This 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.
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.
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.
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.
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.
National Institutes of Health grants (MHO776590 and MHO86481)
The research appears in the current online edition of the American Journal of Psychiatry.