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Apathy Syndrome and Pituitary microadenoma??
I just found this article from The Journal of Neuropsychiatry & Clinical Neurosciences and was wondering if you could comment on the last part of it, which I have asterics in front of;
Although the majority of pituitary adenomas are benign, the physical, emotional, and cognitive changes that these patients experience on their well-being is malignant. Pituitary disease causes a variety of physical illnesses resulting from the alterations in the hypothalamic-pituitary-end organ axis. In addition, patients with pituitary diseases may experience many emotional problems, including depression, anxiety, behavioral disturbances, and personality changes, above and beyond the many reactions these patients may have to the myriad of adjustments that they must make in their lives. There is a growing understanding that pituitary patients may experience these emotional problems as a result of long-term effects that the pituitary tumor itself, treatment, and/or hormonal changes have on the hypothalamic-pituitary-end organ axis.
********** The authors present a series of cases, in which patients with pituitary disease were diagnosed and treated for depression and showed little response to the treatment for depression. When the diagnosis of apathy syndrome was considered and treatment implemented, the patients’ condition improved. A review of the literature on apathy, hypothalamic-pituitary-end organ axis dysfunction, and treatment for apathy syndrome is included.
I have been on between 35 - 40 anti-depressants and anti-anxiety medications with very, very little help to none whatsoever. I'm curious about this Apathy Syndrome and how they might treat it differently. I'm at the point where it is definately worth looking at. My pituitary microadenoma is only 4mm and located on the right side. Over the past couple months I have had increasing numbness and tingling on the left side of my head, light headed feelings and sometimes the left side of my head will go completely numb. I was seen at the Mayo Clinic almost two years ago and they told me they were 100% positive my pituitary microadenoma was not causing me any problems and my symptoms were not related to it at all. At the time I saw them I was seeing two spots almost constantly out of my right eye, insomnia (which has now become constant fatigue), depression, anxiety, erection problems, shaking, shaking during sex, a feeling of being off balance, uncordinated, severe headaches, severe pain behind and above both my eyes and in the middle of my forehead. My eyes feel as if though something is trying to push them out. When I become fatigued my top left eyelid droops, my night vision has become horrific and many other problems.
Although the majority of pituitary adenomas are benign, the physical, emotional, and cognitive changes that these patients experience on their well-being is malignant. Pituitary disease causes a variety of physical illnesses resulting from the alterations in the hypothalamic-pituitary-end organ axis. In addition, patients with pituitary diseases may experience many emotional problems, including depression, anxiety, behavioral disturbances, and personality changes, above and beyond the many reactions these patients may have to the myriad of adjustments that they must make in their lives. There is a growing understanding that pituitary patients may experience these emotional problems as a result of long-term effects that the pituitary tumor itself, treatment, and/or hormonal changes have on the hypothalamic-pituitary-end organ axis.
********** The authors present a series of cases, in which patients with pituitary disease were diagnosed and treated for depression and showed little response to the treatment for depression. When the diagnosis of apathy syndrome was considered and treatment implemented, the patients’ condition improved. A review of the literature on apathy, hypothalamic-pituitary-end organ axis dysfunction, and treatment for apathy syndrome is included.
I have been on between 35 - 40 anti-depressants and anti-anxiety medications with very, very little help to none whatsoever. I'm curious about this Apathy Syndrome and how they might treat it differently. I'm at the point where it is definately worth looking at. My pituitary microadenoma is only 4mm and located on the right side. Over the past couple months I have had increasing numbness and tingling on the left side of my head, light headed feelings and sometimes the left side of my head will go completely numb. I was seen at the Mayo Clinic almost two years ago and they told me they were 100% positive my pituitary microadenoma was not causing me any problems and my symptoms were not related to it at all. At the time I saw them I was seeing two spots almost constantly out of my right eye, insomnia (which has now become constant fatigue), depression, anxiety, erection problems, shaking, shaking during sex, a feeling of being off balance, uncordinated, severe headaches, severe pain behind and above both my eyes and in the middle of my forehead. My eyes feel as if though something is trying to push them out. When I become fatigued my top left eyelid droops, my night vision has become horrific and many other problems.
My understanding is that cataracts typically develop from too much exposure to the sun & it is true that high blood pressure is thought to be a source of headaches. But I can't help but wonder if even small tumors might not cause some kind of pain- like a small pebble that doesn't belong in one's shoe.
I can not help much with experience. I too was at Mayo 2 years ago and again last year with a 3x4mm pit tumor on the right side which they said was not causing me any symptoms. I was sent to 2 different psychiatrist at Mayo and they both ruled that I did not have depression but that maybe some talk therapy could help. I have started to see an internist in my home town now and I have been having headaches daily. They thought it was from my high blood pressure I am scheduled for an mri on the 11th to rule out (I think) that the tumor is not growing. I saw a my old eye dr who was the one that did encourage me to have an mri done 2 yrs ago and the results last week was that I have cataracts now (I'm 49) and he has scheduled me for my peripheral test on friday.
Some of your symptoms are so similar to mine and I just want you to know that your not alone in this and don't give up. Keep doing your research and stay positive.
Care
Some of your symptoms are so similar to mine and I just want you to know that your not alone in this and don't give up. Keep doing your research and stay positive.
Care
Hi. Just thought you might be interested to hear that apathy was really the very first symptom my son exhibited with his pituitary tumor, though of course we didn't recognize at the time that anything was seriously wrong.
He was always a very "typical" little boy - loud, extremely active, very verbal, and curious about everything. When he turned 7, he began to change; less active, more withdrawn. I thought it was school stress causing the change, but it got to the point that he really had no interest in anything. He could still enjoy building Lego creations and origami, but after finishing a project, he couldn't have cared less about it, which was very unlike him. Even a fantastic array of Christmas presents didn't interest him (he has a very generous uncle). He became very depressed about homework, so I still thought it was just school issues.
When he first started showing physical symptoms of illness (abdominal pain, headaches, eating and food issues, and above all extreme light sensitivity) I took him to a GP, an opthalmologist, an allergist and a neurologist. They all suggested he should be seen by a psychiatrist! None of them thought anything was so terribly wrong, except that the neurologist thought he must be autistic! (The GP later apologized for his misdiagnosis, the neurologist did not).
It does make one wonder how many people are walking around with an undiagnosed pituitary disease, who are on anti-depressants because they were told, "it's just stress, you have an anxiety disorder, there's nothing physically wrong with you".
I hope that more doctors now are thinking of hormone dysfunction as a cause of anxiety and apathy. If only they would refer their patients to endocrinologists first, instead of psychiatrists, so many more people would get the early care they really need. Neurosurgeons say, on average , most patients go 2 years before they get the correct diagnosis, but I have talked to many that went 5 years and longer.
He was always a very "typical" little boy - loud, extremely active, very verbal, and curious about everything. When he turned 7, he began to change; less active, more withdrawn. I thought it was school stress causing the change, but it got to the point that he really had no interest in anything. He could still enjoy building Lego creations and origami, but after finishing a project, he couldn't have cared less about it, which was very unlike him. Even a fantastic array of Christmas presents didn't interest him (he has a very generous uncle). He became very depressed about homework, so I still thought it was just school issues.
When he first started showing physical symptoms of illness (abdominal pain, headaches, eating and food issues, and above all extreme light sensitivity) I took him to a GP, an opthalmologist, an allergist and a neurologist. They all suggested he should be seen by a psychiatrist! None of them thought anything was so terribly wrong, except that the neurologist thought he must be autistic! (The GP later apologized for his misdiagnosis, the neurologist did not).
It does make one wonder how many people are walking around with an undiagnosed pituitary disease, who are on anti-depressants because they were told, "it's just stress, you have an anxiety disorder, there's nothing physically wrong with you".
I hope that more doctors now are thinking of hormone dysfunction as a cause of anxiety and apathy. If only they would refer their patients to endocrinologists first, instead of psychiatrists, so many more people would get the early care they really need. Neurosurgeons say, on average , most patients go 2 years before they get the correct diagnosis, but I have talked to many that went 5 years and longer.
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