BeneMin record].
  • Example language: "Researchers are testing whether some anti-inflammatory medicines help depression in people who have signs of inflammation. The results so far are mixed, and reviewers say there isn't enough to make a recommendation yet. It's a question for your psychiatrist, not something to try on your own." (illustrative)
  • Watch for: clients equating research with recommendation; clients assuming an over-the-counter painkiller is equivalent to what trials tested [synthesis].

A2. What the official labelling says (celecoxib and minocycline)

  • Purpose: to know the warnings the prescriber will weigh, so you can recognise and pass on relevant signs. This is not a list for you to apply or for the client to self-monitor instead of medical review.
  • Celecoxib (US prescribing information, revised 11/2024): boxed warning for serious cardiovascular thrombotic events (heart attack, stroke), which can be fatal, may occur early and may increase with duration; contraindicated around coronary bypass surgery; boxed warning for serious gastrointestinal bleeding, ulceration and perforation, which can be fatal and occur without warning, with older people and those with prior ulcer or GI bleeding at greater risk. Further warnings include liver toxicity, hypertension, heart failure and oedema, kidney toxicity, anaphylaxis, serious skin reactions, DRESS and fetal toxicity. Interactions relevant to mental health care: SSRIs and SNRIs with an NSAID may raise bleeding risk beyond the NSAID alone, so the label advises monitoring for bleeding; NSAIDs can raise lithium levels, and the label advises monitoring for lithium toxicity [source: Celebrex prescribing information via Drugs.com].
  • Minocycline (extended-release tablet label): warnings include serious liver injury (sometimes fatal); central nervous system effects (light-headedness, dizziness, vertigo; caution with driving); idiopathic intracranial hypertension (headache, blurred or double vision, vision loss; higher risk in overweight women of childbearing age); autoimmune syndromes with long-term use (lupus-like syndrome, autoimmune hepatitis, vasculitis, serum sickness with fever, rash, joint pain); exaggerated sunburn reactions; tissue hyperpigmentation including teeth, skin, nails and eyes; development of drug-resistant bacteria and superinfection; periodic blood, kidney and liver tests are recommended [source: minocycline ER label via MedLibrary]. [uncertain: other minocycline formulations' labels and their indications are not drawn on.]
  • Example language: "The leaflet for that medicine mentions some side effects your prescriber watches for. If you notice any of these, the right step is to tell them or a pharmacist promptly; I'll help you work out how." (illustrative)
  • Watch for: new headaches with visual change, black or bloody stools, chest pain or stroke symptoms, jaundice, rash with fever: these need same-day medical contact or emergency services, not a wait until next session [source for the signs: labels above; triage advice: synthesis].

A3. Probiotics, "psychobiotics" and faecal microbiota transplant (FMT)

  • Purpose: to test whether altering gut bacteria improves mood or anxiety via the gut-brain axis [source: Dinan et al. 2013].
  • Status: Dinan et al. (2013) described antidepressant and anxiolytic effects as shown mainly in rodents, with human benefits for depression emerging, not proven, and large placebo-controlled trials awaited. Nikolova et al. (JAMA Psychiatry, 2023) ran a double-blind placebo-controlled pilot in 49 adults with incomplete antidepressant response: both groups improved, the probiotic group more so from week four, and it was well tolerated; the researchers framed it as a basis for larger trials, and the product's manufacturer co-funded the work. Green et al. (Canadian Journal of Psychiatry, 2023) ran a 15-person pilot of enema-delivered FMT for depression designed to test feasibility and safety, not efficacy [source: UCC record; KCL Nikolova; JCU record]. A CANMAT task force has published recommendations on probiotics, prebiotics, synbiotics and FMT in adult depression [uncertain: located by title only; full text is not drawn on, so its recommendations are not reported here].
  • Regulation and safety: probiotics are sold as supplements and foods; the FDA has not approved any health claims for them; long-term safety data are limited; serious side effects may be more likely in people with underlying health conditions; in 2023 the FDA warned of severe, potentially fatal infections in premature infants given probiotics; products differ in organisms and effects [source: NCCIH].
  • Example language: "Gut bacteria and mood is a genuinely active research area, but the human studies in depression are still small pilots. If you're thinking of trying a probiotic, please mention it to your GP or pharmacist first, especially given your other health conditions." (illustrative)
  • Watch for: clients with immune suppression, serious physical illness or pregnancy considering products, and anyone exploring DIY FMT; route these to medical advice [synthesis, informed by NCCIH on higher-risk groups]. Gut-health regimes that involve restrictive eating warrant eating-disorder screening (see B12).

Part B. The psychotherapist's interventions

All of Part B is practice synthesis built around the sourced facts in Part A and NCCIH's advice to involve a health care provider and not replace proven treatments [source: NCCIH]; it is not drawn from a published protocol [synthesis].

B1. Routine inquiry about medicines, supplements and over-the-counter products

  • Purpose: clients often do not count supplements, probiotics or painkillers as "medication"; you cannot route a risk you do not know about.
  • Steps: (1) at intake and at reviews, ask specifically about prescribed medicines, over-the-counter painkillers and anti-inflammatories, supplements, probiotics and "gut health" or online-ordered products; (2) record what the client reports without evaluating it; (3) ask whether the prescriber and pharmacist know; (4) if not, agree how the client will tell them.
  • Example language: "Besides your prescribed medicine, are you taking anything else at the moment: painkillers, supplements, probiotics, anything bought online?" (illustrative)
  • Watch for: vague answers ("just some natural stuff"); products bought from overseas sellers. Working: the client's prescriber has a full list.

B2. Responding when a client asks "Should I try an anti-inflammatory or a psychobiotic?"

  • Purpose: honour the question, give an accurate research-status picture, and route the decision.
  • Steps: (1) ask what they have read or heard and what they hope it would do; (2) summarise status in one or two sentences (Part A), naming that reviewers say no clear recommendation can be made; (3) state plainly that whether it is right for them is a prescriber's decision; (4) offer to help them prepare questions for the prescriber (B9); (5) return to what the hope says about their current treatment experience.
  • Example language: "I can tell you what the research says, but I can't tell you whether to take it. That's for your psychiatrist. What would you most want to ask them?" (illustrative)
  • Watch for: your own enthusiasm or scepticism leaking into the answer. Working: the client leaves with a question for the prescriber, not a plan to self-start.

B3. Responding when a client has already self-started

  • Purpose: keep the alliance and get the information to the people who can assess safety, without telling the client to stop or continue.
  • Steps: (1) thank them for telling you; (2) explore what led to it (frustration with treatment, a media story, a friend); (3) ask what they are noticing, good and bad; (4) say clearly that you cannot judge safety or interactions and that the pharmacist or prescriber can, and that this matters more if they take an antidepressant, lithium or other regular medicines (see B4); (5) agree a concrete step and time for contacting them; (6) note it in the record and, with consent, inform the prescriber.
  • Example language: "I'm glad you told me. I'm not the right person to say whether it's safe alongside your other medicines, but your pharmacist can check that today. Would you be willing to call them before our next session?" (illustrative)
  • Watch for: shame or concealment if they feel judged; any warning sign in A2 (route urgently). Working: the prescriber or pharmacist is informed.

B4. Routing interaction risks to the prescriber or pharmacist

  • Purpose: the labelling documents interactions that matter in mental health care: NSAIDs with SSRIs/SNRIs (bleeding) and NSAIDs with lithium (raised levels, toxicity) [source: Celebrex prescribing information via Drugs.com].
  • Steps: (1) when a client on an antidepressant or lithium mentions regular anti-inflammatory use, flag it as a question for the pharmacist or prescriber, without interpreting it; (2) for lithium, remind the client that lithium monitoring is the prescriber's domain and they should be told; (3) if signs of bleeding or of lithium toxicity are described, treat as urgent medical contact; (4) document.
  • Example language: "Some anti-inflammatories can interact with lithium. I don't know if that applies to you, but your prescriber needs to know you're taking them." (illustrative)
  • Watch for: occasional over-the-counter painkiller use mentioned in passing; do not minimise or dramatise, just route. [uncertain: specific lithium-toxicity signs are not listed here because the lithium label is not drawn on; refer to the prescriber.]

B5. Supporting informed consent and shared decision-making, including trial participation

  • Purpose: if a prescriber offers an off-label anti-inflammatory, or a client is invited into a trial, help the client think the decision through.
  • Steps: (1) help the client list their questions: what evidence there is, what the warnings are, what monitoring is needed, what happens if it does not help; (2) for trials, explain in general terms what randomisation and placebo mean, and that participation is voluntary and can be withdrawn; (3) check understanding and pressure (from family, hope, desperation); (4) leave the decision with the client and prescriber or research team.
  • Example language: "In a trial you might get the medicine or a placebo, and nobody may know which until the end. How would you feel about that?" (illustrative)
  • Watch for: consent driven by hopelessness; capacity concerns, which you raise with the team.

B6. Adherence and ambivalence conversations (never advising change)

  • Purpose: clients drawn to experimental options may be ambivalent about their current antidepressant; explore this without steering.
  • Steps: (1) reflect both sides (hopes for something new, doubts about current treatment); (2) explore what has and has not helped; (3) if the client is considering stopping or swapping anything, encourage discussing it with the prescriber first; (4) do not take a position on the medicine itself.
  • Example language: "It sounds like part of you is hoping this could replace your antidepressant, and part of you is unsure. That's an important conversation to have with your psychiatrist before changing anything." (illustrative)
  • Watch for: abrupt self-discontinuation of prescribed medicine in favour of supplements; route promptly.

B7. Monitoring and passing on side effects and warning signs

  • Purpose: you see the client more often than the prescriber; you may hear about side effects first.
  • Steps: (1) when a client is on a prescribed anti-inflammatory or in a trial, ask briefly each session about physical changes; (2) for signs listed in A2 (chest pain, stroke symptoms, black or bloody stools, jaundice, severe headache with visual change, rash with fever, joint pain with fever), direct the client to urgent medical care or emergency services; (3) for milder changes (dizziness, sunburn-like reactions, stomach upset), encourage reporting to the prescriber or trial team; (4) with consent, pass on what you hear; (5) record it.
  • Example language: "Any changes in your body since starting the trial medicine? Headaches, vision, stomach, skin?" (illustrative)
  • Watch for: psychological symptoms being attributed to the drug or vice versa; let the medical team judge. Working: concerns reach the prescriber quickly.

B8. Avoiding overclaiming: media and marketing literacy

  • Purpose: gut-brain and inflammation stories are widely publicised; press releases and product marketing often drop caveats [source for an example of industry co-funding: KCL Nikolova].
  • Steps: (1) ask where the client read it; (2) help them check: was it in humans or animals, how many people, was there a placebo, who funded it; (3) model calibrated language; (4) avoid recommending any product or brand.
  • Example language: "That headline is about a small pilot study; promising, but the researchers themselves said bigger trials are needed." (illustrative)
  • Watch for: your own overclaiming ("your depression is inflammation"); it can shift clients away from treatments with stronger evidence.

B9. Collaborative communication with the prescriber

  • Purpose: close the loop so medical questions are answered by the right person.
  • Steps: (1) obtain consent to share; (2) send a brief factual note: what the client is taking or considering, what they asked, any reported effects or warning signs, and the question for the prescriber; (3) avoid recommendations about the medicine; (4) agree with the client how they will hear back.
  • Example language (note to prescriber): "Client reports starting an over-the-counter probiotic and asked about anti-inflammatory augmentation after a media report. No adverse effects reported. They would value your view at their next review." (illustrative)
  • Watch for: notes that read as prescribing advice.

B10. Integrating psychotherapy alongside

  • Purpose: keep evidence-based psychological treatment going whatever the medical decision [source for not replacing proven treatment: NCCIH].
  • Steps: (1) keep the agreed therapy plan and goals; (2) track mood with your usual measures so the prescriber has data; (3) if the client is in a placebo-controlled trial, avoid speculating about which arm they are in; (4) address lifestyle and stress factors within your usual competence, without diet prescriptions.
  • Example language: "Whatever you and your psychiatrist decide, let's keep working on the things we planned." (illustrative)
  • Watch for: therapy being put "on hold" while waiting for a biological fix.

B11. Crisis and safety planning

  • Purpose: clients seeking experimental options are often in treatment-resistant or prolonged depression, with elevated risk.
  • Steps: follow your standard suicide-risk assessment and safety-planning practice; update the safety plan if hope invested in a new option is disappointed or a trial ends; include the prescriber and crisis contacts; if lethal-means counselling is needed, address safe storage and removal of medicines generally, including stockpiled over-the-counter painkillers.
  • Example language: "If this doesn't help the way you hope, that can be a hard moment. Can we add that to your safety plan now?" (illustrative)
  • Watch for: hopelessness after a null result; increased risk after trial exit.

B12. Eating-disorder caution and screening

  • Purpose: "gut health" and anti-inflammatory diet trends can mask or feed restrictive eating.
  • Steps: (1) ask about eating patterns when a client describes elimination or "anti-inflammatory" regimes; (2) screen with your service's standard eating-disorder screening; (3) refer for medical and dietetic assessment where indicated; (4) do not supply diet plans or targets.
  • Example language: "Some people find these gut-health plans become very restrictive. How has your eating been lately?" (illustrative)
  • Watch for: weight change, rigidity, distress around food.

B13. After a trial or self-experiment ends

  • Purpose: help the client make sense of the outcome, including no effect, which is the most common result in the largest trials [source: HealthDay on Hellmann-Regen et al.; BeneMin record].
  • Steps: (1) explore what they expected and what happened; (2) normalise null results as information, not personal failure; (3) review the overall treatment plan with the client and, with consent, the prescriber; (4) update relapse-prevention and safety plans.
  • Example language: "It didn't do what you hoped, and that's disappointing. It doesn't mean nothing can help; it means this route isn't the one." (illustrative)
  • Watch for: the client concluding they are "untreatable"; renewed hope invested in the next unproven product.

5. Handling problems

The sources do not address the therapist's side of these situations; all guidance below is [synthesis] unless tagged otherwise.

  • Client insists you tell them whether to take it. Restate the boundary warmly and explain why (you cannot assess their medical risks); offer to help draft the prescriber question (B9). "I'd be guessing, and with medicines guessing isn't good enough. Let's get you a proper answer." (illustrative)
  • Client refuses to tell the prescriber. Explore the fear (being dismissed, losing the prescription, judgement). Offer the pharmacist as a lower-stakes first contact. If you judge there is a serious safety risk (warning signs in A2, possible lithium interaction), discuss the limits of confidentiality as your professional code and local law allow, and consult your supervisor.
  • Client has stopped the prescribed antidepressant in favour of a supplement. Do not advise restarting; urge prompt contact with the prescriber, who can assess discontinuation and relapse risk; increase risk monitoring; update the safety plan.
  • Client distrusts "Big Pharma" and sees probiotics as the safe option. Validate the wish for autonomy; share that NCCIH notes limited long-term safety data and that serious effects may be more likely in people with underlying health conditions [source: NCCIH]; point out that supplement trials can be industry-funded too [source: KCL Nikolova].
  • Client is convinced their depression is "just inflammation". Acknowledge it as a live research hypothesis and that trials so far are mixed [source: Simon et al. 2023; HealthDay]; keep psychological and social factors in the formulation; avoid arguing.
  • Client wants you to interpret a CRP or other blood result. Decline; refer to the prescriber or GP. Interpreting results is outside psychotherapy scope.
  • Client in a trial suspects they are on placebo and becomes demoralised. Explore the meaning; remind them that both groups improved in several trials [source: KCL MINDEP; KCL Nikolova]; keep therapy goals active; encourage raising concerns with the research team.
  • Rupture: client feels you are dismissive of their research. Repair by naming what you value in their initiative, apologising for anything that felt dismissive, and showing you take the question seriously by helping them get it answered.
  • Your own pull to overclaim or debunk. Use supervision; check your language against Section 3; keep a short, sourced status summary you update periodically, since this field changes.
  • Overwhelm in clients with complex physical health. Keep the conversation brief and practical: one question, one person to ask, one time to ask.
  • DIY FMT or unregulated online products. Express concern clearly, without instructions or product evaluation; route urgently to medical advice; Green et al. describe FMT for depression only within a supervised pilot trial [source: JCU record].
  • Non-adherence to monitoring tests in a prescribed course. Explore barriers (access, fear of needles, avoidance); encourage contact with the prescriber, as labelling recommends periodic laboratory tests for minocycline [source: minocycline ER label via MedLibrary].

Sources

Sources:

Further reading (not drawn on) [uncertain]: the CANMAT task force recommendations on probiotics, prebiotics, synbiotics and faecal microbiota transplants in adults with major depressive disorder; the Pfizer-hosted Celebrex label page; a Healio report on the Hellmann-Regen trial.

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