Journal
JOURNAL OF CLINICAL PSYCHOPHARMACOLOGY
Volume 37, Issue 5, Pages 578-583Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/JCP.0000000000000754
Keywords
altitude; brain bioenergetics; hypobaric hypoxia; major depressive disorder; serotonin
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Funding
- R. Harold Burton Foundation (Salt Lake City, UT)
- Utah Science, Technology, and Research Initiative (Salt Lake City, UT)
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Purpose: Many women with major depressive disorder (MDD) respond inadequately to standard treatments. Augmentation of conventional antidepressants with creatine monohydrate and 5-hydroxytryptophan (5-HTP) could correct deficits in serotonin production and brain bioenergetics associated with depression in women, yielding synergistic benefit. We describe an open-label study of 5-HTP and creatine augmentation in women with MDD who had failed selective serotonin reuptake inhibitor (SSRI) or serotonin-norepinephrine reuptake inhibitor (SNRI) monotherapy. Methods: Fifteen women who were adequately adherent to an SSRI or SNRI and currently experiencing MDD, with a 17-item Hamilton Depression Rating Scale (HAM-D) score of 16 or higher, were treated with 5 g of creatine monohydrate daily and 100 mg of 5-HTP twice daily for 8 weeks, with 4weeks of posttreatment follow-up. The primary outcomewas change in mean HAM-D scores. Results: Mean HAM-D scores declined from 18.9 (SD, 2.5) at pretreatment visits to 7.5 (SD, 4.4) (P < 0.00001), a decrease of 60%. Participants did not experience any serious treatment-related adverse events. Conclusions: Combination treatment with creatine and 5-HTP may represent an effective augmentation strategy for women with SSRI-or SNRI-resistant depression. Given the limitations of this small, open-label trial, future study in randomized, placebo-controlled trials is warranted.
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