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

肌酸对脑能量代谢的影响增加了开发针对抑郁症的新治疗策略的可能性,这种治疗策略的重点是代谢性脑功能低下区域的治疗。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名重度抑郁症患者(14名女性)对之前的3周抗抑郁药治疗无反应,参加了一项试点,剂量确定,为期4周的双盲平行增强研究,其中将每天5或10 g的肌酸一水合物或安慰剂加入治疗中SSRI / SNRIs / NASA处理。评分量表包括汉密尔顿抑郁量表和临床总体印象严重度量表。总体而言,每天服用5或10 g肌酸与其相应的安慰剂之间没有差异。两名接受肌酸补充治疗的女性患者,但未接受安慰剂治疗的女性患者,在接受肌酸治疗2周后,汉密尔顿抑郁评估量表降低了50%以上。没有临床相关副作用的报道。这项初步研究似乎表明,在服用SSRIs / SNRIs / NASA治疗3周的主要抑郁症妇女中没有显示出“现实生活中的反应”的情况下,使用肌酸增强疗法与安慰剂相比没有优势。但是,在这些女性患者的一小部分亚组中,这种肌酸的增加仍可能引起更快的反应。

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