{"id":71,"date":"2005-07-24T23:23:13","date_gmt":"2005-07-25T03:23:13","guid":{"rendered":"http:\/\/12a2f75c-b190-49b2-b25b-642d8cd23abd"},"modified":"2018-02-03T17:40:56","modified_gmt":"2018-02-03T22:40:56","slug":"ritalin-methylphenidate","status":"publish","type":"post","link":"https:\/\/henry.olders.ca\/wordpress\/?p=71","title":{"rendered":"Ritalin (methylphenidate)"},"content":{"rendered":"

<\/a>Ritalin<\/p>\n

\u2022 -more effective than sertraline in improving cognitive function and maintaining alertness in patients with traumatic brain injury (Lee H 20 p97)
\n\u2022 better tolerated than sertraline (ibid.)
\n\u2022 -found effective in hypoactive delirium, apathy, depressive syndrome (Meyers BJ 148 1738)
\n\u2022 -accelerates antidepressant response in elderly (Lavretsky H 64 1410)
\n\u2022 -useful in depressed or apathetic geriatric patients (Jansen IH 49 474)
\n\u2022 -effective against fatigue in AIDS patients (Breitbart W 161 411)
\n\u2022 -useful in depression in terminally ill cancer patients (Macleod AD 16 193)
\n\u2022 -augments effects of antidepressants particularly improving apathy and fatigue (Masand PS 7 89)
\n\u2022 -in medically ill depressed elderly, is safe and effective; quick onset of action (2-5 days) (Emptage RE 30 151)
\n\u2022 -80% of poststroke depressed elderly had an antidepressant response; few side effects (Lazarus LW 53 447)
\n\u2022 -together with exercise, has a positive effect on fatigue, cognitive function, and functional ability in melanoma patients on interferon-alpha (Schwartz AL 29 E85)
\n\u2022 -substantial improvement in bipolar illness patients with residual depression and sedation, without switch into mania or medication abuse (Carlson PJ 6 416)
\n\u2022 -patient-controlled methylphenidate in advanced cancer patients led to significant improvements in fatigue , overall wellbeing, anxiety, appetite, pain, nausea, depression, and drowsiness, with no serious side effects (Bruera E 21 4439)<\/p>\n

How ritalin works:
\n\u2022 -suppresses sleep, thus may cause partial sleep deprivation if taken early in the morning (sleep deprivation has an antidepressant effect);
\n\u2022 -suppresses REM sleep (has this property in common with other antidepressant treatments including SSRIs, tricyclics, exercise, electroconvulsive treatment);
\n\u2022 -dopamine<\/p>\n

side effects of ritalin:
\n\u2022 nervousness, insomnia (if taken in the evening), appetite decrease (in non-depressed patients), increase in BP, heart rate (usually not clinically important); palpitations (may need to decrease dose)<\/p>\n

indications:
\n\u2022 depression, fatigue, apathy states characterized by excessive sleep or spending excessive time in bed.<\/p>\n

timing:
\n\u2022 -since REM sleep peaks in the morning (possibly around 8 am if the patient is asleep at that time) it is preferable to give the medication well before 8 am to maximize the possibility of significantly decreasing REM sleep.
\n\u2022 -Since it has a short half-life, may need to give a second dose around noon.<\/p>\n","protected":false},"excerpt":{"rendered":"

Ritalin \u2022 -more effective than sertraline in improving cognitive function and maintaining alertness in patients with traumatic brain injury (Lee H 20 p97) \u2022 better tolerated than sertraline (ibid.) \u2022 -found effective in hypoactive delirium, apathy, depressive syndrome (Meyers BJ 148 1738) \u2022 -accelerates antidepressant response in elderly (Lavretsky H… <\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[89],"tags":[94],"class_list":["post-71","post","type-post","status-publish","format-standard","hentry","category-medicine","tag-ritalin"],"_links":{"self":[{"href":"https:\/\/henry.olders.ca\/wordpress\/index.php?rest_route=\/wp\/v2\/posts\/71","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/henry.olders.ca\/wordpress\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/henry.olders.ca\/wordpress\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/henry.olders.ca\/wordpress\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/henry.olders.ca\/wordpress\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=71"}],"version-history":[{"count":4,"href":"https:\/\/henry.olders.ca\/wordpress\/index.php?rest_route=\/wp\/v2\/posts\/71\/revisions"}],"predecessor-version":[{"id":1309,"href":"https:\/\/henry.olders.ca\/wordpress\/index.php?rest_route=\/wp\/v2\/posts\/71\/revisions\/1309"}],"wp:attachment":[{"href":"https:\/\/henry.olders.ca\/wordpress\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=71"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/henry.olders.ca\/wordpress\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=71"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/henry.olders.ca\/wordpress\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=71"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}