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January 15, 2008The Journal of Clinical Psychiatry

Osmotic-Release Oral System Methylphenidate Augmentation of Antidepressant Monotherapy in Major Depressive Disorder

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Key result

Adjunctive OROS methylphenidate did not significantly improve MADRS scores compared to placebo, but significantly improved apathy (P=0.01) and fatigue (P<0.01).

Why the study?

Does adjunctive OROS methylphenidate improve depressive symptoms in outpatients with MDD who failed previous antidepressant monotherapies?

Population

145 outpatients with major depressive disorder who had failed 1 to 3 previous antidepressant monotherapies…

Comparison

Adjunctive osmotic-release oral system… vs Matching placebo added to stable oral…

Design

RCT, randomized, double-blind

Follow-up

5 weeks

Authors

ARArun RavindranSKSidney H. KennedyMOMicheal C. O’Donovan

Discussion

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Overview

Does not support adjunctive OROS methylphenidate for overall MDD symptoms; leaves open targeted benefits for apathy and fatigue.

Study Design

Type

RCT (n=145)

Blinding

Double-blind

Randomization

randomized

Multicenter

Yes

Structured PICO

Does adjunctive OROS methylphenidate improve depressive symptoms in outpatients with MDD who failed previous antidepressant monotherapies?

P
Population
145 outpatients with major depressive disorder who failed 1 to 3 previous antidepressant monotherapies, receiving a stable oral antidepressant regimen, followed for 5 weeks.
I
Intervention
Adjunctive osmotic-release oral system (OROS) methylphenidate (initiated at 18 mg, increased to maximum 54 mg) added to stable oral antidepressant regimen for 5 weeks
C
Comparator
Matching placebo added to stable oral antidepressant regimen
O
Outcome
Montgomery-Asberg Depression Rating Scale (MADRS) at 5-week endpointpatient reported

Adjunctive OROS methylphenidate does not significantly improve overall depressive symptoms in MDD but may improve specific symptoms of apathy and fatigue.

Cite This Study

Ravindran et al. (2008) conducted an RCT in Major depressive disorder (MDD) (n=145). Osmotic-release oral system (OROS) methylphenidate vs. Placebo was evaluated on Montgomery-Asberg Depression Rating Scale (MADRS) score at endpoint. Adjunctive OROS methylphenidate did not significantly improve MADRS scores compared to placebo, but significantly improved apathy (P=0.01) and fatigue (P<0.01).

synapsesocial.com/papers/6a962270ddd6ea87ec165092https://doi.org/10.4088/jcp.v69n0112
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