Glenn J. Wagner and Richard Rabkin
Background: This report documents
findings from a small placebo-controlled trial of
dextroamphetamine for depression and fatigue in men with the
human immunodeficiency virus (HIV). Dextroamphetamine offers the
potential for rapid onset of effect and activation properties,
both of which are important to persons with medical illness and
an uncertain, but limited, life expectancy.
Method: Primary inclusion criteria included the
presence of a DSM-IV depressive disorder, debilitating fatigue,
and no history of dependence on stimulants. The study consisted
of a 2-week randomized, placebo-controlled trial, with the blind
maintained until week 8 for responders, followed by open
treatment through the completion of 6 months.
Results: Of 23 men who entered the study, 22
completed the 2-week trial. Intent-to-treat analysis indicated
that 73% of patients (8/11) randomly assigned to
dextroamphetamine reported significant improvement in mood and
energy, compared with 25% (3/12) among placebo patients (Fisher
exact test, p < .05). Both clinician- and self-administered
measures indicated significantly improved mood, energy, and
quality of life among patients taking dextroamphetamine. There
was no evidence of the development of tolerance of, abuse of, or
dependence on the medication.
Conclusion: These results suggest that
dextroamphetamine is a potentially effective, fast-acting
antidepressant treatment for HIV patients with depression and
debilitating fatigue.
J Clin Psychiatry 2000;61(6):436-440
© Copyright 2000 Physicians Postgraduate Press, Inc.