Does Methylphenidate Reduce the Symptoms of Chronic Fatigue Syndrome?, 2006, Blockmans et al There's this 2006 Belgium study.
I’m glad that the era of trying stimulants on us seems to be over. (Apologies in advance if I am jinxing it.)
Here's the Sci-Hub link: https://scihub.wikicn.top/10.1016/j.amjmed.2005.07.047 The BPS researchers in New South Wales, Australia continue to be keen to research the psychostimulant Modafinil. And, as far as I am aware, the Royal Childrens Hospital in Melbourne continues to prescribe methylphenidate to young people with ME/CFS. My son was prescribed it some time ago, with a scheduled followup 4 months after the initial prescription. There's a thread on stimulants for ME/CFS here. As far as I am aware, the KPAX2 study (which had a null result) is the only significant followup with methylphenidate?
My N=1 of that was: initially: minor short-term improvement but more malaise; long-term: nope nope nope. It did not reduce symptoms, just made it a bit easier to power through like coffee will push back a bit of sleepiness for maybe 30-60 minutes. It's a dead-end, metaphorical band-aid on a wound.
I didn't recognise that Methylphenidate is Ritalin (brand name) until doing a search. Some years ago I re-entered the medical system here in the US (finally having secure insurance though my wife's work that I wasn't afraid to use). I knew that when I presented with classic multi-decade ME/CFS that I might be referred to "behavioral health." I wasn't wrong. I decided not to fight it. As luck would have it, I was put together with a psychiatrist who totally got it. He was validating about my having a terrible illness that was very poorly understood, congratulatory towards me for having held up so well in the face of the challenges, and was apologetic for the lack of tools in his arsenal. He did say he'd be willing to prescribe for Adderall or Ritalin, if I wanted to try it. I passed initially, but in desperation I did a re-think some weeks later and filled the script. I see the researchers are asking in the abstract about the "short-term effects of methylphenidate, an amphetamine derivative, on fatigue, concentration disturbances." LOL. How short term? In my case, sure, helped for a day, but at what cost? The few tries almost guaranteed a serious PEM crash would follow. There have been a couple times when the trade-offs of provoking a horrible crash have been "worth it" to me. The day my son turned 15 I wanted to take him to Malibu (Zuma) for a day of body-surfing. I banked a lot of rest/low-activity in advance as my strategy to be in good shape for the day. Didn't work. Woke up knackered. So I broke into my almost unused supply. I had my day. It "worked." Then I payed. Badly. Worth it to me in some measure, but not sustainable. Not even close. Bill
Like a metaphorical bandaid that protects for one day and then rips open the wound and makes it much worse the next. Certainly dead-end for me. For sure. Still, I have not been able to toss out my "supply." After 5 years (or so) I think I have the original "monthly" bottle with 26/30 remaining tucked away in the back of a medicine cabinet. In my mind they have a metaphorical "break in case of emergency" tag on them. Bill
In Australia, Methylphenidate prescription is heavily restricted, recipients MUST have been diagnosed with ADHD between the ages of 6-18 to receive it. (no adult ADHD diagnoses can receive it)
That wasn't true less than 10 years ago. As I noted above, My son definitely did not/does not have ADHD and was not diagnosed with it. He was diagnosed with CFS. Methylphenidate and melatonin was prescribed at the first consultation. I would like to know if young people with ME/CFS are still being prescribed methylphenidate for ME/CFS by the fatigue clinic at the Royal Childrens Hospital in Melbourne, or elsewhere.
I am partially wrong as the rules have recently changed to allow adult ADHD diagnoses. The information my previous comment was based on was the information on the PBS website which requires hospital authority and ADHD diagnosis. I am still surprised that methylphenidate was prescribed for ME/CFS since everyone I asked was like 'absolutely no unless you have ADHD', and that it was psychiatrist only. I wonder whether it would have helped me finish my undergraduate degree sooner.
Dr Oldmeadow at the Austin Hospital used to prescribe Ritalin for ME/CFS until recently. However, apparently restrictions have been placed on him by the regulator and he is no longer able to prescribe it. (I found a rather troubling review of him online that may explain why.)
