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Efficacy and safety profile of oral creatine monohydrate in add-on to cognitive-behavioural therapy in depression: An 8-week pilot, double-blind, randomised, placebo-controlled feasibility and exploratory trial in an under-resourced area.

European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology
January 1, 2025
Nima Norbu Sherpa et al. (6 authors)
Journal ArticleRandomized Controlled TrialHuman StudyClinical
Study Details

Study Goal

The researchers aimed to investigate whether creatine monohydrate, as an adjunct to cognitive-behavioral therapy (CBT), could improve depression symptoms compared to placebo plus CBT.

Results Summary

Participants taking creatine showed significantly greater reduction in depression scores (PHQ-9) compared to placebo, with comparable rates of adverse events and treatment discontinuations between groups. The study suggests creatine may be a useful and safe supplement to CBT for depression.

Population

100 participants (50 females, mean age 30.4 ± 7.4 years) with depression (mean PHQ-9 score 17.6 ± 6.3).

Effective Dosage

Not specified

Duration

8 weeks

Interactions

None mentioned

Extracted Claims (7)
InterventionDirectionEndpointPopulationDosageImpactClaim #
creatine monohydrate
neutral
-
-
-
could be a useful adjunct to conventional antidepressant treatments
#1
creatine in addition to cognitive-behavioural therapy (CBT)
decrease
Patient Health Questionnaire-9 depression score
participants with depression
-
PHQ-9 scores were lower
#2
creatine in addition to cognitive-behavioural therapy (CBT)
decrease
Patient Health Questionnaire-9 depression score
participants with depression
mean difference= -5.12
significantly more so in participants taking creatine
#3
creatine in addition to cognitive-behavioural therapy (CBT)
no change
acceptability (any-cause dropouts)
participants with depression
-
Treatment discontinuations due to any cause were comparable
#4
creatine in addition to cognitive-behavioural therapy (CBT)
no change
tolerability (dropouts for adverse events)
participants with depression
-
dropouts for adverse events were comparable
#5
creatine in addition to cognitive-behavioural therapy (CBT)
no change
safety (patients experiencing one or more adverse events)
participants with depression
-
proportion of participants with at least one adverse event were comparable
#6
creatine
neutral
-
participants with depression
-
could be a useful and safe supplement to CBT for depression
#7
Abstract

Pre-clinical and clinical evidence proposes that creatine monohydrate, an affordable nutraceutical, could be a useful adjunct to conventional antidepressant treatments. In this pilot feasibility and exploratory study, we investigate the 8-week effects of creatine in addition to cognitive-behavioural therapy (CBT) versus placebo plus CBT in depression. For the primary efficacy outcome of change in Patient Health Questionnaire-9 depression score at study endpoint, we used mixed-model repeated measures analysis of covariance. Logistic regressions were employed to assess acceptability (any-cause dropouts), tolerability (dropouts for adverse events), and safety (patients experiencing one or more adverse events). We calculated effect sizes adjusted for age, sex, and baseline depression score. One-hundred 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). At 8 weeks, PHQ-9 scores were lower in both study arms, but significantly more so in participants taking creatine (mean difference= -5.12). 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. This hypothesis-generating trial suggests that creatine could be a useful and safe supplement to CBT for depression. Longer and larger clinical trials are warranted.

Medical Subject Headings (MeSH)
HumansFemaleCreatineMaleAdultDouble-Blind MethodPilot ProjectsCognitive Behavioral TherapyFeasibility StudiesTreatment OutcomeCombined Modality TherapyYoung AdultAdministration, OralDepressionMiddle Aged
Study Links
Quality Scores
Safety85
Efficacy75/10
Quality80/10
Citation Metrics
Total Citations4
Citations/Year4.0
Research Impact Scores
APT Score0.05
Weight Score3.02
Normalized Score0.80
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