Citation

Kondo DG, Sung YH, Hellem TL, Fiedler KK, Shi X, Jeong EK, Renshaw PF. J. Affect. Disord. 2011; 135(1-3): 354-361.

Copyright

(Copyright © 2011, Elsevier Publishing)

DOI

10.1016/j.jad.2011.07.010

PMID

21831448

PMCID

PMC4641570

Abstract

BACKGROUND: Adolescent major depressive disorder (MDD) is a life-threatening brain disease with limited interventions. Treatment resistance is common, and the illness burden is disproportionately borne by females. 31-Phosphorus magnetic resonance spectroscopy ((31)P MRS) is a translational method for in vivo measurement of brain energy metabolites.
METHODS: We recruited 5 female adolescents who had been on fluoxetine (Prozac®) for ≥ 8 weeks, but continued meet diagnostic criteria for MDD with a Children's Depression Rating Scale-Revised (CDRS-R) raw score ≥ 40. Treatment response was measured with the CDRS-R. (31)P MRS brain scans were performed at baseline, and repeated following adjunctive creatine 4 g daily for 8 weeks. For comparison, 10 healthy female adolescents underwent identical brain scans performed 8 weeks apart.
RESULTS: The mean CDRS-R score declined from 69 to 30.6, a decrease of 56%. Participants experienced no Serious Adverse Events, suicide attempts, hospitalizations or intentional self-harm. There were no unresolved treatment-emergent adverse effects or laboratory abnormalities. MDD participants' baseline CDRS-R score was correlated with baseline pH (p=0.04), and was negatively correlated with beta-nucleoside triphosphate (β-NTP) concentration (p=0.03). Compared to healthy controls, creatine-treated adolescents demonstrated a significant increase in brain Phosphocreatine (PCr) concentration (p=0.02) on follow-up (31)P MRS brain scans.
LIMITATIONS: Lack of placebo control; and small sample size.
CONCLUSIONS: Further study of creatine as an adjunctive treatment for adolescents with SSRI-resistant MDD is warranted.

Language: en

Keywords

Humans; Female; Adolescent; Magnetic Resonance Imaging; Treatment Outcome; Follow-Up Studies; Antidepressive Agents; Depressive Disorder; Fluoxetine; Phosphorus; Depressive Disorder, Major; Magnetic Resonance Spectroscopy; Creatine; Selective Serotonin Reuptake Inhibitors; Radionuclide Imaging; Magnetics; Phosphocreatine