Creatine's effects on brain energy metabolism raise the possibility of developing a new therapeutic strategy in depression focusing on the treatment of metabolic hypoactive brain areas. Previous creatine augmentation studies in patients with major depression showed a beneficial effect. Eighteen patients (14 women) with major depression not responding to previous 3 weeks of antidepressant treatment were enrolled into a pilot, dose finding, 4-week double-blind parallel augmentation study where creatine monohydrate 5 or 10 g daily or placebo was added to ongoing SSRIs/SNRIs/NASA treatment. Rating scales included the Hamilton Depression Rating Scale and the Clinical Global Impression Severity scale. Overall, there was no difference between creatine administered at 5 or 10 g daily and its corresponding placebos. Two female patients on creatine augmentation, but none on the placebo, showed early improvement of more than 50% reduction in Hamilton Depression Rating Scale after 2 weeks of creatine treatment. No clinically relevant side effects were reported. This preliminary study seems to suggest that the strategy using creatine augmentation in major depressive women showing no 'real-life response' to 3 weeks of treatment with SSRIs/SNRIs/NASA treatment is of no advantage compared with placebo. However, such creatine augmentation may still induce a more rapid response in a small subgroup of these female patients.

译文

肌酸对大脑能量代谢的影响增加了开发一种新的抑郁症治疗策略的可能性,重点是治疗代谢减退的大脑区域。先前对重度抑郁症患者进行的肌酸增强研究显示出有益的效果。18名严重抑郁症患者 (14名女性) 对之前3周的抗抑郁药治疗无反应,参加了一项试点,剂量发现,为期4周的双盲平行增强研究,其中将每日5或10g的肌酸一水合物或安慰剂添加到正在进行的SSRIs/SNRIs/NASA治疗中。评分量表包括汉密尔顿抑郁评分量表和临床全球印象严重程度量表。总体而言,每天5或10g的肌酸与其相应的安慰剂之间没有差异。两名接受肌酸增强治疗的女性患者,但安慰剂组无一例,在2周肌酸治疗后,汉密尔顿抑郁量表的早期改善幅度超过50%。没有临床相关副作用的报道。这项初步研究似乎表明,与安慰剂相比,在严重抑郁症女性中使用肌酸增强的策略对SSRIs/SNRIs/NASA治疗3周没有 “现实反应”。但是,这种肌酸增强仍可能在这些女性患者的一小部分中引起更快的反应。

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