Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Rothenhäusler, HB; Ehrentraut, S; von Degenfeld, G; Weis, M; Tichy, M; Kilger, E; Stoll, C; Schelling, G; Kapfhammer, HP.
Treatment of depression with methylphenidate in patients difficult to wean from mechanical ventilation in the intensive care unit.
J Clin Psychiatry. 2000; 61(10):750-755
Doi: 10.4088/JCP.v61n1007
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- Führende Autor*innen der Med Uni Graz
- Rothenhäusler Hans-Bernd
- Co-Autor*innen der Med Uni Graz
- Kapfhammer Hans-Peter
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- Abstract:
- BACKGROUND: Mechanical ventilation is often required to support patients in the intensive care unit (ICU) with life-threatening cardiovascular, respiratory, or neuromuscular disorders. Occasionally, difficulties related to weaning patients from this support occur owing to depression. The traditional and newer-generation antidepressant drugs have a relatively long latency of response that interferes with rehabilitation attempts in the ICU. Psychostimulants such as methylphenidate show a rapid onset of antidepressant activity and a benign side effect profile. METHOD: As consulting psychiatrists in the consultation-liaison service of a university hospital, we treated 7 patients with complex ICU courses presenting prolonged mechanical ventilation and psychomotor retardation associated with markedly depressed mood (DSM-IV criteria) by giving them methylphenidate. Methylphenidate was started on the first day at a dose of 2.5 mg p.o. in the morning and was increased by 2.5 mg each day with twice-a-day dosing in the morning and at noon until the patient responded or showed side effects. A maximum dose of 15 mg/day was not exceeded. Outcome evaluation was performed using the Clinical Global Impressions scale. RESULTS: Five (71 %) of 7 patients showed marked or moderate improvement in mood and activity within 3 to 4 days, and discontinuation of ventilator support was achieved within 8 to 14 days. Side effects with these 5 patients were not encountered. Of the remaining 2 patients (29%), 1 developed psychomotor agitation and anxiety within 4 days. Another patient showed only minimal improvement with regard to activity. CONCLUSION: Methylphenidate might be a rapidly effective and safe treatment for depression in difficult-to-wean patients hospitalized for life-threatening medical illness in the ICU. Implications for future research for this population of patients warrant formal randomized, prospective, clinical case-control evaluation.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Aged -
- Aged, 80 and over -
- Central Nervous System Stimulants - therapeutic use
- Depressive Disorder - diagnosis
- Drug Administration Schedule - diagnosis
- Female - diagnosis
- Humans - diagnosis
- Intensive Care Units - diagnosis
- Male - diagnosis
- Methylphenidate - therapeutic use
- Middle Aged - therapeutic use
- Psychiatric Status Rating Scales - statistics and numerical data
- Respiratory Insufficiency - therapy
- Treatment Outcome - therapy
- Ventilator Weaning - adverse effects
- Ventilators, Mechanical - adverse effects