32% of the creatine group improved significantly by week 2, and 68% by week 4; half were symptom free by week 8 (second trial now recruiting)
Women battling stubborn major depression may have a surprising new ally in their fight - the inexpensive muscle-building dietary supplement creatine (creatine monohydrate).
In a new proof-of-concept study, researchers from three South Korean universities and the University of Utah report that women with major depressive disorder (MDD) who augmented their daily antidepressant with 5 grams of creatine:
• Responded twice as fast,
• And experienced remission of the illness at twice the rate of women who took the antidepressant alone.
These findings, published Aug. 1, 2012, by the American Journal of Psychiatry online, means that taking creatine under a doctor’s supervision could provide a relatively inexpensive way for women who haven’t responded well to SSRI (selective serotonin reuptake inhibitor) antidepressants to improve their treatment outcomes.
“If we can get people to feel better more quickly, they’re more likely to stay with treatment and, ultimately, have better outcomes,” says senior author Perry F. Renshaw, MD, PhD, professor of psychiatry at the University of Utah Medical School.
If these initial study results are borne out by further, larger trials, the benefits of taking creatine could directly affect many people struggling with major depression.
This would be particularly relevant for the state of Utah, Dr. Renshaw notes (where the depression incidence rate is particularly “crippling and common” - roughly 25% higher than for the rest of the U.S., amounting to an estimated yearly cost in treatment and lost productivity of $1.3 billion as of 2008).
Creatine, Stored in Muscle, Supplies ATP During Exercise
Creatine is an amino acid made in the human liver, kidneys, and pancreas. It also is found in meat and fish (and is in fact named after the Greek word for meat, kreas).
• Inside the body it is converted into phosphocreatine and stored in muscle.
• During high-intensity exercise, phosphocreatine is converted into ATP, an important energy source for cells.
• For this reason, creatine has become a popular supplement among bodybuilders and athletes who are trying to add muscle mass or improve athletic ability.
The Benefit May Lie in Creatine's Pro-Energetic Influence
How creatine works against depression is not precisely known, but Dr. Renshaw and his colleagues suggest that the pro-energetic effect of creatine supplementation, including the making of more phosphocreatine, may contribute to the earlier and greater response to antidepressants.
The eight-week study included 52 South Korean women, ages 19 to 65, with major depressive disorder.
• All the women took the antidepressant Lexapro (escitalopram) during the trial.
• Twenty-five of the women received creatine with the Lexapro and 27 were given a placebo. The trial was ‘double-blinded’ (neither the study participants nor the researchers knew who received creatine or placebo).
• Eight women in the creatine group and five in the placebo group did not finish the trial, leaving a total of 39 participants.
• Participants were interviewed at the start of the trial to establish baselines for their depression, and then were checked at two, four, and eight weeks to see how they’d responded to Lexapro plus creatine or Lexapro and a placebo.
• The researchers used three measures to check the severity of depression, with the primary outcomes being measured by the Hamilton Depression Rating Scale (HDRS), a widely accepted test.
The group that received creatine showed significantly higher improvement rates on the HDRS at 2 and 4 weeks (32% at 2 weeks and 68% at 4 weeks) compared to the placebo group (3.7% and 29%).
At the end of eight weeks, half of those in the creatine group showed no signs of depression compared with one-quarter in the placebo group. There were no significant adverse side effects associated with creatine.
The Faster an Antidepressant Works, the Better the Outcome
Antidepressants typically don’t start to work until four to six weeks. But research shows that the sooner an antidepressant begins to work, the better the treatment outcome, and that’s why Dr. Renshaw and his colleagues are excited about the results of this first study. “Getting people to feel better faster is the Holy Grail of treating depression,” he says.
Already Recommending Creatine for Some Patients
Study co-author Tae-Suk Kim, MD, PhD, associate professor of psychiatry at the Catholic University of Korea College of Medicine and visiting associate professor of psychiatry at the University of Utah, already is recommending creatine for some of his female depression patients.
In prior studies, creatine had been shown to be effective only in female rats. But that shouldn’t rule out testing the supplement in men as well, Dr. Renshaw says.
Will Recruit Teen & College Students for Next Trial
University of Utah researchers expect soon to begin another trial to test creatine in adolescent and college-age females who have not responded to SSRI medications.
Principal investigator Douglas G. Kondo, MD, assistant professor of psychiatry, says he is looking for 40 females between the ages of 13 and 21. Recruitment of participants will begin as soon as the U of Utah Institutional Review Board approves the study, expected this summer.
After the initial eight weeks of treatment, study participants will be offered a six-month extension of close supervision and monitoring by the research team and board-certified child, adolescent, and adult psychiatrist at no charge.
Those interested in joining the study can call (801) 587-1549; visit the study Web site www.UtahBrain.org; or email Doug.Kondo@hsc.utah.edu.
Source: Based on University of Utah Health Sciences press release, Aug 8, 2012
Note: This information has not been reviewed by the FDA. It is general information and should not be interpreted as a substitute for the attention and advice of a healthcare professional. It is very important that you make no change in your healthcare plan or health support regimen without researching and discussing it in collaboration with your professional healthcare team.