Methylphenidate

Brand names of methylphenidate

  • Concerta
  • PMS-Methylphenidate
  • Riphenidate
  • Ritalin
  • Ritalin-SR

Methylphenidate is a medication used to stimulate the central nervous system in the brain with an action similar to, but milder than that of amphetamines. One difference that methylphenidate has over amphetamines is that it noticeably produces more affects on mental activities than on motor ones. It has a calming affect on children when used to treat attention-deficit hyperactivity disorder or ADHD. Methylphenidate is also known to reduce hyperactivity in children and an increase in the attention span when children with ADHD are treated with methylphenidate. Methylphenidate and amphetamines can both lead to drug abuse. Methylphenidate has been approved by FDA since as long as 1955.

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Things you need to tell your physician before taking methylphenidate

Before you begin taking methylphenidate make sure to tell your doctor if you are allergic to methylphenidate or any other medication.

If you have been taking monoamine oxidase (MAO) inhibitors or have just stopped taking them then inform your doctor as he will then probably advise you not to take methylphenidate as there must be a gap of at least 14 days between stopping to take an MAO inhibitor and starting on methylphenidate.

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The doctor also needs to be told about all the prescribed or non-prescribed medications you are taking or planning on taking, including vitamins, herbal products or nutritional supplements. Specially mention if you are taking anticoagulants or blood thinners such as warfarin (Coumadin), any antidepressants, decongesting cough and cold medicines, medicines for high blood pressure, seizures or if you are taking selective serotonin reuptake inhibitors (SSRI) as citalopram (Celexa). Mention Ritalin LA if you are using it and also any antacids or other medicines for ulcers and heartburn. It is important to tell the doctor about these as he will need to monitor you for side effects or change the doses of medications.

If you suffer any of the medical conditions listed below then communicate them to the doctor before you begin with methylphenidate as the doctor would probably advise you not to take methylphenidate in some of the conditions.

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If you have a family history of suffering from Tourette's syndrome where a person repeats movements, sounds or words; any facial or motor tics that are uncontrolled or verbal tics when there is repetition of words and sounds, then inform the doctor.

In case you are suffering from glaucoma and there is loss of vision, or if your thyroid gland is overactive, or if feelings of anxiety, tension and depression bother you then communicate it to the doctor. Also tell him if you are being treated either with long-acting extended-release tablet, Metadate ER or the capsule Metadate CD. If you cannot normally digest foods that contain sugar, starch or dairy products then tell your doctor about your condition.

Methylphenidate will probably not be advised for you if any one in your family has had irregular heartbeats or died suddenly. If you have had a heart attack or suffered from any heart defect, high blood pressure, irregular heartbeat, heart or blood vessel disease, hardening of the arteries or any other heart disease then you will first be examined to see if your blood vessels and heart are healthy. In case the condition of your heart is not healthy or there is a chance that you might develop a heart condition the doctor will not start you on methylphenidate.

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If any member of your family has had depression, bipolar disorder, (when the mood changes from highly depressed to highly excitable) or mania (frenzied mood) or if anyone has attempted or thought of suicide then let the doctor know.

Some other conditions that must be mentioned to the doctor are seizures, mental illness or an abnormal electroencephalogram (EEG), or if you have phenylketonuria, where a special diet is followed to prevent mental retardation. Mention if you take chewable tablets or long-acting, extended-release tablets (Concerta). In case you have problems swallowing or if your digestive system suffers from a blockage then tell the doctor.

The doctor should know if you are planning on a pregnancy or are pregnant or breast feeding before you begin with methylphenidate. If you become pregnant while on the medication notify your doctor.

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In case your surgeon or dentist requires for you to have a surgical process then inform them that you are taking methylphenidate.

Methylphenidate is only part of the total ADHD treatment which also includes counseling and special education so you must make sure you follow the entire treatment and in accordance to the guidelines of your therapist or doctor.

Anybody who is 65 or older must talk to the doctor about the possible risks and benefits of methylphenidate before taking the medication because as it is not as safe as some of the other medications for this age group.

Usage

Attention deficit hyperactivity disorder or ADHD is only partly treated with methylphenidate. The full treatment includes psychological, educational and social procedures. Patients who have been treated with this medication for ADHD will show better attention span and a reduction in impulsiveness and hyperactivity. Methylphenidate is also used to treat sleep disorders in patients who have narcolepsy. Methylphenidate also affects the level of neurotransmitters in the nervous system as it is a mild stimulant. This medication should not be used to treat general fatigue.

How to use methylphenidate

The instructions in the medication guide should be thoroughly understood before you begin on methylphenidate and each time you buy a refill. Also ask the doctor or pharmacist to explain what is not understood.

The medication will normally be taken 30 to 45 minutes before a meal unless the doctor has directed you differently. In case of a stomach upset or loss of appetite the medication will be taken with or either after meals or snacks.

The best benefits will ensue with regular use of methylphenidate, so remember to take it at the same time daily. Only after two weeks of regular use of the medicine will the improvements begin to show. The dosage of the medication is based on the patient's medical condition and the response to therapy, so make sure to take the medication exactly as prescribed as the medication is habit forming.

There could be chances of addictive behaviour, though not likely, and so doses must not be increased, taken more frequently or used over longer periods of time than prescribed. Your doctor will know when to increase or decrease the medication and so do not suddenly stop using it without asking the doctor for advice, particularly if taken for long already. Once the medication has been stopped it should remain stopped so that there are minimal chances of addiction.

If methylphenidate has been used over a long period of time and is stopped there could be withdrawal symptoms like severe depression and over activity. To prevent any such reactions the doctor is likely to decrease the dose very gradually. Report any withdrawal symptoms to the doctor; consult him or the pharmacist if you would like more details.

Besides the medication can become ineffective when used over long periods of time and the doses may have to be adjusted. You must talk to your doctor if you feel the medication is no longer working especially if conditions remain the same or worsen.

How methylphenidate works

Methylphenidate is said to be working when norepinephrine, a natural hormone that transmits nerve impulses in the brain, is encouraged to release with the help of the medication. This will decrease restlessness and increase attention in both adults and children, who have problems concentrating, are distracted and very impulsive.

Side effects

Serious
Common
Less common

Possible interactions

Herbal remedies like using St. John's wort, guarana, ma huang or kola along with methylphenidate may cause the central nervous system to be stimulated excessively. Alcoholic beverages like beer need to be totally avoided as also Chianti wines and vermouth, the latter specifically, as it may have a high percentage of tyramine.

Discontinuation

Decrease the dose of the medication in consultation with your doctor only as he will know best how to decrease it suitably, especially if it has been taken over a long period of time.

Storage instructions

The tablets should be stored at room temperature.

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