Creatine as a Novel Treatment for Depression in Females Using Methamphetamine: A Pilot Study.
Creatine as a Novel Treatment for Depression in Females Using Methamphetamine: A Pilot Study.
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DOI：
10.1080/15504263.2015.1100471
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发表时间：
2015
影响因子：
2.2
通讯作者：
Renshaw PF
中科院分区：
文献类型：
--
作者：
Hellem TL;Sung YH;Shi XF;Pett MA;Latendresse G;Morgan J;Huber RS;Kuykendall D;Lundberg KJ;Renshaw PF
甲基苯丙胺使用者的抑郁症在女性中比男性更普遍，但尚未描述这种合并症的性别特异性治疗方案。与男性相比，女性甲基苯丙胺使用者的脑磷酸肌酸水平降低，相关研究表明，难治性抑郁症与脑磷酸肌酸浓度降低之间存在相关性。据报道，营养补充剂肌酸一水合物可减轻服用抗抑郁药的女性青少年和成年人的抑郁症状，并增加健康志愿者的脑磷酸肌酸。因此，本初步研究的目的是调查肌酸一水合物作为女性甲基苯丙胺使用者抑郁症的治疗。14名患有抑郁症和共病甲基苯丙胺依赖的女性参加了一项为期8周的开放标签试验，每天服用5克肌酸一水合物，其中11名女性完成了研究。采用汉密尔顿抑郁评定量表（HAMD）测量抑郁，采用肌酸治疗前后的磷磁共振波谱法测量脑磷酸肌酸水平。次要结果指标包括焦虑症状，用贝克焦虑量表（BAI）测量，以及甲基苯丙胺的使用，每周两次尿液药物筛查和自我报告的使用进行监测。线性混合效应重复测量模型的结果显示，与基线评分相比，早在第2周，HAMD和BAI评分就显著降低。这种改善一直维持到研究完成。与基线扫描相比，第二次磷磁共振波谱扫描时的脑磷酸肌酸浓度较高; M基线= 0.223（SD = 0.013）vs. M治疗后= 0.233（SD = 0.009），t（9）= 2.905，p <0.01，表明肌酸增加了磷酸肌酸水平。此外，到第6周观察到甲基苯丙胺阳性尿液药物筛查减少超过50%。最后，肌酸耐受性良好，与胃肠道症状和肌肉痉挛相关的不良事件被确定为可能与肌酸相关。目前的研究表明，肌酸治疗可能是一个有前途的治疗方法，女性抑郁症和共病甲基苯丙胺依赖。本研究在clinicaltrials.gov上注册（NCT 01514630）。
Depression among methamphetamine users is more prevalent in females than males, but gender specific treatment options for this comorbidity have not been described. Reduced brain phosphocreatine levels have been shown to be lower in female methamphetamine users compared to males, and, of relevance, studies have demonstrated an association between treatment resistant depression and reduced brain phosphocreatine concentrations. The nutritional supplement creatine monohydrate has been reported to reduce symptoms of depression in female adolescents and adults taking antidepressants, as well as to increase brain phosphocreatine in healthy volunteers. Therefore, the purpose of this pilot study was to investigate creatine monohydrate as a treatment for depression in female methamphetamine users. Fourteen females with depression and comorbid methamphetamine dependence were enrolled in an 8 week open label trial of 5 grams of daily creatine monohydrate and of these 14, eleven females completed the study. Depression was measured using the Hamilton Depression Rating Scale (HAMD) and brain phosphocreatine levels were measured using phosphorus magnetic resonance spectroscopy pre- and post-creatine treatment. Secondary outcome measures included anxiety symptoms, measured with the Beck Anxiety Inventory (BAI), as well as methamphetamine use, monitored by twice weekly urine drug screens and self-reported use. The results of a linear mixed effects repeated measures model showed significantly reduced HAMD and BAI scores as early as week 2 when compared to baseline scores. This improvement was maintained through study completion. Brain phosphocreatine concentrations were higher at the second phosphorus magnetic resonance spectroscopy scan compared to the baseline scan; Mbaseline = 0.223 (SD = 0.013) vs. Mpost-treatment = 0.233 (SD = 0.009), t(9) = 2.905, p < .01, suggesting that creatine increased phosphocreatine levels. Also, a reduction in methamphetamine positive urine drug screens of greater than 50% was observed by week 6. Finally, creatine was well tolerated and adverse events that were related to gastrointestinal symptoms and muscle cramping were determined as possibly related to creatine. The current study suggests that creatine treatment may be a promising therapeutic approach for females with depression and comorbid methamphetamine dependence. This study is registered on clinicaltrials.gov (NCT01514630).