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August 23/30, 2000

Treatment of Poststroke Depression—Reply

Author Affiliations

Stephen J.LurieMD, PhD, Contributing EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor

JAMA. 2000;284(8):959. doi:10.1001/jama.284.8.956

In Reply: As Drs Agrawal and Worzniak point out, the evidence supporting the utility and safety of methylphenidate in the treatment of patients with poststroke depression includes, predominantly, case reports and open trials.1,2 The only published double-blind, placebo-controlled trial of methylphenidate in poststroke patients did not examine poststroke depression.3 Although the patients reported a significantly greater improvement in Hamilton Depression Rating Scale score and Zung Self-Rating Depression Scale score when treated with methylphenidate compared with placebo, the patients were not selected for the existence of either major or minor depression and their depression treatment response was not measured.