Psychostimulants in the Treatment of Depression

  title={Psychostimulants in the Treatment of Depression},
  author={Kate Skellington Orr and David Taylor},
  journal={CNS Drugs},
Psychostimulants have euphoric and alerting properties that suggest their usefulness in treating depressive disorders; however, problems with tolerance and dependence with some drugs militate against their widespread therapeutic use where more acceptable licensed alternatives are available. The introduction of modafinil, a stimulant not associated with tolerance and dependence, has re-awakened interest in psychostimulants as antidepressants. The available literature, while containing somewhat… 

Psychostimulants as antidepressants: Their nuanced role?

  • G. Parker
  • Psychology
    The Australian and New Zealand journal of psychiatry
  • 2022
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

Use of adjunctive stimulants in adult bipolar depression.

An updated perspective on the use of stimulants and stimulant-like medications in adult bipolar depression is provided, considering not only recent randomized controlled trials, but also open naturalistic studies, in order to clarify the strengths and limitations of using these agents.

Beyond ADHD and narcolepsy: psychostimulants in general psychiatry

There is currently not enough evidence to recommend their routine use for general psychiatric conditions, and the recent literature regarding psychostimulant use in general and consultation-liaison psychiatry is reviewed.

Psychostimulants and Cognition: A Continuum of Behavioral and Cognitive Activation

A continuum of psychostimulant activation that covers the transition from one drug effect to another as stimulant intake is increased is proposed, which helps account for the seemingly disparate effects of stimulant drugs.

Psychostimulants in moderate to severe affective disorder: A systematic review of randomized controlled trials

Clearly larger well designed placebo-controlled studies with longer follow-up accompanied by evaluations of tolerance/dependence are warranted before psychostimulants can be recommended in routine clinical practice for the treatment of MDD.

The role of methylphenidate in depression

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.

The role of psychostimulants in psychogeriatrics: a New Zealand survey

  • B. Ng
  • Psychology, Medicine
  • 2009
To ascertain the current prescribing practices of psychostimulants by psychogeriatricians in New Zealand, a large number of doctors believe that dexamphetamine, methylphenidate and modafinil should be considered standard treatments in major depression or other affective disorders.



Modafinil monotherapy in depression

Modafinil augmentation of antidepressant treatment in depression.

Modafinil appears to be a drug with promise as an augmenter of antidepressants, especially in patients with residual tiredness or fatigue, and is a particularly attractive alternative to other stimulants because of its low abuse potential and Schedule IV status.

d-Amphetamine versus methylphenidate effects in depressed inpatients

Acute symptomatic improvement after d-amphetamine or methylphenidate is unpredictable and can only be determined by an empirical trial on an individual basis, and data suggest that even if one stimulant is not helpful therapeutically, another might be.

CNS stimulant potentiation of monoamine oxidase inhibitors in treatment-refractory depression.

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.

Use of Psychostimulants in Medically Ill Patients with Neurological Disease and Major Depression

The effective therapeutic response to dextroamphetamine and methylphenidate by five depressed patients with neurological disease is described, and there was a rapid remission of depressive symptomatology with no adverse side effects.

An open study of methylphenidate in bipolar depression.

In this brief, open study, methylphenidate was effective and relatively safe in depressed bipolar subjects and was shown to reduce manic behavior.

Modafinil augmentation in depressed patients with partial response to antidepressants: A pilot study on self-reported symptoms covered by the Major Depression Inventory (MDI) and the Symptom Checklist (SCL-92)

Modafinil appears to be an appropriate augmentation to antidepressant treatment, leading to a remission rate of 43%.

Can long-term treatment with antidepressant drugs worsen the course of depression?

  • G. Fava
  • Psychology, Medicine
    The Journal of clinical psychiatry
  • 2003
The possibility that antidepressant drugs may worsen the course of depression needs to be tested, even though its scientific exploration is likely to encounter considerable methodological and ideological difficulties.

Methylphenidate in depressed medically ill patients.

Methylphenidate provides a safe and effective alternative to tricyclic antidepressants in medically ill populations but appears to be less effective in the presence of delirium.