Ritalin Vs Adderall For Ms Fatigue

Which Stimulants Are Used For Ms Fatigue

Stimulants are primarily prescribed to treat attention-deficit hyperactivity disorder, narcolepsy, and excessive daytime sleepiness. Although not approved by the U.S. Food and Drug Administration for this use, CNS stimulants are sometimes prescribed off-label for the treatment of MS fatigue.

Every individual with MS is different, and what works to improve fatigue in one person might not work for another, or may cause bothersome side effects.

How Long Do They Last

Adderall is the brand name for a mix of two stimulants called amphetamine–dextroamphetamine. Ritalin is the brand name for a stimulant called methylphenidate.

Both medications come in two forms, short-acting and long-acting. You take the long-acting form in the morning, and itâs meant to last all day. The short-acting form lasts about 4 hours.

Some long-acting forms are capsules that hold two kinds of beads: Half dissolve right away and give you one dose of the drug. The rest of the beads don’t go into your system until later.

The long-acting version of Adderall can last 10 to 12 hours, while the long-acting form of Ritalin lasts 6 to 12.

Do Ritalin And Adderall Work The Same

Ritalin and Adderall work differently. Although both come in short and long-acting formulations, here are the differences:

• Ritalin starts working in three to four hours.
• Adderall starts working in four to six hours.

The extended-release versions of both medications differ quite a bit as well.

• Ritalin lasts anywhere from four up to eight hours after ingestion.
• Adderall lasts roughly 10 to 12 hours after ingestion.

Ritalin starts working faster than Adderall in the body, meaning youll need to take more doses of it throughout the day. Does that mean Adderall is stronger than Ritalin?

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Chronic Fatigue Syndrome Physicians Report

Dr. Teitelbaum believes Ritalin is underused in ME/CFS. Dr. Bateman uses both Ritalin and Adderall but in general prefers Adderall. Ritalin can exacerbate sleep problems in some patients. The IACFS/ME Treatment Primer states anecdotal reports suggest that Ritalin can have moderate to marked benefits but that tolerance can develop if used daily.

Other Risks And Considerations

Concerta can be habit-forming. For this reason, the Food and Drug Administration have given it a boxed warning to say that people with a history of drug or alcohol dependence should take this medication with caution.

The FDA added this warning because misusing Concerta can lead to psychological dependence, behavior problems, and even psychotic episodes. After stopping Concerta, a person may experience significant withdrawal symptoms, such as severe depression.

Doctors work closely with the parents and caregivers of children with ADHD to find the right medication at the right dosage to manage their symptoms and minimize the side effects.

However, some side effects are fairly common in children who take medications such as Concerta.

In addition to the crash, children may experience the following side effects of Concerta:

• pain in the upper abdomen, which is the most common complaint among children
• loss of appetite
• slower growth rate, typically for the first year of medication use
• changes in mood

Many people with ADHD continue to show some degree of symptoms throughout their lives, and they may continue to take Concerta. However, the medication is still likely to cause some side effects.

Adults who take Concerta are more likely to experience the following:

Stimulant medications such as Concerta can increase both heart rate and blood pressure. For this reason, doctors usually advise that people with known heart conditions avoid taking this kind of medication.

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Organise Your Living And Work Spaces

You might find there are practical changes that can be made to the places you work and live. Maybe re-organising desks or cupboards, or adjusting the temperature or lighting to suit you better.

Sometimes, the simplest of changes can make the workplace or home more energy efficient for you.

An occupational therapist can help you assess the spaces you use at work and at home and may suggest adaptations or equipment that could help. For more information about the support that occupational therapists can offer, and how to find one, download or order our leaflet Occupational therapy and MS.

Do They Really Make You Smart

Several small trials have tried to determine if Modafinil really does enhance cognition, with mixed results. Participants reported feeling more alert, attentive and energetic on the drug, in one 2003 trial, and some improvements in certain memory tasks – such as digit span and visual recognition – were reported. In addition, there was a decrease in impulsivity. A 2014 trial also showed improvements in impulsive decision making, but no difference in the accuracy of performance.

Modafinil was found to enhance attention and learning and improve decision making and planning in a review of 24 studies. However, it made no difference to working memory or understanding different points of view and negatively affected creativity in a few studies.

Adderall has been used as a study aid based on the assumption that stimulants used for ADHD help reduce hyperactivity, impulsivity, and inattention. However, there are very few trials investigating whether Adderall does enhance cognition in individuals without ADHD. Results were conflicting, with some studies showing no effect, and others showing minor improvements some even showed a negative effect. While Adderall may promote wakefulness, it does not improve IQ. Any short term gains in alertness are overwhelmingly counteracted by withdrawal symptoms and potentially fatal side effects.

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What Are The Side Effects

The most common side effects of stimulant medications for ADHD are:

• increased heart rate
• reduced appetite
• difficulty sleeping

Serious heart-related complications are rare. Doctors should closely monitor people with heart problems who are taking stimulants.

Central nervous system stimulants have a high potential for misuse and dependence. Longer-acting formulations have a lower potential for misuse, so doctors more commonly prescribe these.

Coverage And Cost Comparison Of Provigil Vs Adderall

Provigil is a prescription medication that is typically covered by commercial insurance. Coverage by Medicare plans may vary or require special exceptions to be made. Provigil can cost more than $950 out-of-pocket, but with a coupon from SingleCare, you could get a 30-day supply of the generic for less than $60.

Adderall is a prescription medication that is typically covered by commercial insurance. Coverage by Medicare plans also may vary or require special exceptions to be made. The out-of-pocket price for Adderall can be more than $300. With a SingleCare you can purchase the generic form for substantially less. Just present a SingleCare Adderall coupon at select pharmacies and ask for the generic.

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Rated For Attention Deficit Hyperactivity Disorder/attention Deficit Disorder Predominant Inattentive Type Report

Adderall XR It’s really hard for me to review this product at this time. I think it is doing some good but, no a lot of good. I can tell you one thing I got off it for 2 days. I was fed up with paying for and taking meds. I was soooo wiped out. All I wanted to do was sleep and I didn’t care if the whole world fell apart around me. I have a doctors apt. next week and plan on speaking to him about this issue. The major draw back I am finding is DRY MOUTH big time. I will post again after I have had my apt. and let you all know what becomes of it. He put me on Ritlan to start. Nasty stuff in my veiw. It made me fell like I was walking around drunk. I had terrible equal librium on that stuff. Don’t have that effect on the Adderall. Shirl aka Sobriquet

Risk For Abuse And Dependency

Because of their influence on dopamine , CNS stimulants can be habit forming. In fact, one of the greatest risks of stimulant drugs is their potential for misuse and their risk of dependency. Physicians may hesitate to prescribe stimulants for MS fatigue for these reasons.

Because of their abuse and dependency risk, these drugs are controlled or scheduled substances according to the Drug Enforcement Agency. Amphetamine/dextroamphetamine and methylphenidate are Schedule 2 drugs, for their high risk for abuse and addiction. Modafinil and armodafinil are Schedule 4, as these risks are thought to be lower.

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Common Side Effects Of Provigil Vs Adderall

While Provigil and Adderall do cause some similar adverse events, data on the prevalence of side effects from Adderall is unavailable in the package insert. Both drugs are known to cause serious side effects such as hypertension and tachycardia . Provigil and Adderall are both known to cause a loss of appetite as well.

Provigil may cause headaches and nausea in a significant number of patients. These side effects can affect daily living and productivity, and if they are bothersome and persistent, you should speak with your provider to discuss alternatives. Do not suddenly stop taking these drugs without your providers knowledge as you may experience withdrawal symptoms.

The following list is not intended to be an all-inclusive list of potential side effects. You should consult your healthcare provider for a full list of side effects.

Could The Benefits Be In My Head

Interestingly, a day earlier, I read a study in The Lancet Neurology that looked at three medications commonly prescribed for MS fatigue: modafinil, methylphenidate, and amantadine. The results surprised me.

In the study, 136 MS patients who had their fatigue measured by the Modified Fatigue Impact Scale were rotated through the trio of fatigue medications plus a placebo, spending six weeks on each. Their fatigue levels were measured based on the MFIS after each medication.

Guess what? The medications appear to have done no better than the placebo. Take a look at the estimated mean values of MFIS total scores at baseline and the maximal tolerated dose for each:

• Score at baseline: 51.3
• Score after modafinil: 39.0
• Score after methylphenidate: 38.6

Also, while the medications didnt prove to be better than the placebo in improving MS fatigue, they did result in more frequent adverse events. So, considering the risks and the benefits, the researchers concluded that the results of this study do not support an indiscriminate use of amantadine, modafinil, or methylphenidate for the treatment of fatigue in multiple sclerosis.

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Quillivant Xr And Quillichew Er

Quillivant XR and QuilliChew ER contain methylphenidate in two forms. A small portion of the medication is in an immediate-release form, while the majority of the medication is a film-coated extended release form. This means that part of the medication can be absorbed immediately while the rest is absorbed over up to hours.

Quillivant is a powder that is dissolved in water and swallowed, while QuilliChew is a chewable tablet.

Stimulating The Central Nervous System For More Energy Alertness And Even Calmness In Me/cfs And Fm

Most of the pharmaceuticals used to increase energy in chronic fatigue syndrome are amphetamines or have amphetamine-like structures. Amphetamines have been used in the past to elevate mood, reduce feelings of fatigue and increase alertness, concentration and motivation.

They cardiovascular effects have lead them, at times, to be used in orthostatic intolerance as well. In general they constrict the blood vessels and increase blood pressure and heart rates. They may also increase blood glucose levels.

Historically, amphetamines were used to treat everything from asthma to obesity to hyperactivity to neurological disorders, but abuse problems have restricted their use today to conditions such as attention deficit disorder. When taken correctly the risk of addiction is reportedly very low but taking large doses of stimulants over a long period of time can cause addiction. Sleep and energy levels can be negatively effected in ME/CFS and FM in some patients.

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Drug Interactions Of Provigil Vs Adderall

Adderall should be avoided in combination with monoamine oxidase inhibitors such as selegiline and Linezolid. MAO inhibitors slow amphetamine metabolism, increasing the amphetamines effect on the release of norepinephrine and other monoamines from the nerve endings causing headaches and other signs of hypertensive crisis. While it is unknown if Provigil has the same effect when given with MAOIs, it is recommended to avoid this combination as well.

Serotonergic drugs combined with Adderall may increase the incidence of serotonin syndrome. This syndrome can result in the patient feeling agitated, dizzy, and having an increased heart rate. Common antidepressants such as selective serotonin reuptake inhibitors and selective norepinephrine reuptake inhibitors have serotonergic activity and should be used cautiously in combination with Adderall.

The following table does not list every possible drug interaction for Provigil and Adderall. Consult your pharmacist or doctor for a complete list and professional medical advice.

Study Drugs Come With Health Risks Bu Docs Say

The stress of keeping up with academic life, especially around finals time, can be challenging, even for the best of students. A fall 2007 American College Health Association study found that over 90 percent of college students felt overwhelmed by all that they had to do. So its not surprising that some turn to illegal prescription drugs to boost their ability to study harder and longer. Drugs such as Ritalin and Adderall, used legally to treat attention-deficit hyperactivity disorder , are also used as study aids and are sold illegally for as much as $10 a pill. A March 2007 study in the journal Addiction found the nonmedical use of prescription drugs among American college students increased from about 4 percent in 1993 to about 10 percent in 2001.

Ritalin and Adderall are the drugs of choice because they increase alertness, attention, and energy. We spoke recently with Sara, a BU student who requested anonymity. She has used both Adderall and Ritalin, and she estimates that about 30 percent of BU students occasionally do the same. Sara says that if she needs to stay up all night to finish a paper, she chooses Adderall. If she needs to study for something small, such as a quiz, she uses Ritalin.

I use study drugs because they keep me up to study I dont even have to think about it, she says. They put me on autopilot.

Amy Laskowski can be reached at .

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Rated For Bipolar I Disorder Report

Bipolar/ADHD I have been diagnosed as Bipolar 1 and my therapist prescribed me amphetamine salts because he thought I was also ADHD. I would take 1 tablet in the a.m. and by 4 p.m. I would go into such a rage that even the telephone ringing would set me off. I also did not sleep at all while taking that medication. BAD

Relieving Fatigue Through Cooling

Research has shown that nerves with damaged myelin are sensitive to changes in temperature. A rise in temperature may cause nerve conduction to be less efficient, whereas a reduction in temperature may allow more signals to be transmitted across a damaged nerve.

The idea of cooling people with MS to alleviate symptoms has been researched and practiced for many years, but practical methods of cooling an individual had not been perfected until the 1990s. At this time, MSAA and NASA joined forces to develop and test a cool suit.

Cooling someone too quickly such as taking cold baths or sitting close to the air conditioner can cause shivering and vasoconstriction. This reaction does not help to alleviate MS symptoms. By slowly cooling down the body, an individual with MS may experience improvement in areas of physical performance, cognitive processing, and motor function. Cooling also significantly reduces fatigue, helping a person with MS perform his or her daily activities.

Controlled cooling is now achieved through passive cooling garments. These are portable and allow the wearer to enjoy symptom relief indoors or out. Passive cooling garments, such as a vest and wraps for the neck, wrists, or ankles, use ice or gel packs to give people with MS immediate and simple relief from heat and certain MS symptoms. Some passive garments are dampened and chilled before use.

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Stimulants Not Helpful In Ms Fatigue

Off-label use of Ritalin for MS did not help patients.

The off-label use of methylphenidate to relieve fatigue in multiple sclerosis was called in to question in a recent study that found it less effective than placebo for relieving fatigue or improving balance and gait.

The double-blind, randomized trial was conducted to seek evidence for a treatment of fatigue that has been largely anecdote-driven, and investigate whether a reported possible benefit of methylphenidate on balance and gait in elderly populations, and in those with Parkinsons disease could apply to persons with MS.

Recent research also supports that methylphenidate can improve balance and walking in various populations, but no published studies have evaluated the effects of repeated doses of methylphenidate on fatigue, balance, or walking in MS, indicated Michelle Cameron, MD, PT, and Garnett McMillan, PhD, Department of Neurology, Oregon Health and Science University and VA Portland Health Care System, Portland, Oregon.

At each two-week visit, subjects completed the Modified Fatigue Index Scale , the Activities-specific Balance Confidence scale, the Timed 25-Foot Walk , as well as the oral Symbol Digit Modalities Test , a screen for organic cerebral dysfunction.

By the 30mg twice daily dose, there is at least 80% certainty that methylphenidate was less beneficial than placebo for all outcomes, Cameron and McMillan reported.

Are Stimulants Effective For Ms Fatigue

Psychostimulants work by speeding up the CNS and increasing the amount of two important neurochemicals: norepinephrine and dopamine. For most people struggling with MS fatigue, stimulants on their own are not very effective. In some cases, stimulants can help MS fatigue in combination with other fatigue management interventions. Clinical trials on how well various stimulants treat MS fatigue thus far have been limited.

Current evidence shows contradictory or conflicting results about how well psychostimulants work against MS fatigue. For example, one small study published in the journal Multiple Sclerosis found that methylphenidate was likely less effective at alleviating MS fatigue than placebo.

The TRIUMPHANT-MS study by Johns Hopkins University compared how well modafinil, methylphenidate, amantadine, and placebo helped with MS fatigue. This clinical trial compared each drug to find out whether they worked better than no treatment at all. TRIUMPHANT-MS determined that modafinil and methylphenidate were not more effective at reducing MS fatigue than placebo.

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