methyl phenidate(Ritalin): changes in effectiveness

Hello,



My brother has taken Ritalin(60 mg/day) in total for 4 months. For some
reason the medicine has changed in his effectiveness. This are the details:



He is 17 years old and for a year or so also uses Orap (0.5 mg/day) and
Akineton (1 mg/day). Before he took Ritalin he had concentration problems
because of ADD.



About 4 months ago, soon after he started with Ritalin, he was much more
focussed and could concentrate well in school.



Until two months ago was a vegetarian, but from then on he became veganist
(no animal products at all, lot's of soya). But he didn't stop taking
Ritalin or Akineton.



After about three weeks he stopped using both of the medicines because of
the lactose present in the medicines.



A week after he stopped taking Ritalin, the pharmacist prepared pure
methylphenidate (+ crystalline cellulose). He takes three doses a day. Each
dose consists of 20 mg methylphenidate and 280 mg cellulose. When he took
this as a powder, the effectiveness seemed much less as with the original
tablets. When we used veganistic capsules (made from cellulose) with the
Ritalin-powder this also did not help.



This situation of the less effective Ritalin has been going on for ... weeks
now.



I have the following questions:



- Shortly after he became veganistic he said the Ritalin PILLS (the medicine
in original form) didn't work as well as they used to work. Could his
veganistic eating habit have any effects on the working of the medicine? For
example, the most proteins he eats are from soya products. Could it be that
he misses certain essential amino acids because of this; and thereby causing
the decreased effectiveness? Would then taking supplemental amino acids,
which are maybe not present in soya-proteins, be of any help??



- In original Ritalin pills there is also calciumhydrogenphosphate present.
The pharmacist said this was for achieving a optimal pH grade (acidic) for
resorption. But the calciumhydrogenphosphate is not present in the current p
reperate (only methylphenidate and crystalline cellulose). Could this also
have a significant effect on the effectiveness of Ritalin?



- Could the abruptive stop of taking Ritalin / Akineton has any effects on
the effectiveness of the medicine. And that needs some time to get the
Ritalin working as normal again?



- These last three veganistic weeks he also took the methylphenidate-powder
with soyamilk instead of water. Can this have any effect on resorption?



I would be VERY glad if someone can provide some answers or tips in this
difficult puzzle.



Thanks in advance!

what was the problem with the small amounts of lactose in the original
formulation?

Lactose is obtained from cow milk. Veganists eat no (derived) animal
products. He's a boy with principles.

The cellulose may be causing a sustained release effect.
It tends to clump and surround the drug and cause it to be dispersed more
slowly.
Even if he was on a sustained release manufactured form, the compounded form
may have a different release.
The pharmacist could also use calcium carbonate as a filler but it will be
an immediate release.
But calcium carbonate comes from oyster shells.
I'm not sure if oysters are included in his can't have list.

Sometimes you just gotta weigh rish versus benfit.

BSW

so is he intolerant to lactose, ie; a deficiency in the metabolic enzymes,
or is he intolerant of lactose a simple sugar molecule without any cow
proteins.