In an article published in the American J of Psychiatry in 2012, the addition of creatine to escitalopram (an SSRI, marketed under the brand name Lexapro) led to a more rapid decrease in symptoms and a greater remission rate (the most important outcome parameter when assessing a treatment for depression) in women with major depression. Escitalopram was given at 10mg/d for 1 week, then 20mg/d. Creatine was given at 3 grams a day for 1 week, then 5 grams a day. There was no difference between placebo and creatine in the type of side effects experienced. No serious side effects occurred. Side effects reported included tension headaches, nausea, vomiting and sleep difficulties.
The number needed to treat (NNT) for remission, one of the best measures of the practical usefulness of a treatment, was 4. 52% of patients taking creating with escitalopram went into remission, versus 25% of those taking placebo plus escitalopram.
American Journal of Psychiatry, Sep 2012; 169 (9); 937-945. doi: 10.1176/appi.ajp.2012.12010009