Methylphenidate (Ritalin) Interactions

What is Methylphenidate (Ritalin) Used For?

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Methylphenidate is the chemical compound name for Ritalin. Other brand names include Concerta®, Quillivant®, Quillichew ER®, and Daytrana® (transdermal patch). This prescription drug is a central nervous system (CNS) stimulant. 

This means that when you takes this medication, chemical levels will increase in the brain. These raise alertness, focus, energy, and physical activity. The drug’s effect on the body is similar to amphetamines. 

Ritalin is available in different forms: immediate-release tablet, chewable tables, solution, and extended-release tablet (Ritalin-SR), extended-release capsule (Ritalin-LA), and more. 

Who Gets Prescribed Methylphenidate?

This medication is most commonly prescribed for children and adults with attention deficit hyperactivity disorder (ADHD).

Individuals who live with narcolepsy may also take Ritalin under a doctor’s supervision. 

Who Should Not Take Methylphenidate?

People who have motor tics, Tourette’s syndrome, or a family history of the illness may not be prescribed Ritalin. If you have a family history of heart disease, hyperthyroidism (overactive thyroid), or seizure disorder, you probably won't be prescribed methylphenidate.

Like any other CNS stimulant, Ritalin has a high potential for misuse and dependence. This risk can be higher for individuals with a history of substance abuse, including alcohol use disorder (AUD). 

In severe cases, Ritalin misuse, especially when mixed with other substances, could result in overdose or death. 

Side Effects of Ritalin

Methylphenidate has a series of common side effects, including:

It is important to note that ADHD medications like methylphenidate may worsen symptoms of preexisting mental disorders. For example, Ritalin may trigger manic episodes in individuals living with bipolar disorder. 

New psychotic or manic symptoms may arise in individuals who do not have a prior history of psychotic disorders and are taking methylphenidate. These symptoms include:

• Hallucinations 
• Delusional thinking 
• Mania

Additional medical problems that have occurred in individuals taking Ritalin are:

• Prolonged and painful erections (priapism)
• Allergic reaction (hives or swelling of the eyes, face, lips, mouth, tongue, or throat)
• Peripheral vasculopathy (gradual circulation problems like Raynaud’s phenomenon)
• Stroke
• Chest pain
• Heart problems (heart failure and heart attacks)
• Sudden death 

Women who are breastfeeding should consult their healthcare provider before taking Ritalin. This drug can pass through breast milk.

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Methylphenidate Interactions

Like any other prescription medication, Ritalin may interact with other drugs and intensify unwanted side effects. 

Individuals should consult their medical specialist before taking these drugs with Ritalin:

• Monoamine oxidase inhibitor (MAOI) — this is a type of antidepressant prescribed for people with depression. Examples include linezolid, methylene blue, phenelzine, tranylcypromine, and selegiline. Ritalin can interact with these drugs, even if drug discontinuation has occurred within the past two weeks. This drug interaction may cause aortic dissection, eclampsia (the onset of seizures during pregnancy), pulmonary edema (fluid build-up in the lungs), renal failure, heart attack, and death. 
• Antihypertensive drugs — individuals who take Ritalin or Ritalin-SR may see a decrease in antihypertensive drug efficacy. 
• Halogenated anesthetics  — individuals may experience a sudden increase in blood pressure and heart rate during surgery when halogenated anesthetics and Ritalin or Ritalin-SR are used simultaneously. 
• Antacids or acid blockers  — drugs of this kind may make it more difficult for individuals to absorb long-acting stimulants. Drug absorption depends on the amount of acid in the stomach. 
• CNS stimulants — taking additional stimulants can cause high blood pressure and heart problems such as stroke, heart attack, and even sudden death.

Other substances you should avoid include:

• Alcohol — the effects of taking a stimulant and a depressant are unpredictable and dangerous. Alcohol can increase side effects from methylphenidate. It can also cause extended-release methylphenidate products such as Ritalin LA and Metadate CD to get released into your bloodstream too quickly.
• Caffeine — limity our intake of foods and beverages that contain caffeine. These include coffee, tea, sodas, chocolate, and dietary supplements. Caffeine is also a CNS stimulant and can cause additive side effects. Caffeine increases your risk of anxiety, nervousness, nausea, muscle twitching/palpitations, trouble sleeping, rapid heartbeat and other CNS stimulant side effects.

Can You Take Antihistamines With Ritalin?

If individuals take antihistamines with methylphenidate, no severe side effects should arise. Antihistamines like diphenhydramine (Benadryl®) do not pose a risk of problematic drug interactions. 

In one study exploring antihistamines (cetirizine) and Ritalin, investigators found that positive results in allergic rhinitis and ADHD symptom relief. This means that using both drugs was more effective in treating these conditions than when taken alone. 

However, each individual has specific health needs. Because of that, it is always recommended to consult a healthcare provider before taking other drugs with Ritalin. A doctor will be able to prescribe the most suitable drug combination treatment. 

Dangers of Mixing Ritalin With Other Substances

Because methylphenidate is a prescription stimulant that impacts the central nervous system, mixing the drug with other substances can negatively affect health. 

For example, drinking alcohol and taking Ritalin can put a lot of pressure on the liver. The hepatic organ is responsible for metabolizing both substances in the body. If an individual participates in heavy drinking or binge drinking while taking Ritalin, medical conditions such as liver damage could occur.  

Many other substances can increase the negative side effects of methylphenidate. Others have interactions that create new harmful effects. CNS stimulants are especially dangerous for patients with heart conditions.

Be sure to read the entire drug information included with your prescriptions. Consult your doctor if you have any questions about interactions between methylphenidate and other drugs, food, or diseases.

Ritalin Abuse & Addiction

Symptoms of Ritalin abuse (misuse) may include:

• Increased heart and respiratory rate
• High blood pressure
• Dilated pupils
• Loss of coordination 
• Loss of appetite
• Aggression

In the most severe cases, individuals who combine Ritalin with other substances may overdose or even result in death. 

According to the National Institute on Drug Abuse, the number of Americans to misuse prescription stimulants in 2017 was more than one million.

If you are misusing Ritalin either alone or with other substances, medical advice is available. Individuals thinking about stopping the medication should consult a doctor about developing a treatment plan and monitoring withdrawal symptoms. Although there are no FDA-approved medications for addictions to stimulant medications, doctors can speak to you about other options like behavioral therapies and drug tapering.

The journey to recovery may be difficult, but it is not impossible. 

Methylphenidate Addiction Treatment

Methylphenidate has a high risk for addiction and abuse. In order to recover from a methylphenidate dependency, most people will taper off the medication. This consists of taking decreasing doses over time in order to minimize harmful side effects and withdrawal symptoms.

If you or someone you know is suffering from methylphenidate addiction, it might be a good idea to speak with an addiction specialist. They can help you review your options and choose a treatment program that is tailored to your needs.

Common treatment programs for methylphenidate addiction include:

• Outpatient treatment
• Behavioral therapies
• Partial hospitalization programs (for more severe cases)
• Inpatient treatment (for the most severe cases, or co-occurring disorders)

Find Help For Your Addiction

You don’t have to overcome your addiction alone. Professional guidance and support is available. Begin a life of recovery by reaching out to a specialist today.

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