Ritalin Review By Dr. Kensington
Important Info For Ritalin Users
Ritalin (Generic name: Methylphenidate) is a stimulant that is used to treat ADD and ADHD, otherwise known as Attention Deficit Hyperactivity Disorder.
It interacts with chemicals in the brain that contribute to impulse control and hyperactivity.
It is available in different forms: regular, sustained release, and long acting. Regular is a short-acting tablet that works within 30-60 minutes and is effective in over 70% of patients.
The SR (sustained release) version also begins working within 30-60 minutes but wears off more gradually resulting in less risk of rebound and lower risk of abuse.
The LA (long acting) version has the advantage in that it often only needs to be given once per day and can last for up to 12 hours.
Dosage
The starting regular dose for children is usually 5mg twice daily, about 3 to hours apart.
The starting SR dose is usually 20mg daily.
In addition to not having to take a lunch time dose, the long acting forms of these medications have the benefit of still working after school as your child is trying to do homework.
It is available in 10, 20, 30, and 40mg capsules. Also, unlike the other long acting forms of methylphenidate, the LA capsules can be opened and sprinkled on something if your child can't swallow them whole. See this helpful guide that explains finding the proper dosage.
Ritalin Side Effects
Side effects of stimulants such as this medication often include decreased appetite, irritability, and insomnia.
Decreased Appetite
This is a common side effect of all stimulants. If it continues to be problematic, dosages and medication times can be adjusted. Often a large breakfast, small lunch and large supper can do the trick. Or a late evening snack can also help.
Rebound
Rebound is the phenomenon where some experience irritability or depression for an hour as the drug wears off.
One can avoid rebound by spacing the doses closer together, giving a smaller dose after the final larger dose, or by switching to a longer acting stimulant.
Recently several new long-acting stimulant medications have been released that typically result in less rebound.
The new long-acting ADHD medications tend to be superior in terms of rebound, but rebound may still occur in a certain amount of susceptible individuals.
The Jitters
Ever consumed too much caffiene? Like all stimulants, this medication produces the jitters and the shakes. To avoid this try eliminating all caffeine and other stimulants. A small dose of a beta-blocker (a type of blood pressure medication) can block tremors, shakes and jitters. Be sure to eat regular meals and ingest some food.
Upset Stomach
Another common side effect of any stimulant. Take the medication with meals or eat smaller, more frequent meals.
Sleep Disturbances
Sometimes sleep disturbances are due to ADHD, not the medication. Therefore, it is a good idea to take a sleep history before starting taking any stimulants. If sleep disturbances are due to the medication, there are several options such as adjusting dosages and medication times.
Irritability
Irritability may be due to ADHD but if it is due to the medication the dosage may be altered or another ADHD medication could be substituted.
Withdrawal
For information on withdrawal, click here.
Comparison With Other ADHD Meds
Click the following links for information comparing Ritalin versus Adderall and versus versus Concerta.
Warnings
Do not use if you have used an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), rasagiline (Azilect), or selegiline (Eldepryl, Emsam) within the past 14 days. Serious, life-threatening side effects can occur if you use Ritalin before the MAO inhibitor has cleared from your body.
Also, do not use if you are allergic to methylphenidate or if you have glaucoma, overactive thyroid, severe high blood pressure, tics or Tourette's syndrome, angina, heart failure, heart rhythm disorder, recent heart attack, a hereditary condition such as fructose intolerance, glucose-galactose malabsorption, or sucrase-isomaltase deficiency, or severe anxiety, tension, or agitation.
Abuse Potential Any stimulant may be habit-forming and should be used only by the person for whom it was prescribed. The full dose of Ritalin is released at once if crushed and snorted. Be sure to read about the dangers of snorting and abuse. As always, keep all medication stored in a secure place and no medications should ever be shared with another.
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