AEGiS-ATDN: Ritalin and Cylert May Treat Fatigue

Important note: Information in this article was accurate in 2001. The state of the art may have changed since the publication date.

Ritalin and Cylert May Treat Fatigue

Information Bulletin #13 May June 2001

The doctors that performed the study concluded that both Ritalin and Cylert can be useful treatments for HIV- related fatigue, but they stress that it's important to try and identify the cause of the fatigue first, in case it's a treatable condition like anemia (low red blood cells). The full title of this study is "A Randomized, Double-Blind, Placebo- Controlled Trial of Psychostimulants for the Treatment of Fatigue in Ambulatory Patients With Human Immuno-deficiency Virus Disease," by William Breitbart, MD and colleagues. The technical summary is available online at: http://archinte.ama- assn.org/issues/v161n3/abs/ioi00035.html

In a study published in the February 12, 2001 issue of a scientific journal called the "Archives of Internal Medicine", researchers report that the stimulant drugs Ritalin and Cylert can both be effective at decreasing fatigue associated with HIV infection. Fatigue is a common problem for people with HIV and can reduce quality of life. Fatigue can be linked to medications, medical and psychiatric conditions and other problems, but it's not unusual for severe fatigue to develop without any clear cause. There are several approved treatments for fatigue, depending on its' cause.

This new study included 144 people with HIV who had severe and persistent fatigue that was not associated with depression or other mental problems. Participants were started on either 7.5mg of Ritalin twice daily, 18.75mg of Cylert twice daily or one placebo capsule twice daily. Depending on how well people responded, doses were increased to a maximum of 60mg of Ritalin, 150mg of Cylert and eight capsules of placebo daily.

109 of the participants completed the study. Significant improvement in fatigue was reported in 41% (approaching half) of the Ritalin group, 36% (just over a third) of the Cylert group and 15% (about a sixth) of the placebo group. In addition to improvements in fatigue, people treated with either Ritalin or Cylert also experienced significant decreases in symptoms of depression and psychological distress and improvements in overall quality of life.

The major side effect of the medications was a feeling of hyperactivity and jitteriness, with over half of the people on Ritalin or Cylert reporting one or both of these symptoms. Either of these drugs may also significantly suppress appetite. Many of the study participants reported that these side effects lessened over time, but some people needed to reduce their doses. Only five people dropped out of the study due to side effects, two from the Ritalin group, two from the Cylert group, and one from the placebo group.
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