Table 3. Therapeutic use of stimulants in elderly patients without dementia.
| Author/Year | Design of Study | Drug | Therapeutic Use | Instrument Tool | Main Result |
|---|---|---|---|---|---|
| Gurian, 1990 | Case Report (N = 2) |
Methylphenidate (2.5 mg daily) | “To elevate mood” in very old subjects (91 and 104 years-old) |
DSM III R | Both patients months using methylphenidate were followed at least 8. They responded to low doses of methylphenidate, improving anhedonia, apathy, fatigue and loss of appetite. |
| Pobee, 1996 | Case Report | Methylphenidate (dose has not been reported) | Anorexia Nervosa | Not reported | Trial with methylphenidate failed to improve anorexia. |
| Sonde, 2001 | Double-Blind Placebo- Controlled (N=40) | Amphetamine (10 mg) vs placebo |
Impact of amphetamine added to physiotherapy after stroke |
FM motor performance score ADL with Barthel’s index | There was no significant difference between amphetamine or placebo in addition to physiotherapy on stroke related outcomes. |
| Ayache, 2001 | Case Report | Methylphenidate (5mg daily) | Respiratory insufficiency | Not reported | Methylphenidate accelerated the extubation process in a patient with respiratory insufficiency. |
| Turner, 2003 | Double-blind Pilot Trial (N= 6) | Methylphenidate (20 or 40 mg single dose) vs placebo | Improvement of age-related cognitive decline | CANTAB (PAL, SWM, SSP, NTOL, RVIP, IDED tasks) | There was no cognitive improvement after a single dose of methylphenidate. |
| Devos, 2007 | 3 months of a repeated-measures design was applied with one factor and four levels (N= 17) | Methylphenidate (1mg/Kg of methylphenidate separated in 3 doses per day) | Elderly with Parkinson | SWS test, the Tinetti Scale, the Unified Parkinson’s Disease Rating Scale (UPDRS) part III score and the Dyskinesia Rating Scale | Long term, high doses of methylphenidate, regardless L dopa use, improve gait and motor skills in elderly with Parkinson disease undergoing STN stimulation. |
| Sonde, 2007 | 3 months randomized, double-blind, placebo controlled clinical trail (N= 25) |
Amphetamine (20 or 10 mg/day) and L-dopa (100 or 50 mg/day) vs placebo vs L dopa alone | Stroke rehabilitation | FM motor performance score Barthel's ADL index | Despite not reaching statistical significance, there was an improvement trend in the groups using amphetamines compared with placebo or L dopa. |
| Espay, 2011 | 6 months randomized, placebo- controlled, double-blind (N= 27) | Methylphenidate (64.4 mg/day was the mean dose) | Gait impairment in Parkinson disease | ESS, FOGQ, GDS, H&Y MADRS, UPDRS, EQ-5D | Patients were randomly allocated to methylphenidate or placebo for 3 months and than crossed over for more 3 months of follow up. The use of methylphenidate didn’t improve gait and deteriorate motor function and quality of life. |
| Shorer, 2013 | Double-Blind Randomized Control Trial (N= 30) | Methylphenidate (10mg single dose) | Improving Falls | Single task: standing still; Dual task: standing still performing memory task; Single task: narrow base walking; Dual task: narrow base plus performing cognitive tasks | Single dose of methylphenidate was able to improve gait function in older adults, particularly when tasks demand high executive control such as in complex dual tasks. |