Cognitive Effects of Creatine Monohydrate Adjunctive Therapy in Patients With Bipolar Depression: Results From a Randomized, Double-Blind, Placebo-Controlled Trial

• Published in: Journal of affective disorders Vol. 224; pp. 69 - 75
• Main Authors: Toniolo, Ricardo Alexandre, Ferreira Fernandes, Francy de Brito, Silva, Michelle, da Silva Dias, Rodrigo, Lafer, Beny
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 15-12-2017
• Subjects: Adjunctive therapy; Adult; Antidepressive Agents - therapeutic use; Bipolar disorder; Bipolar Disorder - drug therapy; Bipolar Disorder - psychology; Cognition; Cognitive Dysfunction - drug therapy; Combined Modality Therapy; Creatine - therapeutic use; Creatine monohydrate; Depression; Double-Blind Method; Female; Humans; Male; Middle Aged; Neuropsychological Tests; Psychiatry; Randomized controlled trial; creatine monohydrate; bipolar disorder; adjunctive therapy; depression; cognition; randomized controlled trial; Bipolar disorder; Depression; Cognition; Creatine monohydrate; Adjunctive therapy; Randomized controlled trial
• ISSN: 0165-0327; 1573-2517
• DOI: 10.1016/j.jad.2016.11.029

Abstract Background Depressive episodes and cognitive impairment are major causes of morbidity and dysfunction in individuals suffering from bipolar disorder (BD). Novel treatment approaches that target clinical and cognitive aspects of bipolar depression are needed, and research on pathophysiology suggests that mitochondrial modulators such as the nutraceutical creatine monohydrate might have a therapeutic role for this condition. Methods Eighteen (N=18) patients with bipolar depression according to DSM-IV criteria who were enrollled in a 6-week, randomized, double-blind, placebo-controlled trial of creatine monohydrate 6 g daily as adjunctive therapy were submitted to neuropsychological assessments (Wisconsin Card Sorting Test, Digit Span subtest of the Wechsler Adult Intelligence Scale–Third Edition, Stroop Color-Word Test, Rey–Osterrieth complex figure test, FAS Verbal Fluency Test) at baseline and week 6. Results There was a statistically significant difference between the treatment groups of the change on the total scores after 6 weeks in the verbal fluency test, with improvement in the group receiving adjunctive treatment with creatine. We did not find significant differences between the groups of the changes on other neuropsychological tests. Limitations Small sample and lack of a control group of healthy subjects. Conclusions Our trial, which was the first to investigate the cognitive effects of creatine monohydrate on bipolar depression, indicates that supplementation with this nutraceutical for 6 weeks is associated with improvement in verbal fluency tests in patients with this condition.