Ritalin for ADHD: Uses, Doses, Side Effects, and More

Millions of children in the U.S. take Ritalin every day to help them deal with attention deficit hyperactivity disorder (ADHD) symptoms.

Symptoms of ADHD can affect behavior and the ability to maintain attention, making common daily activities like school, homework, and social interaction difficult. Roughly 4-12% of kids have ADHD, and for more than 50% of those, the symptoms will continue past childhood.

Ritalin has long been a favored medication for assisting in attention, impulse control, and hyperactivity struggles for these children.

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What Is Ritalin?

Ritalin was one of the earliest pill-form drug treatments for ADHD and has been used in its treatment for nearly 70 years. The generic name for Ritalin is methylphenidate.

Ritalin stimulates the central nervous system in ways that help with maintaining mental focus, the ability to pay attention, and controlling behavioral impulses. 

It’s also thought to be beneficial in strengthening mental-organization abilities and listening comprehension.

Ritalin is often a preferred method of treatment due to its fast-acting effects. While some ADHD medication choices can take weeks to build up in the system and begin showing their effects, Ritalin can begin exhibiting measurable results in as little as 20 minutes from the time of ingestion.

Uses for Ritalin

In addition to its widespread popularity as a treatment for ADHD, Ritalin is also commonly prescribed as a second-line treatment to help individuals with the effects of narcolepsy.

Side Effects

Like many drugs that interact with the central nervous system, Ritalin can have a number of side effects. The most common side effects of Ritalin are nervousness and insomnia (trouble sleeping), and loss of appetite.

Other side effects include:

• Abdominal pain
• Abnormal heartbeat
• Dizziness or Drowsiness
• Headaches
• Nausea
• Heart palpitations or rapid heartbeat
• Weight loss (over a prolonged period of usage)

Typically, the side effects of Ritalin are easily managed by a simple reduction in dosage, but occasionally a change in medication is required.

Long-term use in children may affect growth rates and weight, as well as adult height. Because of these risks, many doctors will interrupt the usage of this treatment from time to time to allow the child’s body to regulate its natural growth cycles.

It’s also been found that younger children tend to experience side effects from ADHD medication less often than older children, or adults.

Adults who are prescribed Ritalin should be aware that it includes methylphenidate, which is commonly discouraged during pregnancy, and that the medication does pass through breast milk.

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How Does Ritalin Work

Stimulate medications, like Ritalin, work by helping control the levels of two brain chemicals: dopamine and norepinephrine, that control the ability to concentrate.

The brain uses dopamine molecules to transport signals between nerve cells. The speed and accuracy of these signals directly influence the motivation to perform physical tasks by increasing or depressing brain response.

Studies have found that stimulant medications, like Ritalin, cause an increase in these released dopamine levels, having a positive effect on action, motivation, and cognitive ability.

Ritalin is available in short, intermediate, and long-acting forms.

Short-Acting Ritalin

Available in 5, 10, and 20mg prescriptions, short-acting Ritalin is taken multiple times each day, with each dosage lasting 3-5 hours.

Intermediate-Acting Ritalin

Intermediate doses of Ritalin are effective for 3 to 8 hours.

Long-Acting Ritalin

Long-acting or “once a day” Ritalin lasts up to 12 hours. Though this is often the most convenient option, long-acting Ritalin tends to be much more expensive than other forms, including generic methylphenidate.

Ritalin doses, if missed, can be taken late (scheduling is flexible) but doctors will advise not giving your child any stimulant medication later than 6 p.m., as it can negatively impact their ability to fall asleep or stay asleep.

Anyone who has been prescribed Ritalin for an extended period of time should consult their doctor before ceasing usage, as withdrawal symptoms (including depression, thoughts of suicide, and excessive mood changes) have been known to occur.

Can Ritalin Be Used Long-Term?

Ritalin is classified as a controlled substance (Schedule II) by the Food & Drug Administration (FDA).  The FDA has determined that long-term use of Ritalin may result in dependency issues, especially if the drug is misused or abused.

Dependency has been found to be less likely in long-acting Ritalin, due to its slower release into the central nervous system.

People with ADHD who have struggled with drug or alcohol abuse in the past should discuss this with their doctor before taking any stimulant medication.

There are clear short-term benefits as well as possible long-term consequences related to any stimulant treatment. Parents should discuss their children’s options with a physician and study their alternatives regarding Ritalin and other stimulant treatments for ADHD.

Decisions often come down to weighing the possible long-term effects of taking a medication like Ritalin, as compared to the long-term effects of the symptoms that use of the medication can alleviate.

Negative outcomes like educational, work, and social difficulties, as well as depression and struggles with self-worth.

Ritalin vs Other ADHD Medications

Of the 6.4 million children diagnosed with ADHD in the U.S., the majority experience positive results from stimulant medication (methylphenidate or amphetamine).

Three of the most popularly prescribed ADHD medications in addition to Ritalin, Adderall, Concerta, and Evekeo. Alternatively, you could try natural treatments for ADHD.

Adderall

The combination of stimulant medications amphetamine and dextroamphetamine is sold under the brand name Adderall, and is a well-recognized and often prescribed treatment for ADHD.

Adderall is different than Ritalin because it comes in only two forms, either short-acting or long-acting (once a day). The short-acting version lasts about 4 hours.

Adderall side effects can include, risk of seizures, blurred vision, and problems with circulation in the extremities, while more serious side effects can include mental health episodes like depression, hallucinations, and impaired or delusional thinking.

Concerta

Concerta (methylphenidate hydrochloride) is another long-acting medicine prescribed for both children and adults to help manage ADHD symptoms for the entire school or work day with a single dose.  

Concerta and Ritalin both have the same active ingredients though, of the two, Ritalin is a short-acting stimulant, and so tends to boost focus and attention more quickly.

Side effects, especially loss of appetite or sleep issues — are very similar.

Concerta is a good option for kids who need to remain focused later in the day, and it has the option of a liquid form for children who have trouble swallowing pills.

Evekeo

Evekeo (amphetamine sulfate), like Ritalin, stimulates the central nervous system and is used to help treat symptoms of ADHD by decreasing impulsivity and hyperactivity and increasing attention.

Occasionally, Evekeo is also used as a weight-reduction medication in the treatment of exogenous obesity. Also like Ritalin, it is used in the treatment of narcolepsy.

Side effects from Evekeo are similar to Ritalin, including headache, stomach upset or pain, nausea, weight loss, and other common stimulate side effects. Evekeo users may also experience interactions between it and stomach acid medicines, antidepressants, antipsychotic medications, lithium, or narcotics.

Finding the best medication and dosage for an ADHD patient is often a matter of trial and error. If a particular option doesn’t show results or seems to elicit a lot of side effects, ask your doctor about switching to another option.

Cost

Like many medications, prices for Ritalin and other ADHD options can vary greatly, depending on the pharmacy and personal insurance coverage.

Typically, long-acting forms of stimulant medications will be considerably more expensive than shorter-acting options.

Generic versions, when available, can offer significant savings over name brands.

On average, however, the cost for a supply of 100 5 mg oral Ritalin tablets is around $82, while 10 mg and 20 mg can average $113 and $158 (respectively) depending on the pharmacy you visit.

Takeaway

Medications like oral stimulants like Ritalin are one of many options for the treatment of ADHD, and invariably see the best results when used in conjunction with other important therapies like skill training, counseling, parent education, and school (and home) learning accommodations.

While there is no proven medical cure for ADHD at this time, by focusing on relieving symptoms, developing core strengths, and adjusting environments for improved functionality, ADHD is absolutely manageable.