Citalopram Plus Methylphenidate Better Than Either Alone for Geriatric Depression


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Am Fam Physician. 2015 Nov 1;92(9):820.

Clinical Question

What is the comparative effectiveness of citalopram (Celexa), methylphenidate (Ritalin), or both for the treatment of depression among older patients?

Bottom Line

Combined treatment with citalopram plus methylphenidate provided faster improvement of depression symptoms in older patients with unipolar depression. Combined treatment was also more likely than either medication alone to lead to remission of depression at four weeks and 16 weeks. The study was too small to assess clinically meaningful differences in rare adverse drug effects. Because there was no dose-response effect with titration of the methylphenidate, a low dose (e.g., 5 mg twice daily) seems prudent. (Level of Evidence = 1b)


This randomized controlled trial of older patients with depression compared citalopram plus placebo (n = 48), methylphenidate plus

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