PRP in psychiatry: What research currently shows about depression and anxiety disorders
Platelets, inflammatory signalling and neurotrophic factors are relevant to psychiatric research. So far, however, this has not resulted in an evidence-based PRP treatment.
Why the topic is scientifically interesting
Depression and anxiety disorders are complex conditions. Psychological stress, social circumstances, genetic factors and different biological processes may interact. There is no single universal cause.
Altered inflammatory markers can be observed in some people with depressive disorders. Research therefore examines whether immune processes contribute to symptoms or poorer treatment response in certain patient groups. This does not mean that depression is generally an inflammatory disease.
Platelets, BDNF and inflammatory signals
Platelets are involved in more than blood clotting. They store serotonin, growth factors, BDNF and various inflammatory mediators. For this reason, they have long been studied as possible peripheral biomarkers in depressive disorders.
BDNF, brain-derived neurotrophic factor, contributes to neuronal plasticity and nerve-cell function. A substantial proportion of measurable BDNF in blood is found in platelets. This does not mean that administering PRP therapeutically increases BDNF levels in the brain.
What is known
Platelets store BDNF and other biologically active factors.
What does not follow
That PRP has antidepressant or anxiolytic effects, or reaches effective concentrations in the brain.
What animal studies show — and what they do not
Some preclinical studies have examined PRP in models of neurological injury. A frequently cited study used rats with experimentally induced bile duct ligation. The model causes liver injury, metabolic changes and cognitive impairment. After PRP treatment, changes in memory performance, neuronal apoptosis and synaptic plasticity were reported.
Other animal models concern traumatic, toxic or radiation-induced brain injury. Such findings may provide clues about biological mechanisms. They do not answer whether PRP is effective in primary depression, generalised anxiety disorder, panic disorder or social anxiety disorder.
An animal model can show
- whether a biological effect can be measured in principle,
- which signalling pathways may be involved,
- which risks require further study.
An animal model cannot prove
- clinical efficacy in depression,
- an anxiolytic effect in humans,
- a safe dose or route of administration.
The blood-brain barrier
For components of a PRP preparation to act directly on nerve cells in the brain, they would first have to reach the target tissue. The blood-brain barrier restricts the passage of many proteins and larger molecules from the blood into the central nervous system.
It remains unclear:
- which PRP components could reach the brain at all,
- what concentrations would be achieved,
- whether possible effects would be beneficial, ineffective or harmful,
- which route of administration could be acceptable.
PRP is not a uniform preparation
PRP preparations can differ considerably depending on the system and processing method. Variables include platelet concentration, leukocyte content, residual red blood cells, plasma volume and activation method.
Psychiatric research would therefore first require precise standardisation. Without a defined composition, results from different studies can hardly be compared meaningfully.
Material-related variables
Starting blood, anticoagulant, separation system, centrifugation and activation influence the final preparation.
Biological variables
Age, disease, medication and individual platelet function may further alter the composition.
No robust evidence of efficacy in depression or anxiety disorders
There is currently no robust controlled clinical evidence that PRP is effective as a targeted treatment for a depressive or anxiety disorder. Consequently, there are no accepted specifications for dose, preparation, route of administration, frequency or long-term safety.
Intravenous infusions, intranasal use, subcutaneous injections or freely proposed treatment series must therefore not be presented as established psychiatric procedures.
What research would be required
Before clinical use could be discussed, active components, distribution in the body, possible target structures and risks would need to be studied systematically.
What the current evidence means in practice
People with depression or anxiety disorders should not regard PRP as a scientifically proven treatment. Existing treatment should not be stopped without medical advice or replaced by an experimental application.
Specialist medical or psychotherapeutic assessment is particularly important in severe, recurrent or treatment-resistant illness. Immediate professional emergency help is required in the event of acute risk of self-harm or marked deterioration.
Frequently asked questions
Can PRP treat depression?
Can PRP relieve anxiety disorders?
Does PRP contain BDNF?
Is intranasal or intravenous administration recognised?
Is PRP inherently safe because it is autologous?
Scientific sources and guidelines
Arosio M. et al. Effects of platelet-rich plasma on memory impairment, apoptosis and synaptic plasticity in a rat model of bile duct ligation. Journal of Neuroinflammation, 2021. Open source
Beurel E., Toups M., Nemeroff C. B. The bidirectional relationship of depression and inflammation. Neuron, 2020. Open source
Serra-Millàs M. Are changes in peripheral BDNF levels due to platelet activation? World Journal of Psychiatry, 2016. Open source
Nationale Versorgungsleitlinie Unipolare Depression, Version 3.2. Open source
NICE CG113: Generalised anxiety disorder and panic disorder in adults. Open source