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Citalopram, Methylphenidate, or Their Combination in Geriatric Depression: A Randomized, Double-Blind, Placebo-Controlled Trial
Open accessAbstract
OBJECTIVE: The authors evaluated the potential of methylphenidate to improve antidepressant response to citalopram, as assessed by clinical and cognitive outcomes, in elderly depressed patients. METHOD: The authors conducted a 16-week randomized double-blind placebo-controlled trial for geriatric depression in 143 older outpatients diagnosed with major depression comparing treatment response in three treatment groups: methylphenidate plus placebo (N=48), citalopram plus placebo (N=48), and citalopram plus methylphenidate (N=47). The primary outcome measure was change in depression severity. Remission was defined as a score of 6 or less on the Hamilton Depression Rating Scale. Secondary outcomes included measures of anxiety, apathy, quality of life, and cognition. RESULTS: Daily doses ranged from 20 mg to 60 mg for citalopram (mean=32 mg) and from 5 mg to 40 mg for methylphenidate (mean=16 mg). All groups showed significant improvement in depression severity and in cognitive performance. However, the improvement in depression severity and the Clinical Global Impressions improvement score was more prominent in the citalopram plus methylphenidate group compared with the other two groups. Additionally, the rate of improvement in the citalopram plus methylphenidate group was significantly higher than that in the citalopram plus placebo group in the first 4 weeks of the trial. The groups did not differ in cognitive improvement or number of side effects. CONCLUSIONS: 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. All treatments led to an improvement in cognitive functioning, although augmentation with methylphenidate did not offer additional benefits.
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“Combination of citalopram and methylphenidate may improve mood and well-being and lead to a higher remission rate of LLD compared to either drug alone133.”
From Mechanisms and treatment of late-life depression (2019) · cites this paper as [133]
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“Combination of citalopram and methylphenidate may improve mood and well-being and lead to a higher remission rate of LLD compared to either drug alone133.”
From Mechanisms and treatment of late-life depression (2019) · cites this paper as [133]
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Cognitive function following a major depressive episode: a systematic review and meta-analysis
Semkovska, M., Quinlivan, L., O'Grady, T., Johnson, R., Collins, A., O'Connor, J., Knittle, H., Ahern, E., & Gload, T. (2019) · The Lancet Psychiatry · doi:10.1016/s2215-0366(19)30291-3 · Cited by 631
Mechanisms and treatment of late-life depression
Alexopoulos, G. S. (2019) · Translational Psychiatry · doi:10.1038/s41398-019-0514-6 · Cited by 592
Psychobiological factors of resilience and depression in late life
Laird, K. T., Krause, B., Funes, C., & Lavretsky, H. (2019) · Translational Psychiatry · doi:10.1038/s41398-019-0424-7 · Cited by 229
Self-citationSzymkowicz, S. M., Gerlach, A., Homiack, D., & Taylor, W. D. (2023) · Translational Psychiatry · doi:10.1038/s41398-023-02464-9 · Cited by 234
Chang, Z., D’Onofrio, B. M., Quinn, P. D., Lichtenstein, P., & Larsson, H. (2016) · Biological Psychiatry · doi:10.1016/j.biopsych.2016.02.018 · Cited by 154
Metadata
- Authors
- Lavretsky, H., Reinlieb, M., St. Cyr, N., Siddarth, P., Ercoli, L. M., & Senturk, D.
- Affiliations
- University of California, Los Angeles (US)
- From the UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles; the Department of Psychiatry, UCLA School of Medicine, Los Angeles; and the Departments of Biostatistics and Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles.
- Venue
- American Journal of Psychiatry
- Published
- 2015-06-01
- Volume
- 172
- Issue
- 6
- Pages
- 561-569
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- PMC
- PMC4451432
- OpenAlex
- W2036375653
- Cited by
- 184
- References
- 47
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 14 · 2023: 13 · 2022: 17 · 2021: 34 · 2020: 18 · 2019: 18 · 2018: 12 · 2017: 20 · 2016: 17 · 2015: 10
- FWCI
- 14.14
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institutes of Health
- National Institute of Mental Health (MH086481, K24MH086481, R01MH077650, MH077650)
- Jonsson Comprehensive Cancer Center
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Keywords
- geriatric depression, citalopram, methylphenidate, antidepressant augmentation, combination therapy, depression remission, cognitive function, anxiety, apathy, quality of life, antidepressant side effects
- MeSH terms
- Aged, Anxiety Disorders, Cognition Disorders, Major Depressive Disorder, Double-Blind Method, Drug Therapy, Combination, Female, Humans, Male, Methylphenidate, Middle Aged, Personality Assessment, Psychometrics, Quality of Life, Citalopram, Apathy
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