Augmentation of Dopaminergic Agents for Major Depressive Disorder

Letter to the Editor

Sir: We read with great interest the randomized,
double-blind, placebo-controlled clinical trial (RCT) entitled
"Osmotic-Release Oral System Methylphenidate Augmentation
of Antidepressant Monotherapy in Major Depressive Disorder:
Results of a Double-Blind, Randomized, Placebo-Controlled
Trial" (osmotic-release oral system methylphenidate [OROS
MPH] N = 73, placebo N = 72; mean dose of OROS MPH =
36.4 mg/day), which followed our earlier 4-week RCT (OROS
MPH N = 30, placebo N = 30; mean dose of OROS MPH =
34.2 mg/day). In their article, Ravindran et al. referenced our
study only in the form of an abstract that was presented in a scientific
meeting, without providing any detailed comparisons between
the 2 studies. We therefore will briefly introduce our
study results using a meta-analytic approach to extract findings
from the 2 studies in order to achieve better sample power. We
also provide meta-analytic findings from 4 RCTs of modafinil
augmentation for unipolar and bipolar depression.