Using Ritalin to Treat ADHD

Ritalin (methylphenidate) is a central nervous system stimulant used to treat children and adults with attention deficit hyperactivity disorder or ADHD. It is also used to treat people with narcolepsy. Ritalin can help improve characteristics of ADHD, including reducing hyperactivity, improving attention, and decreasing impulsivity.

When parents think about treating ADHD, they often think about Ritalin, as it was one of the first ADHD medications introduced (amphetamines were first). Ritalin has been used to treat ADHD since the 1950s.

Since Ritalin is often used as a generic term for the whole range of ADHD medications, sometimes people attribute every negative thing they have ever heard about ADHD treatments to Ritalin. This is unfortunate because Ritalin has a good track record of helping many children with ADHD.

Forms of Ritalin for ADHD

Methylphenidate is available in a variety of short, intermediate, and long-acting forms. Focalin (dexmethylphenidate) and Focalin XR are made of just one part or isomer of methylphenidate. These medicines leave out another part, which is inactive and may contribute to side effects.

Doses of stimulants don't usually depend on a child's weight, so your pediatrician will usually start with a low dose and then work upwards until it usually works or is causing side effects.

Although most forms of methylphenidate, including Concerta, must be swallowed whole, it is possible to open Ritalin LA and Metadate CD capsules and sprinkle the contents on food, such as applesauce.

Except for medications such as Daytrana, Quillichew ER, Quillivant XR, Jornay PM, and Adhansia XR, most of these medications are available in generic forms, which can help you save money.

Short-Acting Methylphenidate

Short-acting forms of Ritalin and other brand-name forms of methylphenidate are available in 5mg, 10mg, and 20mg tablets that are usually taken two or three times a day. Each dose lasts three to five hours.

• Ritalin
• Methylin (chewable tablets)

Intermediate-Acting Methylphenidate

With these formulations, a dose lasts 3 to 8 hours.

• Ritalin SR
• Metadate ER
• Methylin ER

Long-Acting Methylphenidate

A dose of these medications lasts 8-12 hours, which means a child only has to take one dose per day. Although convenient, once-a-day forms of Ritalin and other brand-name medications containing methylphenidate are typically much more expensive than generic methylphenidate

• Adhansia XR
• Daytrana (patch)
• Jornay PM
• Metadate CD
• Ritalin LA
• Concerta (methylphenidate ER)
• QuilliChew ER (chewable tab)
• Quillivant XR (oral suspension)

Ritalin Side Effects

The most common side effects of Ritalin are nervousness and insomnia (trouble sleeping). Other side effects include:

• Abdominal pain
• Angina
• Anorexia
• Blood pressure
• Cardiac arrhythmia
• Dizziness
• Drowsiness
• Dyskinesia
• Headache
• Hypersensitivity
• Nausea
• Palpitations
• Pulse changes
• Tachycardia
• Weight loss (when it is taken for a prolonged period of time)
  

Ritalin Warnings

Before taking Ritalin for ADHD, it is important to be aware of important precautions. Tell your doctor if you are allergic to methylphenidate, dexmethylphenidate, or other substances.

Although Ritalin is well tolerated by most children, teens, and adults, there are some who should not take Ritalin, including those with other conditions such as:

• Glaucoma
• Hypersensitivity to Ritalin
• Marked anxiety, tension, and agitation
• Motor tics, Tourette's syndrome, or a family history of Tourette's syndrome
  

Ritalin and Heart Issues

Stimulants can cause increases in heart rate and blood pressure. You should tell your doctor if you or your family have a history of cardiovascular disease. Ritalin has been associated with an increased risk of stroke, heart attack, and increased blood pressure in some people with heart problems. 

According to the American College of Cardiology, people who take stimulants such as Ritalin have a 17% increased risk of developing cardiomyopathy within one year compared to people who do not take stimulants.

Interactions When Taking Ritalin for ADHD

Always tell your doctor about any medications, supplements, or other substances you are currently taking or have recently taken. Some medications or substances can interact with Ritalin or affect how it works. Some medications may lead to side effects such as high blood pressure, drowsiness, bleeding, and serotonin syndrome.

Ritalin may also interact with other medications, including selective serotonin reuptake inhibitors (SSRIs), blood thinners, seizure medications, decongestants, and antipsychotics.

Ritalin Dependence and Withdrawal

Ritalin is a controlled substance, which means that it has a potential for misuse. It carries a risk of dependence and addiction, which is higher for people who have a history of substance use disorder. This is why it is important to take this medication as prescribed. Never take more than the prescribed dose or take it longer than your doctor recommends.

Suddenly stopping this medication or lowering the dose can result in withdrawal symptoms. In many cases, you doctor will recommend gradually tapering your dose over a period of time to minimize unpleasant withdrawal symptoms.