A double-blind, placebo-controlled, exploratory trial of chromium picolinate in atypical depression: effect on carbohydrate craving.

Title	A double-blind, placebo-controlled, exploratory trial of chromium picolinate in atypical depression: effect on carbohydrate craving.
Authors	JOHN P. DOCHERTY, DAVID A. SACK, MARK ROFFMAN, MANLEY FINCH, JAMES R. KOMOROWSKI
Magazine	Journal of Psychiatric Practice
Date	09/01/2005
DOI	10.1097/00131746-200509000-00004
Introduction	A prior small-scale investigation indicated a beneficial therapeutic outcome for individuals with atypical depression treated with chromium picolinate. This observation is noteworthy given the connection between depression, reduced insulin sensitivity, subsequent diabetes, and chromium picolinate's ability to enhance insulin function. This replicated, double-blind, multicentre, 8-week study involved 113 adult outpatients diagnosed with atypical depression. Participants were assigned in a 2:1 ratio to receive either 600 micrograms/day of elemental chromium, delivered as chromium picolinate (CrPic), or a placebo. The Hamilton Depression Rating Scale (HAM-D-29) and the Clinical Global Impressions Improvement Scale (CGI-I) served as the primary measures of effectiveness. From the 113 participants initially assigned, 110 formed the intent-to-treat (ITT) group, having received at least one dose and completed one efficacy assessment. Seventy-five participants were deemed evaluable, having adhered to at least 80% of the study medication without major protocol deviations. Within the evaluable cohort, the average age was 46 years, with 69% being female, 81% Caucasian, and an average body mass index (BMI) of 29.7. No significant differences were observed between the CrPic and placebo groups on the primary efficacy measures across both ITT and evaluable populations. Both groups exhibited substantial improvement from baseline in total HAM-D-29 scores during the treatment period (p < 0.0001). However, within the evaluable population, the CrPic group demonstrated notable improvements from baseline compared to the placebo group on four specific HAM-D-29 items: increased appetite, increased eating, carbohydrate craving, and diurnal variation in mood. A supplementary data analysis of 41 ITT patients with significant carbohydrate craving (26 CrPic, 15 placebo; mean BMI = 31.1) revealed that CrPic recipients had a significantly better response in overall HAM-D-29 scores (65% versus 33%; p < 0.05) and greater improvements in appetite increase, increased eating, carbohydrate craving, and genital symptoms (e.g., libido). Chromium treatment was well-received. The study design did not incorporate a placebo run-in phase, nor did it mandate a minimum duration or severity of depression, enrolling patients with major depression, dysthymia, or depression not otherwise specified. The findings suggest that in adults with atypical depression, many of whom were overweight or obese, CrPic improved specific HAM-D-29 items related to appetite and mood. For a subpopulation with high carbohydrate craving, CrPic treatment led to significantly improved overall HAM-D-29 scores compared to placebo. These results indicate that chromium's primary influence was on carbohydrate craving and appetite regulation in depressed individuals, and that 600 micrograms of elemental chromium could be beneficial for atypical depression patients experiencing severe carbohydrate craving. Additional research is necessary to assess chromium's impact on depressed patients specifically selected for symptoms of heightened appetite and carbohydrate craving, and to determine if higher doses affect mood.
Quote	JOHN P. DOCHERTY, DAVID A. SACK and MARK ROFFMAN et al. A Double-Blind, Placebo-Controlled, Exploratory Trial of Chromium Picolinate in Atypical Depression: Effect on Carbohydrate Craving. Journal of Psychiatric Practice. 2005. Vol. 11(5):302-314. DOI: 10.1097/00131746-200509000-00004
Element	Chromium (Cr)
Industry	Pharmaceutical Industry , Research & Laboratory