The People's Perspective on Medicine

Methylphenidate

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It has been termed "possibly effective" for mild depression or withdrawn behavior in the elderly.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.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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I am an adult with ADD. I had it all my life actually. Taking methylphenidate for the last few years really helps me focus. I do not feel euphoric or stimulated on it, just focused. It wears off in 4-5 hours. Then my mind wanders. Like now. Surfing the web.

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