Generic name: Methylphenidate hydrochlorideBrand names: Metadate, Methylin, Concerta, Ritalin
Ritalin and other brands of methylphenidate are mild central nervous system stimulants used in the treatment of attention deficit hyperactivity disorder in children. With the exception of Ritalin LA, methylphenidate products are also used in adults to treat narcolepsy (an uncontrollable desire to sleep).
When given for attention deficit disorder, Ritalin should be an integral part of a total treatment program that includes psychological, educational, and social measures. Symptoms of attention deficit disorder include continual problems with moderate to severe distractibility, short attention span, hyperactivity, emotional changeability, and impulsiveness.
Excessive doses of Ritalin over a long period of time can produce addiction. It is also possible to develop tolerance to the drug, so that larger doses are needed to produce the original effect. Because of these dangers, be sure to check with your doctor before making any change in dosage; and withdraw the drug only under your doctor's supervision.
Follow your doctor's directions carefully. It is recommended that methylphenidate be taken 30 to 45 minutes before meals. If the drug interferes with sleep, give the child the last dose before 6 p.m. Ritalin-SR and Ritalin LA are long-acting forms of the drug, taken less frequently. They should be swallowed whole, never crushed or chewed. Ritalin LA may also be given by sprinkling the contents of the capsule on a tablespoon of cool applesauce and administering immediately, followed by a drink of water.
Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue giving Ritalin.
These side effects can usually be controlled by reducing the dosage and omitting the drug in the afternoon or evening.
In children, loss of appetite, abdominal pain, weight loss during long-term therapy, inability to fall or stay asleep, and abnormally fast heartbeat are more common side effects.
This drug should not be prescribed for anyone experiencing anxiety, tension, and agitation, since the drug may aggravate these symptoms.
Anyone sensitive or allergic to Ritalin should not take it.
This medication should not be taken by anyone with the eye condition known as glaucoma, anyone who suffers from tics (repeated, involuntary twitches), or someone with a family history of Tourette's syndrome (severe and multiple tics).
This drug is not intended for use in children whose symptoms may be caused by stress or a psychiatric disorder.
This medication should not be used for the prevention or treatment of normal fatigue, nor should it be used for the treatment of severe depression.
This drug should not be taken during treatment with drugs classified as monoamine oxidase (MAO) inhibitors, such as the antidepressants phenelzine and tranylcypromine, nor for the 2 weeks following discontinuation of these drugs.
Your doctor will do a complete history and evaluation before prescribing Ritalin. He or she will take into account the severity of the symptoms, as well as your child's age.
This drug should not be given to children under 6 years of age; safety and effectiveness in this age group have not been established.
There is no information regarding the safety and effectiveness of long-term treatment in children. However, suppression of growth has been seen with the long-term use of stimulants, so your doctor will watch your child carefully while he or she is taking Ritalin.
Blood pressure should be monitored in anyone taking Ritalin, especially those with high blood pressure.
Some people have had visual disturbances such as blurred vision while being treated with Ritalin.
The use of Ritalin by anyone with a seizure disorder is not recommended. Be sure your doctor is aware of any problem in this area. Caution is also advisable for anyone with a history of emotional instability or substance abuse, due to the danger of addiction. If abused, Ritalin may lead to tolerance, dependence, and psychotic episodes. Careful supervision is necessary during Ritalin withdrawal, since it may cause severe depression.
If Ritalin is taken with certain other drugs, the effects of either can be increased, decreased, or altered. It is especially important to check with your doctor before combining Ritalin with the following:Antiseizure drugs such as Phenobarbital and phenytoinAntidepressantsBlood thinners such as warfarinClonidineDrugs that restore blood pressure, such as epinephrineGuanethidineMAO inhibitors (drugs such as the antidepressants phenlzine and tranylcypromine)Phenylbutazone
The effects of Ritalin during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, inform your doctor immediately. It is not known if Ritalin appears in breast milk. If Ritalin is essential to your health, your doctor may advise you to discontinue nursing your baby until your treatment with Ritalin is finished.
The average dosage is 20 to 30 milligrams a day, divided into 2 or 3 doses, preferably taken 30 to 45 minutes before meals. Some people may need 40 to 60 milligrams daily, others only 10 to 15 milligrams. Your doctor will determine the best dose.
These tablets keep working for 8 hours. They may be used in place of Ritalin tablets if they deliver a comparable dose over an 8-hour period.
This drug should not be given to children under 6 years of age.
The usual starting dose is 5 milligrams taken twice a day, before breakfast and lunch; your doctor will increase the dose by 5 to 10 milligrams a week. Your child should not take more than 60 milligrams in a day. If you do not see any improvement over a period of 1 month, check with your doctor. He or she may wish to discontinue the drug.
These tablets continue working for 8 hours. Your doctor will decide if they should be used in place of the regular tablets.
Ritalin LA Capsules
The recommended starting dose is 20 milligrams once daily in the morning. At weekly intervals, the doctor may increase the dose by 10 milligrams, up to a maximum of 60 milligrams once a day.
If you suspect an overdose, seek medical attention immediately.