L-Carnosine combination therapy for major depressive disorder: A randomized, double-blind, placebo-controlled trial

•We assessed the safety and efficacy of L-Carnosine on depressive symptoms of patients with major depressive disorder (MDD).•Over 6 weeks, patients who received L-Carnosine showed significant and rapid-onset improvement in Hamilton Depression rating Scale (Ham-D) scores.•Treatment with L-Carnosine s...

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Published in:Journal of affective disorders 2020-04, Vol.267, p.131-136
Main Authors: Araminia, Behin, Shalbafan, Mohammadreza, Mortezaei, Amirhosein, Shirazi, Elham, Ghaffari, Salomeh, Sahebolzamani, Erfan, Mortazavi, Seyyed Hosein, Shariati, Behnam, Ardebili, Mehrdad Eftekhar, Aqamolaei, Ali, Naderi, Sina, Akhondzadeh, Shahin
Format: Article
Language:English
Subjects:
Antidepressive Agents - therapeutic use
Carnosine - therapeutic use
Citalopram - therapeutic use
Depressive Disorder, Major - drug therapy
Double-Blind Method
Glutamate
Humans
L-Carnosine
Major depressive disorder (MDD)
Randomized controlled trial
Treatment Outcome
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Summary:•We assessed the safety and efficacy of L-Carnosine on depressive symptoms of patients with major depressive disorder (MDD).•Over 6 weeks, patients who received L-Carnosine showed significant and rapid-onset improvement in Hamilton Depression rating Scale (Ham-D) scores.•Treatment with L-Carnosine seems to be well tolerated with no serious adverse event. Evidence for antidepressant effects of L-Carnosine was shown in some experimental studies. In this study we tried to evaluate the efficacy and tolerability of L-Carnosine combination therapy in treatment of patients with major depressive disorder (MDD). Fifty-eight patients with MDD (DSM-V) and Hamilton Depression Rating Scale (HAM-D) score ≥ 19 were randomized to receive either 400 mg twice daily L-Carnosine or placebo in addition to citalopram (maximum dosage of 40 mg/day) for six weeks in a randomized double-blind, and placebo-controlled study. Patients were assessed using the HAM-D scale at baseline and weeks 2, 4, and 6. Fifty-two patients completed the trial. General linear model repeated measure showed significant difference for time × treatment on HAM-D score [F = 3.17, df = 2.39, p-value = 0.03]. Significantly greater improvement was detected in HAM-D score of the L-Carnosine group compared with the placebo group from baseline to weeks 2, 4 and 6 [Ps = 0.013, 0.028 and 0.023; respectively]. Patients in the L-Carnosine group experienced significantly greater response and remission rate than the placebo group [Ps = 0.023 and 0.012; respectively]. There was no significant difference between the two groups in baseline parameters and frequency of side effects. Short follow-up period and small population size were two important limitations of this study. L-Carnosine combination therapy with citalopram can effectively improve symptoms of patients with major depressive disorder. Rapid-onset antidepressant effects of L-Carnosine were also shown which need further investigation.
ISSN:0165-0327
1573-2517
DOI:10.1016/j.jad.2020.02.020