Metabolite Maps Exhibit Add-on Effects of Creatine Monohydrate on Brain ATP in Depressed Subjects

Motivation: Major depression disorder (MDD) is associated with substantial morbidity and mortality, including suicide and suicidal behaviors. Effective and well-tolerated pharmacologic treatments constitute an unmet need in treatment-resistant MDD. Goal(s): We have sought to evaluate brain ATP levels using 31P-MRSI and metabolite maps for the add-on effects of creatine monohydrate in subject with MDD. Approach: Phosphorus magnetic spectroscopy imaging and ROI defined in the CONN toolbox were used for the analysis. Results: Significant add-on effects of creatine monohydrate were observed in MDD patients (p=0.03). Impact: Our preliminary findings suggest that add-on therapy of creatine monohydrate in MDD patients may help replenish ATP efficiently. Serotonin treatment alone may not provide enough therapeutic effects in terms of brain bioenergetics for the buffer system of high-energy phosphates.