Razavi Journal of Medicine

Razavi Journal of Medicine

Impact of probiotics or synbiotics on symptoms of attention deficit hyperactivity disorder: A systematic review and meta-analysis

Document Type : Review Article/ Systematic Review Article/ Meta Analysis

Authors
1 Biotechnology Research Center, Pharmaceutical Technology Institute, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
2 Centre for Research Impact & Outcome, Chitkara College of Pharmacy, Chitkara University, Rajpura, Punjab, India
3 Center for Innovation and Inclusive Research, Sharda University, Greater Noida, Uttar Pradesh, India.
4 Applied Biomedical Research Center, Basic Sciences Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran
5 Pharmaceutical Research Center, Pharmaceutical Technology Institute, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
6 Medical Toxicology Research Center, Basic Sciences Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
7 Department of Molecular Biology and Genetics, Canakkale Onsekiz Mart University, Canakkale 17100, Turkey.
8 Unidad de Investigación Biomédica, Delegación Durango, Instituto Mexicano del Seguro Social, México
Abstract
Context. Some studies have reported that probiotics and/or prebiotics improve psychiatric symptoms in children with autism spectrum disorder; however, others have found no significant effect of synbiotics on attention deficit hyperactivity disorder (ADHD) symptoms, functionality or comorbid autistic symptoms. The goal of this meta-analysis was to assess the impact of prebiotics or synbiotics on ADHD symptoms.

Evidence Acquisition. PubMed, Scopus, Web of Science, ClinicalTrials.gov, and Google Scholar databases were searched using MeSH terms and keywords. Randomized controlled trials (RCT) investigating the efficacy of the probiotic or synbiotic administration on symptoms of ADHD were selected for the meta-analysis. This search was performed from inception to February 09, 2024. The Comprehensive Meta-Analysis (CMA) V4 software was employed to perform a meta-analysis, calculating standardized mean differences (SMDs) based on sample size, means, and standard deviations from each group. A random-effects model, employing the DerSimonian-Laird approach, and the generic inverse variance weighting method were used to consider research design, treatment duration, and demographic characteristics. The effect sizes were presented as SMD and 95% (CI).

Results. The meta-analysis of five clinical trials, including in total 245 subjects, showed that probiotics or synbiotics supplementation has a significant effect on ADHD symptoms (standardized mean differences: –0.284, 95% CI: –0.552, -0.016, p<0.001). The reduction in symptoms of ADHD was robust in the leave-one-out sensitivity analysis.

Conclusion. The consumption of probiotics or synbiotics improves ADHD symptoms.
Keywords

Availability of data and material: Not applicable as no primary data was generated in this study.

Conflicts of interests: The authors have nothing to disclose.

Financial disclosure: No funding was received for this study.

Consent for publication: Not applicable.

Ethical Considerations: Not applicable.

Author contributions: Conceptualization: AS, LESM; Writing-original draft: TJ, AS, LESM; Writing-review & editing: SK.

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

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Articles in Press, Accepted Manuscript
Available Online from 26 August 2026