Cylert

Cylert (Pemoline)

Cylert, the brand name for pemoline, is a central nervous system (CNS) stimulant once widely prescribed for managing attention deficit hyperactivity disorder (ADHD) and narcolepsy. Known for its ability to improve focus, attention, and impulse control, Cylert was a preferred option for individuals unresponsive to first-line ADHD medications like amphetamines or methylphenidate. Although its use has significantly declined due to safety concerns, its unique characteristics continue to hold relevance in discussions of ADHD treatment options.

Key Features and Benefits

1. Long-Lasting Effects

   • Cylert provides extended symptom relief, often requiring only one daily dose for effective management of ADHD.

2. Non-Amphetamine Stimulant

   • Unlike traditional ADHD medications, Cylert is not derived from amphetamines, making it a distinct alternative for some patients.

3. Narcolepsy Management

   • Cylert was effective in promoting wakefulness and reducing excessive daytime sleepiness in individuals with narcolepsy.

4. Minimal Immediate Side Effects

   • In clinical use, it demonstrated fewer immediate side effects like jitteriness or appetite suppression compared to amphetamines.

Common Uses

ADHD Treatment

Cylert was primarily prescribed to children and adults diagnosed with ADHD. Its stimulant properties helped improve concentration, reduce hyperactivity, and enhance task completion.

Narcolepsy

For individuals struggling with excessive daytime sleepiness or sudden sleep episodes, Cylert promoted alertness and wakefulness.

Dosage and Administration

The dosage of Cylert (pemoline) was carefully tailored to individual needs and medical conditions. Although it is no longer widely available due to safety concerns, understanding its former usage provides insight into stimulant therapy for ADHD.

Typical Dosage

• Initial Dose: 37.5 mg once daily, typically in the morning.
• Maintenance Dose: Increased weekly in increments of 18.75 mg, up to a maximum of 112.5 mg daily.

Administration Tips

• Cylert was usually taken orally in tablet form.
• It was recommended to take the medication in the morning to avoid sleep disturbances.
• Regular monitoring of liver function was required due to the risk of hepatotoxicity.

Side Effects and Safety Information

While Cylert was effective in managing ADHD symptoms, it carried risks that led to its withdrawal from the market in many countries.

Common Side Effects:

• Insomnia
• Nervousness
• Mild stomach upset
• Loss of appetite

Severe Side Effects:

• Hepatotoxicity (liver damage)
• Jaundice
• Unexplained fatigue or weakness
• Abnormal liver function test results

Precautions and Contraindications

Cylert’s use was associated with significant risks, necessitating careful patient selection and monitoring.

Who Should Avoid Cylert?

• Individuals with liver disease or abnormal liver function tests.
• Those with a history of hypersensitivity to pemoline.
• Patients with a history of substance misuse or stimulant dependency.

Hepatotoxicity Concerns

One of the primary reasons for Cylert’s decline in use was the risk of severe liver damage. Regular liver function tests were required to monitor for early signs of hepatotoxicity. In rare cases, Cylert use resulted in acute liver failure, underscoring the importance of strict medical oversight.

Drug Interactions

Cylert (pemoline) could interact with other medications, altering its efficacy or increasing the risk of side effects.

Notable Interactions:

• Other CNS Stimulants: Combined use could heighten the risk of overstimulation or cardiovascular side effects.
• Antidepressants: Certain antidepressants might increase the stimulant effects of pemoline.
• Alcohol: Concurrent use could exacerbate CNS side effects, such as nervousness or insomnia.

Storage and Handling

• Store Cylert in a cool, dry place, away from direct sunlight.
• Keep out of reach of children and pets.
• Discard any expired medication responsibly, following local guidelines.

Legal Status and Discontinuation

Cylert was classified as a Schedule IV controlled substance in the United States due to its stimulant properties. However, concerns about liver toxicity and the availability of safer alternatives led to its voluntary withdrawal from the U.S. market in 2005.

Alternatives to Cylert

Although Cylert is no longer available, many safer and equally effective medications are now used to manage ADHD and narcolepsy. These include:

• Methylphenidate (Ritalin, Concerta)
• Amphetamine-based medications (Adderall, Vyvanse)
• Non-stimulant options (Atomoxetine, Guanfacine)