Ritalin (Methylphenidate)

From: 'Chronic Fatigue Syndrome, A Roadmap for Testing and Treatment' <a href="https://sites.google.com/site/cfstestingandtreatmentroadmap/home">https://sites.google.com/site/cfstestingandtreatmentroadmap/home</a>
10 mg twice daily reduces fatigue and improves concetration.<a href="http://www.ncbi.nlm.nih.gov/pubmed/16443425" target="_blank" rel="nofollow">1</a>

Medmedium warns against stimulants

From: Long-Lasting Mental Fatigue After Traumatic Brain
Injury – A Major Problem Most Often Neglected
Diagnostic Criteria, Assessment, Relation to Emotional
and Cognitive Problems, Cellular Background, and
Aspects on Treatment

Methylphenidate inhibits dopamine and noradrenalin reuptake resulting in increased
extracellular concentration of dopamine and noradrenalin [56]. Methylphenidate has been
used for many years in the treatment of ADHD in children, in the first instance to increase
wakefulness, attention and concentration capacity. Methylphenidate has also been tested on
TBI victims with positive effects on information processing speed and, to some extent on
working memory and attention [57-63]. Guidelines for use of methylphenidate for deficits of
attention and processing speed after TBI have been suggested [64], while no such guidelines
exist for fatigue following TBI.
In an open randomized study, methylphenidate significantly improved mental fatigue dosedependently
as assessed with the MFS [42]. The item, pain was also studied and we found that
this item was rated high by most of the subjects in our study as the participants were recruited
on the basis of the items, TBI and pain. However, no significant alleviation of pain was reported
as a result of methylphenidate treatment. However, it is important to note that pain can hide
posttraumatic brain injury symptoms or mental fatigue which is not always connected to the
actual pain. We also found that there was no interaction between the pain and the mental
fatigue in those participants treated with methylphenidate. These findings indicate that, not
only is it necessary to treat patients for the pain for which they are primarily referred to the
clinic, but also for the mental fatigue, if present.
Methylphenidate was well-tolerated by TBI subjects. However, tolerance of methylphenidate
differed between subjects and we therefore recommend starting treatment with an initial low
dose.