期刊
AMERICAN JOURNAL OF PSYCHIATRY
卷 169, 期 9, 页码 937-945出版社
AMER PSYCHIATRIC PUBLISHING, INC
DOI: 10.1176/appi.ajp.2012.12010009
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资金
- AstraZeneca
- Boryung
- Eli Lilly
- GlaxoSmithKline
- Lundbeck
- Organon
- Roche
- NARSAD from the Brain Research Center of the 21st Century Frontier Research Program [2011K000273]
- Global Research Network Program, the Korea Research Foundation [KRF-2008-220-E00021]
- Mental Illness Research, Education and Clinical Center of Veterans Integrated Service Network 19
- National Institute on Drug Abuse [DA-015116, DA-031247, DA-024070]
- NIMH [MH-058681]
Objective: Antidepressants targeting monoaminergic neurotransmitter systems, despite their immediate effects at the synaptic level, usually require several weeks of administration to achieve clinical efficacy. The authors propose a strategy of adding creatine monohydrate (creatine) to a selective serotonin reuptake inhibitor (SSRI) in the treatment of patients with major depressive disorder. Such augmentation may lead to a more rapid onset of antidepressant effects and a greater treatment response, potentially by restoring brain bioenergetics at the cellular level. Method: Fifty-two women with major depressive disorder were enrolled in an 8-week double-blind placebo-controlled clinical trial and randomly assigned to receive escitalopram in addition to either creatine (5 g/day, N=25) or placebo (N=27). Efficacy was primarily assessed by changes in the Hamilton Depression Rating Scale (HAM-D) score. Results: In comparison to the placebo augmentation group, patients receiving creatine augmentation showed significantly greater improvements in HAM-D score, as early as week 2 of treatment. This differential improvement favoring creatine was maintained at weeks 4 and 8. There were no differences between treatment groups in the proportion of patients who discontinued treatment prematurely (creatine: N=8, 32.0%; placebo: N=5, 18.5%) or in the overall frequency of all reported adverse events (creatine: 36 events; placebo: 45 events). Conclusions: The current study suggests that creatine augmentation of SSRI treatment may be a promising therapeutic approach that exhibits more rapid and efficacious responses in women with major depressive disorder.
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