Research has shed new light on the potential benefits of creatine, a common muscle-building supplement, in improving depression symptoms. A systematic review published in a prominent medical journal suggests that creatine monohydrate may be beneficial as an add-on treatment for major depressive disorder, although the evidence remains preliminary.
The researchers, based in Canada, analyzed data from five randomized controlled trials, evaluating the impact of creatine monohydrate intake on mental health. Four of the trials studied major depressive disorder, and another looked at bipolar disorder with a current depressive episode. Notably, one trial found that women with depression who took 5 grams of creatine per day, in addition to the antidepressant escitalopram, experienced greater improvement after eight weeks.
Other studies revealed mixed results, with some finding benefit when creatine was added to cognitive behavioral therapy, while others showed no significant improvements with various dosages of creatine. The researchers noted that previous studies have found that people with mood disorders process creatine differently in the brain, leading them to believe that disruptions in this process may contribute to depression.
Lead study author Bassam Jeryous Fares emphasized that the findings are "interesting, but not a verdict," as two trials pointed one way and three pointed another. Corresponding author Nicholas Fabiano added that creatine "appears to be a safe intervention," with limited side effects. However, he cautioned that the evidence is not yet reliable, and the findings may not be generalizable to everyone.
Thea Gallagher, a psychologist and director of wellness programs at NYU Langone, noted that creatine is best known for supporting muscle performance, but it also helps the brain produce and use energy. Researchers believe that some people with depression may have alterations in brain energy metabolism, and creatine could help support these energy-producing pathways.
Gallagher emphasized that creatine may be most helpful when combined with established depression treatments rather than as a replacement. She also cautioned that supplements have been known to generate "early enthusiasm" before larger studies have revealed "more modest effects." While creatine has a strong safety profile for most healthy adults, it's essential to talk with your healthcare provider before starting any supplement, particularly if you have kidney disease, are pregnant, or have other medical conditions.
For those experiencing signs of depression, Gallagher recommends seeking evidence-based mental healthcare. She noted that depression is a "highly heterogeneous condition, so we still don't know which patients are most likely to benefit or what the optimal treatment approach looks like." While creatine is promising, it's not something people should view as a standalone treatment for depression.
