Efficacy and safety of Morinda officinalis oligosaccharide capsules for depressive disorder: a systematic review and meta-analysis

Abstract

To evaluate the efficacy and safety of Morinda officinalis oligosaccharide (MOO) capsules for depressive disorder. Methods: Eight electronic databases were searched for relevant studies from inception to April 19, 2020. Randomized controlled trials comparing MOO capsules with antidepressants were included. Data analysis was conducted using Review Manager 5.3 software. The risk of bias was assessed using the Cochrane Risk of Bias Tool, and the quality of the studies was evaluated by two researchers using the Grading of Recommendation, Assessment, Development and Evaluations (GRADE) software. Results: Seven studies involving 1,384 participants were included in this study. The effect of MOO capsules for moderate depressive disorder was not different from that of antidepressants (risk ratio [RR] = 0.99, 95%CI 0.92-1.06). Regarding adverse events, no significant difference was found between MOO capsules and antidepressants (RR = 0.84, 95%CI 0.65-1.07). In addition, the quality of evidence related to these adverse events was rated as low. Conclusion: This systematic review suggests that the efficacy of MOO capsules in the treatment of mild to moderate depression is not inferior to that of conventional antidepressants, which may provide a new direction for clinical alternative selection of antidepressants. However, more high-quality research and detailed assessments are needed.

Morinda officinalis oligosaccharides increase serotonin in the brain and ameliorate depression via promoting 5-hydroxytryptophan production in the gut microbiota

“…MOO, a mixture of oligosaccharides ranging from trisaccharides to nonasaccharides and mainly consisting of seven oligosaccharides 12 , have shown pharmacological activities on anti-depressant, anti-dementia and memory-enhancing effects 13 , 14 . MOO has been approved to be a prescription drug against depressant in China in 2012 15 (NMPA approval number: Z20120013), making them a clinical traditional Chinese medicine (TCM) for the treatment of depression. The results of Phase I clinical trial in China 16 showed that after taking MOO capsules, all healthy volunteers in the study showed good tolerance, in groups either administered with MOO as a single dose (50–1000 mg) or continuously administration for 7 days (800 mg/day).…”

“…Mechanism studies for MOO have demonstrated some of its activities in brain, such as enhancing 5-HT neurotransmission, increasing the expression of neurotrophic factor and changing glucose metabolism 19 , 20 . A clinical study showed a significant therapeutic efficacy of MOO capsules in 1384 individuals with mild to moderate depression, and the improvement was not less than that of conventional antidepressants such as fluoxetine hydrochloride and escitalopram 15 . However, based on previous studies, MOO had poor absorption in oral administration 21 ; thus MOO's concentration in blood or brain might be very low.…”

Iterative Synthesis of Inulin-Type Fructooligosaccharides Enabled by Stereoselective β-d-Fructofuranosylation

“…officinalis oligosaccharides, MOO), have exhibited significant pharmacological activities including anti-depressant, anti-dementia, and memory enhancement . Capsules of MOO mixtures have been approved in China as an oral prescribed drug for treating mild and moderate depression since 2012 …”

“…7 Capsules of MOO mixtures have been approved in China as an oral prescribed drug for treating mild and moderate depression since 2012. 8 Recent research has unraveled the correlation of MOO's antidepressant effects with the microbiota−gut−brain axis by regulating 5-HT synthesis in the gut microbiota. 9 More importantly, in-depth studies on every single component in MOO indicated that pentasaccharide exerted a significant antidepressant effect through the mechanism identical to that of the MOO mixture and may be the main anti-depressant constituent in MOO.…”