The Effect of Creatine Monohydrate on Mental Disorders: A Systematic Review of Randomized Controlled Trials: Effet du monohydrate de créatine sur les troubles mentaux : examen systématique des essais contrôlés à répartition aléatoire.

In 30 seconds

This systematic review evaluated randomized controlled trials of creatine monohydrate for psychiatric symptoms and safety in people with mental disorders. Six articles from five trials included 126 participants receiving creatine and 112 receiving placebo; studies examined major depressive disorder (MDD) or bipolar depression, with no other disorders represented. In MDD, creatine combined with escitalopram outperformed SSRI plus placebo at 8 weeks (Cohen’s d = 1.13), and creatine augmentation of psychotherapy also showed benefit. Other comparisons found no difference from placebo. Creatine was generally well tolerated, although hypomania or mania occurred in 2 of 17 recipients.

Key findings

• The review included five RCTs: creatine monohydrate n = 126 and placebo n = 112; four trials studied MDD and one bipolar depression.
• With escitalopram for MDD, creatine outperformed SSRI plus placebo at 8 weeks (Cohen's d = 1.13).
• Creatine added to cognitive behavioural therapy outperformed CBT plus placebo; other augmentation comparisons reported no difference versus placebo.
• Creatine was generally well tolerated, but 2 of 17 recipients experienced hypomania or mania.

Why it matters

The findings suggest a possible adjunctive role for creatine in some MDD treatment settings, but the evidence is limited to a small number of trials and does not extend to most mental disorders. The reported mood-elevation events also make safety relevant when interpreting potential use, particularly in a review that included bipolar depression.

What to keep in mind

Only five RCTs were included, covering MDD and bipolar depression; two trials had low risk of bias and three had some concerns. Treatment lasted 4–8 weeks, and the evidence does not address other mental disorders.