Side effects Ritalin

Amphetamines are drugs that mimic the effects of epinephrine, or adrenalin. Because effects such as mental illness and brain damage can result from overuse of amphetamines, they currently have limited medical use. Metamphetamines are similar to amphetamines in structure and action but have fewer undesirable side effects. Ritalin (methylphemdate), commonly used to treat attention deficit disorder, has essentially the same mode of action as amphetamines. Ritalin abuse by middle and high school students has become a common concern. 

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. 

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. 

The two most common side effects of Ritalin are insomnia and loss of appetite, both of which are known side effects of all stimulants. In a report on ADHD that aired in 1995 on PBS, a child explained how he felt after taking Ritalin You are tired but you can t sleep. Tired with hyperness. . . and you can t sleep because your mind is still awake. 5 His words echoed the experience of cocaine users... 

The doctor gave in and prescribed Ritalin. Leslie got straight As that year and a great SAT score, but she was not happy. She complained that Ritalin made her irritable and that her social life had suffered from it. Eventually, her dose of Ritalin had to be increased to keep her concentration up, and the side effects became worse. Leslie started questioning whether she really wanted to go to college. She felt she could not go to school without Ritalin, but she did not want to take Ritalin forever. 

The DEA (1995b) also observed that adverse effects of irritability or sadness have not been well studied but have been reported in up to 22% of children on stimulant medication. Elsewhere in the same document, the DEA noted that with both Ritalin and amphetamine, psychotic episodes, violent behavior and bizarre mannerisms have been reported (p. 16). Emotionally disturbing adverse effects are even more common with the youngest children. Dulcan and Popper (1991) noted that in preschool children, there is a greater risk of side effects, especially sadness, irritability, clinging, insomnia, and anorexia (p. 188). 

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... 

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. 

Such drugs as Ritalin and Dexedrine act to suppress spontaneous behavior, and also can have severe side effects, which are then modulated by antidepressants, in a vicious circle. Furthermore, herbal or nonorthodox wild foods may aggravate the situation, whereas domesticated foods are more benign. 

This is an expected side effect of Ritalin the client does not need to notify the HCR... 

Sometimes doctors prescribe methylphenidate (Ritalin) or dextroamphetamine (Dexedrine) to treat a mood disorder called dysthymia that is less severe, but more chronic, than major depression. They work more quickly than antidepressants to pep you up, increasing energy and facilitating attention and concentration. Common side effects include nervousness, insomnia, constipation, headache, and changes in heart rate. 

---