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Methylphenidate use in geriatric depression: A systematic review
Author(s) -
Smith Kristin R.,
Kahlon Christie H.,
Brown Jamie N.,
Britt Rachel B.
Publication year - 2021
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.5536
Subject(s) - depression (economics) , medicine , methylphenidate , geriatrics , citalopram , randomized controlled trial , late life depression , pharmacotherapy , population , psychiatry , dosing , clinical trial , major depressive episode , major depressive disorder , attention deficit hyperactivity disorder , antidepressant , cognition , anxiety , environmental health , economics , macroeconomics
Objectives Geriatric depression is common and is often associated with coexisting medical illnesses, cognitive dysfunction, or both. Treatment with pharmacotherapy is usually required, and many patients may not respond to initial therapy. Thus, there is a need for adjunctive treatment options. The objective of this systematic review is to assess the efficacy and safety of methylphenidate (MPH) in the treatment of geriatric depression. Methods PubMed (1946–December 2020) and Embase (1947–December 2020) were queried using the following search terms: geriatrics, aged, geriatric patient, or elderly and depressive disorder, depression, major depression or late‐life depression, and MPH. Studies were included if they were a randomized‐controlled trial or open‐label trial that investigated use of MPH for treatment of depression in adults aged 60 years and older. Results After screening per the inclusion criteria, five prospective trials were included. All studies found improvement in depressive symptoms with use of MPH or MPH combined with citalopram. Study durations ranged from 8 to 16 weeks and MPH dosing ranged from 5 to 90 mg per day. Conclusions Based on the reviewed literature, MPH appears to be most effective when combined with citalopram and used short‐term. MPH should be initiated at a low dose and titrated up to 10 or 20 mg per day based on response. Larger, long‐term trials are needed to further define the role of MPH in this population.