Psychostimulants in the treatment of depression

Psychostimulants promote alertness and reduce fatigues that have suggested their use in the treatment of depressive disorders in the early part of the 20th century. Overall, data support the use of psychostimulants in depression particularly in cases of drug resistance, when there is a severe physical illness or when short-term efficiency is needed, especially in the elderly. Psychostimulants are relatively better tolerated than conventional antidepressants, side effects concern less than 20% of patients. Nevertheless, they have to be prescribed carefully in front of the increased cases of misuse described by the literature and the French national committee of narcotics and psychotropics. Larger randomized, controlled trials with longer follow-up periods are needed to clarify a profile of response to psychostimulants, and assess the risk of developing tolerance or dependence on these substances.