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

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