Methylphenidate / Dexmethylphenidate (Ritalin/Focalin) in Thailand

[manarak]

I have been prescribed Methylphenidate / Dexmethylphenidate (Ritalin/Focalin), one being a substitute for the other incase of unavailability.

I have learned that these meds are only available in Thailand from hospital pharmacies, is that correct?

Can I go there with my prescription (in English) to get the meds?

Or do I need to first visit a Thai doctor so he can write a Thai prescription?

What are the prices like? Any cheap options for buying?

(I am in Pattaya)

[Sheryl]

Methylphenidate can only be gotten from a hospital pharmacy and has to be prescribed by a doctor at that hospital. Dexmethylphenidate is not available in Thailand.

While your prescription from home has no validity here it may be useful to bring with you to show the doctor. Also, if you have a doctor's letter or medical certificate that shows the diagnosis for which it was prescribed that may also help, as many Thai doctors are unfamiliar with its use in adults.

There are several brand names of Methylphenidate in Thailand: Ritalin, Concerta, Rubifen and Methylphenidate Hexal. All of these are imports so there is no cheap option. There is likely some small price difference between these 4 imported brands, and my guess is that the Ritalin is the costliest, but it is unlikely a hospital will stock more than one brand.

[manwithai]

Try a visit to the "Better Being Clinic" in Bangkok. They might be able to provide you with better, more healthy solutions. Retalin is crap and better options exist.

Sent from my iPhone using ThaiVisa app

[manarak]

Methylphenidate can only be gotten from a hospital pharmacy and has to be prescribed by a doctor at that hospital. Dexmethylphenidate is not available in Thailand.

While your prescription from home has no validity here it may be useful to bring with you to show the doctor. Also, if you have a doctor's letter or medical certificate that shows the diagnosis for which it was prescribed that may also help, as many Thai doctors are unfamiliar with its use in adults.

There are several brand names of Methylphenidate in Thailand: Ritalin, Concerta, Rubifen and Methylphenidate Hexal. All of these are imports so there is no cheap option. There is likely some small price difference between these 4 imported brands, and my guess is that the Ritalin is the costliest, but it is unlikely a hospital will stock more than one brand.

Thank you Sheryl

So I will bring my prescription and a copy of the medical report and take them to a hospital.

Another question: if the police tests me for drugs, I think Ritalin can make the test turn positive - will a prescription from my doctor in Switzerland be enough to prove medical use?

[manarak]

Try a visit to the "Better Being Clinic" in Bangkok. They might be able to provide you with better, more healthy solutions. Retalin is crap and better options exist.

Sent from my iPhone using ThaiVisa app

and what would those better solutions be?

I have been taking ritalin for some time now, and it works really well for me.

[manarak]

Update.

I finally sourced inexpensive methylphenidate in Thailand.

I brought my Swiss prescription together with my Swiss medical certificate, with which I first visited a hospital in Pattaya, which has a reputation for being expensive.

I got an appointment for the next day and saw an English-speaking physician, very friendly.

He issued a prescription for Thailand rapidly.

The costs were 1250 baht hospital charges (Physician+"packaged"+Nurse) AND 5040 THB for 120 pills (10mg Methylphenidate, standard), or 42 baht per pill, while the Thai FDA recommends 4 baht per pill - 10.5 times the recommended price, that's something I hadn't seen before.

Then, the next problem was that they had only 60 pills (2 weeks supply for me) on hand and informed me later when I could pickup the next 60. The problem with that was that they informed me three weeks after the appointment, so if I didn't bring a reserve of pills from Switzerland, I would have run out!

So I wasn't very pleased, especially with the price.

For my next appointment I went to Chonburi hospital (government hospital on sukhumvit).

Their service for nutters such as me there is open from 08:00 to 12:00.

I got there at 8:30, alone, and already finding the car park was a bit of a challenge as the place is undergoing construction and there are almost no signs in English.

Same thing inside, I wandered for a while asking people for the reception and found myself on the second floor, bustling with activity everywhere, there must have been 2000 or 3000 people within sight. During the four hours I would spend there, I saw two foreigners.

All signs still in Thai, no "Reception" or "Registration" to be seen. Of the approx. 500 signs around, one was in English and read "appointment center", so I tried my luck there.

I got the classic blank stares of the people wanting to help but not speaking English until a friendly older lady came to help me, she was fabulous.

I explained with the help of google translate on my phone what I needed, and she took me to the patient registration.

To get treated there, one needs to be registered at the hospital.

She took care of nearly everything, from filling up the form to queue jumping.

Registration was done in less than 10 minutes, which was an achievement considering the lines in front of the counters.

She then took me to the service I needed to go to, refused all my offers for coffee, cake or whatever she would have liked and disappeared after I thanked her once again.

At the service, staff spoke just a few words of English. These and my very limited Thai were barely enough to get the business done. I had to wait for nearly 3 hours before seeing the doc. She spoke a bit of English and was at first visibly reluctant to proceed with the prescription, but it then eased after I showed the Swiss papers and the certificate from the Pattaya Hospital.

Then I got the prescription and was sent off to the pharmacy.

There, I had to visit different counters, one for giving the prescription, and that gave me a number on a green piece of paper.

The second counter gave me some sort of invoice with a yellow or pink paper with a number, then I had to pay at the cashier, who gave me a blue paper with a number and the last counter gave me the meds.

I got in at 8:30 and was out at 12:30.

Costs were 480 baht for 120 pills, plus 50 baht service charge.

I can live with that! 555

Pattaya hospital: 6290 baht

Chonburi hospital: 530 baht (4 baht per pill)

In hindsight, I paid the Thai price possibly because of my work permit, which I showed at registration. Otherwise, I heard (or I think I understood from what was being said) that I would have paid 6 baht per pill, which would not be the end of the word either.

[Sheryl]

Many thanks for this info. For a "nutter" you proved very resourceful and competent in handling this! Dealing with Thai government hospitals is a formidible task for non-Thai speakers.

There is usually no mark up on drug prices at government hospitals even if you are a tourist. But if you are on a work permit you are probably covered under Thai Social Security, in which case you should be registered at a hospital and costs would indeed be nominal. (If you are not so registered, ask at work about this).

[manarak]

Many thanks for this info. For a "nutter" you proved very resourceful and competent in handling this! Dealing with Thai government hospitals is a formidible task for non-Thai speakers.

There is usually no mark up on drug prices at government hospitals even if you are a tourist. But if you are on a work permit you are probably covered under Thai Social Security, in which case you should be registered at a hospital and costs would indeed be nominal. (If you are not so registered, ask at work about this).

"Psychiatric Ward" sounds so serious, the word still makes me think: "Really?"

LOL

I wanted to recount my story on a lighter note - but for sure every of my visits to such a service always made me encounter some rather, uh - let's call them "interesting personalities"

I am now registered at Chonburi Hospital.

[yougivemebaby]

Update.

I finally sourced inexpensive methylphenidate in Thailand.

I brought my Swiss prescription together with my Swiss medical certificate, with which I first visited a hospital in Pattaya, which has a reputation for being expensive.

I got an appointment for the next day and saw an English-speaking physician, very friendly.

He issued a prescription for Thailand rapidly.

The costs were 1250 baht hospital charges (Physician+"packaged"+Nurse) AND 5040 THB for 120 pills (10mg Methylphenidate, standard), or 42 baht per pill, while the Thai FDA recommends 4 baht per pill - 10.5 times the recommended price, that's something I hadn't seen before.

Then, the next problem was that they had only 60 pills (2 weeks supply for me) on hand and informed me later when I could pickup the next 60. The problem with that was that they informed me three weeks after the appointment, so if I didn't bring a reserve of pills from Switzerland, I would have run out!

So I wasn't very pleased, especially with the price.

For my next appointment I went to Chonburi hospital (government hospital on sukhumvit).

Their service for nutters such as me there is open from 08:00 to 12:00.

I got there at 8:30, alone, and already finding the car park was a bit of a challenge as the place is undergoing construction and there are almost no signs in English.

Same thing inside, I wandered for a while asking people for the reception and found myself on the second floor, bustling with activity everywhere, there must have been 2000 or 3000 people within sight. During the four hours I would spend there, I saw two foreigners.

All signs still in Thai, no "Reception" or "Registration" to be seen. Of the approx. 500 signs around, one was in English and read "appointment center", so I tried my luck there.

I got the classic blank stares of the people wanting to help but not speaking English until a friendly older lady came to help me, she was fabulous.

I explained with the help of google translate on my phone what I needed, and she took me to the patient registration.

To get treated there, one needs to be registered at the hospital.

She took care of nearly everything, from filling up the form to queue jumping.

Registration was done in less than 10 minutes, which was an achievement considering the lines in front of the counters.

She then took me to the service I needed to go to, refused all my offers for coffee, cake or whatever she would have liked and disappeared after I thanked her once again.

At the service, staff spoke just a few words of English. These and my very limited Thai were barely enough to get the business done. I had to wait for nearly 3 hours before seeing the doc. She spoke a bit of English and was at first visibly reluctant to proceed with the prescription, but it then eased after I showed the Swiss papers and the certificate from the Pattaya Hospital.

Then I got the prescription and was sent off to the pharmacy.

There, I had to visit different counters, one for giving the prescription, and that gave me a number on a green piece of paper.

The second counter gave me some sort of invoice with a yellow or pink paper with a number, then I had to pay at the cashier, who gave me a blue paper with a number and the last counter gave me the meds.

I got in at 8:30 and was out at 12:30.

Costs were 480 baht for 120 pills, plus 50 baht service charge.

I can live with that! 555

Pattaya hospital: 6290 baht

Chonburi hospital: 530 baht (4 baht per pill)

In hindsight, I paid the Thai price possibly because of my work permit, which I showed at registration. Otherwise, I heard (or I think I understood from what was being said) that I would have paid 6 baht per pill, which would not be the end of the word either.

That's great news.

That's good news as I am paying a lot of money for Ritalin right now and need to travel to Bangkok. Is this hospital in Chonburi or is it named Chonburi hospital in Pattaya?

If you have a phone number of the dept or Doctor you saw, I would be grateful.

[Sheryl]

He is referring to Chonburi provincial hospital, which is in Chonburi town. It is a regional hospital so higher level of care and more specialization available than at the average provincial hospital.

Unless you speak Thai reasonably well you would do well to bring a Thai speaker along at least for your initial visit. Once you've gotten through the initial hoops of getting regsitered with a patient number and seen by a doctor in the pysch clinic, return visits are easier to maneuver. However, they will always be very time consuming. Personally I have never -- ever -- had going to a government hospital take me less than a full day (Just got back from one today, in fact -- 11 hours inclusive of round trip travel, and that was typical). ). So bring along plenty of reading material and a large resevoir of patience and good humor (you will see both displayed by the Thai patients in abundance).. Arrive as early as you can as everything is by queue number and they start issuing thsoe numbers hours before the clinics start.

And, for something touchy as a script for Ritalin, bring along any and all past documentation and medical records.

[Anthony5]

On 8/11/2015 at 8:03 PM, Sheryl said:

He is referring to Chonburi provincial hospital, which is in Chonburi town. It is a regional hospital so higher level of care and more specialization available than at the average provincial hospital.

Unless you speak Thai reasonably well you would do well to bring a Thai speaker along at least for your initial visit. Once you've gotten through the initial hoops of getting regsitered with a patient number and seen by a doctor in the pysch clinic, return visits are easier to maneuver. However, they will always be very time consuming. Personally I have never -- ever -- had going to a government hospital take me less than a full day (Just got back from one today, in fact -- 11 hours inclusive of round trip travel, and that was typical). ). So bring along plenty of reading material and a large resevoir of patience and good humor (you will see both displayed by the Thai patients in abundance).. Arrive as early as you can as everything is by queue number and they start issuing thsoe numbers hours before the clinics start.

And, for something touchy as a script for Ritalin, bring along any and all past documentation and medical records.

 

 

I just found this thread since I'm confident my son suffers from ADHD and I would like to try if Rilatine can help him.

 

Would the government hospital in Sriracha, think it's called Somdej hospital, offer the same service as the Chonburi hospital?

 

 

[manarak]

47 minutes ago, Anthony5 said:

I just found this thread since I'm confident my son suffers from ADHD and I would like to try if Rilatine can help him.

 

Would the government hospital in Sriracha, think it's called Somdej hospital, offer the same service as the Chonburi hospital?

 

It's not a medication that you can just try to see if it helps - methylphenidate is strictly controlled in Thailand and your son will have to first see a psychiatrist to get a diagnosis and possibly a prescription.

[Anthony5]

13 minutes ago, manarak said:

 

It's not a medication that you can just try to see if it helps - methylphenidate is strictly controlled in Thailand and your son will have to first see a psychiatrist to get a diagnosis and possibly a prescription.

 

I have been reading up on it for some time already, and it seems that the problem may be to find a competent physician, and even then they will be very reluctant to prescribe Rilatine.

 

I also not that you got your prescription at the Chonburi hospital on the base of your Swiss prescription.

 

In my opinion, I could be wrong, it would do no harm to try the medicine in low dosage for a few weeks and see if it helps. I think if it is effective it would show results in a very short time.

 

I'm pretty confident, from the symptoms he shows for years already, that he suffers from ADHD but I'm not interested in banging my had against a wall in the Thai system.

[Anthony5]

So today I visited Somdej hospital in Sriracha and saw a physician.

 

They agreed to try with a 2 week course of 20mg/day Ritalin. However the doctor was clearly not a mathematician as he prescribed 60 tablets.

 

Total cost hospital visit and medicine was 470 Baht.

 

We will evaluate now for 2 weeks and see how it goes.

 

Since Somdej is not the hospital where he is registered for the 30 Baht scheme, would it be better that if he needs further medication to do this at the registered hospital?

Edited October 4, 2016 by Anthony5

[Sheryl]

If he responds well to the medication and is stabilized on a dosage (so that no longer need to see a specialist) then yes - provided the registered hospital has the med. That in turn will depend on what level facility it is. If they do not have it, get a letter of referral to a hospital that does and it will likewise be covered.  (You could actually get the specialist consultation covered as well but would entail jumping some hoops i.e. convince the hospital where he is registered that he needs psychiatric evaluation and get referred - coming in already with a prescription from a psych dr helps fast-track things).

[Anthony5]

1 hour ago, Sheryl said:

If he responds well to the medication and is stabilized on a dosage (so that no longer need to see a specialist) then yes - provided the registered hospital has the med. That in turn will depend on what level facility it is. If they do not have it, get a letter of referral to a hospital that does and it will likewise be covered.  (You could actually get the specialist consultation covered as well but would entail jumping some hoops i.e. convince the hospital where he is registered that he needs psychiatric evaluation and get referred - coming in already with a prescription from a psych dr helps fast-track things).

 

You mean that if he goes to his registered hospital he will get the meds for free?

 

He's registered at Banglamung hospital, but is also allowed free healthcare at Pattaya city hospital.

 

I now notice also that the Somdej hospital charged 420 Baht for 60 tablets, where Manarak was charged 480 Baht for 120 tablets, so prices even differ between government hospitals. Or may be Manarak can tell us if the prices have changed from the time he made his post.

 

I have appointment on 30 October, and was told by the physician that he will then see " the doctor with the face mask". To me that sounds like a surgeon instead of a psychiatrist.

[Sheryl]

If he is covered under the "30 baht" scheme then yes,  he can get his meds for free (or for 30 baht) at the hospital he is registered (if they have them) or at any hospital that they refer him to (must have the letter of referral). They will however not just dispense the meds, will have to see a doctor there first to get them, but having prescription and hopefully short medical summary or certificate in hand, should help.

 

I have no idea what the "doctor in the face mask" bit is about.

[manarak]

9 hours ago, Anthony5 said:

 

You mean that if he goes to his registered hospital he will get the meds for free?

 

He's registered at Banglamung hospital, but is also allowed free healthcare at Pattaya city hospital.

 

I now notice also that the Somdej hospital charged 420 Baht for 60 tablets, where Manarak was charged 480 Baht for 120 tablets, so prices even differ between government hospitals. Or may be Manarak can tell us if the prices have changed from the time he made his post.

 

I have appointment on 30 October, and was told by the physician that he will then see " the doctor with the face mask". To me that sounds like a surgeon instead of a psychiatrist.

 

prices didn't change - my pharmacy bill still shows 4 baht per pill.

[Anthony5]

Been to the follow up today. Doctor with the mask was general doctor.

 

He admitted that he should see a specialized doctor, and gave me the name of the ADHD specialist for Chonburi, who practices at Burapha Uninversity.

 

Said there is only one like that in the province.

 

A second option was to visit a psychiatrist, which is available at Somdet Hospital, but I was given an appointment on 29 November.

 

I have been talking with my friend who is a doctor in my home country, because the boy complained about dizziness after he took Rilatine.

 

Actually severe dizziness which occurred about 8-9 times in a day, would last only about 20 seconds, but would cause him to see the world in strange colors.

 

I gave him 2 x 10mg a day with about 5 hours between the intake.

 

This is not a side effect of Rilatine, however there are some reports about temporary sight blurriness.

 

My friend advised that if this symptom continued he should have a brain scan performed. He also suggested that the time released version probably would reduce the symptom, but I doubt it is available in Thailand.

 

The symptom disappeared after 2 weeks.

 

I asked the doctor yesterday about a neurologist but he didn't seem to understand what I was talking about.

 

I'm not 100% confident that the Rilatine is effective, and want to avoid continuing the treatment if not necessary.

 

Is such a brain scan expensive for Thai people, and where should I consult for this?

 

Should I wait 1 month to see the psychiatrist or try to contact Dr Ramorn at Burapha university right away in the hope that she is available earlier?

 

I assume that Dr Ramorn also doesn't come under the 30 Baht scheme, or is that a wrong assumption.

 

 

 

[Sheryl]

The only thing that will come under the 30 baht scheme is treatment at the hospital he is registered at plus any other  government hospital that the hospital he is registered at, refers him to (for which a referral letter is needed).

 

Burapha Univ Hospital is a public hospital, so if you can get the letter (it is a standard form), he will be covered under the scheme.

 

For future reference, any time at a govt hospital that it is suggested or agreed that a specialist should be consulted  at another hospital, then and there request the referral letter. As it will otherwise be time-consuming to go back, track down the referring doctors (who may or may not remember the conversation) etc.

 

Otherwise the consultation costs out of pocket are not going to be much. And while you are at it, see if Burapha has a neurologist. A basic neuro exam is the first step before getting a scan and might help determine if one is indicated.

 

Scans are costly, and  because there is such a long waiting list that most people opt to go private. CT would be less than MRI but in either case would need to be done with contrast media,. which adds to the cost. However I suggest you start by seeing what psychiatrist specializing in ADHD and neurologist each think.  A scan would be indicated only  if something like a tumor was suspected, it cannot diagnose ADHD.

 

Another test that might sometimes be indicated is an EEG.

 

It sounds like the problem is that there has not been a proper diagnostic workup.  Anxiety disorders and learning disabilities like dyslexia (which can make a child frustrated and inattentive at school) are among the things that need to be excluded. It is also important to have tests of vision and hearing, as untreated hearing and/or visual problems will also make a child frustrated and inattentive at school.  Anxiety can make a child hyperactive and restless at both school and home.

[Anthony5]

The boy isn't registered at Somdet for the 30 Baht scheme, so I assume they also can't issue a referral letter then, is that correct?

 

He is registered at the Banglamung hospital, but at Somdet they told me they don 't have a psychiatrist there. The doctor also told me that he has to be 13 year to be allowed to see the psychiatrist. He is only 12 year yet, but they seemed willing to make him a year older for that purpose.

 

I have to take him to Banglamung hospital today, to see general doctor for an infection. Would that doctor be able to make me a referral letter for a psychiatrist or for Dr Ramorn?

 

Is it possible that Dr Ramorn at Burapha actually is a neurologist, since she specializes in ADHD, and the doctor at Somdet told me there is only one such doctor in the whole province, while they have psychiatrist at Somdet?

 

I don't know what the difference is between CT and MRI, but it was actually MRI that the doctor in my home country suggested.

 

If he is covered by a referral letter at what cost would I be looking for the MRI or CT scan?

 

Indeed there hasn't been done much diagnostic workup, he suffers for years already from memory loss and lack of energy, which I think started several years ago after he had an accident at school where he lost consciousness. Though this is hard to proof, but it is a fact that he remembers almost nothing from the period before that event, but also from shortly thereafter.

 

I looked at a medical website for symptoms that indicate ADHD and he ticked 5 out of 7. The only ones that didn't apply was actually the hyper activity, since he is just the opposite.

 

He also day dreams a lot, much more than any other student they know about, his class teacher told me. But I can notice this myself, when he sometimes completely stalls while have breakfast or dinner. At the age of 3 he used to do almost an hour over a breakfast, with foods that he liked to eat.

[Sheryl]

Many things can match ADHD symptoms without being ADHD.

New onset of poor memory etc after a head injury definitely needs a thorough neurological work up.

Referral letter needs to come from the hospital he is registered at. They can refer to any govt facility.

I suggest you start by requesting a neuro evaluation given the new info you have provided. May be going in wrong direction by assuming it is ADHD.

MRI with contrast (which is what this needs) at a private imaging center will run around 15-18 k. To do it at govt facility is a very long wait.

[Harlequin88]

Are there any cheap hospitals where can get Ritalin/Rubinfen/Focalin for a decent price. I live in BKK Asoke, I dont care if its private or public, I just want to cheapest medicine as someone stole my bad and all my prescriptions. Urgent, so if anyone know any pharmacy that sells ritalin or know about a hospital who doesn´t rob you, please reply. 

[manarak]

9 hours ago, Harlequin88 said:

Are there any cheap hospitals where can get Ritalin/Rubinfen/Focalin for a decent price. I live in BKK Asoke, I dont care if its private or public, I just want to cheapest medicine as someone stole my bad and all my prescriptions. Urgent, so if anyone know any pharmacy that sells ritalin or know about a hospital who doesn´t rob you, please reply. 

the posts in this thread will provide the information you are looking for.

[Sheryl]

Actually the thread is talking about places convenient to Pattaya.

 

For Bangkok area, try:

 

Chulalongkhorn Hosp psych outpatient

or (less convenient location, but more geared to thsi sort of thing )  Somdet Chaopraya Institute of Psychiatry  in Thonburi  http://www.somdet.go.th/Eng/main.php

 

If you can bring some sort of medical records with you it will help.

 

Private hospitals will usually have only the expensive imported brands.

[Harlequin88]

On 2/10/2017 at 9:45 AM, Sheryl said:

Actually the thread is talking about places convenient to Pattaya.

 

For Bangkok area, try:

 

Chulalongkhorn Hosp psych outpatient

or (less convenient location, but more geared to thsi sort of thing )  Somdet Chaopraya Institute of Psychiatry  in Thonburi  http://www.somdet.go.th/Eng/main.php

 

If you can bring some sort of medical records with you it will help.

 

Private hospitals will usually have only the expensive imported brands.

 

Chulalongkorn Hospitals wait is just insane, I sat there for 7 hours before I gave up. I think I´ll have to try somdet, even if their webpage is beyond atrocious ha ha.