Data were extracted and checked by two authors. Cochrane Collaboration guidelines assessed bias risk in 6-domains. GRADE criteria rated overall evidence. Results Six papers were identified (including two from previous review), outlining five RCTs and two n-of-1 trials. Five used MPD alone and two MPD as adjunct to mirtazapine or SSRI, for a total of 229 patients. Trials compared MPD to placebo or desipramine. Small sample sizes and poor recruitment meant all trials were at high bias risk.

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... unately, trials were heterogeneous and meaningful meta-analysis could not be performed. Most trials showed a trend toward effectiveness, however results were frequently not statistically significant. One recent trial found no evidence of effect. Methylphenidate was generally well-tolerated. Conclusion There remains no conclusive evidence as to whether methylphenidate is an effective antidepressant in PC cohorts. REFERENCE 1. Candy, et al. Psychostimulants for depression. Cochrane Database 2008;(2): CD006722.