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Methylphenidate
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'''Methylphenidate''' is a [[central nervous system]] (CNS) stimulant, most often used for the treatment of attention deficit hyperactivity disorder (ADHD) and [[narcolepsy]].<ref name=":2">{{Cite web|url=https://www.drugs.com/pro/methylphenidate-tablets.html | title = Methylphenidate Tablets - FDA prescribing information, side effects and uses|website=Drugs.com|language=en|access-date=2020-09-28}}</ref> '''Methylphenidate hydrochloride''' has many brand names, including '''Tranquilyn''' and '''Ritalin'''.<ref name=":0">{{Cite web|url=https://www.drugs.com/uk/methylphenidate-hydrochloride-5mg-tablets-leaflet.html | title = Methylphenidate Hydrochloride 5mg tablets | last = | first = | authorlink = | date = | website = Drugs.com|language=en|archive-url=|archive-date=|url-status=|access-date=2020-09-28}}</ref> == Theory == Methylphenidate increases activity in areas of the brain that are underactive in ADHD, including those involved in impulsive behavior and concentration.<ref name=":0" /> ==KPAX002 mitochondria nutrients== Dr. [[Jon Kaiser]] is performing clinical trials on a pharmaceutical product which he developed called Synergy (KPAX002) which is a combination of a low dosage of methylphenidate hydrochloride and over-the-counter mitochondrial support nutrients. The KPAX002 mitochondria support nutrients are: * [[Acetyl-L-carnitine]] (ALCAR), which has a role in metabolism * [[alpha lipoic acid]] (ALA, an antioxidant) * [[beta carotene]], an antioxidant * [[N-acetyl-cysteine]] plus vitamins: * [[vitamin B1]], [[vitamin B2]], [[niacinamide]] (a form of vitamin B3), [[vitamin B5]] (pantothenic acid), [[vitamin B7]] (biotin), [[vitamin C]] plus the minerals: * [[boron]], [[copper]], [[iodine]], [[inositol]], [[iron]], [[magnesium]], [[manganese]], [[potassium]], [[selenium]], [[zinc]] == Evidence == The [[Canadian Consensus Criteria]] suggests using methylphenidate in the mornings only for [[fatigue]], increased energy and alertness, and cautions that it may be habit forming.<ref name="canadianconsensus-CCC">{{Citation | last1 = Carruthers | first1 = Bruce M. | authorlink1 = Bruce Carruthers | last2 = Jain | first2 = Anil Kumar | authorlink2 = Anil Kumar Jain | last3 = De Meirleir | first3 = Kenny L. | authorlink3 = Kenny De Meirleir | last4 = Peterson | first4 = Daniel L. | authorlink4 = Daniel Peterson | last5 = Klimas | first5 = Nancy G. | authorlink5 = Nancy Klimas | last6 = Lerner | first6 = A. Martin | authorlink6 = Martin Lerner | last7 = Bested | first7 = Alison C. | authorlink7 = Alison Bested | last8 = Flor-Henry | first8 = Pierre | authorlink8 = Pierre Flor-Henry | last9 = Joshi | first9 = Pradip | authorlink9 = Pradip Joshi | last10 = Powles | first10 = AC Peter | authorlink10 = A C Peter Powles | last11 = Sherkey | first11 = Jeffrey A. | authorlink11 = Jeffrey Sherkey | last12 = van de Sande | first12 = Marjorie I. | authorlink12 = Marjorie van de Sande | title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols | journal = Journal of Chronic Fatigue Syndrome | volume = 11 | issue = 2 | pages = 7-115 | date = 2003 |pmid = | doi = 10.1300/J092v11n01_02 | url = http://www.investinme.org/Documents/PDFdocuments/CanadianDefinitionME-CFS.pdf }}</ref> Methylphenidate has been used with success in a subset of [[ME/CFS]] patients. In 2016, Blockmans, et al, concluded that use of methylphenidate by [[Chronic fatigue syndrome|CFS]] patients with [[cognitive dysfunction|concentration difficulties]] had a positive effect in about one out of three clinical trial patients.<ref name=":1" /> The phase II study concluded that 36% of the patients taking the Synergy treatment had a >20% reduction in overall ME/CFS symptoms after 28 days.<ref name="Kaiser,2015" /> Kaiser patented the '''KPAX002''' combination prior to publishing the trial results.<ref name="Kaiser,2015" /> ==Dosage== A low dose is suggested for ME/CFS of 5 - 10mg in the mornings.<ref name="canadianconsensus-CCC"/> ==Notable studies== * 2015, A prospective, proof-of-concept investigation of KPAX002 in [[chronic fatigue syndrome]].<ref name="Kaiser,2015" /> [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4565289/ (Full Text)] * 2016, Long-term methylphenidate intake in [[chronic fatigue syndrome]]<ref name=":1">{{Cite journal | last = Blockmans | first = Daniel | last2 = Persoons | first2 = Philippe | date = 27 Jun 2016 | title = Long-term methylphenidate intake in chronic fatigue syndrome|url=https://www.tandfonline.com/doi/full/10.1080/17843286.2016.1200816|journal=Acta Clinica Belgica|language=en|volume=71|issue=6 | pages = 407β414|doi=10.1080/17843286.2016.1200816|issn=1784-3286|via=}}</ref> [https://www.tandfonline.com/doi/full/10.1080/17843286.2016.1200816 (Abstract)] * 2018, KPAX002 as a treatment for [[ME/CFS|Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS)]]: A prospective, randomized trial<ref name="Montoya, 2018" /> [http://www.ijcem.com/files/ijcem0065685.pdf (Full Text)] ==Risks and safety== A wide variety of side effects have been reported, some of which need immediate medical attention. Common side effects include suicidality, mood swings and heart problems.<ref name=":2" /> ==Costs and availability== Prescription only<ref name=":2" /> ==See also== * [[Jon Kaiser]] * [[KPAX002]] ==Learn more== *[https://www.drugs.com/uk/methylphenidate-hydrochloride-5-mg-tablets-leaflet.html Tranquilin patient information leaflet] - drugs.com *[https://www.drugs.com/pro/methylphenidate-tablets.html Methylphenidate FDA prescribing information] - drugs.com ==References== <references> <ref name="Kaiser,2015">{{Citation | last1 = Kaiser | first1 = JD | authorlink1 = Jon Kaiser | title = A prospective, proof-of-concept investigation of KPAX002 in chronic fatigue syndrome | journal = International Journal of Clinical and Experimental Medicine | volume = 8 | issue = 7 | page = 11064β11074 | date = 15 July 2015 | pmid = 26379906 | url = http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4565289/ }}</ref> <ref name="Montoya, 2018">{{Citation | last1 = Montoya | first1 = Jose G | authorlink1 = Jose Montoya | last2 = Anderson | first2 = Jill N | authorlink2 = | last3 = Adolphs | first3 = Danya L | authorlink3 = | last4 = Bateman | first4 = Lucinda | authorlink4 = Lucinda Bateman | last5 = Klimas | first5 = Nancy | authorlink5 = Nancy Klimas | last6 = Levine | first6 = Susan M | authorlink6 = Susan Levine | last7 = Garvert | first7 = Donn W | authorlink7 = | last8 = Kaiser | first8 = Jon D | authorlink8 = Jon Kaiser | title = KPAX002 as a treatment for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): A prospective, randomized trial | journal = International Journal of Clinical and Experimental Medicine | volume = 11 | issue = 3 | page = 2890-2900 | date = 2018 |pmid = | doi = | url = http://www.ijcem.com/files/ijcem0065685.pdf }}</ref> </references> [[Category:Potential treatments]] [[Category:Central nervous system stimulants]]
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