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ADD/ADHD Medicines and Safety 

The Medical Perspective

Methylphenidate  Stimulants

ADD/ADHD Medicines and Safety 

The FDA has issued a warning about the risk of drug abuse with amphetamine stimulants. FDA safety advisors are also concerned about the possibility that all amphetamine and methylphenidate stimulants used for ADHD may increase the risk of heart and psychiatric problems.

The FDA has also issued a warning about a connection between antidepressants (including the non-stimulant Strattera) and an increased risk of suicide in adults aged 18-24, especially in the first one or two months of treatment.

While these risks may seem alarming, keep in mind that experts generally consider these medicines safe. Serious problems are rare. Still, you should discuss the risks and benefits of these drugs with your doctor.

Ritalin

Ritalin Side Effects and Warnings

Schedule II Substance

Brand Names: RITALIN, RITALIN LA, RITALIN SR 

Generic Name: METHYLPHENIDATE HCI (HYDROCHLORIDE)

Category: CEREBRAL STIMULANTS

Ritalin (methylphenidate) is an amphetamine-like prescription stimulant commonly used to treat Attention Deficit Hyperactivity Disorder (ADHD) in children and adults.

Many think Ritalin (methylphenidate) is safe, or mild, because so many children use it. However, the government classifies the psychoactive drug with cocaine and morphine because it is highly addictive.

Were you fully aware of all the "warnings," "drug dependency risks," "precautions," and "adverse reactions" related to the use of RITALIN?

FDA “Black Box” Warning Label

The Food and Drug Administration (FDA) requires the following "black box" warning on all methylphenidate drugs, including Ritalin, which means that medical studies indicate Ritalin carries a significant risk of serious, or even life-threatening, adverse effects.

WARNING

RITALIN-SR IS A FEDERALLY CONTROLLED SUBSTANCE (CII) BECAUSE IT CAN BE ABUSED OR LEAD TO DEPENDENCE. KEEP RITALIN-SR IN A SAFE PLACE TO PREVENT MISUSE AND ABUSE. SELLING OR GIVING AWAY RITALIN-SR MAY HARM OTHERS, AND IS AGAINST THE LAW.

TELL YOUR DOCTOR IF YOU OR YOUR CHILD HAVE (OR HAVE A FAMILY HISTORY OF) EVER ABUSED OR BEEN DEPENDENT ON ALCOHOL, PRESCRIPTION MEDICINES OR STREET DRUGS.

ABOVE: FDA black box warning label means that medical studies indicate the drug carries a significant risk of serious or even life-threatening adverse effects. The bold warning label appears on the manufacturer's wholesale packaging and is the strongest alert the FDA can require of drug-makers.

Used For

Attention deficit disorder

Narcolepsy

How Ritalin Works

We don't know exactly why it produces the effects it does. Methylphenidate (Ritalin) was first synthesized in 1944 in an (unsuccessful) attempt to create a stimulant that would not induce addiction or tolerance. Ritalin is very closely related to amphetamine: similar in chemical structure, metabolization and clinical effects. This close connection is the chief reason Ritalin use raises concern among patients and others.

Do Not Use If

You have high blood pressure or any form of heart disease, are very nervous or have severe insomnia, have a history of addiction to drugs or alcohol. Do not combine with monoamine oxidase inhibitors.

Common Side Effects

Addiction

Nervousness including agitation, anxiety and irritability

Trouble sleeping (insomnia)

Decreased appetite

Headache

Stomach ache

Nausea

Dizziness

Heart palpitations

Other Serious Side Effects Include

Slowing of growth (height and weight) in children

Seizures, mainly in patients with a history of seizures

Eyesight changes or blurred vision

Less Common Side Effects

High blood pressure

Rapid pulse rate (and other heart problems)

Tolerance (constant need to raise the dose)

Feelings of suspicion and paranoia

Visual hallucinations (seeing things that are not there)

Depression

Cocaine craving

Dermatoses (infected or diseased skin)

Urinary tract infection

Infection or viral infection

Elevated ALT enzyme levels in the blood (signaling liver damage)

Overdose Side Effects

Methylphenidate drugs have been extensively abused. Extreme psychological dependence and severe social disability have resulted. Abuse of methylphenidate drugs may cause a sudden heart attack even in those with no signs of heart disease. Symptoms of overdose that require immediate medical assistance include:

Restlessness

Tremor

Aggression

Hallucinations

Panic states

Hyperreflexia (overactive reflexes, which can include twitching or spasms)

Personality changes

Symptoms of depression

Seizures or abnormal EEGs

High blood pressure

Rapid heart beat

Swelling of hands/feet/ankles (for example, numbing of the fingertips)

Delusions

Sweating

Vomiting

Dehydration

Unexplained muscle pain

Lower abdominal pain

Rhabdomyolysis and kidney damage 

Chronic abuse can manifest itself as psychosis, often indistinguishable from schizophrenia

What to Do About Side Effects

The last dose of the drug every day should be taken several hours before bedtime to prevent insomnia.

Nervousness usually goes away and appetite often returns so that weight loss is rarely dangerous.

If high blood pressure, rapid pulse, paranoia, or tolerance becomes a problem, the drug is usually stopped.

Nothing can be done about the addiction except to remember not to stop taking any version of methylphenidate abruptly.

The Alternative Perspective Your Solution

If you are currently taking prescription medication for your symptoms and are interested in building more health and perhaps getting off your medication by addressing the cause of your health concern, please call the office and let us discuss your options.  I will work with your medical doctor to restore your health and reduce or eliminate the need for medication.