METHYLPHENIDATE IN POST LIVER-TRANSPLANT PATIENTS

Methylphenidate (Ritalin, manufacturer: Ciba/Geigy) has been shown eff ective for the treatment of depression in various medically ill popula tions, but to our knowledge its use in organ transplant patients has n ot been described. The authors retrospectively reviewed clinical recor ds of the first eight inpatients who received methylphenidate for trea tment of depressive and/or cognitive symptoms in the post liver transp lant period at Mount Sinai Medical Center. Target symptoms included ps ychomotor and cognitive slowing as well as lack of motivation for reco very, poor rehabilitation effort, social withdrawal, and apathy. A pos itive response was noted in seven patients, and in one patient the res ponse was equivocal. Side effects noted were increased blood pressure (N = 2) and subjective restlessness/agitation (N = 3). Methylphenidate appears to be an effective, rapidly acting agent in this setting at d osages of 10-20 mg/day, with minimal side effects. Methylphenidate may have a significant role in the care of an ever-increasing population of organ transplant recipients with multiple medical problems and asso ciated disabilities.