Psychostimulant treatment of geriatric depressive disorders secondary to medical illness

The records were reviewed for 129 medically ill geriatric inpatients treated with either dextroamphetamine or methylphenidate for secondary depression during a five year period at the Massachusetts General Hospital. Eighty-one percent of patients demonstrated at least some improvement following psychostimulant treatment. Sixty-six percent of these experienced marked to moderate amelioration of their depressive symptoms. Improvement was rapid and usually occurred within the first or second day of treatment. No significant difference in efficacy was noted between the two psychostimulants or across diagnostic categories for depression. Only 8% of patients experienced adverse reactions significant enough to warrant termination of the psychostimulant trial. No instances of anorexia due to psychostimulant treatment were observed.