Serving Skagit, Island, San Juan, and Snohomish Counties
Mon-Fri 8am-5pm

Palliative Pearl:

Day-Night Reversal in Dementia

June 2021 – Caring for a loved one who is up all night is not sustainable.

Using a low dose stimulant, like methylphenidate, in the daytime to treat apathy and daytime drowsiness has helped patients normalize sleep patterns in case reports.

We use methylphenidate to treat end of life fatigue successfully in select patients.  This is a new application to consider.

A starting dose of immediate release methylphenidate 2.5 mg in the morning and early afternoon is well tolerated by our patients. 

Titrating up as tolerated and changing to long acting formulation is recommended if effective.

For more information contact Dr. Leslie Estep or Dr. Anita Meyer at Hospice of the Northwest, 360-814-5550, or  or

About Hospice of the Northwest

Hospice of the Northwest is a skilled, caring and compassionate team of nursing, medical, social and spiritual professionals, volunteers and generous donors. Together, we provide comprehensive care and comfort for patients facing serious illness and the loved ones who care for them. We’ve been serving the residents of Skagit, Island, San Juan and Snohomish Counties since 1989.

We Honor Veterans
CHAP Provider
Seal of Transparency


Sign up to get interesting news and updates delivered to your inbox.

Sign Up Today!