Medication and Treatment Reviews

Ritalin

Generic Name: Methylphenidate hydrochloride

Uses

Ritalin is a central nervous system stimulant medication primarily used to treat attention deficit hyperactivity disorder (ADHD) in children ages 6-12, adolescents, and adults up to age 65. Ritalin may improve focus, and decrease impulsivity and hyperactive behavior, two hallmark symptoms in some patients with the condition. It contains the same active ingredient as medications like Aptensio and Daytrana. According to the FDA, Ritalin is a federally controlled substance (CII) because it can be abused or lead to dependence. It has not been studied in children under the age of 6.

The American Academy of Pediatrics recommends treatment with behavioral therapy before medication for children under the age of 6. For children ages 6 to 11, the AAP says “The primary care clinician should prescribe US Food and Drug Administration–approved medications for ADHD and/or evidence-based parent- and/or teacher-administered behavior therapy as treatment for ADHD, preferably both.” Likewise, the National Institute of Mental Health finds the most successful treatment plans use a combination of ADHD medication, like Ritalin, and behavior therapies.

Ritalin can also be used to treat narcolepsy.

How to Use Ritalin

Before starting or refilling a Ritalin prescription, read the medication guide included with your pills, as it may be updated with new information.

This guide should not replace a conversation with your doctor, who has a holistic view of your or your child’s medical history, other diagnoses, and other prescriptions. If you have questions, ask your doctor or pharmacist before you begin taking the medication.

Dosage

As with all medications, follow your Ritalin prescription instructions exactly. If a patient experiences upset stomach as a side effect, this medication can be taken with food. Taking Ritalin late in the day can disrupt sleep.

The optimal dosage varies patient by patient. It is not determined by age, weight, or height, but rather by how a person metabolizes the medication, and the condition treated. Your doctor may adjust your daily dosage until you or your child experiences the best response — that is, the lowest dosage at which you experience the greatest improvement in symptoms without side effects.

Ritalin is available in several formulations:

  • Short-Acting Tablet: Taken two to three times daily, 30 to 45 minutes before a meal. Available in 5mg, 10mg, and 20mg dosages. Each tablet lasts for approximately three to four hours. Tablets should be swallowed whole with water or other liquids. Tablets should never by crushed or chewed. Dosage should not exceed 60mg daily.
  • Sustained-Release Tablet (Ritalin SR): Taken 30 to 45 minutes before a meal. Each tablet lasts for approximately eight hours. Available in 20mg dosage. Tablets should be swallowed whole with water or other liquids. Tablets should never by crushed or chewed.
  • Extended-Release Capsule (Ritalin LA): Taken orally, with or without food, once daily. The first dose is typically taken first thing in the morning; it should be taken at the same time each day for the best results. If your child is unable to swallow the capsule, it can be opened and sprinkled over a spoonful of applesauce. Taken this way, the mixture should be swallowed whole without chewing, followed by a drink of water or other liquid. Capsules should never by crushed or chewed. Capsules are available in 10mg, 20mg, 30mg, 40mg, and 60mg dosages. The time-release formulation is designed to maintain a steady level of medication in your body throughout the day, or for approximately eight to ten hours. Dosage should not exceed 60 mg daily.

Do not drink alcohol while taking this medication, as it can cause the medicine to be released too quickly.

During treatment, your doctor may periodically ask you to stop taking your Ritalin so that he or she can monitor ADHD symptoms; check vital statistics including blood, heart, and blood pressure; or evaluate height and weight. If any problems are found, your doctor may recommend discontinuing treatment.

Some patients report developing a tolerance to Ritalin after long-term use. If you notice that your dosage is no longer controlling your symptoms, talk to your doctor to plan a course of action.

Side Effects

The most common side effects of Ritalin are as follows: headache, decreased appetite, stomach ache, nervousness, difficulty sleeping, mood swings, sweating, shaking, fever, increased heartrate, weight loss, and dizziness.

Other serious side effects include slowing of growth in children, seizures, priapism, and eyesight changes or blurred vision.

If side effects are bothersome, or do not go away, talk to your doctor. Most people taking this medication do not experience any of these side effects.

Report to your doctor any heart-related problems or a family history of heart and blood pressure problems. Patients with structural cardiac abnormalities and other serious heart problems have experienced sudden death, stroke, heart attack, and increased blood pressure while taking Ritalin. Stimulants can increase blood pressure and heart rate. Physicians should monitor these vital signs closely during treatment. Call your doctor immediately if you or your child experiences warning signs such as chest pain, shortness of breath, or fainting while taking Ritalin.

Also disclose to your physician all mental health issues including any family history of suicide, bipolar illness, tics, or depression. Ritalin may create new or exacerbate existing behavior problems, bipolar illness, or Tourette’s syndrome. The FDA recommends evaluating patients for bipolar disorder, tics, and Tourette’s syndrome prior to stimulant administration. It can cause psychotic or manic symptoms in children and teenagers. Call your doctor immediately if you or your child experiences new or worsening mental health symptoms including hallucinations or sudden suspicions.

Discuss circulation problems with your doctor before taking Ritalin, which has been known to cause numbness, coolness, or pain in fingers or toes, including Raynaud’s phenomenon. Report to your doctor any new blood-flow problems, pain, skin color changes, or sensitivities to temperature while taking Ritalin.

Stimulants like Ritalin have a high potential for abuse and addiction, especially among people who do not have ADHD. It is a “Schedule II Stimulant,” a designation that the Drug Enforcement Agency uses for drugs with a high potential for abuse. Other Schedule II drugs include Dexedrine, Ritalin, and cocaine. People with a history of drug abuse should use caution when trying this medication. Taking the medication exactly as prescribed can reduce potential for abuse.

The above is not a complete list of potential side effects. If you notice any health changes not listed above, discuss them with your doctor or pharmacist.

Precautions

Store Ritalin in a secure place out of the reach of children, and at room temperature. Do not share your Ritalin prescription with anyone, even another person with ADHD. Sharing prescription medication is illegal, and can cause harm.

You should not take Ritalin if you have any of the following conditions: allergy or hypersensitivity to Ritalin or any of the ingredients in Ritalin medications, anxiety/agitation, glaucoma, tics or history of Tourette’s syndrome, or if you are taking monoamine oxidase inhibitors (MAOIs).

You should use caution while taking Ritalin if you have a history of heart or mental problems, seizures, abnormal brain wave tests, circulation problems, or esophagus/stomach/intestine problems.

If you’re thinking of becoming pregnant, discuss the use of Ritalin with your doctor. Animal studies indicate a potential risk of fetal harm. Ritalin is passed through breastmilk, so it is recommended that mothers do not nurse while taking it.

The safety of Ritalin for children under age six has not been established.

Interactions

Before taking Ritalin, discuss all other active prescription medications with your doctor. Ritalin can have a dangerous, possibly fatal, interaction with antidepressants including MAOIs.

Tell your doctor if you are taking seizure medications, blood thinners, blood pressure medication, or any medication containing a decongestant.

Share a list of all vitamin or herbal supplements, and prescription and non-prescription medications you take with the pharmacist when you fill your prescription, and let all doctors and physicians know you are taking Ritalin before having any surgery or laboratory tests. Ritalin can have a dangerous interaction with certain anesthetics. The above is not a complete list of all possible drug interactions.

Sources:

https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=cd83fc91-47a3-4be4-9727-caf9ec0371e8
https://www.pharma.us.novartis.com/sites/www.pharma.us.novartis.com/files/ritalin_ritalin-sr.pdf

20 reviews

  1. We started our 5 year old son on Ritalin about a month ago as he was not doing well in kindergarten at all. He has responded well on this medication and is doing great in school but now, a month later, when he comes down from the medication he is almost psychotic. He lashes out in anger, has no impulse control, is negative and down right mean to everyone and everything around him.

  2. My 11 year old son has been taking Vyvanse for about 4 years and it worked for him. Lately he’s been having issues with anger and impulsivity when the med wears off. The doctor prescribed Ritalin LA, 10 mg(the lowest dose)The first day he took the Ritalin was Saturday so I observed him all day. It was like he had taken nothing! I couldn’t imagine sending him to school like that. On Sunday I gave him 2 pills, for the equivalent of 20mg and didn’t see much of an improvement.

  3. My son takes 30mg of Ritalin LA each morning and for the past week I have also been giving him the Claritin chewable tablets for children. The Ritalin seems to be wearing off quicker than it had in the weeks prior to starting the allergy medication.

  4. I am now on 20mg instant release Ritalin. I can take up to five doses a day and find that 3 hours between doses is optimal. I need to be careful that if I do take a fifth dose that it is before 7pm otherwise I can be awake all night.

  5. I presently take one 36mg Concerta XR capsule every morning, and it’s been very effective in helping me stay focused and on task at work. I noticed that when I got home from work I was struggling with keeping things organized. My doctor added a 10mg tablet of Ritalin, which I take at 4:00 in the afternoon. The extra dose has really helped with organization at home.

  6. I’ve been taking 20 mg of Ritalin SR for 3 months now. I first started with the generic Ritalin SR, however it gave me horrible side effects when it was wearing off. I then began taking the brand name for Ritalin SR and also started taking 5 mg of Ritalin IR around 5pm, since the SR would wear off 6-7 hours later. The first two days of taking 20 mg Ritalin SR at 8:00 am and 5 mg Ritalin IR at 5:00 PM worked really well, I was able to focus. However after two days the positive effects decreased and now I feel tired and less motivated to do things.

  7. I had been on Adderal for 20 years. I’m 71 years old. I got off of Adderal (with about three weeks of mild withdrawal symptoms) and my sex life has improved 100%.

  8. I’m a 46 year old male. I was finally diagnosed with inattentive ADHD so I lacked the hyperactive element. I was put on 5mg IR 3 times a day and I am astounded by the difference. I do, however, notice that after about 4 or so hours I get a slump.

  9. I take a daily dosage of 40mg Ritalin LA in morning. The initial effect peaks at 1.5hrs, the second peak at 4hrs, and then it’s all out of my system by 6 hrs.

  10. I am 28 and was just diagnosed with ADHD (inattentive). I have a prescription for Ritalin 10 mg 2-3x per day. I have used it for 5 days now and have experienced major crashes when the drug wears off. It seems to last 2-3 hours. When I crash after the med wears off I get headaches, mind racing, inability to focus and mood swings (depressive thoughts).

  11. Around 5 months ago I started drug therapy for adult ADHD. In the past 1.5 months my hair loss has increased and I’m beginning to notice it feeling thinner when I make a ponytail.

  12. I’m 39 years old male and my doctor started me on Ritalin 5mg in the morning and another 5mg around 2pm. This is my first week and can’t really feel anything in the day but I can’t sleep.

  13. I have been taking Ritalin for a few years now. I started on 5mg found it quite strong at first. I would fall asleep. Notice my speech slowing down and generally quite relaxed. In a few weeks this subsided. After 4 to 6 months I couldn’t feel it at all and increased the dose to 10mg. I stay off the Ritalin on the weekend to maintain my sensitivity.

  14. I’m a 37 year old female that was diagnosed with ADHD. I was tried on Ritalin and was soon taken off of it as I was experiencing stroke-like symptoms. I then started on 5mg dose x2 a day and was fine on that dose and it helped! Once I was bumped up to 10mg x2 a day on the 2nd dose, my tongue felt like it was swelling and the left side of my face felt numb.

  15. At 53 years I was started out on 5 mg. I had loss of appetite for couple months. Lost a few pounds, around 10 lbs. After 6 months, I went up to 10mg. I am very sensitive to meds. My heart also raced at first. I don’t have either problem anymore.

  16. I went on Ritalin a few months ago and it was working great – until I started a new job a couple of months ago. It’s not working as well as it did when I first started it. I have been taking 30 mg twice per day.

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