Improves Chronic Fatigue in

liver411

DG DISPATCH - ACG: Ritalin (Methylphenidate)
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.