A psychostimulant used for treating depression in patients with a prognosis of <3 months because they may not live long enough to benefit from conventional antidepressants. A response is achieved in a few days by increasing the dose until benefit or undesirable effects occur.
Well tolerated; no lag time to effect; rapid clearance from the body; improves appetite.
Can only be given PO; may precipitate or exacerbate delirium; undesirable effects include restlessness, hallucinations, insomnia, tachycardia and hypertension; tolerance may develop.
Start with 2.5 mg in the morning, increase progressively every 2 days if necessary up to 20 mg in the morning.
Psychostimulants. Twycross R, Wilcock A (Ed). Palliative Care Formulary. 3rd Ed. Palliativedrugs.com Ltd, United Kingdom, 2007. pp. 167-171.