Pilocarpine With Psychostimulants

Abstract

To the Editor:— Dr. Nathan S. Kline's The Practical Management of Depression ( JAMA 190 : 732 [Nov 23] 1964) should be instructive to the physicians who are not psychiatrists but who are obliged to treat millions of depressed patients each year. Since there are not enough psychiatrists to handle these patients, it is reassuring to know that, except for the acutely suicidal patient, the personal physician can and should treat most depressed patients. Incidentally, Dr. Kline points out that psychostimulants almost always reduce salivation and that he has found no successful pharmacological treatment for this side effect. I have used small doses of pilocarpine nitrate per os—as little as 2.5 mg once, twice, or three times a day—with considerable success in counteracting this side effect. Judging from its pharmacological action, pilocarpine might also help alleviate the constipation and dysuria that have been recorded with the use of psychostimulants.