Creatine and Anxiety: Three Small Open Studies, No Anxiety Trial, and Ten Reports to the FDA

"Creatine and anxiety" is searched both ways: people who started creatine and felt on edge, and people who read that creatine might help their mood. The research answers neither question directly. It contains small open studies where anxiety was a side measure, brain-scan studies that found less creatine in some anxious brains, a handful of adverse-event reports, and no trial built to test creatine in anxiety.

This page stays on anxiety. Depression has its own literature and is on creatine and the brain claims, and sleep is on creatine and sleep.

The studies that measured an anxiety scale

Every human study that reports an anxiety score alongside creatine was designed around something else — depression, PTSD or drug dependence. None had anxiety as its primary outcome, and the three below had no placebo group.

The figures are as each study reports them; none of them is a recommendation.

Two things limit what this table can say. First, without a placebo arm, a falling score in a small group of people starting new treatment is the expected result whatever is in the capsule. Second, in all three, anxiety came with something larger — depression, PTSD, addiction — so a fall in anxiety may simply follow improvement in the main condition. The 2006 PTSD paper was published as a letter without an abstract; its details here come from the 2025 review by Han and colleagues at the University of Utah, which describes it.

The Roitman result matters for a different reason: it is the earliest report of creatine apparently tipping people with bipolar depression into hypomania or mania. Two people is not a rate, but the warning has carried through every later review.

What brain scans show

Magnetic resonance spectroscopy can measure creatine inside the living brain. Several such studies report lower creatine in anxiety disorders:

• in social anxiety disorder, lower creatine in the left dorsolateral prefrontal cortex, with lower levels tracking more avoidance and fear on the Liebowitz scale;
• in generalised anxiety disorder without early trauma, lower total creatine in white matter than in healthy controls — but not in people with GAD and early trauma;
• in panic disorder, lower creatine in the right medial temporal lobe, in a 2002 study.

These are cross-sectional snapshots. They show that some anxious brains hold less creatine, not that low creatine causes anxiety, and not that a scoop of creatine monohydrate would change it. No study has measured whether supplementing raises brain creatine in people with an anxiety disorder, let alone whether symptoms follow; the wider brain-supplementation record is on creatine and the brain claims.

What a population survey shows

A 2026 analysis of the 2022 Korean national nutrition survey linked how much creatine 5,257 people got from food with their mental-health answers. Higher dietary creatine went with lower depression scores, and with lower odds of generalised anxiety disorder — until lifestyle factors entered the model, at which point the anxiety association was no longer significant. Dietary creatine comes mostly from meat and fish, so it travels with diet quality, income and activity. The authors say causality cannot be inferred. The lead author discloses advisory and commercial interests in creatine.

The other direction: reports of anxiety on creatine

The FDA's adverse-event reporting system for foods and supplements (CAERS) is the public record of what consumers and clinicians reported. On 2026-10-22, the openFDA database held 210 reports naming a product with "creatine" in its brand name. Of these:

• 10 list anxiety as a reaction;
• 5 list a panic attack (some overlap with the anxiety reports);
• 5 of the 10 anxiety reports also name other supplements — tribulus, multi-ingredient "stacks", a fat burner product, liver formulas — and several list many unrelated reactions at once.

The five anxiety reports naming a single creatine product cover plain monohydrate from four brands between 2010 and 2025. A CAERS report records that something happened after a product was used; it does not establish that the product caused it, and the system's own documentation says so. Ten reports across fifteen years of a supplement used by millions is not a signal by itself, and it is also not proof that nothing happens.

What the trials report as side effects of creatine is mostly gastrointestinal — the creatine side effects page has the counts. Anxiety does not appear as a recurring adverse event in placebo-controlled creatine trials.

Stimulants are the usual suspect

Creatine has no stimulant action. Pre-workout powders, which often contain creatine, also contain caffeine — in this site's census of 130 pre-workout labels that state it, a median of 350 mg a serving (range 50–450 mg) — and sometimes other stimulants. A person who switches from plain creatine to a creatine-containing pre-workout, or who uses both, has changed more than one thing. The caffeine-and-creatine question is on creatine and caffeine, and the label census of pre-workouts is on the pre-workout label census.

The trial that has not been run

A ClinicalTrials.gov search on 2026-10-22 for creatine as an intervention with the term anxiety returned 23 records. They are trials in depression, methamphetamine use, stroke, concussion, fibromyalgia, multiple sclerosis, bipolar disorder (a ketogenic-diet trial) and healthy volunteers, plus several unrelated drug trials the search picked up. None tests creatine in people diagnosed with an anxiety disorder with anxiety as the main outcome. One registered trial in female methamphetamine users lists anxiety among its conditions (NCT02568878).

What is not established

• Whether creatine reduces anxiety in people with an anxiety disorder. It has not been tested against placebo.
• Whether creatine causes anxiety. Placebo-controlled trials do not show it; a few reports exist, with confounders.
• Who is at risk. The one consistent psychiatric warning — mania or hypomania in bipolar disorder — comes from case reports and a two-person observation, not a measured rate.

Anyone with an anxiety disorder, bipolar disorder or a psychiatric prescription is a case for a clinician before any supplement change, and the trials above give that clinician very little to go on.

Sources

All opened 2026-10-22.

• Roitman S et al. "Creatine monohydrate in resistant depression: a preliminary study." Bipolar Disord 2007;9(7):754–8. PMID 17988366
• Amital D et al. "Open study of creatine monohydrate in treatment-resistant posttraumatic stress disorder." J Clin Psychiatry 2006;67(5):836–7 (letter, no abstract). PMID 16841637
• Hellem TL et al. "Creatine as a Novel Treatment for Depression in Females Using Methamphetamine: A Pilot Study." J Dual Diagn 2015;11(3–4):189–202. PMID 26457568
• Han ES et al. "The role of brain creatine in behavioral health conditions." Front Psychiatry 2025;16:1667639 (full text). PMID 41280460
• Yue Q et al. "Quantitative 3.0T MR spectroscopy reveals decreased creatine concentration in the dorsolateral prefrontal cortex of patients with social anxiety disorder." PLoS One 2012. PMID 23110183
• Coplan JD et al. "Decreased choline and creatine concentrations in centrum semiovale in patients with generalized anxiety disorder." Psychiatry Res 2006. PMID 16797939
• Massana G et al. "Reduced levels of creatine in the right medial temporal lobe region of panic disorder patients." Neuroimage 2002. PMID 12169267
• Ostojic SM et al. "Dietary creatine intake and mental health among the Korean population." Nutr Neurosci 2026;29(2):239–247. PMID 40962503
• openFDA, food/event endpoint (CAERS): products.name_brand:creatine, reaction counts and anxiety/panic records, queried 2026-10-22. api.fda.gov
• ClinicalTrials.gov API v2: intervention "creatine", term "anxiety", 23 records, queried 2026-10-22.