Disputing preliminary findings on methylphenidate-desipramine responses

issue),be awareJ. Dnimmer, M.D., that methylphenidateand associates did not seem originally was introducedand, before the adventto assaying that a therapeutic“mood elevation from methylphenidate response to desipramine.” Thepredicted that 20 ofa treatmentfor depressive26 methylphenidateimip-the tricyclics, was quite also used with success,mine es in and the amobarbitalsuccessful. The amphetamines were as were a combination of amphetathat, unfortunately, is no longer disorders. to develop onthe market.All theseit wasa varietyunusual forvery goodsuccess-ramine or desipramine is not sufficient basis, because any comparison with an “expected” response rate, based on the literature, would be unconvincing. Similarly, among methylphenidate nonresponders, five of five patients given amitriptyline improved, but no methylphenidate responders wereUnfortunately, tolerance andline, onlyamitniptyline.the datanortniptycan saydoses.as an early symptom relief their positiveMany clinicians still use methylphenidate adjunct to the treatment of depression to give during the time the tricyclics require to produce effect. HANSwhich is certainly that most patientsvery interesting, the respond to tricyclics. JEFFREYA. MATTES,Belle Mead,N.J.R. HUESSY, Burlington,M.D. Vt.Dr. SabelliDr. GitlinSIR: We appreciate Dr. Huessy’s brief synopsis of the history of psychostimulants in the treatment of depression. If his purpose was to point out that methylphenidate alone has antidepressant action, we do not dispute that. In fact, weSIR: We agree with Dr. Mattes that a study of imipramine and desipramine in methylphenidate nonresponders should be conducted because it is not an established fact that methylphenidate predicts responsiveness to these agents. This very fact moved us to report our observations. We donot agreehis conclusionwe couldnot excludethe possibilitymethyl-phenidate was the sole active agent in our case. However,...