Depression Clinical Trial
Official title:
Creatine as a Treatment Option for Depression in Methamphetamine Using Females
Methamphetamine (MA) is a psychostimulant drug with high abuse potential. MA can be smoked,
snorted, injected or ingested orally to produce a release of high levels of dopamine into
the brain and reduction of dopamine uptake. Its use results in feelings of pleasure,
increased energy, and greater alertness lasting up to 12 hours. In 2010, the National Survey
on Drug Use and Health reported that 353,000 Americans aged 12 or older reported being
current MA users. Over the past decade MA use rates have fluctuated with current use rates
on the decline; however, importantly, even though overall use rates are declining, use rates
among males and females are approaching equal proportions. This use rate pattern is unlike
other drugs of abuse, which typically demonstrate males using more than females. In some
states, more females than males consider MA as their drug of choice. Namely, in a 2010
report in the state of Utah, more females were diagnosed with MA as a primary substance of
abuse than males upon admission to treatment.
Depression and MA use are highly comorbid. The relationship between MA use and depression is
likely bidirectional, with MA use causing changes in mood and being used as a
self-medicating behavior to reduce symptoms of depression. Several studies have shown that
depression rates are higher in MA-using females compared to their male counterparts. It is
likely that neurobiological and psychosocial mechanisms contribute to increased incidence of
depressive symptoms in females.
No clear treatment model exists to suggest how the comorbidity of depression and MA use is
best managed. In studies of antidepressants for treatment of MA withdrawal and dependence,
findings have suggested that antidepressants are ineffective for treating depressive
symptoms.
Creatine is an organic acid occurring naturally in vertebrates, where it takes part in
energy homeostasis in tissues with fluctuating energy demands. Exogenous creatine has been
shown to increase brain concentrations of PCr. Neuroimaging studies of creatine have shown
increased brain phosphocreatine (PCr) content with creatine administration. Therefore, we
hypothesize that oral creatine administration will increase PCr levels and reduce depressive
symptoms in a sample of depressed female MA users. This hypothesis will be tested by a
within subjects design by giving depressed MA using females oral creatine for eight weeks
and measuring PCr pre- and post-treatment with magnetic resonance spectroscopy. Moreover,
depressive symptoms will be measured by administration of the Hamilton Depression Rating
Scale twice weekly during the course of creatine treatment.
n/a
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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