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  • Ritalin reduces calorie intake by one-third in obese men


    Posted by .(JavaScript must be enabled to view this email address)
    Tuesday, February 24, 2004 10:47 am Email this article
    Ritalin (methylphenidate) reduces calorie intake of obese men by one-third according to a study published in Obesity Research.

    Obese men ate 34 percent fewer calories when given Ritalin an hour before they were fed pizza (726 calories versus 1095 calories).

    DOSE

    Three-fourths of the men (7 of 9) responded to a moderate dose of Ritalin equal to 0.23 mg per pound of body weight (0.5 mg per kg), while the other one-fourth (2 of 9) required a high dose of 0.45 mg per pound of body weight (1 mg per kg).

    For a 154 pound person, the moderate dose would be 35 mg of Ritalin, while the high dose would be 70 mg.

    For a 198 pound person, the moderate dose would be 45 mg of Ritalin, while the high dose would be 90 mg.

    For a 242 pound person, the moderate dose would be 55 mg of Ritalin, while the high dose would be 110 mg.

    Dose used for attention deficit disorder and narcolepsy are 15 to 60 mg per day (5-20 mg given three times per day).

    LONGER STUDIES NEEDED

    Many drugs reduce appetite in the short-term, but lose their effectiveness long-term. Longer studies are needed to prove Ritalin?s effectiveness in causing weight loss, although weight loss has been observed in people given Ritalin, especially in children.

    SHORT-ACTING RITALIN USED

    The study used short-acting Ritalin, not the extended-release (Ritalin SR).

    BRAND NAMES

    Although there are other brands of extended-release methylphenidate, the only immediate-release methylphenidate include Ritalin.

    It is my belief that, in most cases, for weight loss immediate-release drugs are preferable to the extended-release forms, simply because more of the drug is released at the time you want it to reduce appetite.

    DESCRIPTION

    Ritalin is a central nervous system (CNS) stimulants used to treat attention-deficit hyperactivity disorder (ADHD), and narcolepsy (uncontrollable desire for sleep or sudden attacks of deep sleep).

    SUBJECTS

    The study involved nine obese men who were given either a a moderate dose of Ritalin (0.23 mg per pound of body weight; 0.5 mg per kg), a high dose of Ritalin (0.45 mg per pound of body weight; 1 mg per kg), or a placebo.

    HOW IT WORKS

    Ritalin is a dopamine reuptake inhibitor. It reduces appetite by increasing dopamine levels.

    SIDE EFFECTS

    Possible side effects of Ritalin include:

    More common
    ? Fast heartbeat;?  increased blood pressure ?

    Less common
    ? Chest pain
    ? Fever
    ? Joint pain
    ? Skin rash or hives
    ? Uncontrolled movements of the body?

    Rare

    ? Black, tarry stools
    ? blood in urine or stools
    ? blurred vision or other changes in vision
    ? convulsions (seizures)
    ? muscle cramps
    ? pinpoint red spots on skin
    ? uncontrolled vocal outbursts and/or tics (uncontrolled and repeated body movements)
    ? unusual bleeding or bruising?

    With long-term use or at high doses

    ? Changes in mood
    ? confusion
    ? delusions (false beliefs)
    ? depersonalization (feeling that self or surroundings are not real)
    ? hallucinations (seeing, hearing, or feeling things that are not there)
    ? weight loss?

    Symptoms of overdose

    ? Agitation
    ? confusion (severe)
    ? convulsions (seizures)
    ? dryness of mouth or mucous membranes
    ? false sense of well-being
    ? fast, pounding, or irregular heartbeat
    ? fever
    ? hallucinations (seeing, hearing, or feeling things that are not there)
    ? headache (severe);? increased blood pressure
    ? increased sweating
    ? large pupils
    ? muscle twitching
    ? overactive reflexes
    ? trembling or shaking
    ? vomiting?

    Other side effects may occur that usually do not need medical attention.

    These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

    More common

    ? Loss of appetite
    ? nervousness
    ? trouble in sleeping?

    Less common

    ? Dizziness
    ? drowsiness
    ? headache
    ? nausea
    ? stomach pain?

    Side Effects after stopping Ritalin

    After you stop using this medicine, your body may need time to adjust. The length of time this takes depends on the amount of medicine you were using and how long you used it. During this period of time check with your doctor if you notice any of the following side effects:

    ? Mental depression (severe)
    ? unusual behavior
    ? unusual tiredness or weakness ?

    ADDITIONAL INFORMATION

    Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although not specifically included in product labeling, methylphenidate may be used in certain patients with the following condition:

    ? Depressive disorder secondary to physical illness in patients who cannot take antidepressant medicines.

    PRECAUTIONS, WARNINGS AND CONTRAINDICATIONS

    According to the National Library of Medicine’s Drug Information Databse Ritalin should not be taken with:

    ? Amantadine (e.g., Symmetrel) or
    ? Amphetamines or
    ? Appetite suppressants (diet pills) or
    ? Bupropion (e.g., Wellbutrin, Zyban) or
    ? Caffeine (e.g., NoDoz) or
    ? Chlophedianol (e.g., Ulone) or
    ? Cocaine or
    ? Medicine for asthma or other breathing problems or

    ? Medicine for colds, sinus problems, hay fever or other allergies (including nose drops or sprays) or

    ? Nabilone (e.g., Cesamet) or

    ? Pemoline (e.g., Cylert)?Using these medicines with methylphenidate may cause severe nervousness, irritability, trouble in sleeping, or possibly irregular heartbeat or seizures.

    ? Monoamine oxidase (MAO) inhibitor activity (isocarboxazid [e.g., Marplan], phenelzine [e.g., Nardil], procarbazine [e.g., Matulane], selegiline [e.g., Eldepryl], tranylcypromine [e.g., Parnate])?Taking methylphenidate while you are taking or less than 2 weeks after taking an MAO inhibitor may cause sudden extremely high blood pressure and severe convulsions; at least 14 days should be allowed between stopping treatment with an MAO inhibitor and starting treatment with methylphenidate.

    ? Pimozide (e.g., Orap)?Pimozide is not used to treat tics that are caused by medicines. Before tics are treated with pimozide, the doctor should find out if the tics are caused by methylphenidate.

    Make sure you tell your doctor if you have any other medical problems, especially:
    ? Alcohol abuse (or history of) or

    ? Drug abuse or dependence (or history of)?Dependence on methylphenidate may be more likely to develop

    ? Epilepsy or other seizure disorders?The risk of having convulsions (seizures) may be increased

    ? Gilles de la Tourette’s disorder (or family history of) or
    ? Glaucoma or
    ? High blood pressure or
    ? Psychosis or
    ? Severe anxiety, agitation, tension, or depression or

    ? Tics (other than Tourette’s disorder)?Methylphenidate may make the condition worse.

    REFERENCE

    Leddy JJ, Epstein LH, Jaroni JL, Roemmich JN, Paluch RA, Goldfield GS, Lerman C. Influence of methylphenidate on eating in obese men. Obes Res. 2004 Feb, 12(2):224-32.

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