UCLA. US: A new study by
researchers at UCLA found that the combination of Ritalin
(methylphenidate) and Celexa (citalopram) can accelerate and improve the
overall antidepressant effects of the medications in the elderly. Most
patients who responded to the combination achieved remission in the
first month. The researchers had also hoped to find that the combination
would work more quickly and be tolerated better by this elderly
population than either drug alone. They found that the combination was
working faster, but the side effects and cognitive benefits did not
differ between the groups.
IMPACT
Geriatric depression is a risk factor for developing dementia or
Alzheimer’s disease later in life. The study offers a new approach for
treating depression in older adults who tend to linger with low mood,
poor interest, low motivation, and a wish to die for months or years,
and get them out of depression much faster than the standard
antidepressants.
METHOD
The authors conducted a 16-week randomized trial for geriatric
depression in 143 older outpatients diagnosed with major depression.
They compared treatment response in three treatment groups:
methylphenidate plus placebo (48 people), citalopram plus placebo (48
people), and citalopram plus methylphenidate (47 people). The primary
outcome measure was change in depression severity. Secondary outcomes
included measures of anxiety, apathy, quality of life and cognition.
BACKGROUND
Geriatric depression is very difficult to treat because of the
delayed and relatively poor response to medications. Normally the
remission rate is about 30 percent at the first try, and it can take
anywhere from 12 to 16 weeks to see improvement.
AUTHOR
First author Dr. Helen Lavretsky, professor of psychiatry and director of the
Late-Life Depression, Stress, and Wellness Research Program at the UCLA Semel Institute for Neuroscience and Human Behavior, and colleagues.
FUNDING
National Institutes of Health grants (MHO776590 and MHO86481)
JOURNAL
The
research appears in the current online edition of the American Journal of Psychiatry.