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Generic Name: Methylphenidate
Brand Name(s):
Information updated: April 1, 2000
Overview
Ritalin is a mild stimulant prescribed primarily for attention deficit
disorder (ADD), with or without hyperactivity.
Ritalin should not be the
sole treatment for ADD, which is best managed in an integrated program of
educational, psychological and social support.
Diagnosis of the
condition requires input on psychological and social factors as well as medical
and educational issues. Not all children with ADD respond to Ritalin, but many
find it helpful.
Ritalin is also prescribed for narcolepsy, a sleep
disorder which results in sudden and unexpected daytime sleepiness.
It
has been termed "possibly effective" for mild depression or withdrawn behavior
in the elderly.
Side Effects and Interactions
The most common side effects of Ritalin are
nervousness and insomnia.
Children often react with stomach ache, loss
of appetite, weight loss, trouble sleeping, and rapid heart beat.
Rash
is occasionally the first sign of a severe skin reaction. Notify the physician
promptly.
Other possible responses include hives; fever; joint pain;
nausea; dizziness; palpitations; changes in the pulse or blood pressure; chest
pain; hair loss; headache; unusual movements; Tourette's syndrome; and anemia.
Ritalin may impair physical coordination or mask tiredness, making
driving and operating machinery more dangerous.
Periodic tests should be
conducted to monitor blood cell counts. Report any symptoms or suspected
reactions to the physician promptly.
Many medicines, including Coumadin,
several anticonvulsants, antidepressants such as amitriptyline or imipramine
(Tofranil), and MAO inhibitors (Eldepryl, Nardil, Parnate) can interact with
Ritalin.
Other possible interactions include the blood pressure drug
guanethidine.
Check with the pharmacist and physician to make sure
Ritalin is safe in combination with any other medicines.
Special Precautions
Ritalin is not approved for use in children younger than six.
Long-term safety of Ritalin has not been adequately studied in children. Some reports suggest that growth may be adversely affected.
The doctor may suggest periodic "drug-free days" in which Ritalin is not taken in order to assess whether the child still needs it.
Ritalin is not appropriate for people who are severely depressed or psychotic.
Those with high blood pressure or a history of seizures may aggravate these conditions by taking Ritalin.
Glaucoma or a family history of Tourette's syndrome are also reasons to avoid Ritalin.
Ritalin is considered a controlled substance with a potential for abuse. In the event of abuse, withdrawal must be carefully supervised.
Taking the Medicine
Ritalin is taken two or three times a day, preferably 30 to 45 minutes before meals.
People who experience insomnia in reaction to Ritalin should take the last dose before 6:00
p.m.
Ritalin-SR (slow release) tablets must be swallowed whole, never chewed or
crushed.
Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. Their syndicated radio show can be heard on public radio.
© 2000