Open label trial of creatine as a treatment option for methamphetamine using females

Methamphetamine (MA) is a powerful drug that results in short- and long-term consequences for users. Study findings suggest that female MA users have higher rates of comorbid depression and anxiety than male MA users. Further, neuroimaging studies have found that female MA users have lower levels of brain phosphocreatine (PCr) measured by magnetic resonance spectroscopy (MRS) brain compared to male MA users. Treatment options for the comorbidity of depression and MA dependence are limited. The results of an integrative review of treatment options for comorbid MA use and depression suggest that psychological, a combination of psychological with pharmacological and pharmacological approaches are not effective. Further, gender differences with response to treatment are understudied. Magnetic resonance spectroscopy has been used in drug abuse research to investigate brain chemistry changes with substance use. There have been nearly 50 publications over the past 10 years that describe MRS changes in substance use disorders. While MRS studies of MA dependence have been most frequently studied, information from all drug classes have demonstrated quantitative correlates of injury relevant to substance use. The nutritional supplement creatine has been used as an adjunctive treatment for depression in female adolescents and adults. Further, creatine has been associated with increased brain PCr levels in healthy volunteers. Considering, a within subjects study was iv conducted using 8 weeks of daily creatine to treat depression among female MA users. Primary outcomes of the study included Hamilton Depression Rating Scale (HAMD) scores and brain PCr levels. Secondary outcomes included Beck Anxiety Inventory (BAI) scores and substance use. The results of the study showed a reduction in HAMD scores as early as week 2. Brain PCr levels were found to be higher at the second scan compared to the first scan (M = 0.233, SD = 0.009, t(9) = -2.905, p < .01). Also, BAI scores were reduced as early as week 1, as well as a reduction by over half in MApositive urine drug screens by week 6 (baseline: 50% MA positive urine drug screens; week 6: 21.4%). Finally, creatine was well tolerated.