Creatine as a Treatment Option for Depression in Methamphetamine Using Females
Status:
Completed
Trial end date:
2015-02-01
Target enrollment:
Participant gender:
Summary
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.