Methylphenidate is a central nervous system stimulant, typically used in the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in children and adults. Take this medication exactly as prescribed and discuss with your doctor or healthcare provider before starting any other medication (prescribed or over the counter) while on methylphenidate, as adverse effects can occur.

Methylphenidate brand names

  • Ritalin/Ritalin LA
  • Methylin
  • Adhansia XR
  • Aptensio XR
  • Concerta
  • Relexxii
  • Cotempla XR-ODT
  • Daytrana
  • Quillichew ER
  • Quillivant XR
  • Jornay PM
  • Metadate ER (discontinued)

What is methylphenidate prescribed for?

Methylphenidate is prescribed for the treatment of ADHD in children and adults. It will often be used alongside other treatments, such as talking therapies, to produce the best results. [1][2]

Methylphenidate is not typically prescribed to children under six years old, as the safety and efficacy of this is not clear and younger children may be more likely to experience serious side effects. [3]

ADHD in children typically presents as an inability to focus, hyperactivity, and impulsivity. Adults with this diagnosis generally exhibit less hyperactivity than is seen in children but may experience ongoing restlessness and difficulties concentrating. [4]

Methylphenidate is also sometimes prescribed to treat narcolepsy in adults. Aside from ADHD and narcolepsy, methylphenidate is sometimes prescribed for off-label uses, such as treating fatigue or improving cognitive abilities in dementia and cancer patients. [3]

How does methylphenidate work?

Methylphenidate affects the release and transportation of the neurotransmitter dopamine, increasing its concentration in a certain area of the brain. This results in a reduction in impulsiveness, which then allows for higher levels of concentration and focus. [3]

How is methylphenidate usually taken?

Methylphenidate is available in a number of different forms, which are taken in different ways.

  • Tablets, to be swallowed whole (do not crush)
  • Chewable tablets, to be chewed and swallowed, followed by a glass of water or other soft drink
  • Oral disintegration tablets, to be placed on the tongue where they will dissolve
  • Capsules, to be swallowed whole,or opened and sprinkled on a small amount of food and swallowed without crushing
  • Caplets (coated tablets), to be swallowed whole
  • Liquid, to be swallowed without mixing with food or drink and dispensed in an accurate measuring device (always shake the bottle prior to administering to ensure medication is properly mixed)
  • Patch, to be stuck on clean, clear skin for around 9 hours

The various forms of this medication are available in a variety of strengths, from 5mg up to 72mg, and as immediate release, sustained release, and extended release capsules.

The various speeds of release impact the amount of medication released into the body and how long the effects last. [5] Medication that has an extended release is usually only taken once per day, while immediate release may be 1-3 times per day.

Ensure you take your medication exactly as prescribed, using the correct type of medication, the correct dose, and at the correct time, as adverse effects can occur if you do not. If you are unsure about how to take your medication, be sure to ask your doctor.

Unless you are prescribed Jornay PM, which is taken at night, you should avoid taking methylphenidate medication after 5pm, as it may impact your sleep.

Your doctor will likely begin your prescription on a low daily dose, steadily increasing it to find the appropriate dosage for you. Your prescription will depend on your age, weight, and the severity of your condition, so your dose may be altered during your treatment.

Each dose will typically not be more than 60mg of immediate release, or 120mg of extended release. Higher doses may increase the risk of overdose or developing a dependency on the medication. [6]

If a dose is missed, take the medication as soon as possible, or if it is close to the next dosage time, skip the missed dose. Never take double your prescribed dose in one go, as this can have adverse effects.

How long does methylphenidate stay in your system?

Once you begin taking this medication, you may notice an improvement in your symptoms within a few days or weeks, but it may take several months before it takes full effect.

A single dose may continue to affect you for 3-9 hours (depending on the release speed).

After your final dose of this medication, it may take several days for methylphenidate to be completely out of your system.

Depending on the length of time you have been taking methylphenidate and the dosages you have been using, you may experience withdrawal symptoms after stopping the medication. Your doctor will likely reduce your prescription slowly to help prevent these symptoms. You should never suddenly stop taking methylphenidate without proper medical advice and supervision.

Methylphenidate side effects

When you begin a new medication, you may experience some side effects. These will usually decrease within a week or two, but if they continue or become problematic, or you experience any serious side effects, you should consult your doctor immediately.

Common side effects of methylphenidate include:

  • Stomach pain, includingdiarrhea, constipation, nausea, or vomiting
  • Appetite loss
  • Mild anxiety
  • Difficulty sleeping
  • Dizziness
  • Sweating

Rare or serious side effects of methylphenidate include:

  • Increase in blood pressure or heart rate
  • Shortness of breath or chest pain
  • Feeling very tired or drowsy
  • Muscle pain or weakness
  • Dehydration, including dark urine or excessive thirst
  • Changes in the color or feeling in your fingers or toes
  • Blurry vision
  • Mood changes, including severe anxiety, panic attacks, psychotic symptoms such as hallucinations or delusions, or mania
  • Allergic reaction, including rash, swelling of the face or mouth, blisters, or itching

Methylphenidate precautions

Discuss with your doctor all your current and previous physical health conditions, as they may impact your ability to take this medication safely.

You may not be able to take this medication safely if you have ever experienced any heart condition, due to the potential heart-related side effects and risks. [1] Those taking this medication will have their heart rate and blood pressure monitored regularly.

You should also discuss your mental health history with your doctor prior to starting methylphenidate, as this medication can sometimes worsen symptoms of depression, anxiety, mania, and agitation. [2]

Tell your doctor about all medications you are currently taking, or plan to take (including vitamins and dietary supplements), as they may cause adverse reactions.

Consult your doctor prior to starting this medication if you are pregnant or plan to become pregnant. ADHD and methylphenidate treatment can affect your fetus, so it is important that you are aware of the associated risks in order to make an informed decision about your treatment and how to manage these risks.

If you are breastfeeding, there may be risks to your baby, although the information on this is currently unclear, [2][3] so discuss this with your doctor prior to starting methylphenidate. Practice caution and monitor your baby for unusual changes in sleep, appetite, and weight.

Risk of addiction

Methylphenidate is a Schedule II controlled substance, because of the high potential for abuse or dependency. [6] As such, this medication may not be suitable for you if you have a history of alcohol or substance addiction.

It is very important that you, or a child taking this medication, take only what is prescribed and do not share it with others under any circumstances.

It is advised that children who require doses during the day only carry with them to school what is needed, to prevent intentional or accidental misuse of the medication. You may wish to discuss this with your doctor, so your child has a prescription that reduces the need for doses during the day (such as patches or extended release).

Methylphenidate interactions

Medications to treat seizures and high blood pressure, and some antidepressants and blood thinners, may interact with methylphenidate, impacting the effectiveness or safety of the medication.

Caffeine and alcohol can interact with methylphenidate, so should be limited or avoided.

Antidepressants called monoamine oxidase inhibitors (MAOIs) should not be taken with methylphenidate, as they can cause serious effects and may be fatal. There should be at least 14 days between your last dose of MAOI and your first dose of methylphenidate. [1][2]

Methylphenidate storage

Always keep all medications out of reach of children.

Store methylphenidate in its original packaging, in airtight containers, and at room temperature (never above 86ºF).

If you need to dispose of medication that has expired or is no longer needed, contact a medical professional to ensure it is disposed of appropriately. Never flush medications down the toilet or casually deposit them in a garbage bin, as this can create unnecessary risks.

What to do if you overdose on methylphenidate

In the case of a methylphenidate overdose, call a medical professional or Poison Control on 1-800-222-1222, or in case emergency medical attention is required, call 911. Symptoms of a methylphenidate overdose may include nausea or vomiting, rapid or abnormal heart rate, seizures, hallucinations, or paranoia.

Frequently asked questions about methylphenidate

Is methylphenidate an amphetamine?

Methylphenidate is not an amphetamine, but the two have been found to have similar pharmacological actions and may have similar effects in the case of methylphenidate overdose or misuse. [6]

Does methylphenidate expire?

As with most medications, methylphenidate does expire, and the expiry date will be written on the medication packaging. Do not take expired medication and ensure it is disposed of appropriately by a healthcare professional.

Resources:

  1. The College of Psychiatric and Neurologic Pharmacistsand the National Alliance on Mental Illness. (n.d). Methylphenidate or dexmethylphenidate.NAMI. Retrieved from https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Methylphenidate-or-Dexmethylphenidate-(Concerta-R
  2. MedlinePlus [Internet]. American Society of Health-System Pharmacists, Inc. (n.d). Methylphenidate. Retrieved from https://medlineplus.gov/druginfo/meds/a682188.html
  3. Verghese, C., & Abdijadid, S. Methylphenidate. (Updated January 2022). Treasure Island, FL: StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK482451/
  4. Centers for Disease Control and Prevention. (n.d). Symptoms and diagnosis of ADHD.CDC. Retrieved from https://www.cdc.gov/ncbddd/adhd/diagnosis.html
  5. Shultz, J., Strosher, L., Nathoo, S. N., & Manley, J. (2011). Avoiding potential medication errors associated with non-intuitive medication abbreviations. The Canadian Journal of Hospital Pharmacy, 64(4), 246–251. Retrieved from https://doi.org/10.4212/cjhp.v64i4.1036
  6. Morton, W. A., & Stockton, G. G. (2000). Methylphenidate abuse and psychiatric side effects. Primary Care Companion to the Journal of Clinical Psychiatry, 2(5), 159–164. Retrieved from https://doi.org/10.4088/pcc.v02n0502