**READ FIRST for information on Ritalin

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**READ FIRST for information on Ritalin 2011-04-28T19:47:50+00:00

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    Ritalin® and Ritalin SR®

    What is the active ingredient?


    How does it work?

    The methylphenidate leads to a decrease in reuptake of the dopamine from the presynaptic sites of the neuron and makes more dopamine available.

    How is it metabolized and excreted?

    It is metabolized in the liver by cytochrome enzymes and excreted in the kidney.

    How fast does it work and how long does it last?

    The short acting Ritalin lasts between 3-5 hours. The SR lasts a bit longer but goes in smoother. The SR version only comes in a 20 mg dose which makes titration very difficult. The immediate release Ritalin can be crushed and split if necessary.

    What are the common side effects?

    >60% of the patients may suffer from initial insomnia, appetite suppression, headaches, mild nausea, emotional lability as the medications are wearing off, a seriousness in attitude often seen as a perception of dysphoria, dry mouth, dry eyes, diarrhea, and gastric irritation. There are other side effects but they are not common.

    Are there any specific major risk factors?

    There are cardiovascular risk factors and possibility of sudden death IF there is a preexisting cardiac structural defect, a family history of a conduction problem and/or if the patient themselves had a sudden loss of consciousness that could only be explained by an erratic heart rate.

    Can it be safely combined with other medications?

    Yes, though it may potentiate the effects of similar agents including those that have a central effect on the brain (e.g. alcohol, cannabis, cocaine etc.)

    If it doesn’t work, what should I do next?

    Ask your doctor for guidance always but switching to another psychostimulant is usually successful. Some people just respond to another psychostimulant class, like dextro-amphetamine, better.

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