Stimulants for depression: On the up and up?

  title={Stimulants for depression: On the up and up?},
  author={Gin S. Malhi and Yulisha Byrow and Darryl L Bassett and Philip Boyce and Malcolm Hopwood and William Lyndon and Roger T. Mulder and Richard J. Porter and Ajeet B Singh and Greg Murray},
  journal={Australian \& New Zealand Journal of Psychiatry},
  pages={203 - 207}
The use of traditional psychostimulants (methylphenidate and dexamphetamine) and stimulant-like drugs (modafinil and armodafinil) for the treatment of depression is a growing concern given the lack of research evidence supporting their effectiveness. The current article describes the role of stimulants in treating depression – specifically their risks and benefits and their potential use alongside antidepressants. Clinically, the rapid amelioration of depressive symptoms with traditional… 
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Methylphenidate was associated with a 54% reduction in incidents of self-harm or suicide attempts, indicating that methylphenidate may potentially be useful in patients with depression with suicidal- or self-harming behaviour.
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
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[Psychostimulants in the treatment of depression].
A review of the use of stimulants and stimulant alternatives in treating bipolar depression and major depressive disorder.
The promising results of 1 recent lisdexamfetamine RCT, when considered in the context of the deleterious effect of subsyndromal depression, suggest consideration of dopaminergic medications in treatment-refractory unipolar or bipolar depression when modafinil is cost prohibitive or otherwise contraindicated.
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.
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 stimulants in late-life depression.
  • J. Nelson
  • Psychology, Medicine
    The American journal of psychiatry
  • 2015
The authors found that the combination treatment accelerated response and increased the remission rate, and the differences were statistically significant and clinically meaningful.
The Integrative Management of Treatment-Resistant Depression: A Comprehensive Review and Perspectives
The success of switching to a different antidepressant following a first-line agent is supported by evidence, but there is limited evidence for effective combination strategies.
Adjunctive lisdexamfetamine in bipolar depression: a preliminary randomized, placebo-controlled trial
LDX was well tolerated and was not associated with any serious adverse events, but there was one case of suspected misuse, which may have limited the detection of important drug–placebo differences.
Coadministration of Modafinil and a Selective Serotonin Reuptake Inhibitor From the Initiation of Treatment of Major Depressive Disorder With Fatigue and Sleepiness: A Double-Blind, Placebo-Controlled Study
Primary measures suggested modafinil may have provided benefit for symptoms of excessive sleepiness in patients with depression, and mixed-model analysis of the change in the Epworth Sleepiness Scale showed no difference between modaf inil- and placebo-treated patients.
Modafinil augmentation therapy in unipolar and bipolar depression: a systematic review and meta-analysis of randomized controlled trials.
Modafinil is an effective augmentation strategy for acute depressive episodes, including for symptoms of fatigue, in both unipolar and bipolar disorders.
Citalopram, methylphenidate, or their combination in geriatric depression: a randomized, double-blind, placebo-controlled trial.
Combined treatment with citalopram and methylphenidate demonstrated an enhanced clinical response profile in mood and well-being, as well as a higher rate of remission, compared with either drug alone.