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Methylphenidate-Enhanced Antidepressant Response to Citalopram in the Elderly: A Double-Blind, Placebo-Controlled Pilot Trial

From the Department of Psychiatry and Biobehavioral Sciences, UCLA School of Medicine, Los Angeles, California (HL, SP, PS, AK), and the Department of Psychiatry, Intervention Research Center for Late-Life Mood Disorders, the University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (CFR).

Objective: The authors evaluated the potential of methylphenidate to accelerate and enhance antidepressant response to citalopram in elderly depressed patients.

Methods: Sixteen outpatients with major depression were treated in a 10-week double-blind trial. Response was defined as a score on the Hamilton Depression Rating Scale (24-item) of less than 10.

Results: An accelerated response was observed by week 3 in five subjects receiving citalopram (CIT) + methylphenidate (MPH) and in none of those receiving CIT + placebo (PBO). Subjects receiving citalopram and methylphenidate showed a significant improvement in depressive symptoms compared with those on citalopram and placebo.

Conclusion: Combined treatment with citalopram and methylphenidate appears to be a viable strategy for accelerating and enhancing antidepressant response in elderly depressed patients limited by tolerability and safety.

Key Words: Geriatric depression • accelerated response • stimulants • methylphenidate • citalopram • SSRI • augmentation • combination

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