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Although many treatments for agitation in patients with Alzheimer disease have been studied, less attention has been paid to apathy, a common early-onset and persistent contributor to caregiver burden, treatment participation, and overall patient dysfunction. In this multicenter North American trial, 200 patients with Alzheimer disease, mild-to-moderate cognitive impairment, and substantial apathy (80% were receiving antidementia medications) were randomized to receive the stimulant methylphenidate (10 mg twice daily) or placebo.
During 6 months of treatment, improvement in apathy scores was significantly greater with methylphenidate than with placebo; the largest benefit was observed during the first 100 days. At 6 months, proportions of pa…