Posted by Dr. Gary A. Mellick on August 25, 1998 at 18:44:15:
In Reply to: Re: Update on Cluster Headaches and Ritalin Therapy posted by Cindy C. on August 25, 1998 at 16:37:59:
Cindy,
Yes, nausea is an adverse side effect of Ritalin in some patients.
10-mg of Ritalin may be enough but all patients respond in their own special way. You did not say, but if he can not keep the Ritalin down, then it is can't be doing him any good.
I recently spoke to a mother of a child with attention deficit disorder. She told me that her child experiences upset stomach and vomiting when taking the generic methylphenidate (Ritalin) and even as a young child, he knows the difference.
When I first started treating some patients with reflex sympathetic dystrophy, a few felt nauseous and experienced vomiting but if I recall correctly, we were using a generic brand of methylphenidate. This adverse response has not happened for nearly a year now.
So far, none of the cluster headache patients treated by me have experienced nausea as a Ritalin side effect.
Suggestions only (Not Recommendations): These suggestions must first be discussed with your family physician.
1. You might consider contacting a local pediatrician and ask what he/she does for the children on Ritalin who have similar complaints. He or she might be very sympathetic as well as an expert in managing Ritalin therapy reactions.
2. If what my patient tells me is true, you might speak with your pharmacist. They are very well versed on adverse reactions to medications and you can also establish if your prescription is generic or not.
3. You might ask your local family doctor to prescribe anti-nausea medications and a medication to slow his stomach muscle contractions. Your doctor can decide which are best for Ken.
4. You might consider changing his regimen by breaking the 10-mg tablet into four equal sections and have him take one quarter tablet every 3 to 4 hours or longer if needed.
5. You might have Ken try taking Ritalin on a full stomach.
6. If it is generic, you might ask that the next prescription be written "DAW" so you will not be given a generic Ritalin substitute.
Ken, keep thinking positive and maintain that fighting spirit and you can't help but beat this monster.
Best Wishes and Good Luck,
Dr. Gary A. Mellick