What is Ritalin?
Ritalin is a brand name of methyphenidate, the most commonly prescribed medication for ADHD. Although technically not an amphetamine, methylphenidate is a stimulant. Methylphenidate was introduced in 1956.
For whom is this medication intended?
Ritalin has been approved for use in patients age 6 years and older for the treatment of ADHD. In some cases, it may be prescribed for children younger than age 6 who are diagnosed with attention deficit hyperactivity disorder.
How does it work?
Exactly how methyphenidate works is still not understood. Most experts agree that it affects the midbrain, the part of the brain that controls impulses. Methylphenidate most likely changes the balance of chemicals in the brain, so that it can more selectively respond to impulses.
Researchers at Duke University reported a link between Ritalinand Serotonin, a naturally occurring chemical in the brain appears to inhibit behavior and activity. The Duke study seems to indicate that ADHD symptoms may be reduced by raising the level of Serotonin in the brain. An abstract of the research article is available online from PubMed.
Is there any difference in Ritalin and the generic methylphenidate?
Chemically, the two are identical. No difference in effectiveness has been shown to exist. However, there are reports from patients who seem to feel that there is a difference between the two. These patients claim that name brand Ritalin is more effective for them or their child than the generic version. These claims, however, have not been validated through any clinical trials or other research. Whether these differences are caused by the medications or by a placebo effect among patients is unclear. Other patients report finding no difference and use methylphenidate as their medication of choice.
What are the side effects of methylphenidate?
Some side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:
More common: Loss of appetite; nervousness; trouble in sleeping
Less common: Dizziness; drowsiness; headache; nausea; stomach pain
Check with your doctor as soon as possible of any of the following side effects occur:
More Common: Fast hearbeat (tachycardia); increased blood pressure
Less Common: Black, tarry stools; blood in urine of stools; chest pain; fever; joint pain; pinpoint red spots on skin; skin rash or hives; uncontrolled movements of the body; unusual bleeding or bruising
Rare: Blurred vision or any change in vision; uncontrolled vocal outbursts and tics (uncontrolled and repeated body movements)
With long-term use or at high doses: Mood or mental changes; weight loss
Symptoms of overdose: Agitation; confusion (severe); convulsions (seizures); dryness of mouth or mucous membranes; false sense of well-being; fast, pounding, or irregular heartbeat; fever; headache (severe); increased blood pressure; increased sweating; large pupils; muscle twitching; overactive relexes; seeing, hearing, or feeling things that are not there; trembling or tremors; vomiting
Does Ritalin affect the growth of children?
Research from the University of Iowa found that Ritalin does not affect the final adult height of children who use the medication. This study confirms research from as early as 1976 on the growth of children taking methylphenidate and other medications used to treat ADHD. A 1988 study also found that methylphenidate does not compromise final adult height .
One reason for this association between medication use and the growth of children may be answered by a study that showed the possibility of ADHD-associated growth delays . Research conducted at Massachusetts General Hospital in Boston reported that changes in expected growth rates appear to be caused by ADHD and not its treatment.
Although Ritalin does not appear to effect final height, researchers warn that clinicians should monitor the growth of hyperactive children who are taking methylphenidate and consider dosage reduction in individual cases should evidence of growth suppression occur.
For more information about Ritalin, see the Harvard Medical School's Consumer Health Information page about this medication.