Ritalin

adult adhd ritalin

By Tammy Preston, MS

Brand Names: Concerta, Metadate CD, Metadate ER, Methylin ER, Ritalin, Ritalin LA, Ritalin-SR, Daytrana

Generic Names: Methylphenidate (meth-ill-FEN-eh-date), Methylin (METH-ill-in)

Manufacturer: The various brand name formulations of the drug methylphindate are produced by several different manufacturers.

What Is Ritalin?

Marketed under numerous brand names, the best known of which is Ritalin, methylphenidate and other amphetamines function as central nervous system (CNS) stimulants, and have been FDA approved for the treatment of both childhood and adult attention deficit hyperactivity disorder (ADHD) as well as narcolepsy in adults.

How Does Ritalin for Adults Work?

Although it is not known exactly how Ritalin works, it is believed to increase the flow of the neurotransmitters dopamine and norepinephrine, chemicals that carry the signal between neurons (cells of the nervous system). This can result in an increase in a person’s ability to focus over extended periods of time.

How Do I Take Methylphenidate?

There are several brand named drugs that contain methylphenidate, including instant release (IR) formulations and sustained release (SR), also known as extended release (ER) and controlled release (CR), formulations. There is also a methylphenidate trans-dermal patch, which delivers a sustained dose of drug over a long period of time, making it easier to ensure you get the right dose without having to constantly remember to take an oral pill.

Research has shown that the SR formulations of methylphenidate are just as effective, if not more effective, than IR formulas [1-4]. These time-release medications are also less prone to be misused and abused.

Methylphenidate Formulations

Instant Release (IR) Tablets
· Ritalin: 5, 10 or 20mg
· Attenta: 10mg
· Methylin: 5, 10 or 20mg
· Equasym: 5, 10, 20 or 30mg
· Rubifen: 5, 10 or 20mg

Sustained, Controlled or Extended Release (SR, CR or ER) Tablets
· Ritalin SR: 20mg
· Methylin ER: 10 and 20mg
· Metadate ER: 10 and 20mg
· Concerta: 18, 27, 36 and 54mg

Controlled-release Capsules
· Ritalin LA: 10, 20, 30 or 40mg
· Metadate CD: 10, 20, 30, 40 or 60mg

Trans-dermal Patch
· Daytrana 10, 15, 20 or 30mg

Is Ritalin Effective for Adult ADHD?

Methylphenidate was the first drug to be used in the treatment of ADHD, originally to treat children in the 1960’s. Since its discovery, methylphenidate has been used to treat ADHD in both children and adults for many years. Recent research has demonstrated the efficacy of this classic ADHD treatment in adults with the disorder [5].

Ritalin Minor Side Effects

Common side effects are similar to those typically associated with the use of stimulants, and include:
· Dry mouth
· Upset Stomach
· Diarrhea or Constipation
· Irritability and Restlessness
· Loss of appetite
· Difficulty falling asleep
· Weight loss
Most minor side effects of ritalin resolve over the first week or two, as your body adjusts to the medication.

Ritalin Precautions

Addiction & Abuse
Studies have been done to address concern that use of stimulant medications may lead to later drug dependency and abuse. Although, untreated ADHD has been linked to an increased risk of substance abuse later in life [6], the likelihood of future drug abuse disorder is actually decreased when ADHD is properly treated [7].

Still, because methylphenidate is an amphetamine and stimulant, there is the potential for increasing tolerance to the medication over long-term use as well as the danger of abuse. And this medication is not recommended for people who have a history of drug abuse.

Cardiac Precautions
Methylphenidate and other amphetamines may not be right for you if you have a history of heart problems, such as hardened arteries (arteriosclerosis), heart disease, high blood pressure (hypertension), or any other pre-existing cardiac condition.

Other Precautions
The drug is also not recommended for people with overactive thyroid, glaucoma, epilepsy and seizure disorders, severe anxiety or agitation and those who have taken MAO inhibitors within the past two weeks. Before taking methylphenidate, be sure to tell your doctor if you have any of these problems.

Pregnancy Category C
As a category C medication, methylphenidate may be harmful to an unborn baby. This drug can also pass into breast milk and may be harmful to your baby if you nurse. Be sure to tell your doctor if you are pregnant or plan to become pregnant while you are being treated for ADHD.

Ritalin Withdrawal
If you stop taking Ritalin too quickly, you will experience withdrawal symptoms. The most common of these include fatigue, agitation, depression, and hunger.

Sources

1. Steele, M., et al. (2006). “A randomized, controlled effectiveness trial of OROS-methylphenidate compared to usual care with immediate-release methylphenidate in Attention Deficit-Hyperactivity Disorder“. Can J Clin Pharmacol. 2006 Winter;13(1):e50-62.
2. Pelham, W.E., et al. (2001). “Once-a-day Concerta methylphenidate versus three-times-daily methylphenidate in laboratory and natural settings“. Pediatrics. 2001 Jun;107(6):E105.
3. Keating, G.M., McClellan, K., Jarvis, B. (2001). “Methylphenidate (OROS formulation)“. CNS Drugs. 2001;15(6):495-500; discussion 501-3.
4. Hoare, P., et al. (2005). “12-month efficacy and safety of OROS methylphenidate in children and adolescents with attention-deficit/hyperactivity disorder switched from MPHPDF“. Eur Child Adolesc Psychiatry. 2005 Sep;14(6):305-9.
5. MedScape (2006) New Findings Expand Understanding of Adult ADHD.
6. Richardson. (2005) When Too Much Isn’t Enough, Ending The Destructive Cycle of AD/HD and Addictive Behavior, Pinon Press
7. Wilens, et al. (2003) Does Stimulant Therapy of Attention-Deficit/Hyperactivity Disorder Beget Later Substance Abuse? A Meta-analytic Review of the Literature, Pediatrics Vol. 111 (1).
8. http://www.drugs.com/MTM/methylphenidate.html

Comments

  1. I was wondering if anyone knows of or if the manufactor of ritalin ir, generic even has a care program as other companies like lilly cares,….as i am on cymbalta too and i am on their program where they send you 3 months at a time do to we have -0- mental health coverage, and do to many medical probelms there is no way we can afford it out of pocket,….especially the Cymbalta very high and there is no generic form,….anyone if you can help with imformation please do,….thanks

  2. @TexasAngel – that’s not something I know a lot about. Here are some resources that may be helpful:
    * Partnership for Prescription Assistance – http://www.pparx.org/
    * Needy Meds – http://www.needymeds.org/
    * RX Assist – http://www.rxassist.org/
    Good luck and keep us updated as to how thing go.

  3. Sharon Hildebrandt says:

    I am on short acting ritalin 2 doses 6am 30mg and noon 30mg and it dosnt last but 2 hours. im getting a different pyschiatris and going to try for Adderal. hoprfully yhat will work better. i was on 72mg Concerta and it worked great but my insuranc did away with all long acting stimulants.

  4. HELP My doctor (an internist) has decided that I no longer should take ritalin which I have been on since I was 50 because I am 77. What studies are out there that I can beg her with. Does anybody know any doctors in central New Jersey (somerville Area) that know how to treat adult adhd. I only take 5 to 10 mg 3 times a day depending on the situation. Thanks

  5. Sandra June says:

    I am 77 and want to start taking Ritalin. Why has your doctor stopped your prescription. I am going to buy some on line

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