Creatine for Depression in Women

In a small study of depressed women the dietary supplement creatine significantly boosted the response to an SSRI (serotonin antidepressant).

Creatine is an amino acid that is made from other amino acids in the body, so it is not considered an essential amino acid – meaning one that you have to get from diet.

Creatine is widely used by body builders. Americans use more than 2 million pounds of it last year.  Studies find that supplementation with creatine can increase performance in weight training exercises by 5 – 15%. There are some studies that suggest it might help people with muscle atrophy from injury or in older adults, however these results are not consistent.

When muscles are used in weight training exercises the source of energy for the work that they do is a molecule called ATP. However ATP is quickly (within seconds) used up. The fastest way to restore levels of ATP is by using phosphocreatine. How creatine is thought to help boost short term muscle strength is by increasing the amount of phosphocreatine in muscles.

Think of ATP as like the battery in your cell phone – it is what makes muscles work. Phosphocreatine is like a battery booster, it can restore energy when the main source of energy gets used up.

However, both ATP and phosphocreatine get used up pretty quickly, so the booster is not helpful in aerobic or endurance workouts (running, cycling, etcetera).

Research on depression has consistently found that depressed brains are less active than non-depressed brains. Other research has suggested that improvements in depressive symptoms and response to antidepressants are linked to brains that are more energetic.

Creatine has been shown to boost brain phosphocreatine, just as it boosts muscle phosphocreatine. And two studies found that creatine helped cognitive performance and mood in people who were sleep deprived.

Why this might work is a little bit confusing since brain activity does not depend on anaerobic metabolism (it is more like the muscle activity in running than the bursts of activity in weight lifting).

Based on studies that found that creatine helped in female rats who were in a state that looks similar to human depression, researchers tried creatine supplementation in women who were depressed and were also started at the same time on an SSRI (serotonin antidepressant). In the study the addition of creatine (5 grams per day) resulted in faster and more complete antidepressant responses to the antidepressant. This was a small study but the results were pretty impressive (see drawing to the right).

In general creatine supplementation appears to be safe, the main concern is in people with kidney or renal disease. Consumers Lab, which is the only reliable source of information about the quality of dietary supplements, finds that creatine powders are of good quality, but it found that both of the creatine liquid supplements it tested did not meet its quality standards. The supplements that we show below all met CL standards.

Creatine appears to be most helpful in people with low levels of the amino acid, for instance in vegetarians.