[The treatment with methylphenidate of demoralisation, apathy and hypoactive delirium in patients with somatic illness]

Abstract

In 3 patients, 2 women aged 21 and 65 and a man aged 60, admitted for the treatment of B-cell lymphoma, trauma caused by a traffic accident and Kahler's disease respectively, hypoactive delirium, apathy of unknown origin and depressive disorder or adjustment disorder with depressive mood ('demoralisation') were seen and caused somatic recovery to be compromised. The consulting psychiatrist prescribed methylphenidate with good results. They formed part of a group of 34 patients who were given methylphenidate on these indications over a period of 12 months. These indications are not among the accepted indications for this drug. In the literature, the beneficial use of psychostimulants in somatic illness has been described almost exclusively in palliative care and case reports of other somatically-ill patients with a poor prognosis. No reports were found on the effects of methylphenidate used for treatment of patients with hypoactive delirium nor were guidelines for its use in somatically-ill patients with a good prognosis. A randomised clinical trial to substantiate these reported findings is warranted.