d-Amphetamine versus methylphenidate effects in depressed inpatients.
BACKGROUND
Both d-amphetamine and methylphenidate cause similar behavioral and subjective effects and can relieve depressive symptoms in some patients. However, the neurochemical effects of d-amphetamine and methylphenidate are distinct, and clinical experience suggests that individual depressed patients may respond dissimilarly to each stimulant.


METHODS
d-Amphetamine and methylphenidate were administered sequentially to 18 DSM-III diagnosed depressed inpatients on consecutive days, and the acute effects were measured by a variety of instruments.


RESULTS
Although many patients were acutely better after taking one drug or the other, as assessed by Hamilton Rating Scale for Depression and Global Visual Analogue Scale scores, relatively few responded with equal improvement to both.


CONCLUSIONS
Acute symptomatic improvement after d-amphetamine or methylphenidate is unpredictable and can only be determined by an empirical trial on an individual basis. These data also suggest that even if one stimulant is not helpful therapeutically, another might be. The long-term benefits of selective stimulant therapy in depressed patients remain to be assessed.
Little
K Y
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Psychobiology Laboratory, Ann Arbor Veteran's Administration Medical Center, MI 48105.
D000328:Adult; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D003913:Dextroamphetamine / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use*; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
D008774:Methylphenidate; D003913:Dextroamphetamine