Effects of Dextroamphetamine on Depression and Fatigue in Men With HIV: A Double-Blind, Placebo-Controlled Trial

Background: This report documentsfindings from a small placebo-controlled trial ofdextroamphetamine for depression and fatigue in men with thehuman immunodeficiency virus (HIV). Dextroamphetamine offers thepotential for rapid onset of effect and activation properties,both of which are important to persons with medical illness andan uncertain, but limited, life expectancy.

Method: Primary inclusion criteria included thepresence of a DSM-IV depressive disorder, debilitating fatigue,and no history of dependence on stimulants. The study consistedof a 2-week randomized, placebo-controlled trial, with the blindmaintained until week 8 for responders, followed by opentreatment through the completion of 6 months.

Results: Of 23 men who entered the study, 22completed the 2-week trial. Intent-to-treat analysis indicatedthat 73% of patients (8/11) randomly assigned todextroamphetamine reported significant improvement in mood andenergy, compared with 25% (3/12) among placebo patients (Fisherexact test, p < .05). Both clinician- and self-administeredmeasures indicated significantly improved mood, energy, andquality of life among patients taking dextroamphetamine. Therewas no evidence of the development of tolerance of, abuse of, ordependence on the medication.

Conclusion: These results suggest thatdextroamphetamine is a potentially effective, fast-actingantidepressant treatment for HIV patients with depression anddebilitating fatigue.