Brief ReportMethylphenidate for Apathy and Functional Status in Dementia of the Alzheimer Type
Section snippets
METHODS
We conducted a 12-week open-labeled study with immediate release formulation of methylphenidate. This study was approved by local institutional review boards. Informed consent was obtained from the patient after evaluation of competency. If they were found to be incompetent to consent, their legal surrogates signed the consent in addition to the assent from the patient. All patients had a diagnosis of DAT by Diagnostic and Statistical Manual IV-Text Revision criteria, Mini-Mental State
RESULTS
Twenty-one of the 23 subjects were white, one was African American, and one was Hispanic. Only one subject was woman. All patients were community dwelling, and their mean age was 70.4 years (±9.5), other baseline variables are presented in Table 1. Apathy was confirmed in all patients by the NPI. Other behavioral problems endorsed on the NPI include irritability (96%), agitation (78%), depression (78%), appetite disturbance (65%), sleep disturbance (57%), anxiety (57%), disinhibition (43%),
CONCLUSION
Apathy is a significant problem in patients with dementia. Treatments for apathy could have positive impact on caregiver burden and functional status. In this report, we found significant improvement in apathy during the 12-week trial of methylphenidate. This is in keeping with the previous reports with methylphenidate. Significant improvement was also noted in IADL. This finding could have significant impact on the quality of life of patients with DAT and could translate to decreased caregiver
References (11)
- et al.
Reliability and validity of the Apathy Evaluation Scale
J Psychiatr Res
(1991) - et al.
Development and validation of a geriatric depression screening scale: a preliminary report
J Psychiatr Res
(1982–83) Apathy: a neuropsychiatric syndrome
J Neuropsychiatry Clin Neurosci
(1991)Differential diagnosis and classification of apathy
Am J Psychiatry
(1990)- et al.
Methylphenidate treatment of negative symptoms in patients with dementia
J Neuropsychiatry Clin Neurosci
(1997)
Cited by (81)
Apathy in Alzheimer's disease: A neurocircuitry based perspective
2023, Ageing Research ReviewsTreating Apathy in Late-Life Depression
2021, American Journal of Geriatric PsychiatryNeuropsychiatric Aspects of Alzheimer Dementia: From Mechanism to Treatment
2020, Psychiatric Clinics of North AmericaSerotonergic system, cognition, and BPSD in Alzheimer's disease
2019, Neuroscience LettersBehavioral and psychological symptoms in Alzheimer's dementia and vascular dementia
2019, Handbook of Clinical NeurologyCitation Excerpt :A large placebo response and small sample size limit its interpretability. Methylphenidate has been studied in two RCTs and one open-label trial (Herrmann et al., 2008; Padala et al., 2010; Rosenberg et al., 2013). Apathy in Dementia Methylphenidate Trial (ADMET) was the first parallel group, multicenter, RCT of a medication intervention specifically designed to assess apathy in AD (Drye et al., 2013).
This work was supported by MXH/99-925-1314 grant from the Clinical Research Center at University of Nebraska Medical Center (to PRP) and the Nancy & Ronald Reagan Alzheimer's Scholarship Fund Award (to PRP).
This article was presented at the Annual meetings of the American Geriatrics Society and the International Conference on Alzheimer's Disease.