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.