Methylphenidate (Ritalin)

July 20, 2008

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Methylphenidate (Ritalin)

by Robert Needlman, M.D., F.A.A.P.
reviewed by Robert Needlman, M.D., F.A.A.P.

Ritalin is the brand name for methylphenidate, for years the most-prescribed medication for ADHD. Methylphenidate stimulates parts of the brain that are important for paying attention and thinking before acting.

How can methylphenidate help?
Methylphenidate can improve your child's attention span, his ability to follow directions, and his ability to think before acting. It can help with legibility of handwriting and completion of schoolwork and homework. It often decreases hyperactivity, stubbornness, and aggressiveness.

Other treatments
Methylphenidate is not the only answer for ADHD. Other medications might be more effective for your child with fewer side effects. The only way to find out is to try different medications. In treating a child with ADHD, I often start with methylphenidate because it has been around for so long, and studied so much, that I feel comfortable with it. If methylphenidate doesn't work, I'll suggest a related medication (a stimulant), because many children who don't do well on one stimulant respond well to another.

Any medication for ADHD works best when used together with special help in school and behavior modification procedures. Some children and families also benefit from individual, family, or group psychotherapy. If methylphenidate does not help, or if it causes side effects that are a problem, you should discuss other medications with your pediatrician.

How long does a dose last?
Methylphenidate lasts three to four hours. Sustained-release Ritalin may last six to eight hours, but this varies a lot from child to child. Newer long-acting methylphenidate preparations may be more consistent in their effects. Two long-acting methylphenidate preparations are Metadate and Concerta.

What are the side effects?
It's important to remember than any medication may have side effects. For example, there is always a chance that a child will be allergic to a medication or to one of the nonmedication ingredients in the pills or liquid. Because your child is a unique individual, your doctor will work with you to find the medication and dose that works best with the fewest negative effects.

The list of side effects below does not include some of the rare or unusual ones. Please talk to your doctor if you suspect the medicine is causing a problem.

Common side effects--These often go away after about two weeks or if the dose is lowered by the doctor.

Lack of appetite. Encourage a good breakfast and afternoon and evening snacks; give medicine after meals, rather than before.

Trouble falling asleep

Headaches

Stomachaches

Irritability, crankiness, crying, emotional sensitivity, staring into space, loss of interest in friends, rapid pulse or increased blood pressure.

Rarely, as the medicine wears off, hyperactivity or bad moods get worse than before the medicine was started. This is called "rebound." Your child's doctor can adjust the dosage to help this problem. A few children may not grow quite as fast as usual, so have your child's doctor check his height and weight every three to four months. Growth usually catches up if the medicine is stopped. Occasionally nervous habits, like picking at skin or stuttering, may appear.

Serious side effects--Tell the doctor right away.

Muscle tics, which are repeated twitches or jerking movements that are not under a child's control. Common tics are eye blinking, head shaking, or shrugging. Vocal tics (sudden barking noises or swear words) are more serious.

Sadness that lasts more than a few days, a possible sign of depression

Any concerning behavior that is very unusual for your child.


RELATED INFORMATION

			ADHD Treatment: Overview
			Commonly Asked Questions About Ritalin(R)
			Attention Problems
			Medicines

Attention Problems: ADHD and More

Created September 06, 2000
Reviewed August 15, 2004

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