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| |  DG DISPATCH - ACG: Ritalin (Methylphenidate) Improves Chronic Fatigue in Patients With Cirrhosis By Jill Stein Special to DG News
NEW YORK, NY -- October 17, 2000 -- New data suggest that Ritalin (methylphenidate) improves moderate and severe chronic fatigue symptoms in patients with cirrhosis and chronic hepatitis. The data were presented here at the 56th Annual Scientific Meeting of the American College of Gastroenterology. Dr. David C. Wolf and associates at New York Medical College and Westchester Medical Center in Valhalla conducted a retrospective study of the safety and efficacy of Ritalin (methylphenidate) in 15 patients with chronic liver disease. Eight patients had hepatitis C-induced cirrhosis, four had hepatitis C virus with alcoholic cirrhosis, two had primary biliary cirrhosis and one had chronic hepatitis C. Patients were started on oral Ritalin (methylphenidate) 10 mg twice daily for five consecutive days, with mandatory drug discontinuation for two consecutive days. Patients were allowed to increase their dose to 20 mg twice daily or decrease it to 10 mg once daily. The median duration of treatment was six months. Results showed that the improvement in fatigue was mild in 27 percent of patients, moderate in 53 percent and marked in 20 percent. Seventy-three percent of patients experienced moderate or marked improvement in their need to take naps, 67 percent noted moderate or marked improvement in their ability to perform household chores and 53 percent noted moderate or marked improvement in their family interactions. One patient attributed his return to fulltime employment to Ritalin (methylphenidate) therapy. Side effects included anxiety in five (33 percent) patients, insomnia in three (20 percent) and dry mouth in two (13 percent). No symptoms were severe enough to require premature withdrawal from the study and no patient using the two day per week drug holiday schedule developed drug dependence. One patient who took Ritalin (methylphenidate) every day developed tachyphylaxis. Dr. Wolf said he believes Ritalin (methylphenidate) can be combined with physical therapy and nutritional counseling as part of a strategy to treat chronic fatigue in patients with liver disease. Results of the present study, he added, need to be confirmed in a randomized, prospective trial.
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