METHYLPHENIDATE AUGMENTATION OF SEROTONIN SELECTIVE REUPTAKE INHIBITORS - A CASE SERIES

Background: The serotonin selective reuptake inhibitors (SSRIs) are ef fective in treating major depressive episodes. However, for the subgro ups of patients who remain refractory to therapy, augmentation strateg ies can improve the efficacy of these agents. Method: We report the re sults of an open trial of methylphenidate to augment SSRIs in the trea tment of five consecutive cases of DSM-III-R diagnosed major depressio n. Results: Self-reported symptom reduction was achieved rapidly in al l cases, with methylphenidate dosages ranging from 10 to 40 mg/day. Sy mptom remission was independent of the presence of attention-deficit/h yperactivity disorder. Also, the beneficial effects of the methylpheni date-SSRI combination appeared to be robust and sustained. No patients abused or misused methylphenidate. Conclusion: The empirical use of m ethylphenidate added to ineffective or only partially effective SSRI t reatment appeared to be a rapid, safe, and efficacious alternative to existing augmentation strategies for the treatment of major depression . Prospective controlled studies are required to confirm or refute the se findings.