Psychostimulants in the therapy of treatment-resistant depression Review of the literature and findings from a retrospective study in 65 depressed patients

The use of psychostimulants as an adjuvant therapy in treatment-resistant depression is not very common nowadays and has been the subject of much criticism. This article gives a brief review of the literature and reports on the findings from a retrospective study carried out in 65 depressed patients treated with psychostimulants (amphetamine and methylphenidate) in addition to conventional antidepressants. Thirty-eight out of 65 patients showed significant improvement, in particular with respect to energy mood, and psychomotor activity. The best response to psychostimulants was seen in inhibited types of depression and in combination with a tricyclic antidepressant. None of the patients developed drug dependency. The incidence of side effects was low, and agitation and restlessness improved with an additional short-term treatment with benzodiazepines. It is concluded that the rapid onset of action (2-3 hours) after administration may help cover the therapeutic latency period of conventional antidepressants and probably potentiates their effect. In view of their potential benefits in treatment-resistant depressive states, psychostimulants should be tried more often.