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Drug InfoNet Doctors' Answers to Frequently Asked Questions - Ritalin

Doctors' Answers to "Frequently Asked Questions" - Ritalin

These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.

Ritalin [posted 1/12/99]
Question: I am trying to find the date when Ritalin was approved by the FDA and when it went on sale. Also, are there any countries that it is not sold in?

Answer: You'd need to check with the company, Novartis: 888-669-6682.

Ritalin and elevated liver enzymes [posted 1/8/99]
Question: I have been taking Ritalin (10 mg 2 or 3 times daily) for about 20 years for fatigue. I have been diagnosed with MS and this treatment has been associated with that disease. I currently show elevated liver enzymes and I wonder if long term usage of Ritalin could cause these symptoms?

Answer: Not usually, but it could occur. You really won't know without stopping the drug and watching.

Ritalin for Adults [posted 11/18/98]
Question: I need as much info re ritalin use for adults as I can get, can you refer me to any resources. my son has used high dosages of ritalin(80 to 160mg/daily) for five years and has become very very depressed. so much so that he was given ect which helped but he is still on ritalin for add. I have seen the development of depression during the last five years although he was always somewhat depressed before, now it has become severe. He has tried to stop taking the ritalin and has reacted with increased severe depression. Thank You

Answer: The ritalin is not the cause of the depression, he needs to see a psychiatrist who is adept at drug manipulation. Also, some neuropsychiatric testing to document his problem would be helpful.

Ritalin for Sleepiness ? [posted 10/29/98]
Question: I noted one FAQ dealt with 3 doses daily of Ritalin. I was prescribed for "sleepiness" and told to take 10 mg three times daily. I quickly cut that back to 10mg ONCE a day as I became "hyper" and oversensitized. It causes insomnia for me as well. Now, if I need a "boost", I take one tablet (10mg) and break it into fourths. One fourth = 3 hours of increased awareness; one half = 8 hours; etc. Any dosage causes some insomnia for at least one night. My regular maintenance medications are ADALAT, 60mg; LIPITOR, 20mg; 325gr Aspirin. I also take Vitamin E 400 units.

Answer: Why are you sleepy? Do you have a sleep disorder. If so, see a sleep lab or a sleep specialist, don't use these drugs for drowsiness unless there is no alternative. I assume you have cardiac or hypertension problems with your meds, this drug is used with great caution in either situation.

Ritalin [posted 8/14/98]
Question: Is ritalin from a cocaine derivative and does it cause liver damage?

Answer: It is not related to cocaine. Occasional patients have had elevated liver enzymes, but this is an uncommon problem with this drug.

Ritalin And Long Term Effects [posted 8/11/98]
Question: I have a 20 year old son that took ritalin from age 5 until he was a junior in high school. Since he graduated from high school he has had several encounters with the law with regards to marijuana and alcohol. It recently was brought to my attention that there could be a connection as to when we took him off the ritalin and the problems he is currently facing. Is there any connection to ritalin and substance abuse? The individual that made this point also indicated that if my son was not put back on ritalin that things will become even worse, especially when he reaches the age of 30 Is there any truth to these statements?

Answer: I would try a repeat of the Ritalin. Since we are just seeing the first generation of children treated for ADD, we do not know whether these children need to be treated long term as adults. Like children, start the medication and observe his attention/behavior. That would be my approach. Whether it will have any affect on the drug behavior is unpredictable.

Ritalin [posted 8/7/98]
Question: My grandson was recently placed on Ritalin. What could the long term affects of this drug be? Around my wife and I he was perfectly calm could sit and read to us, do first grade math, color, etc., for hours and even play catch. Now he seems very tired most of the time. When his parents used to show up he would misbehave frequently, until my wife or I asked him to behave like a nice young man and he would.

Answer: The question is whether his concentration is better at school with the drug or not. I would ask him, he will know. The dosage may need to be adjusted depending on his performance on the drug.

Ritalin and Alcohol Interactions
Question: I have heard some people say it is OK to take ritalin and to have a drink or two. I have also heard some people state that it is not safe to mix these two. What is a safe time between the last ritalin dosage and having a drink? I did not know if 3 or 4 hours would do, or if it needed to be something more along the lines of 8 or 9 hours.

Answer: There shouldn't be a big deal for a drink or two. However, individuals vary. Start with only one drink several hours post dosage and see what your reactions are. I wouldn't go past two.

Question: Are there any studies about taking Ritilan while pregnant? I am a 34 year old and have been on Ritilan (20 mg sr) for three years.

Answer: There have been no studies in animals or humans concerning this drug. There are no anecdotal studies in the literature concerning case studies. Risks are unknown currently.

Question: I need information about adverse reactions with Ritalin.

Answer: Ritalin (methylphenidate hydrochloride) is a central nervous system stimulant whose mode of action is not completely clear. It may cause insomnia, nervousness, allergic reactions (rash, hives, fever, arthritis) nausea, irregular heart beats and types of psychotic thought processes. Several cases of Tourette's Syndrome have been reported as well, but is a rare problem.

Ritalin Dosage
Question: How much Ritalin is too much for a 65 pound, 7 year old female. The doctor has prescribed 10 mg upon awakening, 20 mg at 8:30 a.m., 20 mg at noon, 20 mg at 4:00 p.m., and 10 mg at 7:00 p.m.

Answer: Ritalin use in children is based on effectiveness. That is, using the minimal dose to decrease the hyperactivity. Very large doses are occasionally used, focusing on the effect. Once the child is normal the dosage is slowly decreased until the child becomes more active. The dose is usually titrated up and down based on the child’s response.

General Information
Question:What food, drinks, drugs, and activities should one be careful of or avoid when taking this drug. The patient is 35yrs old, male, and an active athelete.

Answer:Ritalin(methylphenidate hydrochloride) is a drug with several uses. The most common is in the treatment of hyperactive children. It is also used in attention deficit disorders and narcolepsy. It can have potential interactions with MAO inhibitors and may affect the metabolism of different drugs like coumadin, dilantin, phenobarbital and tricyclic antidepressants. There does not appear to be major problems with foods.

Question: My son Dylan has been put on ritalin. Our doctor and teacher agree that it should help him in school, his grades are good but he has to try real hard. He can not stay still or stay focused on what is goning on. After reading all the negative things about it. I still wonder if it was the right thing to do?

Answer: Ritalin is used in ADD ( attention deficit disorder) as well as treating the "hyperactive kid'. In the right population it can be very effective. Paradoxically, it tends to calm overactive children who have difficulty concentrating rather than the normal effect seen in adults of increasing agitation. There are many support groups concerning ritalin and I would discuss your concerns with other parents. Like many things they can give the best information. There are many people who think this is an overdiagnosed problem and that we are harming a generation of children. It clearly is extremely effective in properly selected children.

Course of Action
Question: If ritalin is a stimulant, why does it "calm" hyperactive children?

Answer: Excellent question-no one knows for sure. Clearly, it affects some inhibitor site as well as an activator site. Where and how is not known.

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