@article{ref1,
title="Open-label adjunctive creatine for female adolescents with SSRI-resistant major depressive disorder: a 31-phosphorus magnetic resonance spectroscopy study",
journal="Journal of affective disorders",
year="2011",
author="Kondo, Douglas G. and Sung, Young-Hoon and Hellem, Tracy L. and Fiedler, Kristen K. and Shi, Xianfeng and Jeong, Eun-Kee and Renshaw, Perry F.",
volume="135",
number="1-3",
pages="354-361",
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.<p /><p>Language: en</p>",
language="en",
issn="0165-0327",
doi="10.1016/j.jad.2011.07.010",
url="http://dx.doi.org/10.1016/j.jad.2011.07.010"
}