Pituitary macroadenoma: Is anyone familiar with Apathy Syndrome?

Posted by medfordor @medfordor, Sep 14, 2020

I had a pituitary macro adenoma removed 10 years ago and I have developed a severe case of apathy, both in my personal and professional life. I cannot focus or concentrate at work and I have not motivation to either work or pursue my former leisure interests. I have seen some studies on this, but never met anyone that knows anything about it.

Interested in more discussions like this? Go to the Brain Tumor group.

Hi @medfordor, welcome to Mayo Clinic Connect. You'll notice that I added your question to the Brain Tumor group (https://connect.mayoclinic.org/group/brain-tumor-support-group/) as well as the Endocrine System group. I think fellow members like @daphne2020 @astaingegerdm @rubyjane @gemttaz and others may have experience with the side effect of apathy after surgery. Here are some additional related discussions you may wish to review.

– Saying Hello! Just had surgery for a pituitary tumor https://connect.mayoclinic.org/discussion/saying-hello-1/
– Pituitary microadenoma causing hormonal issues https://connect.mayoclinic.org/discussion/pituitary-microadenoma/
– Pituitary macroadenoma tumor removal and short term memory loss https://connect.mayoclinic.org/discussion/pituitary-macroadenoma-and-short-term-memory-loss/

@medfordor, you said your surgery was 10 year ago. Has apathy always been a side effect since then or is it a more recent development?

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@colleenyoung

Hi @medfordor, welcome to Mayo Clinic Connect. You'll notice that I added your question to the Brain Tumor group (https://connect.mayoclinic.org/group/brain-tumor-support-group/) as well as the Endocrine System group. I think fellow members like @daphne2020 @astaingegerdm @rubyjane @gemttaz and others may have experience with the side effect of apathy after surgery. Here are some additional related discussions you may wish to review.

– Saying Hello! Just had surgery for a pituitary tumor https://connect.mayoclinic.org/discussion/saying-hello-1/
– Pituitary microadenoma causing hormonal issues https://connect.mayoclinic.org/discussion/pituitary-microadenoma/
– Pituitary macroadenoma tumor removal and short term memory loss https://connect.mayoclinic.org/discussion/pituitary-macroadenoma-and-short-term-memory-loss/

@medfordor, you said your surgery was 10 year ago. Has apathy always been a side effect since then or is it a more recent development?

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Thank you mod Colleen! My apathy has become more noticeable in the past five years. I though maybe I was just bored at work and at home – my doctors thought it was depression, but 4 years of varying antidepressants had no effect. It was only recently I read an article in the Journal of Neuropsychiatry about apathy in pituitary surgery patients that I recognized all my symptoms.

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I just joined this site and saw your post in apathy from 2 years ago. I had 4 surgeries since 2000 and radiation. I too struggle with this. Have you received more info or treatment for this?

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@limorris

I just joined this site and saw your post in apathy from 2 years ago. I had 4 surgeries since 2000 and radiation. I too struggle with this. Have you received more info or treatment for this?

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Hello @limorris and welcome to Mayo Clinic Connect. It looks like you may be attempting to respond to @medfordor, is that right?

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@limorris

I just joined this site and saw your post in apathy from 2 years ago. I had 4 surgeries since 2000 and radiation. I too struggle with this. Have you received more info or treatment for this?

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After reading your initial comments about apathy syndrome I did some research and have nothing more but questions. Can I Be directed to anyone at Mayo who participated in multiple studies about apathy syndrome?

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@jrlynch

After reading your initial comments about apathy syndrome I did some research and have nothing more but questions. Can I Be directed to anyone at Mayo who participated in multiple studies about apathy syndrome?

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Hi @jrlynch, do you suspect that you may have apathy syndrome?

@limorris, what type of brain tumor did you have? How do you manage the side effect of apathy?

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@colleenyoung

Hi @jrlynch, do you suspect that you may have apathy syndrome?

@limorris, what type of brain tumor did you have? How do you manage the side effect of apathy?

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My research is for my brother. A Neurosurgeon placed a stent in his brain to alleviate pressure cause by excess cerebral fluid a condition called “normal pressure hydrocephalus”. Since then he has exhibited symptoms of Apathy including dizziness with nausea and vomiting, and constant sleeping. Doctors here cannot find any reasons for his condition. That’s why I am researching Apathy Syndrome.

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@jrlynch

My research is for my brother. A Neurosurgeon placed a stent in his brain to alleviate pressure cause by excess cerebral fluid a condition called “normal pressure hydrocephalus”. Since then he has exhibited symptoms of Apathy including dizziness with nausea and vomiting, and constant sleeping. Doctors here cannot find any reasons for his condition. That’s why I am researching Apathy Syndrome.

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It is definitely something to bring up with his neurologist. @jrlynch, you may also be interested in these NPH-related discussions:
– Normal Pressure Hydrocephalus https://connect.mayoclinic.org/discussion/normal-pressure-hydrocephalus/?pg=2
– normal pressure hydrocephalus research https://connect.mayoclinic.org/discussion/normal-pressure-hydrocephalus-2/
– Normal pressure hydrocephalus (NPH) and dealing with work https://connect.mayoclinic.org/discussion/nph-and-dealing-with-work/

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@colleenyoung

Hi @medfordor, welcome to Mayo Clinic Connect. You'll notice that I added your question to the Brain Tumor group (https://connect.mayoclinic.org/group/brain-tumor-support-group/) as well as the Endocrine System group. I think fellow members like @daphne2020 @astaingegerdm @rubyjane @gemttaz and others may have experience with the side effect of apathy after surgery. Here are some additional related discussions you may wish to review.

– Saying Hello! Just had surgery for a pituitary tumor https://connect.mayoclinic.org/discussion/saying-hello-1/
– Pituitary microadenoma causing hormonal issues https://connect.mayoclinic.org/discussion/pituitary-microadenoma/
– Pituitary macroadenoma tumor removal and short term memory loss https://connect.mayoclinic.org/discussion/pituitary-macroadenoma-and-short-term-memory-loss/

@medfordor, you said your surgery was 10 year ago. Has apathy always been a side effect since then or is it a more recent development?

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My pituitary adinoma surgery was Nov 93. I have recently in the last couple years been noticing a decline in interest to do things. I have sought medical help and they treated me for depression. Now that i have begun to learn more about apathy and the pituitary, i feel like that is closer to what I am experiencing. Is there any testing i can do to be certain and what are the treatments for apathy?

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Have you learned about any resources since posting this information, i am interested to learn more about the apathy as I feel like i am developing this as a result of my pituitary adenoma from 1993.

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@rbraley

My pituitary adinoma surgery was Nov 93. I have recently in the last couple years been noticing a decline in interest to do things. I have sought medical help and they treated me for depression. Now that i have begun to learn more about apathy and the pituitary, i feel like that is closer to what I am experiencing. Is there any testing i can do to be certain and what are the treatments for apathy?

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Hi Rbraley, prompted by your post, I did a little digging and found this article
– Apathy Is Not Depression https://neuro.psychiatryonline.org/doi/full/10.1176/jnp.10.3.314
Some key points in the article that struck me are:
"…apathy and depression are clinically distinct neuropsychiatric syndromes"
"Apathy is defined as diminished motivation not attributable to decreased level of consciousness, cognitive impairment, or emotional distress. Depression involves considerable emotional distress, evidenced by tearfulness, sadness, anxiety, agitation, insomnia, anorexia, feelings of worthlessness and hopelessness, and recurrent thoughts of death."

In the article, the authors mention the Apathy Evaluation Scale. Here's a link to more information.
– Clinical Utility and Psychometric Properties of the Apathy Evaluation Scale https://psycnet.apa.org/fulltext/2020-59952-004.html

@jrlynch @limorris @medfordor @rbraley, have any of your doctors talked about apathy evaluation with you?

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Living with Panhypopituitary (no pituitary function) and Apathy
My pituitary function is gone due to a macro-adenoma. I had transsphenoidal surgery for removal in 2013. I am on various hormone supplements and am steroid dependent. Getting full treatments has been an ongoing journey. I feel pretty good physically, but cannot get past the feeling of apathy. I am Not Depressed! I don’t feel hopeless, or sad and I have a loving and caring spouse. But, I have changed. I was outgoing, had lots of friends, many interests and kept busy, busy, busy! (My profession was an Activity Director!) have dropped so many interests, my creativity is all but gone and the worst, is that I have become detached from relationships. It makes me so sad because I am a shell of the person I was and I don’t know how to fix it.

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