Can Creatine Help With Depression? New Review Says Results Are Inconclusive

A caller systematic reappraisal finds that creatine whitethorn somewhat easiness depressive symptoms, but inconsistent results and low-quality grounds mean it’s excessively early to urge it arsenic a treatment.

Review: Creatine supplementation for treating symptoms of depression: a systematic reappraisal and meta-analysis. Image Credit: Bowonpat Sakaew / Shutterstock

In a caller study published successful the British Journal of Nutrition, researchers examined nan effects of creatine supplementation connected depressive symptoms.

Major depressive upset (MDD) is among nan starring causes of disablement and non-fatal wellness loss, affecting astir 280 cardinal individuals worldwide. Despite nan readiness of therapies, important unmet needs remain. For instance, galore group do not person capable curen owed to constricted wellness literacy, financial constraints, aliases stigma. Moreover, existent treatments often origin broadside effects, require semipermanent commitment, and do not supply satisfactory relief.

Biological Role of Creatine successful Brain Function

Creatine is wide utilized to amended sports performance. It plays a captious domiciled successful encephalon power homeostasis, and little creatine levels successful nan encephalon person been linked to depressive symptoms and therapeutic resistance. Notably, dietary intake of creatine is inversely associated pinch slump prevalence. Notwithstanding nan promising evidence, creatine is not presently recommended by awesome objective guidelines.

Research Objective and Database Search Strategy

In this study, researchers evaluated the efficacy of creatine supplementation connected depressive symptoms. The Cochrane Library, Web of Science, Medline, and Embase databases were searched for randomized controlled tests (RCTs) that included involution (creatine) and power (placebo) groups and reported outcomes connected depressive symptoms.

Study Design and Analytical Approach

Studies pinch co-interventions, specified arsenic exercise, psychotherapy, aliases antidepressants, were besides included, provided that some groups received nan intervention. Titles/abstracts were screened, followed by afloat matter reviews and information extraction. The squad performed pairwise meta-analyses utilizing random-effects models pinch Hartung-Knapp-Sidik-Jonkman adjustment.

Risk of Bias and Evidence Grading Methods

Risk of bias was assessed utilizing nan revised Cochrane Risk of Bias tool. Heterogeneity was evaluated utilizing I-squared statistics. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria were adopted to measure nan value of evidence.

Subgroup analyses were performed based connected nan consequence of bias and superior test of affective disorders.

Study Pool Characteristics and Intervention Details

The hunt protocol yielded 558 records. Following deduplication and title/abstract screening, afloat texts of 34 studies were analyzed. Of these, 11 studies were retained for analysis.

Most RCTs were small, pinch sample sizes ranging from 10 to 100 participants, and were conducted chiefly successful nan United States, followed by Brazil. All tests employed a parallel-group design, comparing oral creatine management pinch a placebo. The median regular dose of creatine was 5 grams crossed studies.

Creatine was prescribed based connected assemblage weight successful 2 trials. Two different tests progressive aggregate involution groups; 1 study tested 3 different creatine doses comparative to a azygous placebo dose, while nan different evaluated 2 creatine and 2 placebo doses.

Co-interventions included antidepressants successful 4 trials, electroconvulsive therapy successful 1 study, and psychotherapy successful 1 trial. The long of curen was mostly short-term (4–10 weeks).

Measured Outcomes and Quality Assessment

Six tests recruited group pinch an affective upset (bipolar upset aliases MDD), and nan remainder recruited different patient people. Depression symptomatology was measured utilizing due scales crossed trials, though their preferences were highly variable.

Six tests had a precocious consequence of bias overall, while only 1 proceedings had a debased consequence of bias. The meta-analyses revealed an relation betwixt creatine supplementation and a statistically important but mini simplification successful depressive symptoms.

However, location was important heterogeneity betwixt studies. The certainty of grounds was rated arsenic “very low” based connected nan GRADE criteria. Based connected 3 trials, nan results for slump remission were important successful favour of creatine.

A abstracted study of 2 tests connected curen response, however, recovered nary grounds of a quality compared to nan placebo. The authors noted that some findings were highly imprecise.

One proceedings reported value of life, and aft 5 years, some groups showed a clinically unimportant mean alteration of 0.1 points from baseline.

While immoderate tests recovered nary adverse events, others reported a somewhat accrued occurrence of gastrointestinal issues and mild elevations successful serum creatinine successful nan creatine group.

Subgroup and Bias Analyses

In subgroup analyses, nan affirmative effect was driven wholly by studies pinch a precocious consequence of bias, while higher-quality studies pinch a little consequence of bias showed a null effect. Furthermore, erstwhile nan researchers utilized a statistical method (the “trim and fill” method) to set for imaginable publication bias, nan corrected effect estimate was reduced to null, suggesting nan main uncovering is apt an overestimation. Effect sizes were besides larger successful studies that included populations pinch an affective upset compared to tests pinch patient individuals.

Summary of Findings and Clinical Implications

In sum, nan findings bespeak statistically important but not clinically important little slump scores pinch creatine supplementation compared to placebo. Depression symptomatology was astir 2.2 points little successful nan creatine groups, a simplification beneath nan period for objective meaningfulness and an effect nan authors statement whitethorn beryllium “undetectable by clinicians.”

While nan results mightiness propose a mini aliases mean use for group pinch depression, nan authors reason that nan grounds is very uncertain and nan existent effect whitethorn beryllium “trivial aliases null.” They powerfully be aware that nan observed use is apt biased owed to nan debased value of astir included studies and nan imaginable for unpublished antagonistic trials.

Therefore, larger and much rigorous RCTs are required for definitive conclusions, specifically tests that incorporated amended blinding methods (such arsenic masking biochemical trial results) and are designed to minimize nan effect of co-interventions.