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What is Ritalin?
Ritalin, also known by its medical name methylphenidate, is a prescription drug that affects the central nervous system (CNS). Doctors primarily prescribe Ritalin to treat Attention Deficit Hyperactivity Disorder (ADHD) in children and adolescents. It is also used to treat narcolepsy, which is a sleep disorder that affects both children and adults.
Methylphenidate was first formulated in 1944 and was tested on humans as early as 1957 by Ciba Pharmaceutical Company. It was originally prescribed to treat chronic fatigue, psychosis associated with depression, and narcolepsy.
Methylphenidate was used well into the 1960s to counteract barbiturate or sedative drug overdoses. It was once sold as a tonic in the 1960s to help balance hormones and increase mood.
Some of the street names for Ritalin include:
- West Coast
- Vitamin R
- Kiddy Coke
- R-ball
- Speed
Use and Dosage
This drug is often prescribed in 5 mg and 10 mg dosages. Most commonly, methylphenidate is prescribed in time-release capsules and is taken up to three times a day. Prescriptions do not exceed 60 mg a day, as most patients begin to see an increase in adverse side effects above 60 mg.
Ritalin is prescribed in the following types of tablets:
- Oral ingestion water-soluble tablets
- Chewable tablets
- Long-acting tablet
- Sustained-release tablets
- Extended-release tablets
Effects of Ritalin Usage
Ritalin causes an increase of dopamine and norepinephrine in the brain, which control reactions to external and internal stimuli.
External stimuli could come in the form of:
- A passing car
- Another upset child in the room
- Background noises or music
- Sounds like traffic, road work, sirens, or dogs barking
Internal stimuli could be:
- Having to use the bathroom
- Knowing when to eat
- Excitement that may mask the sensations of other needs
Although these stimuli are everyday occurrences to someone with ADHD, they create a rush of dopamine, which is why those with symptoms of ADHD may seem:
- Unable to focus
- Restless
- Fidgety
- Bored
- Hyperactive
- To have roller coaster-like emotions
- Easily agitated
- Uninterested in tasks
However, Ritalin can assist in correcting the way the brain reacts to these stimuli for ADHD affected children. The correct dosage of Ritalin has been formulated to release norepinephrine and dopamine. This dosage is specially formulated to fight the lows and highs of ADHD that require constant stimulation to stay on task.
Ritalin’s time-release capabilities help children diagnosed and treated for ADHD maintain a more consistent energy level throughout the day. This ensures they have the opportunity to focus on everyday tasks and functions similarly to their non-ADHD peers. Regular Ritalin use allows the brain to focus on the right thing at the right time.
Side Effects
The most common side effects of Ritalin usage are mild and can include:
- Insomnia
- Irritability
- Difficulty falling asleep or staying asleep
- Dizziness or headache
- Loss of appetite and weight loss
- Restlessness
Ritalin can also cause some severe side effects within the body. These can include, but are not limited to:
- Hallucinations, hearing voices, or believing things that are not true
- Mood changes and depression
- Fast, pounding, and/or irregular heartbeat
- Sudden death in those with heart-related health problems
- Stroke and heart attacks in adults
- Shortness of breath
- Seizures
- Blistering or peeling of skin
- Slow of growth/low weight gain in children
Ritalin vs. Adderall
Ritalin is a conventional choice for doctors to prescribe to children under the age of 12 due to its quick dissolve and time release properties. However, doctors typically prescribe Adderall to 12-year-old patients through adulthood, as its effects last longer in the body.
A study in 1999 compared both Ritalin and Adderall's usage and effects in 25 children. The results showed that both Ritalin and Adderall are highly effective in treating children and adults with ADHD. More specifically, both drugs effectively lower negative behaviors in those with ADHD.
Throughout the study, the children showed signs of increased academic productivity with Adderall. Clinical recommendations for continued medication also favored Adderall three to one.
Risks of Ritalin
The increased heart rate associated with regular dosage can lead to heart attacks in adults and severe heart issues in children. Long term use can also cause depression in adults.
Drug Interactions
Mixing the following drugs with Ritalin can lower its effects. Mixing drugs can also cause serious side effects and increase health risks. Always consult a doctor before beginning the use of the following drug types:
- Cold medication that contains decongestants — the drowsy effects of these cold medications and the stimulating effects of methylphenidate counteract each other. As a result, the interaction can cause delirium in some patients
- Blood thinners — increases toxicity of methylphenidate in the bloodstream
- Blood pressure medication — negates the effect of blood pressure medicine as it raises heart rate
Ritalin users should not consume large amounts of chocolate. The caffeine in the chocolate can increase the number of adverse side effects of the drug. However, a bite-sized portion is typically not detrimental to the patient.
Ritalin and Alcohol
Ritalin is a central nervous system (CNS) stimulant medication that can increase your blood pressure, heart rate, and breathing rate, along with fever. Alcohol, on the contrary, is a CNS depressant. However, the effects of mixing Ritalin and alcohol do not negate each other. Instead, they increase potential adverse side effects including:
- Alcohol poisoning
- Drug overdose
- Withdrawal symptoms
Alcohol use while on methylphenidate increases the risk of alcohol poisoning. Methylphenidate masks the effects of alcohol, making it harder for the user to determine how intoxicated they are, and thus they continue to drink. This may result in alcohol abuse such as binge drinking.
Alcohol can also enhance any adverse side effects of Ritalin and give a user:
- Rapid heart rate
- High blood pressure
- Mood disorders such as depression or anxiety
- Trouble sleeping
- Increased drowsiness
Is Ritalin Addictive?
Yes, it is possible to develop an addiction or physical dependence on Ritalin. Methylphenidate is a schedule II substance and has a high potential for misuse. Long-term use can lead to a substance use disorder (SUD) and drug tolerance (only if misused). Patients will then require a more frequent or higher dosage to achieve the same effects.
As with other stimulant drugs, patients often self medicate and increase their dosage frequency to maintain the high and alertness they are used to experiencing.
Abuse and Addiction Symptoms
Ritalin does not develop a tolerance if taken as prescribed per the correct dosage. However, substance use disorders (SUDs) can form in patients who use the drug long-term. These patients will continuously require higher, more frequent doses, under doctor supervision for the drug to continue to be effective, which increases their dependence on the drug.
Ritalin is often misused for its methamphetamine like qualities. It is most commonly abused by college students who believe it enhances their study performance.
Abusers may crush the pills and snort them or dissolve them in water for intravenous injection.
- When snorted — Ritalin enters the bloodstream in a more concentrated manner compared to swallowing a pill and does not maintain its time-release attributes, causing a faster "come down" from the drug.
- When injected — the user feels a feeling of complete euphoria, which causes them to increase dosage each time to recreate the initial high. As with other injected stimulants, the half-life of the stimulant is shorter than the half-life of the orally prescribed dosage. This shorter half-life perpetuates a cat and mouse-like relationship of chasing the high through dangerous substance abuse.
Overdose
At high dosage or overdosage, prescription stimulants can lead to dangerously high body temperature, irregular heartbeat, heart failure, and even seizures. In some cases, in both adults and children, Ritalin overdose can cause constant hallucinations and paranoia. Patients may hear voices or see things that are not there.
When abused, Ritalin can have similar effects on the body to cocaine, but with a longer duration and a slower peak.
Ritalin overdose can be fatal. You should call 911 immediately if you suspect an overdose is occurring, as it can often cause heart issues and seizures, even in children.
Withdrawal
Ritalin withdrawal is normal in patients who abruptly stop taking the drug after long-term use. Some of the symptoms of withdrawal include:
- Depression or bipolar like symptoms
- Insomnia or sleep-related problems
- Extreme fatigue or even muscle malfunction
Treatment Options
In order to break a dependency or addiction to Ritalin, most people slowly stop using the prescription over time in order to minimize harmful side effects and withdrawal symptoms. Withdrawal should always be monitored by an addiction professional or doctor. You should also never quit “cold turkey.”
Addicted patients will require professional intervention to recover successfully. Many addiction treatment programs are designed to spread awareness about the dangers of abusing prescription drugs.
Common treatment programs for Ritalin addictions may include:
- Behavioral therapies
- Inpatient treatment
- Outpatient treatment
- Family, group, and individual therapy
