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Most patients with unipolar depression experience residual symptoms after initial treatment, and those who experience only partial resolution have higher relapse risk and lower quality of life. Studies of psychostimulants (modafinil, armodafinil, methylphenidate, dextroamphetamine, lisdexamfetamine [LDX]) for antidepressant augmentation have yielded mixed results. The most convincing evidence is from two studies showing better outcomes with add-on methylphenidate than with citalopram alone in depressed older adults (medium-to-large effect sizes; e.g., NEJM JW Psychiatry Apr 2015 and Am J Psychiatry 2015; 172:561). LDX, a newer psychostimulant prodrug with a low potential for abuse and with FDA approval for treating attention-deficit/hyperac…