Overall, methylphenidate or Ritalin, as it is known by its brand name, is used quite safely on the majority of children and youth who take it. Although initially a child may seem overly sedated when beginning methylphenidate, this is often due to too high a dosage and it is easily corrected by lowering the dosage. This is common when beginning young children and teens on Ritalin. It takes guesswork and trial and error to find the correct dose. Ritalin is not meant to sedate a child or put him or her into a trance-like state. However, there are serious and sometimes even life-threatening physical side effects that can result from methylphenidate use and it is important to be fully aware of these before beginning a methylphenidate program.
Physical Side Effects
Appetite Disturbance
One of the most common side effects, changes in appetite are usually most noticeable in younger children. When Ritalin is first introduced, it seems to have the greatest affect on the users appetite. Once the body has become more accustomed to the medicine, appetite usually improves and goes back to normal. If the problem persists, speak with your pediatrician or physician about the possibility of using a lower dosage. There is also the option of using a non-stimulant medication, such as Strattera, which does not affect the appetite.
Stomach Aches
Stomach aches most often occur when the medicine is taken on an empty stomach. To relieve these pains, ensure that the patient receives something to eat prior to taking Ritalin.
Headaches
Another common effect of Ritalin, headaches should improve with time. If they persist, it may be a sign that dosage is too high or a different type of medication would be better. In this case, talk to you pediatrician or physician to explore alternate options. In other cases, headaches are caused from lack of caffeine as many users dramatically decrease caffeine intake when starting Ritalin. This withdrawal headache from caffeine is sometimes mistaken as an effect of the Ritalin.
Stunted Growth
Though it was previously thought untrue, new research has found that long-term use of Ritalin does affect a child’s growth. After three years of using Ritalin, children are approximately 1 inch shorter and 4.4 pounds lighter than their peers. This has been found in the Effects of Stimulant Medication on Growth Rates Across 3 Years in the MTA Follow-Up study, which was published in the Journal of the American Academy of Child and Adolescent Psychiatry in August 2007.
Rebound
While the medication helps control the symptoms of ADHD while it is active, when it begins to wear off, sometimes there is a rebound period. The behavior that takes place during this rebound period can range from mild to severe, depending on the individual. If difficulty arises as the medicine wears off, talk to you doctor about taking doses closer together, adding a smaller dose after a large final dose or switching to a long-acting stimulant.
Difficulty Sleeping
Prior to starting Ritalin, it is helpful to keep a sleep diary to document any issues with sleep. ADHD can cause difficulty sleeping and a diary will help to determine if the ADHD or the Ritalin is the cause of the problem. A major cause of sleep problems is that the medicine has not worn off by the time the individual is ready to go to sleep. To amend this problem, your pediatrician or physician may recommend a different type of Ritalin that has a different length of effectiveness. This will ensure that the stimulant has worn off by the time the patient is ready for sleep.
Irritability
Irritability is often due to ADHD or another psychiatric disorder, not Ritalin. If it is clearly the Ritalin that is causing this disruption and the irritability is affecting the user’s lifestyle, talk with your pediatrician or physician about possibly reducing the dosage or switching to a different medication.
Anxiety
Traits of anxiety can be increased by the use of Ritalin. If this is the case, it may be best to treat the anxiety and then start Ritalin to treat ADHD or other disorder. Speak with your pediatrician or physician to determine the best choice for you.
Jittery Feelings
Jittery actions and feelings are most commonly a side effect when there is another stimulant present such as caffeine or other stimulant medications. Eliminate any other stimulants and ensure the the user is eating regular meals. If the problems persists, contact your doctor.
Depression
Though more common with long-acting medications, depression is an effect that can occur early or late when using Ritalin. If there is a family history of depression, it may be necessary to treat the depression and then start the use of Ritalin. If Ritalin is causing the depression, your doctor may recommend switching to an alternative medicine.
Blood Glucose Changes
If the user is a diabetic, it is imperative that they keep a close watch on their blood sugar levels. Stimulants can cause an increase in blood sugar. If the user’s appetite has been affected, the lack of food can also affect their blood sugar.
Blood Pressure Changes
Blood pressure concerns usually occur in individuals who are taking high doses of Ritalin. If you have any blood pressure problems, discuss them thoroughly with your doctor prior to using Ritalin.
Paranoia/Psychosis
Psychosis and paranoia are not common side effects of Ritalin, but do occur in some cases. They are often more prevalent with individuals who suffer from bi-polar or other psychotic disorders. Taking a dosage of Ritalin that is too high can also induce these reactions. If these effects occur, stop taking the medication immediately and contact your pediatrician or physician.
Seizures
Individuals with Epilepsy should consult with their doctor prior to taking any stimulants. In many cases, a dosage can be arranged to be taken safely when the Epilepsy is well controlled. Contact your doctor immediately if any seizures occur and stop taking the medication.
Death
Though rare, Ritalin has been known to cause sudden death in a few individuals. While many times there are additional factors that lead to this fatal ending, it is a dangerous effect to be aware of.
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