What you need to know about Ritalin

Excerpted from an article written in the Association for Medical Ethics website and titled, "What you need to know about Ritalin"

What is Ritalin? What does it do?

Ritalin is a brand name for the drug Methylphenidate. Methylphenidate is a stimulant prescribed to control symptoms of Attention Deficit Hyperactivity Disorder and to treat narcolepsy.

Ritalin is a "Schedule II" drug, a controlled substance with a high risk of abuse, which has medical uses.

Ritalin is presumed to activate the brain stem arousal system to produce a stimulant effect but how it works is not understood and there is no specific evidence establishing how its effects relate to the central nervous system.

Does Ritalin work?

Whether or not Ritalin has any beneficial effect has been debated for decades. Doctors don't agree on how to treat ADHD, what ADHD is or whether ADHD even exists. Some doctors argue that the symptoms of ADHD are only normal childhood behavior and that the medications prescribed to treat these symptoms are dangerous drugs that may be causing patients harm or have permanent effects on the brain.

Some studies have shown short-term beneficial effects from Ritalin and other "attention-deficit" medications but no study has found any long-term beneficial effect of these drugs. In 2009, the results of a ten-year study were published, following 600 children. The study compared groups of patients separated into four treatment methods, which included medication alone, therapy alone, medication plus therapy and a community-care control group that received no systematic treatment. At first this study suggested that medication, or medication plus therapy, produced the best results but after three years the results had faded and after ten years were completely gone. The study concluded that benefits of medication in managing ADHD extended about ten months beyond the intensive treatment phase.

What should I ask my doctor about before I decide to give my child Ritalin?

Ritalin is a stimulant and has many of the same adverse effects other stimulants have.

Lower doses of stimulants can increase blood pressure, heart rate and body temperature, and decrease sleep and appetite, which can lead to malnutrition. Higher doses can lead to serious cardiovascular complications, including stroke. Regular or continued use of stimulants can lead to personality changes, to increased feelings of hostility and paranoia and stimulants are highly addictive.

Ritalin has many adverse side effects and has even caused sudden death in patients, including children, who have heart problems or heart defects. Ritalin can cause increased blood pressure and heart rate, and stroke and heart attack in adults. Patients who are nervous, tense or agitated should not take Ritalin. Patients who have glaucoma, tics or Tourette's Syndrome should not take Ritalin. Patients can overdose on Ritalin and it should not be taken with decongestants and certain anti-depressants. Serious side effects of Ritalin include slowing growth in children, seizures, eyesight changes or blurred vision. Ritalin can also cause behavior and emotional problems, including worsening some psychiatric conditions such as bipolar disorder and psychosis, new or worse aggressive behavior or hostility and hearing voices and believing things that are not true.

What if I'm already taking Ritalin?

Never stop taking any prescription medication without talking to your doctor first. Ritalin may become addictive over time and people taking it have experienced withdrawal symptoms, including suicidal depression.

Learn everything that you can about Ritalin before you start taking it.