Posted by SLS on January 15, 2007, at 20:15:12
In reply to Re: Depressives' sensitivity to stimulants! » linkadge, posted by SLS on January 15, 2007, at 19:44:18
There are some studies that demonstrate an association between an acute antidepressant response to amphetamine (but not methylphenidate) and a positive response to antidepressant (tricyclic) treatment.
Note that these mental giants were too dumb to consider using amphetamine chronically to see if it were useful as a long-term treatment. Perhaps it never entered their minds. It's funny, though. I didn't detect a trace of stupidity when I spoke to Dennis Murphy several years ago regarding selegiline and propargyl derivatives. Maybe he's just dumb when it comes to stimulants. Or maybe he's smart there too.
I don't have a problem with using amphetamine. I am not terribly concerned with abuse. I certainly believe that it has an important place as an augmentor of standard antidepressants. I might want to add Adderall to my regime if I get stuck. However, as monotherapy to treat MDD or BD, I question its efficacy beyond the acute response.
- Scott
----------------------------------------------Am J Psychiatry. 1978 Oct;135(10):1179-84. Related Articles, Links
Prediction of imipramine antidepressant response by a one-day dextro-amphetamine trial.
van Kammen DP, Murphy DL.
This study provides additional evidence that there is a moderate association between the acute activation, euphoria, and antidepressant responses to dextro-amphetamine and the antidepressant response to imipramine during a four-week trial. Comparison of the responses of 13 patients to dextro-amphetamine on two different days during a double blind trial indicated that differences in dextro-amphetamine response are consistent, replicable characteristics of individual depressed patients. The variables of sex, diagnosis, diurnal mood variation, platelet MAO activity, and MMPI scale scores were of minimal assistance in revealing factors that might be associated with activation or antidepressant responses to dextro-amphetamine in this small patient group. The authors suggest the need for larger-scale studies in this area.
Publication Types:
* Clinical Trial
* Controlled Clinical Trial
PMID: 358845 [PubMed - indexed for MEDLINE]Display Show
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1: J Clin Psychopharmacol. 1988 Jun;8(3):177-83. Links
Comment in:
J Clin Psychopharmacol. 1989 Dec;9(6):453-4.Amphetamine, but not methylphenidate, predicts antidepressant efficacy.
* Little KY.
Department of Psychiatry, University of Kentucky Medical Center, Lexington 40536-0080.
Several researchers have explored the possibility that acute stimulant response may predict eventual improvement after specific antidepressants. This review analyzes the relationship between stimulant response and nonspecific antidepressant response. In five studies, amphetamine responders were found to eventually improve after antidepressant treatment in 85% of the cases, while nonresponders improved in 43% of the cases. In contrast, acute methylphenidate responders and nonresponders eventually improved on antidepressants at equivalent rates. Amphetamine sensitivity appears to be a trait (possibly pharmacodynamic) that is independent of depressive illness but predictive of tricyclic responsiveness. Other evidence has suggested that amphetamine and methylphenidate cause similar behavioral and symptomatic effects through distinct mechanisms of potential clinical relevance. The most effective method for administering an amphetamine challenge and its appropriate clinical use remain unclear.
PMID: 3288653 [PubMed - indexed for MEDLINE]
poster:SLS
thread:721931
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