Methylphenidate improves HIV-1-associated cognitive slowing

Sixteen HIV-1 seropositive individuals participated in a single-blind, plac ebo-controlled, cross-over-design study of the effectiveness of 30 mg/day o f methytphenidate (MPH) in the treatment of HIV-associated cognitive slowin g. Regression analyses revealed that participants who entered the study wit h a greater degree of either depressive symptomatology or cognitive slowing tended to demonstrate a better response to MPH on computerized measures of choice and dual-task reaction time. Participants without evidence of cogni tive slowing at study entry did not show greater improvement on MPH than on placebo. Contrary to expectation, symptoms of depression did not respond;r d better to MPH than to placebo, regardless of initial symptomatology. Info rmation processing slowing in HIV-I infection therefore appears amenable to pharmacologic intervention with the dopamine agonist MPH. However, results suggest clinicians should consider reserving the use of MPH for patients w ith more pronounced cognitive and affective deficits.