Creatine is mainly known as a supplement associated with muscle development, but it is also being studied as a possible aid in the treatment of depression, due to its potential role in the energy metabolism of brain cells.
In a new one, published this Tuesday in Brain Medicineresearchers analyzed six scientific reports relating to five randomized clinical trials, which involved a total of 238 participants. The results, however, were mixed.
Two of the trials, both conducted in women with major depressive disorder, concluded that adding creatine to usual care was associated with improvements in depressive symptoms. The remaining three found no statistically significant differences between participants who received creatine and those who received placebo.
According to , four trials focused on people with major depressive disorder, while one involved participants with bipolar disorder going through a depressive episode. The majority of participants were female and two studies included only women.
In one of the trials with positive results, participants took five grams of creatine per day in conjunction with the antidepressant escitalopram. After eight weeks, they recorded a greater reduction in depressive symptoms than participants who received escitalopram and placebo.
In another study, creatine was combined with cognitive behavioral therapy. Here too, participants who received the supplement showed a greater improvement in symptoms.
The remaining trials, however, did not confirm these benefits. Creatine did not show a statistically significant advantage in people whose depression had not responded to medication, in female adolescents, or in participants with bipolar disorder in a depressive episode.
In this last group, researchers also highlighted a safety concern. Two participants who received creatine developed manic or hypomanic episodes. Although the adverse effects described in the review were, in general, mild, this data reinforces the need for caution, especially in people with bipolar disorder.
The authors emphasize that the available evidence remains insufficient to recommend the routine use of creatine in the treatment of depression. The trials analyzed were small, had methodological differences and included a high proportion of women.
Therefore, although creatine shows potential as a complementary treatment, larger, longer studies with more robust methodologies will be needed to confirm its efficacy and safety before it can be recommended in clinical practice.
