Post-stroke depressions are under recognized and under treated. As most of the people with such depressions are elderly, physicians are often reluctant to prescribe antidepressants, because of the side-effects associated with antidepressant use. While antidepressants can be used, methylphenidate has also been found to be effective, and often is better tolerated. Treatment should be initiated with a dose of 5 mg. In the morning, and the dose can be gradually increased to a maximum of 1 mg per kg of body weight.
Most patients do best with doses on the lower end of the dosage range.
Many people with Seasonal Affective Disorder continue to get benefit from bright light therapy for many years. However, some people with this disorder do best when bright light therapy is supplemented by the use of antidepressant medications. Slightly more than one-third of 59 patients treated for Seasonal Affective Disorder at the National Institutes of Health for an average of 8.8 years required antidepressants in addition to light treatments. Tricyclic antidepressants, MAO inhibitors, and SSRIs were all found to be useful for some of these patients. Patients maintained on long-term SSRIs frequently have recurrences of their depressions despite the therapy.