Creatine monohydrate in resistant depression: a preliminary study
Roitman S, Green T, Osher Y, Karni N, Levine J.
Ness Ziona Mental Health Center, Sackler Faculty of Medicine,
Tel Aviv University, Tel Aviv, Israel.
Bipolar Disord. 2007 Nov;9(7):754-8.


OBJECTIVES: Creatine plays a pivotal role in brain energy homeostasis, and altered cerebral energy metabolism may be involved in the pathophysiology of depression. Oral creatine supplementation may modify brain high-energy phosphate metabolism in depressed subjects. METHODS: Eight unipolar and two bipolar patients with treatment-resistant depression were treated for four weeks with 3-5 g/day of creatine monohydrate in an open add-on design. Outcome measures were the Hamilton Depression Rating Scale, Hamilton Anxiety Scale, and Clinical Global Impression scores, recorded at baseline and at weeks 1, 2, 3 and 4. RESULTS: One patient improved considerably after one week and withdrew. Both bipolar patients developed hypomania/mania. For the remaining seven patients, all scale scores significantly improved. Adverse reactions were mild and transitory. CONCLUSIONS: This small, preliminary, open study of creatine monohydrate suggests a beneficial effect of creatine augmentation in unipolar depression, but possible precipitation of a manic switch in bipolar depression.
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