Apathy Due to Cerebrovascular Accidents Successfully Treated With Methylphenidate: A Case Series

Spiegel, David R.; Kim, B.S. Jeffrey; Greene, Brendan; Conner, Blaire; Zamfir, Dan

doi:10.1176/jnp.2009.21.2.216

Cited by 18 publications

(7 citation statements)

References 13 publications

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“…That study found a significant improvement in AES scores after 12 weeks of treatment. Other case reports have described using MTP to effectively treat apathy in the depressed population [135,136], the Parkinson's population [131], cerebrovascular accident patients [139], and patients with idiopathic normal pressure hydrocephalus [133]. Another recent RCT reported that apathy scores improved significantly in depressed patients who were treated with MTP in combination with an antidepressant, compared to patients using the antidepressant alone [138].…”

Section: Pharmacotherapy (Table 2)mentioning

confidence: 99%

The Role of Dopamine in Symptoms and Treatment of Apathy in Alzheimer's Disease

Mitchell

Herrmann

Lanctôt

2011

CNS Neuroscience & Therapeutics

109

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Section: Pharmacotherapy (Table 2)mentioning

confidence: 99%

The Role of Dopamine in Symptoms and Treatment of Apathy in Alzheimer's Disease

Mitchell

Herrmann

Lanctôt

2011

CNS Neuroscience & Therapeutics

109

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“…Some aver that apathy responds better to cholinesterase inhibitors, while a reduction in irritability and agitation may be more closely associated with memantine treatment (Cummings et al 2008). The successful use of methylphenidate to treat stroke-induced apathy has been reported (Spiegel et al 2009). Atypical antipsychotics given to patients with schizophrenia (clozapine alone or with mirtazapine, respiradone, olanzapine) as well as certain antidepressants (buproprion) and psychostimulants (amphetamine, methylphenidate, and modafinil) used in the treatment of various brain disorders are also said to have benefited apathy (Marangell et al 2002;Corcoran et al 2004;Daiello 2007;Padala et al 2007Padala et al , 2010.…”

Section: Current Therapeutic Approachesmentioning

confidence: 99%

Apathy in Neuropsychiatric Disease: Diagnosis, Pathophysiology, and Treatment

Chase¹

2010

Neurotox Res

116

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Apathy is an increasingly recognized concomitant of a broad range of central nervous system disorders. Nevertheless, its nosology, pathogenesis and therapy remain shrouded in confusion and controversy. As yet, there is little consensus regarding methods for detecting apathy, or distinguishing it from depression, or for assessing its severity. Many now regard the apathy syndrome as primarily reflecting a lack of motivation that compromises emotional, cognitive, and overt behavioral function. Even though under-recognized and under-diagnosed, apathy hardly appears uncommon: current epidemiologic studies suggest over 10 million Americans may be affected. Its reported frequency in various neurologic and psychiatric conditions varies widely, from less than 10 to over 80%, reflecting differences in population characteristics and assessment procedures. Often apathy has been associated with such neurodegenerative disorders as Alzheimer's disease, Parkinson's disease, and fronto-temporal dementia. But it also occurs in those with psychiatric disorders such as schizophrenia and major depression. Clinical, neuropathologic, and neuroimaging observations increasingly suggest that apathy reflects dysfunction of frontal-subcortical circuits, especially those linking the ventromedial prefrontal cortex to related regions in the basal ganglia. Therapeutically, numerous small studies suggest that psychostimulants, dopaminergics, and cholinesterase inhibitors may benefit those manifesting this syndrome. However, no adequately powered, randomized controlled trials have reported success and no medication have ever been approved for this disorder. The accelerating pace of current research nevertheless promises to improve our understanding of apathy and to better address the unmet medical needs of those suffering its consequences.

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“…It is believed to be due to malfunction of the brain's motivational circuitry . Research implies myriad causes, including basal ganglia dysfunction as seen in Parkinson disease, prefrontal and/or basal ganglia damage due to stroke, and endocrine dysfunction following a tumor or traumatic brain injury . Apathy is important to study because poorer outcome has been identified in those with apathy among numerous clinical populations.…”

Section: Introductionmentioning

confidence: 99%