What to Expect When Starting Ritalin


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Have you recently been diagnosed with adult ADHD and are exploring your medication options? Maybe your physician has suggested starting Ritalin, and you are wondering how it works and what to expect once you start using this medication. 

Ritalin, generically known as methylphenidate, is a stimulant medication that was first FDA-approved to treat ADHD in adults in the mid-1950s. Ritalin has proven safe and effective and is considered the first-line drug for treating attention deficit hyperactivity disorder.

In this post, we’ll discuss everything you need to know when starting Ritalin for the first time. We’ll cover the following:

  • How Ritalin works
  • Ritalin’s effects on the body
  • What taking Ritalin to manage ADHD symptoms feels like
  • Potential side effects of Ritalin
  • Possible drug interactions with other drugs
  • How to use Ritalin properly to manage your ADHD symptoms

If you are looking for fast and convenient treatment for your ADHD symptoms and think Ritalin might be the right medication, Klarity can help. Book an appointment on Klarity today and get started with an ADHD-trained mental health provider who can diagnose ADHD and prescribe ADHD treatments online if needed, like Ritalin. 

How Ritalin Works

Ritalin, a neuro-stimulant, increases the levels of dopamine and norepinephrine in your brain. These two neurotransmitters are essential chemical messengers partially responsible for regulating motivation, action, and cognition.

What Does Dopamine Do?

Dopamine is a critical neurotransmitter in the reward system of the brain. As a result, dopamine levels directly affect a person’s motivation, memory, and ability to learn, alongside other factors. Dopamine also plays a smaller role in your body’s fight-or-flight response.

Dopamine helps regulate the following:

  • Pleasurable reward and motivation
  • Behavior and cognition
  • Sleep and arousal
  • Mood
  • Learning
  • Attention
  • Movement
  • Memory

What Does Norepinephrine Do?

Norepinephrine is both a hormone and a neurotransmitter. It plays a vital function all over the body, helping to trigger the fight or flight response across multiple organ systems. 

As a neurotransmitter, Norepinephrine helps regulate:

  • Wake and sleep cycles
  • Alertness
  • Increasing attention and maintaining focus
  • Memory storage
  • Mood 

As a hormone, Norepinephrine helps your body physically adapt to stress:

  • Dilates pupils
  • Increases heart rate and blood pressure
  • Increases blood flow and oxygen to muscles
  • Deepens breathing
  • Improves energy

The Effects of Ritalin on the Body

Even though Ritalin works primarily by increasing neurotransmitter levels in your brain, its effects are felt throughout the body due to norepinephrine and dopamine’s role in regulating the fight or flight response across multiple organ systems. 

Central Nervous System

In ADHD patients, Ritalin improves concentration, decreases restlessness, and increases attention span. It can, however, increase irritability and anxiety in some patients and may lead to depression.

Stimulants, including Ritalin, may cause you to experience blurry vision. The stimulant effects of Ritalin can also cause insomnia and lead to daytime drowsiness. If you experience any of these unwanted side effects, be sure to let your doctor know immediately. 

Circulatory System

Increased body temperature, heart rate, and blood pressure can all occur secondary to Ritalin use. If you have a known heart condition or a history of hypertension (high blood pressure), you may not be able to use Ritalin. These side effects are typically temporary for patients without these conditions and will subside after a few weeks. 

If you notice that your toes and fingers are cold or have bluish discoloration, it may indicate that Ritalin is causing peripheral circulatory problems, and you should let your doctor know immediately.

Digestive System

Ritalin can cause you to have a decreased appetite which may lead to unintentional weight loss. Some patients initially develop nausea and diarrhea when starting Ritalin; however, these side effects typically subside with continued medication use.

Respiratory Systems

Rapid breath can be common when you start on Ritalin but should subside within a few days of starting the medication as your body gets used to it. If rapid breathing persists, this needs to be discussed with your doctor.

Muscular & Skeletal System

Ritalin can cause muscle weakness and pain, and joint discomfort. These symptoms usually indicate you are using too much Ritalin and that your medication needs to be adjusted or stopped.

Reproductive System

After prolonged use of Ritalin or following an increase in their Ritalin dosage, some men can experience long and painful erections. This condition, known as priapism, may require medical intervention. 

What Does Taking Ritalin Typically Feel Like?

ADHD patients taking Ritalin typically describe feeling focused, in control, and having a sense of clarity. As a stimulant, Ritalin can make you feel “up,” alert, awake, filled with a sense of euphoria, or more talkative. All of these feelings can be very helpful in tending to your daily activities and tasks, making you more efficient and effective. 

On the other hand, note if you are becoming agitated, irritable, or aggressive or if your skin is tingling and you feel like electricity is running through you. You may be “overstimulated” and must discuss these feelings with a board-certified ADHD-trained medical provider.

Schedule an appointment to speak with an ADHD-trained medical provider and learn more about what to expect when starting Ritalin. 

Why Does Ritalin Make You Feel Calm?

In patients with ADHD, Ritalin increases the levels of dopamine and norepinephrine in the brain. These increased neurotransmitter levels allow for an overall improvement in executive functioning, making you feel calm and in control of your ability to handle activities and tasks rather than be overwhelmed by them.

How Long Does it Take for Ritalin to Wear Off?

An immediate-release capsule of Ritalin takes 4-6 hours to wear off. But the extended-release capsule of methylphenidate, such as Ritalin LA, effectively controls ADHD symptoms for 8-10 hours. 

Licensed providers on Klarity provide personalized mental health treatment. Find a provider that matches your needs and preferences.

Ritalin Side Effects in Adults

As with all safe and effective medications, Ritalin may have some undesired effects on your body. Most of these side effects are temporary and can be safely managed with the help of your doctor. Ritalin side effects in adults include:

  • Fast heart rate
  • Headache
  • Trouble sleeping
  • Anxiety
  • Excessive sweating
  • Weight loss
  • Decreased hunger
  • Dry mouth
  • Irregular heartbeat
  • Nausea
  • Stomach pain
  • High blood pressure
  • Painful erections 
  • High blood pressure
  • Unexplained wounds appearing on fingers or toes

Ritalin is Habit Forming and Can Lead To Substance Use Disorder if Misused

As a Schedule II stimulant, Ritalin (methylphenidate) is classified as a controlled substance by the Drug Enforcement Administration (DEA). This means it has the potential for abuse and dependence. 

Though Ritalin is effective for managing the symptoms of ADHD, it should only be used as prescribed and under the guidance of a healthcare professional.

Signs of Ritalin dependence may manifest in various ways. Individuals may find that they require higher doses of the medication to achieve the desired effects over time, or they might experience withdrawal symptoms when they stop taking Ritalin. 

Ritalin isn’t the only Schedule II stimulant that carries these risks. Other stimulant medications in this class include: 

  • Methylphenidate (Ritalin, Concerta): These stimulant medications are chemically different from amphetamines but have similar effects.
  • Dextroamphetamine (Dexedrine): This amphetamine medication is used for ADHD and narcolepsy.
  • Lisdexamfetamine (Vyvanse): It is a prodrug that remains inactive until metabolized in the body and is prescribed for ADHD and binge eating disorder.
  • Methamphetamine (Desoxyn): This potent central nervous system stimulant is used in rare instances to treat ADHD and obesity treatment.

Fortunately, when used as directed by a healthcare professional, the risk of developing a Ritalin dependence is significantly reduced. It’s crucial to be open with your healthcare providers when being prescribed Ritalin to ensure this medication is the best one for you.

Ritalin Withdrawal

You can experience Ritalin withdrawal symptoms if you stop taking Ritalin or generic methylphenidate abruptly. These symptoms can include:

  1. Fatigue and lethargy
  2. Depression or anxiety
  3. Irritability or agitation
  4. Difficulty sleeping or insomnia
  5. Increased appetite
  6. Headaches
  7. Difficulty concentrating or remembering
  8. Flu-like symptoms such as muscle aches and pains, chills, and sweating

Symptoms of withdrawal may vary in severity depending on the dosage of Ritalin and the length of time someone takes it. You are more likely to experience withdrawal if you have been on high doses for a long period of time and have developed some tolerance.

The best way to minimize potential withdrawal is to gradually lower the dose under a healthcare provider’s guidance. This allows the body to adjust to the lower dosage of Ritalin more slowly and may help reduce the severity of these withdrawal symptoms.

What Drugs Interact With Ritalin?

  1. Antidepressants: Some antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants, can increase the levels of Ritalin in the body, leading to a greater risk of side effects like high blood pressure, heart palpitations, and insomnia.
  2. Blood Pressure Medications: Certain blood pressure medications, such as beta-blockers, can interfere with the effectiveness of Ritalin and decrease its ability to control symptoms of attention deficit hyperactivity disorder (ADHD).
  3. Antipsychotics: Antipsychotic medications can also interfere with the effectiveness of Ritalin and decrease its ability to control symptoms of ADHD.
  4. Seizure Medications: Some seizure medications, such as phenytoin and carbamazepine, can increase the metabolism of Ritalin, which can lower its effectiveness.
  5. Antacids: Antacids can increase the absorption of Ritalin, leading to higher levels of the drug in the body and an increased risk of side effects.
  6. Monoamine Oxidase Inhibitors: Monoamine Oxidase Inhibitors (MAOIs), when taken together with Ritalin, can increase the effects of Ritalin and lead to potentially life-threatening side effects such as high blood pressure, fever, seizures, and coma. Ritalin should not be taken with MAOIs or within 14 days of stopping MAOI treatment, as there may be a risk of a dangerous drug interaction.

It’s important to talk to your healthcare provider about any medications or supplements you are taking, including over-the-counter products, to ensure they are safe to take with Ritalin and other central nervous system stimulants.

Your provider can help you avoid drug interactions and adjust your medication regimen.

How to Take Ritalin Correctly

Ritalin is a controlled substance. You should only take Ritalin as prescribed by your healthcare provider. Once on Ritalin, you must be monitored to see if the medication works as intended. You’ll also be monitored for any unwanted symptoms and side effects. 

For most adults starting immediate-release capsules of Ritalin, you will take your medication 2 or 3 times a day, 30-45 minutes before a meal. For Ritalin LA, the extended-release formulation, you take it once per day. Your healthcare provider will adjust your dose as needed.  Do not adjust your dose on your own. 

Discuss Ritalin With A Board-Certified ADHD-Trained Medical Provider 

Starting any new medication requires a bit of self-education and preparation. Before taking Ritalin or another ADHD treatment to manage your ADHD symptoms, you’ll want to talk to ADHD specialists who can help you determine an effective treatment plan.

Luckily, Klarity makes connecting with a board-certified ADHD specialist as easy as possible. 

Here’s how we streamline the process of ADHD treatment online

  1. Take our brief, free ADHD self-assessment to see if online ADHD treatment suits your needs.
  2. If you are a good fit for Klarity’s services, we’ll connect you with a fully-licensed ADHD-trained mental health provider who can diagnose and prescribe ADHD treatments if needed, like Ritalin in 48 hours or less.
  3. Meet with your provider at your chosen time and place—your appointment is virtual! 
  4. If your provider finds it necessary, pick up your treatment at your local pharmacy. 

Klarity takes ADHD treatment into the 21st century.

Medically Reviewed By Dr. Zoe Russell

Dr. Zoe Russell received a dual bachelor’s degree in biology and psychology from the University of Michigan-Dearborn, pursued a master’s degree in public health from Michigan State University, and received her doctorate in osteopathic medicine from Michigan State’s College of Osteopathic Medicine in 2021. Currently, Dr. Russell is completing her residency training in family medicine and hopes to specialize in female reproductive and mental health.

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