Safety and efficacy of methylphenidate for apathy in Alzheimer's disease: a randomized, placebo-controlled trial

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Paul B Rosenberg1, Krista L Lanctôt, Lea T Drye

  • 1Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine.

The Journal of Clinical Psychiatry
|September 12, 2013
PubMed
Abstract

Insights

Methylphenidate effectively treated apathy in Alzheimer's disease patients, showing significant improvements in global impression and neuropsychiatric scores. The treatment was well-tolerated, with a trend towards cognitive benefits.

Area of Science:

  • Neurology
  • Psychiatry
  • Gerontology

Background:

  • Apathy is a common and debilitating symptom in Alzheimer's disease (AD).
  • Previous research suggested methylphenidate may alleviate apathy in AD.
  • The Apathy in Dementia Methylphenidate Trial (ADMET) was designed to further investigate this.

Purpose of the Study:

  • To assess the efficacy and safety of methylphenidate for treating apathy in Alzheimer's disease.
  • To evaluate changes in apathy using the Apathy Evaluation Scale (AES) and other measures.

Main Methods:

  • A 6-week, randomized, double-blind, placebo-controlled, multicenter trial.
  • 60 participants with AD and apathy were assigned to methylphenidate (20 mg/day) or placebo.
  • Primary outcomes included changes in AES and ADCS-CGI-C scores.

Main Results:

  • Methylphenidate showed a trend towards improving AES scores (P=.23).
  • Significant improvement was observed in ADCS-CGI-C (OR=3.7, P=.02) and NPI apathy scores (P=.02).
  • A trend towards improved Mini-Mental State Examination (MMSE) scores was noted (P=.06), with minimal adverse events.

Conclusions:

  • Methylphenidate treatment demonstrated efficacy in improving global impression and specific apathy measures in AD.
  • The drug was safe and well-tolerated, with a potential benefit for global cognition.
  • Methylphenidate is a promising treatment option for apathy in Alzheimer's disease.

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