Methylphenidate side-effects

The side effects of methylphenidate are very similar to the amphetamines, but because it is somewhat less potent they may be a little milder. The common side effects of methylphenidate are appetite loss, weight loss, insomnia, and nausea. Taking methylphenidate with meals and no later than 6 PM can control most of these. On rare occasions, methylphenidate can cause headache, dizziness, nervousness, increased heart rate, increased blood pressure, tics, and, in extremely rare cases, paranoia. 

Pataki, C., Carlson, G., Kelly, K., and Rapport, M. (1993) Side effects of methylphenidate and desipramine alone and in combination in children./ Am Acad Child Adolesc Psychiatry 32 1065-1072. 

Buitelaar, J.K., Van der Gaag, R.J., Swaab-Barneveld, J.T, and Kui-per, M. (1996) Pindolol and methylphenidate in children with attention-deficit hyperactivity disorder. Clinical efficacy and side effects. / Child Psychol Psychiatry 37 587-595. 

Barkley, R.A., McMurray, M.B., Edelbrock, C.S., and Robbins, K. (1990) Side effects of methylphenidate in children with attention deficit hyperactivity disorder a systemic, placebo-controlled evaluation. Pediatrics 86 184-192. 

Aman, M.G., Kern, R.A., McGhee, D.E., and Arnold, L.E. (1993) Fenfluramine and methylphenidate in children with mental retardation and ADHD clinical and side effects. / Am Acad Child Adolesc Psychiatry 32 851—859. 

Handen, B.L., Feldman, H., Gosling, A., Breaux, A.M., and McAu-liffe, S. (1991) Adverse side effects of methylphenidate among mentally retarded children with ADHD. / Am Acad Child Adolesc Psychiatry 30 241—245. 

ADHD, attention-deficit hyperactivity disorder DD, developmental disabilities DEX, dexedrine MPH, methylphenidate N, total number of subjects in entire study n, number of preschool-age subjects in study SE, side effect. 

Pindolol. In a controlled study comparing pindolol with methylphenidate treatment, 32 ADHD children (ages 7-13 years) had modest improvement in CD and ADHD however, side effects were problematic (Buite-laar et al., 1996). 

Even when effective in controlling behavior, Ritalin and other stimulants have side effects common with use of amphetamines. These include nervousness, insomnia, and perhaps some more long-term problems such as dependency, slowed growth, or depression. Critics sometimes note the similarity between cocaine and the active chemical ingredient in Ritalin, methylphenidate. Both stimulate the dopamine system of the brain, but cocaine does so quickly and methylphenidate does so slowly. The similarities show in the abuse of Ritalin for its pleasure-inducing qualities. 

Because of methylphenidate s unknown effects on long-term use and side effects, much controversy surrounds it. Many mental health workers, physicians, and education groups... 

Figure 25-8 Baseline separation of enantiomers of the drug Ritalin by HPLC with a chiral stationary phase. One enantiomer is pharmacologically active for treating attention deficit disorder and narcolepsy. The other enantiomer has little activity but could contribute to undesired side effects. Pharmaceutical companies are moving toward providing enantiomerically pure drugs, which could be safer than mixtures of optical isomers. [From R. Bakhtiar, L Ramos, and F. L. S. Tse, "Quantification of Methylphenidate in Plasma Using Chiral Uquid-Chromatography/Tandem Mass Spectrometry Application to Taxicokinetic Studies," Anal. Chim. Acta 2002, 469.261.]...

The primary drug therapies are psychostimulants which are indicated for both emotional based sleep disorders (i.e., narcolepsy) as well as ADHD. The drugs of choice are Ritalin (methylphenidate), dextroamphetamine or Cylert (pemoline), all CNS stimulants that effect the monoamine systems. The current therapies provide symptomatic relief but the current medications are not without side effects, including abuse potential, cardiovascular effects, insomnia, appetite suppression, head and stomach aches, crying and nervous mannerisms. 

Methylphenidate (Ritalin Ritalin SR Concerta Metadate) doses range from 5 mg/day bid to a maximum of 60 mg/day, divided fid. Side effects include nervousness, insomnia, loss of appetite and headaches. 

Q7 What are the side effects associated with the use of methylphenidate ... 

Q7 Side effects of methylphenidate are appetite suppression, nausea, abdominal pain, nervousness, irritability and insomnia. The patient s blood pressure needs to be checked as use of the drug may involve headaches and dizziness. In the long term, the medication may affect a child s height and weight and his growth should be monitored during prolonged treatment. The effectiveness of the medication should also be reassessed before the onset of puberty. 

Medication to treat ADHD should generally be used in concert with behavioral, psychological, and educational interventions and support for the child and family that is, medication alone is not recommended. Although some new nonstimulant medications are coming on the market for the treatment of ADHD, it will be some time until we know how well they work and with what side effects and risks. Meanwhile, the mainstay of medication treatment continues to be the stimulants, such as methylphenidate (trade name Ritalin), dextroamphetamine (trade name Dexedrine), and amphetamine/dextroamphetamine (trade name Ad-derall). The stimulant drug pemoline (trade name Cylert) is sometimes... 

Side effects of modafinil include headache, nausea, nervousness, and insomnia. Amphetamines and methylphenidate have a fast onset of effect and durations of 3 to 4 hours and 6 to 10 hours, respectively, for excessive... 

Co-administration with methylphenidate does not increase cardiovascular side effects beyond those seen with methylphenidate alone... 

Stimulants have been used as antidepressants for many years, especially dextroamphetamine (Dexedrine) and methylphenidate (Ritalin). They have the side effects of anxiety, insomnia, agitation, and appetite suppression. They can be quite effective antidepressants but are now usually reserved for medically ill patients such as those who have had a stroke and those unresponsive to other antidepressants. 

The initiation or dose escalation of narcotic analgesics may cause drowsiness and impair cognitive function. Tolerance usually develops fairly quickly to these side effects, but other medications that induce somnolence will produce an additive effect when taken concomitantly. If sedation remains problematic, in order to achieve adequate analgesia a psychostimulant such as caffeine, dexamphetamine, or methylphenidate may be added to counteract the side effect (22). 

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