Kious Brent M, Sabic Hana, Sung Young-Hoon, Kondo Douglas G, Renshaw Perry
From the *Department of Psychiatry and †Brain Institute, University of Utah; and ‡Veterans Integrated Service Network 19 Mental Illness Research Education Clinical, Centers of Excellence, Salt Lake City Veterans Affairs Medical Center, Salt Lake City, UT.
J Clin Psychopharmacol. 2017 Oct;37(5):578-583. doi: 10.1097/JCP.0000000000000754.
Many women with major depressive disorder (MDD) respond inadequately to standard treatments. Augmentation of conventional antidepressants with creatine monohydrate and 5-hydroxytryptophan (5-HTP) could correct deficits in serotonin production and brain bioenergetics associated with depression in women, yielding synergistic benefit. We describe an open-label study of 5-HTP and creatine augmentation in women with MDD who had failed selective serotonin reuptake inhibitor (SSRI) or serotonin-norepinephrine reuptake inhibitor (SNRI) monotherapy.
Fifteen women who were adequately adherent to an SSRI or SNRI and currently experiencing MDD, with a 17-item Hamilton Depression Rating Scale (HAM-D) score of 16 or higher, were treated with 5 g of creatine monohydrate daily and 100 mg of 5-HTP twice daily for 8 weeks, with 4 weeks of posttreatment follow-up. The primary outcome was change in mean HAM-D scores.
Mean HAM-D scores declined from 18.9 (SD, 2.5) at pretreatment visits to 7.5 (SD, 4.4) (P < 0.00001), a decrease of 60%. Participants did not experience any serious treatment-related adverse events.
Combination treatment with creatine and 5-HTP may represent an effective augmentation strategy for women with SSRI- or SNRI-resistant depression. Given the limitations of this small, open-label trial, future study in randomized, placebo-controlled trials is warranted.
许多患有重度抑郁症（MDD）的女性对标准治疗反应不佳。用一水肌酸和5-羟色氨酸（5-HTP）增强传统抗抑郁药可以纠正与女性抑郁症相关的血清素生成和脑生物能学缺陷，产生协同效益。我们描述了一项对患有MDD且选择性5-羟色胺再摄取抑制剂（SSRI）或5-羟色胺-去甲肾上腺素再摄取抑制剂（SNRI）单药治疗失败的女性进行5-HTP和肌酸增强治疗的开放标签研究。
15名充分坚持服用SSRI或SNRI且目前患有MDD、17项汉密尔顿抑郁量表（HAM-D）评分为16分或更高的女性，每天接受5克一水肌酸和每天两次100毫克5-HTP治疗，为期8周，并进行4周的治疗后随访。主要结局是HAM-D平均评分的变化。
HAM-D平均评分从治疗前访视时的18.9（标准差，2.5）降至7.5（标准差，4.4）（P < 0.00001），下降了60%。参与者未经历任何严重的治疗相关不良事件。
肌酸和5-HTP联合治疗可能是对SSRI或SNRI耐药抑郁症女性的一种有效增强策略。鉴于这项小型开放标签试验的局限性，有必要在随机、安慰剂对照试验中进行进一步研究。
