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d-Amphetamine versus methylphenidate effects in depressed inpatients
1Psychobiology Laboratory, Ann Arbor Veteran's Administration Medical Center, MI 48105.
The Journal of Clinical Psychiatry
|September 1, 1993
Summary
Stimulant medications like d-amphetamine and methylphenidate can help depression symptoms, but individual responses vary. Empirical trials are necessary to determine which stimulant, if any, is most effective for each depressed patient.
Area of Science:
- Psychiatry
- Neuroscience
- Pharmacology
Background:
- D-amphetamine and methylphenidate share behavioral effects and can alleviate depressive symptoms.
- Distinct neurochemical profiles exist between d-amphetamine and methylphenidate.
- Clinical observations indicate varied patient responses to these stimulants in depression.
Purpose of the Study:
- To compare the acute effects of d-amphetamine and methylphenidate in depressed patients.
- To assess the differential therapeutic responses to these two stimulant medications.
Main Methods:
- Sequential administration of d-amphetamine and methylphenidate to 18 inpatients diagnosed with depression (DSM-III).
- Acute effects were measured using the Hamilton Rating Scale for Depression and Global Visual Analogue Scale.
- Evaluation of patient responses on consecutive days.
Main Results:
- Many patients showed acute improvement with either d-amphetamine or methylphenidate.
- Few patients experienced equal improvement from both stimulant medications.
- Individual responses to the stimulants were not uniform.
Conclusions:
- Acute symptomatic improvement from d-amphetamine or methylphenidate in depression is unpredictable.
- Individual empirical trials are essential to identify effective stimulant therapy.
- The potential for one stimulant to be effective when another is not warrants further investigation.
- Long-term efficacy of selective stimulant therapy in depression requires further assessment.