Methylphenidate may treat apathy independent of depression.
OBJECTIVE
To report a case of apathy treated with methylphenidate in which improvement in apathy was independent of improvement of depression.


METHODS
A 47-year-old woman with a 20-year history of recurrent major depression was diagnosed as having significant apathy with lack of initiative and motivation. Over the course of a 4-week treatment regimen with methylphenidate, her apathy, as measured by the Apathy Evaluation Scale, improved, with her score decreasing from 57 to 31. During this period, her depression, as assessed by the 21-item Hamilton Rating Scale for Depression, remained unchanged.


CONCLUSIONS
Our report of improvement of apathy with methylphenidate is consistent with other reports in the literature, although previous studies have not specifically used the rating scales to assess apathy. Even though this patient had experienced apathy for a long time, it had not been detected due to lack of direct questioning. In this case, as noted, the improvement of apathy was independent of improvement in depression.


CONCLUSIONS
A high degree of suspicion and specific inquiry is required for identification of apathy. Once detected, methylphenidate may be beneficial in its treatment, a strategy that may work independently of augmentation of antidepressants.
Padala
Prasad R
PR
Omaha Veterans Affairs Medical Center, Omaha, NE 68105-1873, USA. ppadala@unmc.edu
Petty
Frederick
F
Bhatia
Subhash C
SC
D000342:Affective Symptoms / Q000188:drug therapy* / Q000523:psychology; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006801:Humans; D008774:Methylphenidate / Q000627:therapeutic use*; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D013997:Time Factors; D016896:Treatment Outcome
D000697:Central Nervous System Stimulants; D008774:Methylphenidate