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What are the side effects and risks of Ritalin?

What are the side effects and risks of Ritalin?
Doctors often prescribe Ritalin for the treatment of ADHD and sometimes for narcolepsy. Ritalin can cause various side effects and also has the potential for misuse and addiction.

Ritalin is the brand name for methylphenidate, a medication that stimulates the production of dopamine and norepinephrine in the brain. Experts believe that these two chemicals play an important role in attention deficit hyperactivity disorder (ADHD).

Some people misuse Ritalin because of the stimulant effect it has on the brain.

In this article, we look at the side effects of Ritalin along with its uses, dosage, and precautions. We also discuss Ritalin addiction, whether long-term use is harmful, and when to see a doctor.

Side effects

As with all medications, Ritalin can cause side effects in some people. The following table lists the possible side effects of Ritalin:

Very commonCommonRare
nervousnessanxietyconvulsions
sleeplessnessagitationtics
stomach upsetrestlessness and feeling jitterystroke
dry mouthheadachevisual disturbances
upper respiratory infectionsdrowsinessblurred vision
decreased appetitedizzinessabnormal liver function
uncontrolled, involuntary movementsdrug-induced skin diseases
coughmuscle cramps
abdominal painsevere allergic reactions
vomitingblood disorders
heartburn
toothache
rapid heartbeat
increased blood pressure
rash
fever
hair loss
excessive sweating
joint pain

Uses

ritalin side effects tablets

Doctors prescribe Ritalin for the treatment of ADHD in children and adults.

The Food and Drug Administration (FDA) have approved Ritalin for the treatment of ADHD in children and adults.

ADHD is a behavioral disorder that affects a person’s ability to focus and pay attention. Other symptoms can include impulsivity and hyperactivity.

Doctors also prescribe Ritalin as a second-line treatment option for people with narcolepsy.

Narcolepsy is a rare, neurological disorder that affects a person’s sleeping and waking patterns. People may feel tired throughout the day and can be prone to suddenly falling asleep in the middle of daily activities.

Doctors may sometimes also prescribe Ritalin off-label to help reduce fatigue in people with cancer or to treat symptoms of depression in older adults.

Some people misuse Ritalin for its stimulant and memory effects. In the United States, the federal government classify Ritalin as a Schedule II substance, which means that it has a high risk of misuse and can cause severe psychological and physical dependence.

Dosage

Ritalin is available as:

  • Immediate-release tablets, which release into a person’s body immediately after ingesting.
  • Extended-release tablets, which gradually release into a person’s body after ingestion.
  • A patch that a person applies to their skin.

The following table lists the available strengths in milligrams (mg) of methylphenidate products.

Drug nameFormulationRelease typeStrength
Ritalinoralimmediate release5 mg, 10 mg, 20 mg
Ritalin-SRoralextended release20 mg
Ritalin-LAoralextended release10 mg, 20 mg, 30 mg, 40 mg
Daytranapatchextended release10 mg, 15 mg, 20 mg, 30 mg

ADHD

According to the manufacturer’s leaflet, children aged 6 years and older can start on a dose of 5 mg, twice daily, of immediate-release Ritalin. A doctor may increase the dose by 5 mg or 10 mg every week until they achieve the desired effect.

The average dose for adults is between 20 mg and 30 mg.

Doctors may switch people from immediate-release tablets to extended-release tablets. This allows the person to take fewer doses per day but still get the same effect from the medication.

A person can wear a Daytrana patch on the skin for a maximum of 9 hours. The starting dose is usually 10 mg, although some people may need a higher dose.

The maximum dose of Ritalin for both children and adults is 60 mg per day.

Narcolepsy

Ritalin is a second-line option for the treatment of narcolepsy. Doctors may prescribe Ritalin for people with narcolepsy if other drug options have been unsuccessful.

Typical doses of Ritalin for narcolepsy are between 5 and 10 mg.

Precautions

ritalin side effects cold

People should monitor their fingers and toes in cold temperatures when taking Ritalin.

Anyone who has an allergy to Ritalin or medications containing methylphenidate should not take Ritalin.

People taking monoamine oxidase inhibitor (MAOI) antidepressants should also avoid Ritalin because the two drugs interact with each other. The manufacturer recommends that people stop taking MAOIs 14 days before starting Ritalin.

Ritalin can cause small increases in blood pressure and heart rate, so doctors will exercise caution when prescribing this medication to individuals with hypertension and tachycardia.

There have been reports of sudden death in children with heart conditions who were taking Ritalin.

Similarly, people with structural abnormalities of the heart should not take Ritalin.

Before a doctor prescribes Ritalin, they will assess the person for preexisting psychotic or bipolar disorders, as Ritalin can worsen symptoms of these conditions.

In rare cases, Ritalin can cause or worsen Raynaud phenomenon. Raynaud phenomenon is a condition where the blood vessels in the fingers and toes restrict blood flow in response to cold temperatures and stress.

When people are taking Ritalin, they should monitor their fingers and toes in cold temperatures and when under stress and report any changes to their doctor.

Ritalin addiction

At the correct dose, Ritalin is not addictive. However, people who misuse this drug or take very high doses of Ritalin are at risk of physical dependence and addiction.

Is long-term use harmful?

ritalin side effects doctor appointment

Doctors who prescribe Ritalin for longer than 4 weeks will assess the safety of this medication for each person.

Doctors prescribe Ritalin for the treatment of people with ADHD or narcolepsy, both of which are chronic conditions. There have been no clinical trials to evaluate the effectiveness of Ritalin for more than 4 weeks of treatment, however.

Doctors who prescribe Ritalin for longer than 4 weeks will assess the long-term effectiveness and safety of this medication for each person.

Researchers concerned about the safety and effectiveness of Ritalin for long-term use have designed the Attention Deficit Hyperactivity Disorder Drugs Use Chronic Effects (ADDUCE) study.

This study is assessing the effectiveness of Ritalin for treating ADHD in children and adolescents and the effect of the drug on:

  • growth and development
  • cardiovascular health
  • psychiatric health
  • neurological health

ADDUCE is a large, ongoing 2-year study, and the results are not yet available. Further information and updates are available on the study website.

Children and adolescents sometimes take Ritalin for more than 2 years. Future studies are necessary to assess the safety and efficacy of Ritalin for longer treatment durations.

When to see a doctor

People can speak to their doctor about any severe or concerning side effects they experience while taking Ritalin. A doctor may recommend adjusting the dosage or changing to a different treatment.

Ritalin can cause long-term growth problems in children, so doctors will usually monitor this closely. In adults taking Ritalin, healthcare professionals may regularly assess blood pressure and heart rate, particularly in those with preexisting cardiovascular conditions.

People who experience symptoms of psychotic or bipolar disorders while taking Ritalin should seek medical attention. Stimulant medications can cause psychotic symptoms, even in individuals without a history of mental disorders.

Rarely, Ritalin can cause painful and prolonged erections in males. Anyone who experiences this side effect should seek immediate medical attention.

Summary

Ritalin is generally a safe and effective medication for the short-term treatment of ADHD and narcolepsy. However, Ritalin can cause a range of side effects, and its long-term safety and effectiveness are still under investigation.

Ongoing follow-ups of both children and adults taking Ritalin to ensure the benefits outweigh the risks are an essential part of the treatment that doctors will give.

Doctors usually prescribe Ritalin at the lowest effective dose to minimize side effects and the potential for addiction.

Ritalin may not be safe for everyone. People should report any severe or concerning side effects to their doctor.

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