Stimulant May Speed Antidepressant Response Time in Elderly

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March 04, 2015

The combination of the methylphenidate (multiple brands) and the antidepressant citalopram (multiple brands) may

accelerate the rate of response in elderly patients with depression, new research suggests.

A randomized, placebo-controlled study conducted by investigators at the University of California, Los Angeles

(UCLA) showed that most patients who responded to the treatment achieved remission within the first month.

Importantly, the investigators note, the combined therapy did not increase side effects.

"The combination can shorten time to remission to 1 to 4 weeks in patients who are depressed," lead author Helen

Lavretsky, MD, professor of psychiatry in residence and director of the Late- Life Mood, Stress, and Wellness

Research Program at UCLA's Geffen School of Medicine, told Medscape Medical News.

The study was published online February 13 in the American Journal of Psychiatry.

Slower Response

Elderly patients with depression have a slower response to antidepressants sometimes as long as 12 to 16 weeks

as well as lower rates of remission.

"Methylphenidate and other stimulants have had a known fast onset of action, up to 72 hours in depressed patients,

and that was a rationale for use in this study," said Dr Lavretsky.

The study is the first randomized, placebo-controlled trial to evaluate the combination of methylphenidate and the

selective serotonin reuptake inhibitor (SSRI) citalopram for depression in the elderly in comparison with monotherapy

with either drug, the authors noted.

For the double-blind trial, 143 outpatients whose average age was 69.7 years and who were diagnosed with major

depression in accordance with DSM-IV-TR criteria were randomly assigned to one of three treatment groups:

methylphenidate plus placebo (n = 48), citalopram plus placebo (n = 48), and the combination of citalopram plus

methylphenidate (n = 47).

Patients were treated with daily doses ranging from 20 mg to 60 mg for citalopram (mean, 32 mg) and from 5 mg to

40 mg for methylphenidate (mean, 16 mg).

At 16 weeks, all groups met the primary outcome measure of significant improvement in depression severity (P