Posted by Dr. Gary A. Mellick on August 25, 1998 at 09:02:49:
Dear Cluster Headache Suffers, Families, and Friends:
One of my email contacts from South Africa reported that he was taking other medications including lithium when he first tried Ritalin. When he stopped the lithium and Desyrel, Ritalin started to be effective for him. It may be found that certain medications interact with Ritalin inhibiting its effectiveness in cluster headache sufferers.
This treatment of cluster headache is new and all the facts are not yet in. As some doctors have suggested further scientific investigation is needed. I enjoyed Simon’s post “latest research in the UK regarding a cluster headache focal point in the hypothalamus (Lancet). More discoveries like these will help advance the care of cluster headache suffers worldwide.
One patient with SUNCT syndrome of heada and facial pain did not respond to Ritalin. Sometimes migraine variants or chronic paroxysmal hemicrania are misdiagnosed as cluster headaches. Their response to methylphenidate (Ritalin) is still uncertain.
Ritalin may not be appropriate for everyone as the information Tom PharmD’s posting so generously points out. The knowledge he provides supports the opinion that the decision to use or not use Ritalin should only be made between the patient and the hometown family doctor or neurologist.
So far, in Ohio we are having much success with Ritalin in the treatment of cluster headaches as well as with pain of sympathetic origin (i.e., reflex sympathetic dystrophy). However, a few patients have developed side effects such as enhanced irritability and sleeplessness.
In my opinion, patients with marked enhancement of irritability should discontinue Ritalin. A grumpy relative made worse by Ritalin is a cross to burdensome for anyone to bear. Isn’t life tough enough already?
On a personal note, I am delighted by every success story such as that of Jean-Louis and saddened by every failure. Potential new treatments like Ritalin can change so many lives for the better.
Best Wishes,
Dr. Gary Mellick