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Ritalin (Methylphenidate Hydrochloride) - Summary

 
 



BOX WARNING

Drug Dependence

Ritalin should be given cautiously to patients with a history of drug dependence or alcoholism. Chronic abusive use can lead to marked tolerance and psychological dependence with varying degrees of abnormal behavior. Frank psychotic episodes can occur, especially with parenteral abuse. Careful supervision is required during withdrawal from abusive use, since severe depression may occur. Withdrawal following chronic therapeutic use may unmask symptoms of the underlying disorder that may require follow-up.

 

RITALIN SUMMARY

Ritalin hydrochloride, methylphenidate hydrochloride USP, is a mild central nervous system (CNS) stimulant, available as tablets of 5, 10, and 20 mg for oral administration; Ritalin-SR is available as sustained-release tablets of 20 mg for oral administration.

Attention Deficit Disorders, Narcolepsy

Attention Deficit Disorders (previously known as Minimal Brain Dysfunction in Children). Other terms being used to describe the behavioral syndrome below include: Hyperkinetic Child Syndrome, Minimal Brain Damage, Minimal Cerebral Dysfunction, Minor Cerebral Dysfunction.

Ritalin is indicated as an integral part of a total treatment program which typically includes other remedial measures (psychological, educational, social) for a stabilizing effect in children with a behavioral syndrome characterized by the following group of developmentally inappropriate symptoms: moderate-to-severe distractibility, short attention span, hyperactivity, emotional lability, and impulsivity. The diagnosis of this syndrome should not be made with finality when these symptoms are only of comparatively recent origin. Nonlocalizing (soft) neurological signs, learning disability, and abnormal EEG may or may not be present, and a diagnosis of central nervous system dysfunction may or may not be warranted.

Special Diagnostic Considerations

Specific etiology of this syndrome is unknown, and there is no single diagnostic test. Adequate diagnosis requires the use not only of medical but of special psychological, educational, and social resources.

Characteristics commonly reported include: chronic history of short attention span, distractibility, emotional lability, impulsivity, and moderate-to-severe hyperactivity; minor neurological signs and abnormal EEG. Learning may or may not be impaired. The diagnosis must be based upon a complete history and evaluation of the child and not solely on the presence of one or more of these characteristics.

Drug treatment is not indicated for all children with this syndrome. Stimulants are not intended for use in the child who exhibits symptoms secondary to environmental factors and/or primary psychiatric disorders, including psychosis. Appropriate educational placement is essential and psychosocial intervention is generally necessary. When remedial measures alone are insufficient, the decision to prescribe stimulant medication will depend upon the physicianÂ’s assessment of the chronicity and severity of the childÂ’s symptoms.


See all Ritalin indications & dosage >>

NEWS HIGHLIGHTS

Media Articles Related to Ritalin (Methylphenidate)

Study: Teens start misusing ADHD drugs and other stimulants earlier than you might think
Source: ADHD / ADD News From Medical News Today [2015.06.03]
Despite stereotypes about college students resorting to black-market Ritalin to help them cram for exams, young people are actually most likely to start misusing prescription stimulant drugs in their...

more news >>

Published Studies Related to Ritalin (Methylphenidate)

The Effect of Methylphenidate on Fatigue in Advanced Cancer: An Aggregated N-of-1 Trial. [2015]
advanced cancer... CONCLUSION: MPH does not improve fatigue in the population of patients with

Drug-specific laterality effects on frontal lobe activation of atomoxetine and methylphenidate in attention deficit hyperactivity disorder boys during working memory. [2014]
CONCLUSIONS: The study shows both shared and drug-specific effects. ATX

Long-term (1 year) safety and efficacy of methylphenidate modified-release long-acting formulation (MPH-LA) in adults with attention-deficit hyperactivity disorder: a 26-week, flexible-dose, open-label extension to a 40-week, double-blind, randomised, placebo-controlled core study. [2014]
26-week, open-label extension phase of the same study (NCT01338818)... CONCLUSIONS: In adult patients with ADHD, use of MPH-LA up to 1 year continued to

Effect of extended-release dexmethylphenidate and mixed amphetamine salts on sleep: a double-blind, randomized, crossover study in youth with attention-deficit hyperactivity disorder. [2014]
measures of sleep... CONCLUSIONS: Higher stimulant doses were associated with reduced sleep duration

A randomized, double-blind, placebo-controlled, parallel-group study to evaluate the efficacy and safety of osmotic-controlled release oral delivery system methylphenidate HCl in adults with attention-deficit/hyperactivity disorder in Japan. [2014]
attention-deficit/hyperactivity disorder (ADHD)... CONCLUSIONS: OROS MPH in a dose range of 18-72 mg once daily was effective and

more studies >>

Clinical Trials Related to Ritalin (Methylphenidate)

Methylphenidate Study in Breast or Gastrointestinal Cancer Patients [Terminated]
The goal of this clinical research study is to see if the drug OROS Methylphenidate HCl (Concerta) can help to control fatigue in patients with breast, gastrointestinal, lymphoma, myeloma or lung cancer who are going through chemotherapy or hormonal treatment or have completed chemotherapy or hormonal treatment in the last 12 months. The safety of this drug will also be studied. Another goal of the study is to see how certain cytokines change while patients undergo chemotherapy or hormonal treatment.

Study of the Effect of Individualizing Daytrana Wear-times on Sleep in Children With ADHD [Completed]
Methylphenidate may improve sleep in children with ADHD. By leaving Daytrana (methylphenidate) patch for a longer time then 9 hours, many children report short sleep latencies and better quality of sleep.

The Effect of Methylphenidate on Non-motor Symptoms and Postural Control in Parkinson's Disease. [Terminated]
This project aims to determine if methylphenidate can improve deficits in attention and symptoms of orthostatic hypotension, two common non-motor symptoms, in patients with Parkinson's Disease. This project also seeks to evaluate the effect of methylphenidate on postural control in these patients, a debilitating motor symptom that places patients at an increased risk of falling. This study will build on existing data to support a new indication for the use of methylphenidate in Parkinson's Disease. Using standard and objective evaluations, this study will quantify the effect of methylphenidate at two doses on attention levels, orthostatic hypotension, and measures of postural control. Phase I of the study will compare methylphenidate 10mg three times daily to placebo and Phase II of the study, for those tolerating the lower dose in Phase I, will compare methylphenidate 20mg three times daily to placebo. By incorporating two different doses, the study also seeks to determine if any improvements are dose-related. Secondary endpoints will include safety assessments (adverse event monitoring and vital signs) performed every 30 minutes following supervised drug administration. Visual analog scales will be presented to each participant before treatment and following the final dose of each treatment to assess changes in fatigue. A secondary task will be added to postural tests to assess the influence of cognitive processes. It is hypothesized that methylphenidate will demonstrate a significant beneficial effect on all outcomes. It is projected that objective improvements will be observed following treatment with methylphenidate at both doses (10 and 20mg three time daily) when compared to placebo. It is further hypothesized that the effects will be dose-related and therefore more profound with higher doses.

A Study to Explore Plasma Levels of CONCERTA, Ritalin-SR and Novo-Methylphenidate ER-C in Healthy Volunteers [Completed]

Ritalin, Memory and Attention in MCI: a Behaviour-EEG Study [Recruiting]
Traditionally, memory impairments in the elderly population are treated using cholinesterase inhibitors, although impairments remain after treatment. Dopamine (DA) is also involved in cognition and is especially of interest in healthy ageing because of the role in processing speed and cognitive control. To what extent dopamine treatment improves memory and attention in older impaired individuals is unknown. However, such an effect is conceivable because of the close relationship between memory and attention in aging and since improved processing speed and cognitive control may lead to improved memory. The investigators aim to examine, in the impaired older population, whether a treatment using methylphenidate, a DA re-uptake inhibitor that enhances DA, improves attention and memory. The study will be conducted according to a cross-sectional, double-blind, placebo-controlled, 2-way cross-over design. 20 male and female patients with Mild Cognitive Impairment (MCI), amnestic type, aged above 60 years of age; 20 male and female patients with MCI, non-amnestic type, will be recruited from the Orbis Medical Centre. Participants will be treated once with 20 mg methylphenidate (MPH) and once with placebo. All medications will be administered orally with a capsule. The treatment order will be established by counterbalancing.

more trials >>

Reports of Suspected Ritalin (Methylphenidate) Side Effects

Drug Ineffective (30)Depression (21)Suicidal Ideation (20)Fatigue (20)Aggression (20)Attention Deficit/hyperactivity Disorder (20)Agitation (19)Anxiety (19)Disturbance in Attention (19)Tremor (17)more >>


PATIENT REVIEWS / RATINGS / COMMENTS

Based on a total of 11 ratings/reviews, Ritalin has an overall score of 8.09. The effectiveness score is 8.55 and the side effect score is 7.82. The scores are on ten point scale: 10 - best, 1 - worst. Below are selected reviews: the highest, the median and the lowest rated.
 

Ritalin review by 59 year old female patient

  Rating
Overall rating:  
Effectiveness:   Highly Effective
Side effects:   No Side Effects
  
Treatment Info
Condition / reason:   fibromyalgia
Dosage & duration:   10 mg taken 3 times a day for the period of 10+ years
Other conditions:   migraine, ibs, dry eye syndrome
Other drugs taken:   synthroid, norvasc
  
Reported Results
Benefits:   was placed on ritalin due to extreme fatigue assosicated with fibromyalgia. medication highly effective in overcoming lack of energy and the tiredness that would never seem to go away. the fatigue was worse than the physical pain associated with fibromyalgia.
Side effects:   well tolerated--none
Comments:   i take 15 mgs in am and noon and 10 mg late afternoon. this medication has given me a life back and am forever grateful to be on it. this medication sometimes gets a bad rap and does not appear to be used widely for the treatment of fibromyalgia, but for me it is a true, true positive medication with no side effects.

 

Ritalin review by 28 year old female patient

  Rating
Overall rating:  
Effectiveness:   Considerably Effective
Side effects:   Moderate Side Effects
  
Treatment Info
Condition / reason:   ADD
Dosage & duration:   20mg taken twice a day for the period of 2 months
Other conditions:   none
Other drugs taken:   none
  
Reported Results
Benefits:   While i take this drug, i feel very well, happy, I can concentrate in my activities. It helps me to make decisions, I can complete activities, i talk a lot, i stay in a good mood, but just while is during the effects.
Side effects:   My heart beats faster and i feel its not in a constant rhythm. My mouth is dry and I feel extremely anxious, and because of this, very clumsy.
Comments:   My diagnostic of ADD was not really accurate. A did just some practical test but no brain exam. The doctor prescribe ritalin as a test, but because of the side effects I had to stop. I did psychotherapy during the treatment. The ritalin helped me but,of course, didn't stop my problems. I feel really better now, but i didn't find yet a drug to help instead of ritalin.

 

Ritalin review by 48 year old female patient

  Rating
Overall rating:  
Effectiveness:   Moderately Effective
Side effects:   Mild Side Effects
  
Treatment Info
Condition / reason:   depression
Dosage & duration:   20 mg/day taken daily for the period of began six months ago
Other conditions:   cancer, high cholesterol
Other drugs taken:   Tamoxifen, Cymbalta, Zyprexa, Lipitor, Valtrex, Cilicaine VX
  
Reported Results
Benefits:   When I first began taking the Ritalin, I noticed a dramatic effect on my mood. I felt wonderful! I was energetic and positive and I felt that I could handle anything that came my way. I don't want to sound as though I felt euphoric or manic - I just felt really GOOD about life. However, after only a few days, that sense of confident well-being drained away.
Side effects:   Initially, the medication kept me awake all night but that only happened for a night or two. I take them on an empty stomach in the morning and sometimes my hands shake very slightly for a while but it's not enough to cause any problems.
Comments:   My psychiatrist put me on it to 'give a boost' to my other antidepressant. He says I am taking a miniscule amount, and that I could increase the dosage if I wished but I have been reluctant to do so. Perhaps I should - I may not be taking enough to be effective but I am on three different antidepressants and I feel uneasy about sharply increasing the Ritalin dose. In short, initially, I felt GREAT but now I feel just the same as ever - struggling with the thoughts that cause lack of energy & enjoyment in many spheres of life.

See all Ritalin reviews / ratings >>

Page last updated: 2015-08-10

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