Methylphenidate

Methylphenidate is a central nervous system (CNS) stimulant, most often used for the treatment of attention deficit hyperactivity disorder (ADHD) and narcolepsy. Methylphenidate hydrochloride has many brand names, including Tranquilyn and Ritalin.

Theory
Methylphenidate increases activity in areas of the brain that are underactive in ADHD, including those involved in impulsive behavior and concentration.

Evidence
Methylphenidate has been used with success in a subset of ME/CFS patients. In 2016, Blockmans, et al, concluded that use of methylphenidate by CFS patients with concentration difficulties had a positive effect in about one out of three clinical trial patients.

Dr. Jon Kaiser is performing clinical trials on a pharmaceutical product which he developed called Synergy (KPAX002) that is a combination of a low dosage of methylphenidate hydrochloride and over-the-counter mitochondrial support nutrients. 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. Kaiser patented the KPAX002 combination prior to publishing the trial results.

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.

Dosage
A low dose is suggested for ME/CFS of 5 - 10mg in the mornings.

Notable studies

 * 2015, A prospective, proof-of-concept investigation of KPAX002 in chronic fatigue syndrome. (Full Text)


 * 2016, Long-term methylphenidate intake in chronic fatigue syndrome (Abstract)


 * 2018, KPAX002 as a treatment for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS): A prospective, randomized trial (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.

Costs and availability
Prescription only

Learn more

 * Tranquilin patient information leaflet - drugs.com
 * Methylphenidate FDA prescribing information - drugs.com