Treatment with methylphenidate is not effective for depression in selective serotonin reuptake inhibitor (SSRI)-treated patients with advanced cancer in hospice or receiving palliative care, a study published in the journal Psycho-Oncology has shown.1
For the double-blind study, investigators enrolled 34 patients who had received prior treatment with an SSRI. Participants were randomly assigned to receive methylphenidate or placebo for 18 days. Depression was assessed using the Montgomery-Asberg Depression Rating Scale.
Results showed at day 18, 85% of methylphenidate-treated patients and 60% of those in the placebo arm were in depression remission, defined as a 50% or greater reduction in the rating scale score (P =.22).
The average time to depression remission was 10.3 days and 8.1 days in the methylphenidate and placebo arms, respectively.
Researchers also found that the mean score for the Hospital Anxiety and Depression Scale (HADS) was 10.4 in each group at baseline and decreased by 3.6 in the methylphenidate group and 2.3 in the placebo group (P =.51) by day 18.
Once in remission, 1 patient in the methylphenidate arm and 5 in the placebo arm relapsed to depression (P =.18). There was no significant difference in mortality between the 2 groups during the 18-day trial.
Of note, these findings were limited by small sample size attributed to the difficulty in recruiting patients who are terminally ill.
1. Sullivan DR, Mongoue-Tchokote S, Mori M, Goy E, Ganzini L. Randomized, double-blind, placebo-controlled study of methylphenidate for the treatment of depression in SSRI-treated cancer patients receiving palliative care. Psychooncology. 2016 Aug 12. doi: 10.1002/pon.4220. [Epub ahead of print]