31P-MRS and Resting State Functional Connectivity Analysis of the Effects of 5-hydroxytryptophan and Creatine for Antidepressant Augmentation in Patients With SSRI/SNRI-resistant Major Depressive Disorder
This is a three-armed clinical trial examining the effect of 5-hydroxytryptophan and creatine monohydrate as augmenting agents for the treatment of depression. Subjects will be randomized between 5-HTP 100mg BID + creatine 5g daily, 5-HTP 200mg BID + creatine 10g daily, vs double placebo, for 8 weeks. The ability of the interventions to affect biomarkers associated with depression will be assessed using brain phosphorus magnetic resonance spectroscopy, functional connectivity imaging, and plasma serotonin levels.
• Adults age 18-65 years inclusive
• Current diagnosis of MDD identified by the MINI (Mini Neuropsychiatric Interview)
• Current HAM-D17 score of \>= 16
• Adequate adherence to any FDA approved SSRI or SNRI for at least 8 weeks
• Right-handed
• Residing at \> 4000 ft for at least 12 weeks