Creatine increases the antidepressant efficacy of cognitive-...
Nicholas Fabiano, MD@NTFabiano
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Jan 28, 2025
~1 min read
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Creatine increases the antidepressant efficacy of cognitive-behavioural therapy.
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These findings are from a study in @els_psychiatry which investigated the 8-week effects of creatine in addition to cognitive-behavioural therapy (CBT) versus placebo plus CBT in depression. sciencedirect.com/science/articl… 2/10
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Creatine monohydrate (creatine) is a safe and inexpensive nutraceutical (i.e., a subset of food such as dietary supplements) that can reach the central nervous system. 3/10
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Aside from being naturally present in food (milk, meat, fish), endogenous creatine is synthesised in the liver and in the brain, where it is normally stored in high concentrations and serves important functions for its energy metabolism. 4/10
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Altered regulation of brain energy stores, especially in the form of low creatine levels, has been associated with both depressive symptoms and resistance to pharmacological or behavioural treatments in animals and humans. 5/10
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Furthermore, creatine is a neuroprotective agent, and modulates neuroreceptors (serotonin, noradrenaline, dopamine, adenosine, N-methyl-d-aspartate [NMDA]) implicated in depression while also interacting with established antidepressant medications. 6/10
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In this study, 100 participants (50 females, mean age= 30.4 ± 7.4 years) with depression (mean PHQ-9 = 17.6 ± 6.3) were randomised to either creatine+CBT (N = 50) or placebo+CBT (N = 50). 7/10
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At 8 weeks, PHQ-9 scores were lower in both study arms, but significantly more so in participants taking creatine (mean difference= -5.12). 8/10
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Treatment discontinuations due to any cause and to adverse events, and proportion of participants with at least one adverse event were comparable between study arms. 9/10
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Overall, these results suggest that creatine could be a useful and safe supplement to CBT for depression, however, longer and larger clinical trials are warranted. 10/10
