Ritalin (methylphenidate) is a central nervous system stimulant that causes an increase in mental alertness by increasing the amount and effectiveness of a neurotransmitter in the body called dopamine. It is a prescription-only medication in the United States. Ritalin is primarily used to treat attention-deficit hyperactivity (ADHD) and is also used in the treatment of narcolepsy.

Dosage FAQs

  • What is a safe dose of this drug?
    • To treat ADHD: For adults, Ritalin can be administered in an initial dose of 10 mg orally, two or three times daily. The medication should be taken about 30 to 45 minutes before breakfast and lunch, and a third dose may be taken in the afternoon before dinner if necessary. If the person in treatment has trouble sleeping at night while using Ritalin, the last dose should be taken before 6 p.m. Dosage may be increased by 5 mg to 10 mg every week if necessary, but should not exceed 60 mg without consulting your health care provider. For children six years of age or older, an initial dose should be 2.5 mg to 5 mg twice per day, about 30 to 45 minutes before breakfast and lunch. Dosage may be increased by 5 mg to 10 mg per week depending on your doctor’s recommendation.
    • To treat narcolepsy: Initially, a 10 mg dose of Ritalin may be given orally two or three times daily, 30 to 45 minutes before eating. Dosage can be increased each week by 5 mg to 10 mg and should not exceed 60 mg per day.
       
  • Is this drug safe to use during pregnancy?
    The U.S. Food and Drug Administration (FDA) has placed this medication into pregnancy category C, which means that animal studies have demonstrated a risk to the fetus if taking this medication when pregnant. However, there are no well-controlled studies on humans. As a result, all possible treatments should be discussed before taking Ritalin. It should only be taken after thoroughly assessing if the benefits to the mother will outweigh the risks.
     
  • How is this drug processed in my body?
    Ritalin is absorbed in the body in two phases after being taken orally. It is metabolized in the liver and is mostly removed from the body in the urine. A tiny amount of the drug is removed in the feces.
     

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    How can I get the most out of my treatment with this drug?
    If you are an adult or child prescribed this drug for ADHD treatment, it may help you achieve a better mental health outcome if you pair your medication with a type of psychotherapy. In fact, the American Academy of Pediatrics recently updated its clinical guidelines on ADHD treatment to recommend a combined treatment approach for young children that includes therapy whenever medication is prescribed. Medication is great for controlling symptoms, but it cannot help a person modify behavior, understand what they are experiencing, or help them develop coping strategies should symptoms arise. Finding a therapist or counselor may help you or your child work on a better long-term result than may be achieved with medication alone.

Drug Interactions of Ritalin

If your doctor prescribes you this medication, be sure to discuss all minerals, vitamins, medications, and supplements you regularly take. The following drugs may interact with Ritalin:

Adverse Effects of Ritalin

This medication is associated with several serious and some less serious side effects. Some of the adverse effects of Ritalin include:

  • Persistent headaches
  • Hypertension
  • Nausea, constipation, and vomiting
  • Anxiety
  • Seizures
  • Tachycardia (Increased heart rate)
  • Chest pain
  • Cerebral hemorrhage
  • Increased irritability
  • Vertigo
  • Fatigue
  • Stiff muscles
  • Skin rash
  • Dry mouth
  • Loss of sex drive
  • Blurry vision
  • Shortness of breath

Precautions Associated with Ritalin

Ritalin is contraindicated for those experiencing glaucoma, motor tics, and Tourette syndrome. Additionally, it should not be taken if the person requiring treatment has used an MAOI drug within the past two weeks.

If you are undergoing prolonged therapy with this medication, discuss periodic blood tests with your physician. Many sources recommend periodic complete blood counts (CBC), blood differential tests, and platelet counts to ensure there is not too much buildup of this medication in your system.

Ritalin should be used with extreme caution by those experiencing high blood pressure.

Safe Withdrawal from Ritalin

If you need to stop taking this medication, it is best to consult with your doctor to work out a safe plan for withdrawal. It is possible to build both tolerance and a dependency on Ritalin. To reduce the occurrence and severity of withdrawal symptoms, dosage should be tapered down over time if possible. It may take anywhere from a few days to a few weeks for Ritalin to completely clear from your system. If you stop taking this drug abruptly, you may experience varying degrees of:

References:

  1. Scharman EJ, Erdman AR, Cobaugh DJ, Olson KR, Woolf AD, Caravati EM, Chyka PA, Booze LL, Manoguerra AS, Nelson LS, Christianson G, Troutman WG (2007). "Methylphenidate poisoning: an evidence-based consensus guideline for out-of-hospital management". Clinical Toxicology 45 (7): 737–52. doi:10.1080/15563650701665175. PMID 18058301.
  2. Heal DJ, Pierce DM (2006). "Methylphenidate and its isomers: their role in the treatment of attention-deficit hyperactivity disorder using a transdermal delivery system". CNS Drugs 20 (9): 713–38. doi:10.2165/00023210-200620090-00002. PMID 16953648.
  3. Chan YP, Swanson JM, Soldin SS, Thiessen JJ, Macleod SM, Logan W (1983). "Methylphenidate hydrochloride given with or before breakfast: II. Effects on plasma concentration of methylphenidate and ritalinic acid". Pediatrics 72 (1): 56–59. PMID 6866592.
  4. Pappadopulos E, Woolston S, Chait A, Perkins M, Connor DF, Jensen PS (2006). "Pharmacotherapy of aggression in children and adolescents: Efficacy and effect size". Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent 15 (1): 27–39. PMC 2277275. PMID 18392193.

Page content reviewed by James Pendleton, ND.