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 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 physician’s assessment of the chronicity and severity of the child’s symptoms.
Published Studies Related to Ritalin (Methylphenidate)
Drug-specific laterality effects on frontal lobe activation of atomoxetine and
methylphenidate in attention deficit hyperactivity disorder boys during working
CONCLUSIONS: The study shows both shared and drug-specific effects. ATX
Effect of methylphenidate and folic Acid on ADHD symptoms and quality of life and
aggression: a randomized double blind placebo controlled clinical trial. 
CONCLUSION: considering the marked limitations of this trial, this primarily
Effects of methylphenidate on acute math performance in children with
attention-deficit hyperactivity disorder. 
CONCLUSIONS: MPH improves acute math performance in children with ADHD. Younger
Extended-release dexmethylphenidate 30 mg/d versus 20 mg/d: duration of
attention, behavior, and performance benefits in children with
attention-deficit/hyperactivity disorder. 
performance in children with attention-deficit/hyperactivity disorder... CONCLUSIONS: D-MPH-ER 30 mg was superior to D-MPH-ER 20 mg at later time points
A post hoc comparison of the effects of lisdexamfetamine dimesylate and
osmotic-release oral system methylphenidate on symptoms of attention-deficit
hyperactivity disorder in children and adolescents. 
methylphenidate (OROS-MPH) on symptoms of ADHD in children and adolescents... CONCLUSIONS: This post hoc analysis showed that, at the doses tested, patients
Clinical Trials Related to Ritalin (Methylphenidate)
A Comparative Effectiveness Study Evaluating OROS® Methylphenidate HCl, Ritalin® (Methylphenidate HCl), and Placebo for the Treatment of Attention Deficit Hyperactivity Disorder in Children [Completed]
An Effectiveness and Safety Study Evaluating OROS® Methylphenidate HCl, Ritalin® (Methylphenidate HCl) and Placebo in Children With Attention Deficit Hyperactivity Disorder [Completed]
The purpose of this study is to provide data on the effectiveness of the OROS®
Methylphenidate HCl formulation compared to placebo and standard immediate-release Ritalin®
with respect to improving attention and behavior, and decreasing hyperactivity in children
with Attention Deficit Hyperactivity Disorder (ADHD). Both OROS® Methylphenidate HCl and
Ritalin® contain the central nervous system stimulant, methylphenidate HCl. The safety
associated with the two methylphenidate formulations will also be compared with placebo.
A Double-Blind Randomized, Placebo-Controlled, Crossover Study of Single Doses of OROS Methylphenidate Hydrochloride (CONCERTA) and Long-Acting Methylphenidate Hydrochloride (RITALIN LA) in Healthy Adults [Completed]
This is a double-blind, placebo-controlled study, three-period crossover study to examine the
likeability of a single dose of OROS MPH (CONCERTẢ 90mg) and a single dose of Long-acting
MPH (RITALIN LẢ 90mg). Hypotheses are as follows:
Hypothesis 1: OROS-MPH (CONCERTẢ) will be later than SODOS-MPH (RITALIN LẢ) in its Tmax
(time to Cmax).
Hypothesis 2: The subjective feelings of detection and likeability would be greater for
SODOS-MPH (RITALIN LẢ) than for an equivalent total dose of OROS-MPH (CONCERTẢ).
A Multicenter Study Comparing the Efficacy and Safety of OROS® Methylphenidate HCl, Ritalin® (Methylphenidate HCl) and Placebo in Children With Attention Deficit Hyperactivity Disorder [Completed]
The purpose of this study is to evaluate the efficacy and safety of OROS® Methylphenidate HCl
as compared with placebo and standard immediate-release Ritalin® (taken three time per day)
for the treatment of Attention Deficit Hyperactivity Disorder in children. Both OROS®
Methylphenidate HCl and Ritalin® contain the central nervous system stimulant,
Naturalistic Substitution of Concerta in Adult Subject With ADHD Receiving Immediate Release Methylphenidate [Completed]
This is a single-blind study looking at the efficacy and satisfaction of Concerta
substitution in adult subjects with ADHD receiving immediate release methylphenidate.
Subjects will be administered a maximum dose of 1. 3mg/kg/day of either methylphenidate or
Concerta. The specific hypotheses of this study are:
Hypothesis 1: ADHD symptomatology in adults with DSM-IV, ADHD will continue to be controlled
in patients switched from MPH IR TID to Concerta.
Hypothesis 2: Patient satisfaction will not decrease in patients switched from MPH IR TID to
Concerta (ie., all patients will be equally or more satisfied on Concerta as compared with
MPH IR TID.
Reports of Suspected Ritalin (Methylphenidate) Side Effects
Drug Ineffective (30),
Suicidal Ideation (20),
Attention Deficit/hyperactivity Disorder (20),
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
|Overall rating:|| || |
|Effectiveness:|| || Highly Effective|
|Side effects:|| || No Side Effects|
|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|
|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
|Overall rating:|| || |
|Effectiveness:|| || Considerably Effective|
|Side effects:|| || Moderate Side Effects|
|Condition / reason:|| || ADD|
|Dosage & duration:|| || 20mg taken twice a day for the period of 2 months|
|Other conditions:|| || none|
|Other drugs taken:|| || none|
|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
|Overall rating:|| || |
|Effectiveness:|| || Moderately Effective|
|Side effects:|| || Mild Side Effects|
|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|
|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.|
Page last updated: 2014-11-30