Stimulants for ADT fatigue?

[A0007720]

Has anyone tried Ritalin (methylphenidate) or some similar stimulant for ADT fatigue?

Doing some research last night, I found another bulletin board where TALL ALLEN referenced 7 years ago the 1st article listed below, by Richard et al, on the use of Ritalin for ADT fatigue. (The 2nd reference is more general, and addresses various drugs for overall cancer related fatigue).

With 6 more ADT months left, having done 18 months, I'm still fighting BAD fatigue every afternoon. I do the Mediterranean diet, I exercise 7 days per week 3-4 days Aerobic and 3-4 days weights. I sleep ok at night, but naps don't work.

The weight training, suggested by London441, is the main thing that helps me with the fatigue. When I'm tired, I go straight to the gym and do weights. That does help. The aerobic exercise helps, but to a lesser degree. I work my engineering job full time still, and sometimes I can't get to the gym before work.

As I reported in the last 2 weeks, you all helped me kick the depression! Heavens I love this group.

REFERENCES:

Richard, P.O., Fleshner, N.E., Bhatt, J.R., Hersey, K.M., Chahin, R. and Alibhai, S.M. (2015), Phase II, randomised, double‐blind, placebo‐controlled trial of methylphenidate for reduction of fatigue levels in patients with prostate cancer receiving LHRH‐agonist therapy. BJU Int, 116: 744-752. doi.org/10.1111/bju.12755

Minton O, Richardson A, Sharpe M, Hotopf M, Stone P. Drug therapy for the management of cancer-related fatigue. Cochrane Database of Systematic Reviews 2010, Issue 7. Art. No.: CD006704. DOI: 10.1002/14651858.CD006704.pub3.

[Hidden]

Probably would, or even adderall, but its just another chemical in the mix. and something you have to get off of eventually. Its just an amphetamine. People get addicted to it. Plus it gives you headaches. I"m referring to adderall, I have some experience with that. I would assume ritalin is very similar.

[A0007720 in reply to Hidden]

Hey Anomalous, thanks for taking the time. I'll ask about Adderall, when I pose the question to my docs. Nal has suggested some thyroid measurements, from his earlier posting, that I'm going to have also. I used to be on Adderall, and frankly, I loved the stuff other than the headaches.

[tango65]

Ritalin is a dopaminergic activating medication which could be effective in ADT fatigue. Blood pressure should be monitored.

ncbi.nlm.nih.gov/pmc/articl...

[A0007720 in reply to tango65]

Hi Tango, thanks for the additional reference! After I do Nal's recommended thyroid testing, I'll ask the docs about this, or the adderall. I don't want to take them every day, just as a last resort, on a spot basis, when I need to. Thank you for your time, sir!

[tango65 in reply to A0007720]

Ritalin need a few days to get a steady state level. It is pretty well tolerated. I had some problems with the systolic blood pressure. Blood pressure should be monitored initially to see if there are changes. Ritalin can improve the mood since it is a dopaminergic medicine, similar to anti depressant like Wellbutrin etc. It is not a amphetamine like Adderall.

[MateoBeach]

Yes Ritalin ( methylphenidate) can be very helpful in this setting. 5 mg twice daily for example. Some physicians may be reluctant to prescribe it for “fatigue”. But if you claim “difficulty focusing and staying on tasks” they will most likely approve it for those symptoms, as a variant of adult ADHD. Make the system work for you and try it. Estradiol patch can also be helpful.

[A0007720 in reply to MateoBeach]

Thank you Mateo! I think I'm going to have some blood work first, then see the results, then ask for the Ritalin as a last resort. Thank you!

[EdBar]

Ritalin has been found to be very effective to combat cancer treatment fatigue in a variety of cancers and it’s use is more common than you may think. It may also help with cognitive issues caused by ADT. You can always give it a try and if it doesn’t work or it’s not for you you can just stop.

Ed

[A0007720 in reply to EdBar]

Thank you Ed! I didn't consider cognitive issues! I think I'm going to have some blood work first, then see the results, then ask for the Ritalin as a last resort. Nal mentioned that low thyroid hormones can lead to the fatigue. Thank you!

[EdBar in reply to A0007720]

Yes I’ve had my thyroid tested, I think it was Dr. Sartor who ordered the test, it was normal but good to rule out. ADT causes anemia too, I had anemia for a while, some iron supplements helped with that, I still take them and monitor iron levels which is important. Anemia can cause fatigue too. If you are prescribed Ritalin or Adderall it’s a good idea to monitor BP etc regularly just in case it causes any problems in that area. It’s a good idea to do that regardless, some ADT drugs are notorious for causing BP issues like Xtandi. Ritalin can help greatly with QOL, start with a low dose until you see what dose works for you.

Ed

[lewicki in reply to EdBar]

Thanks

[London441]

Drugs work, but always at a cost. I’m not telling you not to take them, but I am suggesting you be in sufficient good health overall to risk it.

You’ve been on ADT for 18 months.. It invariably takes a toll...what is your weight? More importantly how much fat are you carrying? Have you had any dexa scans that break down your composition? (The dexa scan also tells you your bone density, very important since ADT is poisonous to it.)

Do you have diabetes or pre-diabetes? What’s your fasting glucose?

Any history of cardiovascular issues? Do you know your cholesterol and triglyceride levels? High blood pressure?

I also can’t know the quality of your workouts other than you say they’re frequent, which is good. But for most of us they can always be better.You say your diet is clean also-good.

But if were you I’d be very honest with myself about my condition before adding stimulants.

Any co morbidities you have makes taking these drugs a very bad plan in my opinion. My opinion only!

But hopefully my reasoning is obvious.

What I do know it isn’t hard to find a doctor who will prescribe them without asking any of these questions.

[A0007720 in reply to London441]

Hey London, Once again, you give me the voice of reason, thank you. I don't know the answers to your questions, which proves you're right that I shouldn't be taking this step yet. I'm going to have some blood tests, the ones you propose and the thyroid panel proposed by Nal. Thanks for the wisdom.

[j-o-h-n]

Get a (very large) dog and walk it......or let the dog walk you....

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 04/25/2021 10:20 PM DST

[A0007720 in reply to j-o-h-n]

Hey John, I love dogs, but the wife won't have one, so I'm stuck. And she's a GREAT cook and a good wage earner, so I'm going to keep her. Cheers

[Hidden in reply to A0007720]

We are all looking for relief if on adt? I had a young friend that was on riddaline . Said it helped him focus on college. So I tried one on. I felt the earth spinning , dizzy ,I hated it . Not for me. Plus I don’t relish adding another dammed chemical to an already bad brew . each to his own . It could help . If you don’t try it , you won’t know .? I’m of the mind set to try just about anything once . Feeling better is the goal. Good luck . Keep rolling . 🤙🏽✌️

[A0007720 in reply to Hidden]

Thank you L700 for the reply. Nal and London have said basically the same thing, about adding another medicine into the pot. So I'm going to have some tests done first. I'm glad you have a doggy that your wife likes!

[Hidden in reply to A0007720]

Thank you . Hang in there .. we tread water . 🤙🏽

[Hidden in reply to A0007720]

My wife didn’t want one either. 4 years now and she’s in love with lulu our pup.

[j-o-h-n in reply to A0007720]

Secret is get a dog who can perform in Hollywood and can cook up a storm....

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 04/27/2021 7:11 PM DST

[NRH_Beach]

I was diagnosed with ADD in my early 40’s. I take a very low dose of Adderall generic in AM and at noon. I’m still working 2 years into ADT therapy and its sometime hard to imagine getting through the week without it. What is commonly misunderstood is the action of the low dose in actually calming the central/executive function.

[Hidden in reply to NRH_Beach]

If it works. Great! 👏🏼👏🏼👏🏼

[A0007720]

Thanks Beach! Best wishes for your ADT and your ADHD!

[Hidden]

I was never a morning workout person so I'm not at all surprise I'm even less now on ADT +AA. Like you I'm an engineer working FT.I find going to the gym after work ( 4:30 pm) is best for me. I do cardio before my workout and I workout with weights 5x per week.

3 cups of coffee in the morning is my Ritalin.

[A0007720 in reply to Hidden]

Thanks Tom! Best wishes for the engineering job. And the bosses, who will want it faster, better and cheaper than any of us can ever do!

Wow, the members of this group set a high bar for me! Weights 5x per week. XP01 and others working out a lot. And Nal, with his picture of a sculpted body at age 78! I can't slack off! THANKS

[Chugach]

I took it for awhile (6mo) honestly it didn’t help much. Perhaps the dosing was too low? I drink black coffee, green tea and Yerba Mate - that helps me better

[A0007720 in reply to Chugach]

Thanks Chugach! Love the black coffee. Will look into the Yerba Mate. Cheers

[louschu]

Wisconsin Ginseng provides a gentle lift.

[A0007720 in reply to louschu]

Hey Lou, I've never been much for things like Ginseng, but the more I read about it, the more I believe it offers some promise. Certainly can't hurt me. Will give it a try. Thanks.

[louschu in reply to A0007720]

It was recommended by Mark M at Michigan who writes a lot for PCRI. I feel but its not an expresso.