Date of Award

2019

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Department Chair

Laura Levy, DHSc, PA-C

Abstract

OBJECTIVE The objective of this selective EBM review is to determine whether or not “Is methylphenidate effective in reducing apathy among Alzheimer’s disease patients?”

STUDY DESIGN Systematic review of two randomized controlled trials published in 2008 and 2013 and one open label study published in 2010.

DATA SOURCES Two randomized controlled trials and one open label study were obtained using PubMed and Medline.

OUTCOMES MEASURED The focus of this review is to determine the efficacy of methylphenidate in decreasing symptoms of apathy in Alzheimer’s disease patients. The efficacy of methylphenidate was assessed in all three studies by using the Apathy Evaluation Scale (AES). The significance of these outcomes was also determined by calculating the relative benefit increase, the absolute benefit increase and the numbers needed to treat.

RESULTS All three studies demonstrated improvement of AES score when treated with methylphenidate. The study by Padala et al. demonstrated a 20.26-point improvement on the AES with methylphenidate treatment. The study by Herrmann et al. demonstrated a 2.31-point improvement on the AES in the experimental group and the study by Rosenburg et al. demonstrated a 1.9-point improvement on the AES in the experimental group.

CONCLUSIONS The studies analyzed in this selective EBM review suggest that methylphenidate is effective at improving apathy in Alzheimer’s disease patients. The studies by Padala et al. and Herrmann et al. demonstrated statistically significant results of apathy improvement in Alzheimer’s patients with methylphenidate treatment. Further analysis is warranted to determine tolerability based on dosing.

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