Methylphenidate

Methylphenidate is an FDA-approved central nervous system (CNS) stimulant commonly prescribed to treat attention-deficit hyperactivity disorder (ADHD) in children and adults.

Common Brand Names: Ritalin, Concerta, Methylin, Metadate

Methylphenidate produces a stimulant effect in the body by activating the brain stem’s arousal system and cortex. As with other stimulant drugs, though, methylphenidate has found use as a study aid, a party drug, or a way to help individuals function through long work hours. Because of the drug’s high potential for abuse and dependence, it is classified as a Schedule II substance as per the Controlled Substances Act.

Medical Applications of Methylphenidate

Methylphenidate is prescribed to treat attention-deficit hyperactivity disorder (ADHD), as well as narcolepsy. The drug is also used off-label to enhance memory as well as to treat depression in elderly patients, fatigue in terminal cancer patients, and apathy in patients with Alzheimer’s disease.

Because of its properties as a CNS stimulant, methylphenidate can be habit-forming, and chronic use of the drug may lead to substance abuse and dependence.

Ways That Methylphenidate Is Misused or Abused

As with many other stimulant drugs, methylphenidate is often misused and abused for its perceived beneficial effects. Some individuals may treat the medication as a study or productivity drug to help them stay awake and improve their ability to focus. Others may combine methylphenidate with depressants such as alcohol to increase their alertness or to feel less intoxicated.

A few specific examples of how individuals may misuse or abuse methylphenidate include the following:

• Taking a higher dosage of methylphenidate than prescribed
• Snorting crushed methylphenidate tablets
• Injecting methylphenidate into the bloodstream by crushing and then dissolving the drug in water
• Chewing methylphenidate tablets

Drugs That Are Known to Interact with Methylphenidate

Taking methylphenidate with other kinds of drugs can cause serious adverse effects. Some medications that may interact with methylphenidate are the following:

• Monoamine oxidase inhibitors (MAOIs): Using methylphenidate in combination with MAOIs may result in hypertensive crisis (a sharp spike in blood pressure). This may result in the following conditions:

• Aortic dissection (surging of blood through a tear in the inner and middle layers of the heart’s main artery)

• Eclampsia (convulsions in pregnant women suffering from high blood pressure)
• Myocardial infarction (heart attack)
• Ophthalmological complications (medical problems in the eyes)
• Pulmonary edema (excess fluid in the lungs)
• Renal failure (failure in one or both kidneys)
• Stroke
• Death

Examples of MAOIs include the following:

• Isocarboxazid
• Linezolid
• Methylene blue
• Phenelzine
• Selegiline
• Tranylcypromine

Drugs used to treat hypertension

 Methylphenidate may decrease the effectiveness of antihypertensive drugs, such as the following:

• Angiotensin II receptor blockers (ARBs)
• Angiotensin-converting-enzyme (ACE) inhibitors
• Beta blockers
• Calcium channel blockers
• Centrally acting alpha-2 receptor agonists
• Potassium-sparing and thiazide diuretics

• Halogenated anesthetics: Taking methylphenidate with these types of medications may suddenly increase one’s blood pressure and heart rate. Examples of these drugs include:

• Desflurane
• Enflurane
• Halothane
• Isoflurane
• Sevoflurane

Immediate Side Effects of Methylphenidate

As with any drug, you may experience certain side effects when taking methylphenidate. These include:

• Nervousness, irritability, or restlessness
• Difficulty falling or staying asleep
• Dizziness, nausea, or vomiting
• Loss of appetite and/or weight loss
• Stomach pain or diarrhea
• Heartburn
• Dry mouth or heavy sweating
• Headache, back pain, or muscle tightness
• Drowsiness
• Uncontrollable reflexes
• Decreased libido

More serious side effects that require medical attention include:

• A change in skin color (pale to blue to red)
• Agitation
• Blurred vision or changes in vision
• Chest pain or shortness of breath
• Depression
• Difficulty speaking or speaking more slowly than usual
• Difficulty swallowing or breathing
• Excessive tiredness or fainting
• Fast, pounding, or irregular heartbeat
• Fever
• Frequent, painful erections, or erections that last for over 4 hours
• Hallucinations
• Hives, rashes, blisters, and itching or peeling of the skin
• Hoarseness
• Mood changes or an abnormally excited mood
• Motor or verbal tics
• Numb or weak limbs
• Numb, sensitive, or painful extremities, particularly when exposed to temperature changes
• Paranoia
• Seizures
• Swollen eyes, face, lips, mouth, tongue, or throat
• Unexplained wounds on the extremities

If you are experiencing any of these side effects, you should contact a doctor immediately to avoid complications.

Long-Term Side Effects of Methylphenidate

Long-term use or misuse of methylphenidate can lead to severe psychological consequences, such as delusions and paranoia.These psychotic symptoms, as well as the individual’s impaired impulse control, emotional instability, and feelings of panic, are often considered the catalysts for violent behavior, and may sometimes cause incidents of homicide or suicide.

Chronic use of methylphenidate has also been found to suppress growth and weight gain in children who take the medication for the treatment of ADHD.

Symptoms of Methylphenidate Overdose

When methylphenidate is taken in excessively large or frequent doses, you may experience the following symptoms:

• Agitation
• Anxiety
• Cardiac arrhythmias (irregular heartbeats)
• Confusion
• Convulsions, which may lead to coma
• Delirium
• Diarrhea
• Dryness of the mucous membranes
• Euphoria
• Flushing
• Hallucinations
• Headache
• Hyperpyrexia (very high fever above 106.7 Fahrenheit)
• Hyperreflexia (overactive or over-responsive reflexes)
• Hypertension (high blood pressure)
• Hypotension (low blood pressure)
• Muscle twitching
• Mydriasis (dilation of the pupil)
• Nausea
• Palpitations
• Restlessness
• Rhabdomyolysis (leakage of broken down skeletal muscle fibers into the bloodstream)
• Sweating
• Tachycardia (faster than normal heartbeat)
• Tachypnea (faster than normal breathing)
• Tremors
• Vomiting

Any combination of the above symptoms may indicate that you’ve overdosed on methylphenidate. If you notice one or more of these signs in yourself or another individual, contact 911,  local emergency services, or your doctor ASAP.

Signs of Methylphenidate Addiction

Misusing methylphenidate over a long period may cause a person to develop a substance use disorder. An addiction to methylphenidate can negatively affect a person’s professional performance and their relationships as they prioritize the drug over all else.

Medical professionals often consult the Fifth Edition of the Diagnostic and Statistical Manual for Mental Disorders (also referred to as the DSM-5) to assess whether an individual has become addicted to a particular substance. The DSM-5 enumerates 11 diagnostic criteria that may point to substance use disorder:

• Taking too much methylphenidate or taking it for a longer period than intended
• Having a desire to decrease or stop the intake of methylphenidate, but not being able to do so
• Spending excessive amounts of time to acquire, take, or recover from using methylphenidate
• Feeling cravings to take methylphenidate
• Becoming unable to manage your commitments because of using methylphenidate
• Continuing to take methylphenidate even if it has been causing problems in your relationships
• Giving up on important activities due to using methylphenidate
• Continuing to take methylphenidate, even if doing so means putting yourself in danger
• Continuing to take methylphenidate, even if doing so will worsen existing psychological or physical problems
• Increasing your tolerance to methylphenidate
• Experiencing withdrawal symptoms when you stop taking methylphenidate

Methylphenidate Withdrawal Symptoms

Methylphenidate raises levels of dopamine in the brain. Once the brain becomes used to these chemicals, it begins to rely on the drug. A restructuring of the brain’s reward pathways results in a dependence on the substance. As such, if you become dependent on methylphenidate, you may experience withdrawal symptoms in the absence of the drug. 

Withdrawal symptoms will vary from person to person, but generally, you are likely to experience these symptoms 12 to 24 hours after cessation of use. The most severe stages of methylphenidate withdrawal usually occur in the first few days after drug use stops. These symptoms can include:

• Dysphoric mood
• Fatigue
• Hypersomnia
• Increased appetite
• Insomnia
• Psychomotor retardation or agitation
• Vivid and unpleasant dreams

It’s important to note that these withdrawal symptoms can happen even in individuals who have not necessarily developed an addiction to methylphenidate. A dependence on the drug can occur not only in people who have misused or abused it, but also in patients who used the drug as prescribed over a long period.

That said, how do you differentiate methylphenidate dependence from methylphenidate addiction? To put it simply, dependence is the result of the body becoming used to the presence of a particular medication in the bloodstream. Meanwhile, drug addiction is characterized by an inability to stop taking the drug despite knowing the negative consequences of continuing to do so.

If you experience any of the above withdrawal symptoms, don’t hesitate to ask your doctor about methylphenidate detox programs. These are designed to help you gradually wean yourself off of the substance by following a recommended tapering schedule.

The Process of Methylphenidate Detoxification 

In most cases, methylphenidate withdrawal can be overwhelming and frightening. Without a plan to deal with these withdrawal symptoms, it’s easy for an individual to relapse, continuing the vicious cycle of drug dependence. Fortunately, it’s possible to undergo a detoxification program in a safe and stable environment, where medical professionals can help you manage your symptoms.

Indeed, there are many benefits to undergoing withdrawal from methylphenidate in a vetted medical detox facility. Here’s a general idea of what you can expect to experience should you ever need to go through methylphenidate detox:

• Under medical supervision, you will be able to taper off of the medication, which can ease some of the worst withdrawal symptoms.
• Depending on what the medical team deems necessary, you may be provided with nutritional supplements and IV fluids.
• You will have access to medical and psychological treatment for withdrawal-related symptoms like dysphoria and insomnia. 
• You will receive round-the-clock care throughout the duration of your stay at the medical detox facility.

Getting Treatment for Methylphenidate Addiction

Many individuals in the U.S. struggle with overcoming methylphenidate addiction, as they may not know how to best address it. They may also withdraw from society and attempt to self-medicate.

However, recovering from a methylphenidate use disorder should never be undertaken alone, as without the proper medical guidance, you could potentially put yourself in danger. Even after you’ve gone through the detoxification process and have managed most of your physical symptoms, the psychological symptoms may leave you vulnerable to relapse.

If you have suspicions that you’ve developed a methylphenidate use disorder and require professional assistance, it may be beneficial to look for a treatment center within your immediate area. The staff at these types of facilities can put you on a customized addiction treatment program and help you get back on track to recovery. All in all, signing up for a methylphenidate rehabilitation program can make the process much less overwhelming and greatly increase your odds for long-term success.

Typically, rehabilitation programs for methylphenidate use disorders are carried out via the following set-ups:

• Outpatient methylphenidate addiction treatment: Generally recommended for lower-risk patients or for individuals with a much milder substance use disorder, outpatient rehab will require you to regularly go to a treatment center for scheduled therapy and counseling sessions. The rest of the time, you can stay at home, which means you can continue to go to work or school without any disruptions to your daily routine.

• Inpatient methylphenidate addiction treatment: For high-risk patients who are considered to have moderate or severe cases of substance use disorder, going through inpatient rehab may be the best course of action to take. Unlike outpatient rehab, this type of set-up will require you to stay at the treatment center for an extended period of time so that you can have 24/7 medical supervision. You may also be given a mix of different treatment modalities such as drug education classes, family therapy, group counseling, and individual therapy.

Substance use disorders are partly physical and partly psychological, and both aspects must be addressed to have a successful recovery. Depending on your specific circumstances, your medical team may recommend that you go through psychotherapy to achieve complete abstinence from methylphenidate. Whether you undergo inpatient or outpatient rehab, you will receive the support, knowledge, and treatment needed to recover and stay sober in the face of any challenges that may come your way.

Find a Treatment Program by Calling a Recovery Support Advisor

Have you been struggling with methylphenidate use disorder? Are you concerned about methylphenidate’s long-term effects? Have you noticed signs and symptoms of methylphenidate use in a loved one and aren’t sure where to turn?

Whatever your situation may be, there’s no shame in seeking professional help. Fortunately, many insurance plans offer coverage for addiction rehabilitation services, so you won’t have to worry about paying for everything out of pocket. If you don’t have an insurance plan, the good news is that there are other possible ways to finance your treatment.

Call us at (800) 429-7690 now and one of our recovery support advisors will help you find a cost-effective treatment facility that is the best fit for you. They will work with you to get a better understanding of your needs and will check the level of coverage your insurance plan can offer. Should you not have any insurance, our recovery support advisors will assist you in figuring out alternative ways of financing your treatment.

A Brief History of Methylphenidate

Methylphenidate was first synthesized by Leandro Panizzon in 1944 and patented 10 years later in 1954. The Ciba-Geigy Pharmaceutical Company marketed it the following year under the brand name Ritalin, based on the first name of Panizzon’s wife, Rita. Though it was initially used for treating lethargy, depression, and narcolepsy, it was noted that methylphenidate could significantly reduce ADHD symptoms. Today, methylphenidate is considered the most effective medication for ADHD treatment.