Do the old psychostimulant drugs have a role in managing treatment‐resistant depression?

  title={Do the old psychostimulant drugs have a role in managing treatment‐resistant depression?},
  author={Gordon Parker and Heather L Brotchie},
  journal={Acta Psychiatrica Scandinavica},
Parker G, Brotchie H. Do the old psychostimulant drugs have a role in managing treatment‐resistant depression? 
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A survey of medical literature suggests that for patients with depression who have not responded to other augmentation strategies, psychostimulants may offer improvements in mood, energy, and
While practice guidelines offer consensus‐based expert treatment recommendations, little is known about "real world" pharmacology decision making by practicing psychopharmacologists.
Psychostimulants in the treatment of depressive disorders
This review study reviewed the available literature on the efficacy of stimulants or stimulant alternatives as adjunctive antidepressants for treatment of refractory unipolar and bipolar depression and suggested psychostimulants as potential candidates to promote acceleration of response.
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A review of the literature on the efficacy of using methylphenidate to manage depression found 10 reports, including randomized controlled, case series, and retrospective chart review studies, were identified and assessed.
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There is a striking paucity of research on experimental treatments for patients with bipolar disorder, mainly involving small incompletely controlled trials of add-on treatment, and findings remain preliminary.
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The authors simply ignore the justification given in the DSM-5 itself and reach the conclusion that hybrid dimensional nosology for personality disorders should be dropped.
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Electroconvulsive therapy, vagus nerve stimulation, transcranial magnetic stimulation, lesion surgery, and deep brain stimulation are reviewed and the early clinical effects and main reported complications of these methods are described.
Treatment-resistant depression and the elephant in the room
Treatment approaches to depression are detrimentally narrow, with little research addressing the psychological or social realms of the disorder, and systematic barriers to certain treatment approaches exist, limiting access to care and hindering optimal treatment outcomes.
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    The Australian and New Zealand journal of psychiatry
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While effectively the 'first antidepressants', the psychostimulants are rarely prescribed as antidepressant drugs seemingly in light of their judged low effectiveness, side effects, tolerance as well


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Preface 1. Depression and bipolar disorders 2. Classical antidepressants, serotonin selective reuptake inhibitors and noradrenergic reuptake inhibitors 3. Newer antidepressants and mood stabilizers
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The authors describe the utility of combining the 5-hydroxytryptamine (5-HT) re-uptake blocker, fluoxetine (Prozac) with a psychostimulant, pemoline (Cylert), for some of depressed patients.
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Psychostimulants may be useful as adjuncts to standard antidepressants in refractory depression, but have particular utility in conditions where a prompt therapeutic effect is desired and where tolerance and dependence are less of a concern.
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With properly motivated and complaint patients and careful clinical monitoring by the prescribing psychiatrist, stimulant potentiation of MAOIs may be a viable option for treatment-resistant depressed patients.
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These data suggest that adjunctive modafinil at doses of 100-200 mg a day may improve depressive symptoms in patients with bipolar disorder.
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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.
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Twelve weeks of modafinil augmentation relieved excessive sleepiness, reduced fatigue, and improved patients' overall clinical condition, including mood.
Pharmacokinetic and Pharmacodynamic Drug Interactions in the Treatment of Attention-Deficit Hyperactivity Disorder
Psychostimulant pharmacology is examined, reported drug-drug interactions are summarized, underlying pharmacokinetic and pharmacodynamic considerations for interactions are explored and it appears that these agents may be safely coadministered.
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