Varun Monga1, Prasad R Padala1. 1. Dr. Monga is from Banner Thunderbird Medical Center, Glendale, Arizona, and Dr. Padala is from the Central Arkansas Veteran's Healthcare System Geriatric Research Education and Clinical Center, Little Rock, Arkansas.
Abstract
OBJECTIVE: The objective of this article is to present a case of improved outcome of apathy syndrome with aripiprazole. CASE SUMMARY: A 42-year-old man with depression and seizure disorder had significant apathy that did not respond to carbamazepine, sertraline, and topiramate. Apathy was assessed using Apathy Evaluation Scale. Discontinuation of carbamazepine did not alleviate apathy. Aripiprazole, a novel antipsychotic with partial agonistic activity at dopamine D2 receptors, was introduced and the dose adjusted to 15mg a day. The patient showed significant improvement in apathy after six weeks of therapy with aripiprazole. DISCUSSION: Depression is often mistaken for apathy, which is different in symptoms, presentation, and treatment options. Selective serotonin reuptake inhibitors are known to cause or increase symptoms of apathy in some patients. Recent evidence suggests that dopamine receptor agonists can be helpful in treatment of apathy. Apathy significantly improved in this patient after initiation of aripiprazole. CONCLUSION: Aripiprazole may be useful for treatment of apathy syndrome. Its role in treatment of apathy requires further investigation in clinical trials.
OBJECTIVE: The objective of this article is to present a case of improved outcome of apathy syndrome with aripiprazole. CASE SUMMARY: A 42-year-old man with depression and seizure disorder had significant apathy that did not respond to carbamazepine, sertraline, and topiramate. Apathy was assessed using Apathy Evaluation Scale. Discontinuation of carbamazepine did not alleviate apathy. Aripiprazole, a novel antipsychotic with partial agonistic activity at dopamine D2 receptors, was introduced and the dose adjusted to 15mg a day. The patient showed significant improvement in apathy after six weeks of therapy with aripiprazole. DISCUSSION: Depression is often mistaken for apathy, which is different in symptoms, presentation, and treatment options. Selective serotonin reuptake inhibitors are known to cause or increase symptoms of apathy in some patients. Recent evidence suggests that dopamine receptor agonists can be helpful in treatment of apathy. Apathy significantly improved in this patient after initiation of aripiprazole. CONCLUSION:Aripiprazole may be useful for treatment of apathy syndrome. Its role in treatment of apathy requires further investigation in clinical trials.
Authors: Prasad R Padala; William J Burke; Valerie K Shostrom; Subhash C Bhatia; Steven P Wengel; Jane F Potter; Frederick Petty Journal: Am J Geriatr Psychiatry Date: 2010-04 Impact factor: 4.105
Authors: Prasad R Padala; Kalpana P Padala; Varun Monga; Daniel A Ramirez; Dennis H Sullivan Journal: Ann Pharmacother Date: 2012-02-21 Impact factor: 3.154
Authors: M L Levy; J L Cummings; L A Fairbanks; D Masterman; B L Miller; A H Craig; J S Paulsen; I Litvan Journal: J Neuropsychiatry Clin Neurosci Date: 1998 Impact factor: 2.198