Methylphenidate augmentation of serotonin selective reuptake inhibitors: a case series.
BACKGROUND
The serotonin selective reuptake inhibitors (SSRIs) are effective in treating major depressive episodes. However, for the subgroups of patients who remain refractory to therapy, augmentation strategies can improve the efficacy of these agents.


METHODS
We report the results of an open trial of methylphenidate to augment SSRIs in the treatment of five consecutive cases of DSM-III- R diagnosed major depression.


RESULTS
Self-reported symptom reduction was achieved rapidly in all cases, with methylphenidate dosages ranging from 10 to 40 mg/day. Symptom remission was independent of the presence of attention-deficit/hyperactivity disorder. Also, the beneficial effects of the methylphenidate-SSRI combination appeared to be robust and sustained. No patients abused or misused methylphenidate.


CONCLUSIONS
The empirical use of methylphenidate added to ineffective or only partially effective SSRI treatment appeared to be a rapid, safe, and efficacious alternative to existing augmentation strategies for the treatment of major depression. Prospective controlled studies are required to confirm or refute these findings.
Stoll
A L
AL
Psycho-pharmacology Unit, Division of Psychiatry, Brigham and Women's Hospital, Boston, MA 02115, USA.
Pillay
S S
SS
Diamond
L
L
Workum
S B
SB
Cole
J O
JO
D000328:Adult; D000368:Aged; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005473:Fluoxetine / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use*; D017374:Paroxetine / Q000009:adverse effects / Q000627:therapeutic use; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
D005473:Fluoxetine; D008774:Methylphenidate; D017374:Paroxetine; D017367:Selective Serotonin Reuptake Inhibitors