Methylphenidate, a prescription, mental stimulant, goes by many brand names, including the generic name Ritalin, Ritalin LA, Concerta and Methylin; however, most people are familiar with Ritalin. You may be surprised to discover that Ritalin is a stimulant and not a sedative since most people associate this drug with treating Attention Deficit Hyperactivity Disorder (ADHD). However, methylphenidate is not the same type of stimulant as caffeine or sugar, it doesn’t stimulate the brain in a manner that produces hyperactivity but, in fact, it does quite the opposite.

It is actually not quite known how Ritalin acts upon the brain, but it is believed that Ritalin somehow corrects an imbalance of the neurotransmitters (brain cell pathways) and hormones dopamine and serotonin. Neurotransmitters relay and modulate signals between a neuron (brain cell) and another cell. Ritalin seems to function by inhibiting dopamine blockers in the brain and simultaneously increasing dopamine production. Since dopamine and serotonin are two of the brain’s transmitters that communicate with the logical, rational portions of the brain and help to reduce impulsivity, Ritalin enhances a person’s ability to reason, control his or her behavior, learn better at school and interact with peers and family.

What Is Ritalin Used For?

Most likely, you are aware that the generic Ritalin is used to treat ADHD since this is its most common application. However, Ritalin has several other uses as well. Ritalin is sometimes prescribed for people with CFS or Chronic Fatigue Syndrome, whereby sufferers experience extreme physical and mental fatigue, intellectual difficulty, muscle pain and arthritis. It is also used to treat people who suffer from the sleep disorder known as narcolepsy, which is characterized by EDS, or Excessive Daytime Sleepiness. During EDS, a person experiences micro-sleep, which is similar to a tiny, undetectable blackout, a sudden onset of sleep and persistent need for sleep even after several hours of uninterrupted nighttime sleep.

Typically, Ritalin is prescribed for children and teenagers who are experiencing Attention Deficit Hyperactivity Disorder (ADHD). ADHD is characterized by a number of symptoms in the young child including hyperactivity, an inability to focus strictly on one task, aggressiveness, impatience and a plethora of other challenging traits. ADD, Attention Deficit Disorder, is a similar condition in that a child finds it very difficult to focus on a particular activity; however, hyperactive behaviors are not present. Both of these conditions can make it very difficult for a child to learn at school, develop social skills and interact well with peers and family.

What Are the Dangers of Ritalin?

If your child is diagnosed with ADHD, the decision to place him or her on Ritalin is undoubtedly a difficult one. Furthermore, people with little or no experience or knowledge of the drug often tend to repeat misconceptions about Ritalin, making it even more difficult for parents to use medical treatment for their child. That is why it is always important to refer to your child’s attending pediatrician or physician when asking for clarification about Ritalin. It is wise never to depend upon a layperson for this information, even those whose own children have taken the drug since children react differently to Ritalin.

That said, methylphenidate is not recommended for people with heart conditions, overactive thyroid gland, or who are suffering from Tourette’s Syndrome or excessive anxiety. Although Ritalin is proven to have positive consequences for children suffering from ADHD, it can also produce negative side effects such as hallucinations, mood swings, nervousness, headaches and diarrhea. It is now confirmed that Ritalin does have a long-term effect on height and weight which was previously believed to be untrue.

Short Term (Effective for 3-5 hours)

• Ritalin is a fine, white, powdery substance that can be ingested in a number of ways. It can be taken as a capsule or a tablet.
• Methylin, also a form of methylphenidrate, can be taken as either a chewable tablet or as an oral solution. The chewable tablet tastes good, but due to the manner in which it is ingested, it doesn’t have a slow-release factor.

These are immediate release drugs and can be broken, crushed or chewed making them easier for children to take.

One downfall is that they have to be taken more than once a day which can be a problem for some users. An additional dose often needs to be taken around lunchtime and many patients either forget or don’t want to take their medication at school/work in front of their peers.

Intermediate (Effective for 3-8 hours)

Ritalin SR, Metadate ER and Methylin ER are all extended release forms of methlyphenidate. These are usually administered in the form of a pill or capsule and can be taken with or without food.

It is important to take extended release medicines in their entirety. Do not to crush, break or chew the pills as this will release too much medication into the system at once.

Long Term (Effective for 8-12 hours)

Concerta, Metadate CD and Ritalin LA are all forms of Ritalin that offer a slow-release action rather than an immediate release. These medications are usually given only once a day and the caplets/pills must be swallowed whole. While short-term forms of Ritalin can be opened and sprinkled onto food, this will release too much medication into the system too quickly with long-term forms.
The Daytrana Patch is another form of Ritalin. The dermal patch functions exactly as the nicotine patch. It is applied to the skin, usually on the upper arm, and worn throughout the day. It is a slow-release medication that can be used by children and adults.

Children and teens who have not been diagnosed with other emotional or mental disorders and who are not taking other medications can usually safely use methylphenidate as a treatment for ADHD. However, children suffering from various mental illnesses and emotional disorders need to be especially cautious when taking Ritalin, Ritalin-SR, Ritalin-LA, generic Ritalin and any other form of this drug. In cases where the disorder has not been identified, the use of Ritalin can exaggerate the symptoms making them more prominent. It’s important to monitor any psychiatric side effects and attend to them immediately. In many cases, if there are other emotional disorders present, Ritalin should not be prescribed.

Who Should Not Use Ritalin (Methylphenidate)

Anxiety Disorders and Ritalin

People with psychological disorders should not take Ritalin. These include individuals with severe anxiety disorders, such as obsessive-compulsive disorder, panic disorder, general anxiety disorder, social phobia and post-traumatic stress disorder. Should a person suffer from these conditions a doctor may avoid prescribing Ritalin altogether because the side effects of the Ritalin may increase their symptoms and make them worse. There are some instances where Ritalin is the optimal drug and needs to be offered. In these cases, if the anxiety disorder is treated first, Ritalin can often be used with minimal side effects.

Alcohol and Ritalin

People who drink should almost never use Ritalin. This is because alcohol increases the stimulant effect of methylphenidate. As a result, a person can lose the ability to concentrate, become jittery and highly irritable. Simple tasks such as driving a car, operating machinery, riding a bicycle and many others can become dangerous. Since Ritalin can also be abused people with alcohol problems are more likely to abuse Ritalin than those who do not drink.

Bipolar Disorder and Ritalin

The two main features of bipolar disorder (formerly known as manic-depression) are depression and mania. Depression is a mental illness often displayed as a severe form of sadness, and affects the body, mood and thoughts. Mania is the opposite. Mania is characterized by hyperactivity, rapid thoughts and speech, jitters, irritability, euphoria and sometimes hallucinations. A lighter version of mania is known as hyper-mania and seldom involves irritability or hallucinations.

There is such a medical program as a combination of methylphenidate and various medications to control bipolar disorder. This is usually the case when a child has been diagnosed as Bipolar/ADHD. Sometimes there is justification for placing an individual with this condition on a stimulant drug. If symptoms improve over time then there is probably no concern with using Ritalin for someone with a Bipolar condition.

The concern about using a stimulant with bipolar disorder is that the patient might develop severe mania as a result. The individual’s behavior and state of mind needs to be constantly monitored should that be the case and even subtle changes in behavior and mood should be reported to the treating physician.

Tourette’s Syndrome and Ritalin

Children and youth with Tourette’s syndrome and/or tics should avoid methylphenidate since it can worsen the symptoms of these disorders. If Ritalin is found to be the best medication for children with these disorders, lower dosages may prove to be successful. Discuss all options thoroughly with your physician and monitor consistently for any problems.

Heart Conditions and Ritalin

Perhaps the most serious conditions that warrant avoiding the use of any stimulants are heart conditions, including a congenital heart defect, heart rhythm disorder or a recent heart attack. Children with these conditions have died suddenly without warning from using methylphenidate and other stimulants.

Epilepsy and Ritalin

Epilepsy and other seizure disorders also place children at serious risk when combined with methylphenidate absorption. While it is risky, there has been some success administering Ritalin when the Epilepsy is well-controlled. It is imperative to always discuss a full, detailed medical history with a physician before placing your child or teen on Ritalin.

Pregnancy and Ritalin

Any women who are planning to become pregnant, pregnant or nursing should refrain from using Ritalin. It is not known if the drug is dangerous for an unborn baby or can pass through breastmilk to the infant. Any woman planning on becoming pregnant while using methylphenidate needs to discuss her plans with her physician ahead of time.

Addictions and Ritalin

Persons addicted to alcohol or other drugs also need to be especially careful about methylphenidate use. Methylphenidate can interact in a harmful or even lethal manner with illicit drugs or with alcohol abuse. If you are suffering from an addiction, it is best to treat the addiction prior to beginning the use of Ritalin.

Young Children and Ritalin

Children under the age of six should only receive Ritalin under the direct supervision and recommendation of a physician. There are more pronounced side effects for this age group, requiring extra monitoring.

Ritalin’s origins began many decades ago when research scientists began to experiment with a drug using natural stimulants including ephedrine and caffeine. Initially, it was tested on lab rats and the studies revealed that the rats were more focused and easier to manage. By 1950, Ritalin was introduced as a treatment for Mohr’s Syndrome, not for Attention Deficit Hyperactivity Disorder (ADHD) and Attention Deficit Disorder (ADD). Mohr’s Syndrome is characterized by a cleft palate, an enlarged roof of the mouth and a forked tongue. Eventually methylphenidate’s calming and stabilizing effects were used to treat ADHD and ADD.

In 1980, the National Institute of Mental Health (NHIM), officially acknowledged ADHD as a childhood syndrome. Ritalin sales increased significantly and it became one of the most commonly prescribed medications for ADHD. Novartis, a medical laboratory located in the United States, is a significant producer of the drug. During the 1980’s and 1990’s, Novartis faced several lawsuits from parents of children who used Ritalin and developed severe side effects, including suicidal thoughts, and whose children died as a result of taking the drug.

The Demographics of Methylphenidate

In 1902, symptoms of ADHD were listed in medical textbooks, but sufferers were described as mentally retarded, culturally disadvantaged or emotionally disturbed children. After research was conducted during the 1940’s it was decided that hyperactive and impulsive children suffered from Hyperkinetic Disorder of Childhood. By 1980, this condition was renamed Attention Deficit Hyperactivity Disorder. The fact of the matter is that it can be very difficult to make an ADHD diagnosis since its symptoms can mimic many other disorders and illnesses.

In 1997, 5 million children were listed as using psychotropic drugs, Ritalin being among the most common. Ritalin use has increased by 700% since 1990. By the year 2000, it was prescribed for approximately 7 million children. Attention Deficit Hyperactivity Disorder is diagnosed eight times more often in boys than in girls. Of these diagnosed children, 90% use a stimulant to help control the disorder. 70% of children with ADHD are prescribed Ritalin. 20% use its counterpart, the generic form known as methylphenidate and an amphetamine known as Dexedrine.

The United States produces 90% of the world’s Ritalin. It produces, sells and distributes more methylphenidate than any other country worldwide. In addition to the United States, methylphenidate is frequently used in the United Kingdom and Germany. It is used in many European countries, but in much smaller percentages than in the United States. Some countries don’t use the drug at all, such as Sweden, which has banned the drug. Australia comes closest to the United States for usage of Ritalin and Canada’s usage is increasing significantly.

As long as schools, psychiatrists, pediatricians and families identify excessive impulsive and hyperactive behavior in children, it is likely that the prescription of Ritalin, methylphenidate and other forms of Ritalin will increase in the United States and worldwide.