Psychostimulants in post-stroke depression

The hospital charts of 17 patients with post-stroke depression who were treated with either dextroamphetamine or methylphenidate during a 5-year period at the Massachusetts General Hospital were examined. Eighty-two percent of the patients showed improvement after psychostimulant treatment. Forty-seven percent of all patients showed marked or moderate improvement in depressive symptoms. The authors saw no significant differences in efficacy between the two psychostimulants or across the diagnostic categories for depression. Patients improved quickly, usually within the first 2 days of treatment. Adverse reactions necessitating the termination of psychostimulant treatment occurred in three patients. Anorexia was not observed as a side effect of either dextroamphetamine or methylphenidate treatment. Psychostimulants appear to be a safe and rapidly effective alternative to tricyclic antidepressants in inpatients with post-stroke depression.