Ritalin info and experiences

[EastCoastChris]

I have wanted to do a medication forum for a long time but couldn't figure a way to do it that wasn't a liability.
One of our members(thanks Elise) made a suggestion that I think is brillant. I will post a medication with a little info from a medication website and members can post their personal experiences then we will archive it. This way if someone is looking for info we can refer them to the archives. I hope this is helpful to all of us. If there is a medication that I miss,you just e-mail me. I will do one medication a day. Thanks.

 

[EastCoastChris]

Ritalin will be the first medication, since it is so often prescribed for ADHD.

Our experience when difficult child was 5 was dramatic. He really went from a whooping,wild child to someone who could sit in a chair and ask for breakfast. We were blown away at the results on his hyperactivity and his focus.


methylphenidate

Pronunciation: meh thill FEH nih date
Brand: Concerta, Metadate ER, Methylin, Ritalin, Ritalin-SR

What is the most important information I should know about methylphenidate?
• Use caution when driving, operating machinery, or performing other hazardous activities. Methylphenidate may cause dizziness, cause drowsiness, cause blurred vision, or impair your ability to concentrate. If you experience dizziness, drowsiness, blurred vision, or impaired concentration, avoid these activities.
• Do not crush, chew, or break the sustained- or extended-release formulations of methylphenidate (Ritalin SR, Metadate ER, Concerta). Swallow these tablets whole with water or another beverage. They are specially formulated to release slowly into your body.


What is methylphenidate?
• Methylphenidate is a mild stimulant to the central nervous system (brain and nerves). The exact way that methylphenidate works is unknown.
• Methylphenidate is used to treat attention deficit disorder (ADD), attention deficit hyperactivity disorder (ADHD), and narcolepsy.
• Methylphenidate may also be used for purposes other than those listed in this medication guide.


Who should not take methylphenidate?
• Do not take methylphenidate if you have taken a monoamine oxidase (MAO) inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days.
• Do not take methylphenidate without first talking to your doctor if you have
· an allergy to methylphenidate;
· severe tension, agitation, or anxiety;
· glaucoma;
· motor tics or have been diagnosed with Tourette's syndrome;
· depression;
· a psychotic condition such as schizophrenia;
· epilepsy or another seizure disorder;
· high blood pressure (hypertension);
· a history of alcohol or drug abuse; or
· a narrowing or blockage of your gastrointestinal tract (esophagus, stomach, or intestines).
• You may not be able to take methylphenidate, or you may require a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.
• Methylphenidate is in the FDA pregnancy category C. This means that it is not known whether methylphenidate will harm an unborn baby. Do not take methylphenidate without first talking to your doctor if you are pregnant.
• It is not known whether methylphenidate passes into breast milk. Do not take methylphenidate without first talking to your doctor if you are breast-feeding a baby.


How should I take methylphenidate?
• Take methylphenidate exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain the instructions to you.
• Take each dose with a full glass (8 ounces) of water.
• Take each dose of Ritalin or Methylin 30 to 45 minutes before a meal.
• The sustained-release forms of methylphenidate (Ritalin-SR, Metadate ER, Concerta) can be taken with or without food.
• Do not crush, chew, or break the sustained- or extended-release formulations of methylphenidate (Ritalin SR, Metadate ER, Concerta). Swallow these tablets whole with water or another beverage. They are specially formulated to release slowly into your body.
• If you are taking Concerta, do not be alarmed if you see in your stool what looks like a tablet. This is the outer shell of the tablet, the medication has been absorbed by your body.
• Store methylphenidate at room temperature away from moisture and heat.


What happens if I miss a dose?
• Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take only your next regularly schedule dose unless otherwise directed by your doctor. Do not take a double dose of this medication.


What happens if I overdose?
• Seek emergency medical attention.
• Symptoms of a methylphenidate overdose include agitation, tremors (shaking), muscle twitches, seizures, confusion, hallucinations, sweating, flushing, headache, fast or irregular heartbeat, large pupils, and dryness of the mouth and eyes.


What should I avoid while taking methylphenidate?
• Use caution when driving, operating machinery, or performing other hazardous activities. Methylphenidate may cause dizziness, cause drowsiness, cause blurred vision, or impair your ability to concentrate. If you experience dizziness, drowsiness, blurred vision, or impaired concentration, avoid these activities.


What are the possible side effects of methylphenidate?
• If you experience any of the following serious side effects, stop taking methylphenidate and seek emergency medical attention:
· an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);
· an irregular or fast heartbeat;
· chest pains or very high blood pressure (blurred vision, severe headache, flushing);
· unusual behavior or confusion; or
· liver damage (yellowing of the skin or eyes, nausea, abdominal pain or discomfort, unusual bleeding or bruising, severe fatigue).
• Other, less serious side effects may be more likely to occur. Continue to take methylphenidate and talk to your doctor if you experience
· insomnia (difficulty sleeping);
· nervousness;
· drowsiness;
· dizziness;
· headache;
· blurred vision;
· tics (repetitive movements);
· abdominal pain, nausea, or vomiting;
· decreased appetite or weight loss; or
· slower weight gain and/or growth.
• Methylphenidate may cause drug dependence.
• Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.


What other drugs will affect methylphenidate?
• Do not take methylphenidate if you have taken a monoamine oxidase (MAO) inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate) in the last 14 days.
• Before taking methylphenidate, tell your doctor if you are taking any of the following medicines:
· warfarin (Coumadin);
· phenytoin (Dilantin);
· phenobarbital (Luminal, Solfoton);
· primidone (Mysoline);
· a tricyclic antidepressant such as nortriptyline (Pamelor), amitriptyline (Elavil, Endep), doxepin (Sinequan), desipramine (Norpramin), clomipramine (Anafranil), or imipramine (Tofranil);
· a selective serotonin reuptake inhibitor such as fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft);
· clonidine (Catapres); or
· guanethidine (Ismelin).
• You may require a dosage adjustment or special monitoring if you are taking any of the medicines listed above.
• Drugs other than those listed here may also interact with methylphenidate. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.


Where can I get more information?
• Your pharmacist has more information about methylphenidate written for health professionals that you may read.

 

Fran- excellent idea with all the medications out there it would be helpful to have them all in one place with personal experiences that you don't get by going to the medication sites. This is really great!! Good for you guys

 

Brilliant is right! Excellent idea and much needed.

At age 5 difficult child was diagnosis with-ADHD. Clinical psychologist recommended Adderall; pediatrician mandated Ritalin because it is "the first line recommendation" in his "book." Started at 5mg Ritalin. Kindergarten reported wonderful results -- difficult child could focus, was better able to sit still and listen, etc. Some, but not much, difference was seen at home (home is with-two adults vs school environment). Rebound affect was not good and medication wore off around noon. Ritalin worked well at school in the a.m. for roughly 6 to 8 weeks -- then teacher reported it had pretty much lost its effect.

psychiatrist would not change medication (I'm smarter now than I was then. When 1st grade started, medication was increased to 5 mg Ritalin in am; 5 mg Ritalin at noon. Worthless.

Went back to psychiatrist -- had to DEMAND we try Adderall. Rx was changed to Adderall; results was good plus it stayed in his system longer than Ritalin.

Adderall has had to be increased over time. Until two weeks ago, difficult child was taking 10 mg in a.m.; 5 mg at noon. Excellent results in a.m.; so-so in the afternoon. medication was gone by "homework" time. Yes, poor mom and difficult child, too.

difficult child has what I call "performance" anxieties related to school. Feels he can't please anyone, no matter how hard he tries. Since school started in August, it has caused unnecessary problems. Also, he's getting to the age where he (and his peers)recognizes things like difficult child going to the nurse at noon for his afternoon medication, his classmates even remind him to go because they see the change in his behavior, etc. New psychiatrist recommended trialing 20 mg Adderall XR -- it lasts 12 hours and therefore does not require trip to nurse. This appears to have helped with-self-esteem. Also helps with getting through "homework time."

So far, so good.

 

Ritalin was very effective for my younger son with ADHD, but the "rebound effect" was a problem. Adding another dose in the afternoon helped, but then he had trouble getting to sleep at night.

He was on Ritalin during kindergarten, and it did allow him to have a successful school year in terms of behavior, ability to learn, and ability to socialize.

 

[bossmom50]

Great idea, Fran -

We first tried Ritalin with our oldest boy who is now 11 1/2 when he was 7 and in grade 2. It seemed to work immediately in that his teacher, whom we had not told about the trial, called after the 3rd day and asked if we had started medications for him. His initial diagnosis was ADHD, but once he was on the Ritalin, it became apparent that he was not hyperactive in that the only times he acted "impulsively" in class where when he thought he might have to write on the board or share his written paperwork with another child and those times were actually intentional rather than impulsive. He was given a new diagnosis of ADD primarily inattentive, which is him, he is a space cadet! After a while we raised him to 5 mgs. am and 5 at lunchtime. He then developed rebound and loss of appetite. Since he weighed about 44 lbs, the eating was a significant concern for us. The rebound was also very bad. We eventually tried the sustained release Ritalin, but then he wouldn't eat lunch (we had been giving him his lunch in between the 2 doses to get some food into him). The afternoon rebound was also horrendous. At the beginning of third grade, we switched to Adderall. He is now on 7.5mgs am and none at school and it seems to work. When he went to school medication free for 3 days, he wound up suspended for saying the "f" word in class. It was an important lesson to him (I think that if I had told the teacher I was not giving medications those days, he wouldn't have gotten the suspension. The problem with the suspension was that he LOVED being in the ISS room - it was quiet- and he got 100's on all 3 tests, science, math and Latin that he took in there!).

When my second son was given a diagnosis of mild ADHD/possible ODD midway through 1st grade, I was very reluctant to try Ritalin again. His in school behavior was such that we felt we had no choice; it was unfair to his teacher and classmates and torture on him to send him to school the way he was acting. Within 2 days, the Ritalin made dramatic improvements in him as well. He has not been suspended since and we only had to come and get him once at the beginning of this year. His reading is improving, his temper tantrums and rages are mostly behind us and he shuts down (passsive aggressive stance) much less frequently. He is willingly going to remedial reading and now enjoys art and music specials whereas last year he was always in the office for misbehaving during them. He does not have rebound and is now on 5 mgs morning and lunchtime. He has the appetite loss as well, but he is built differently from his brother and weighs 59 lbos at the same age that his bro weighed 44, so husband and I aren't worried in the same way.

The one thing I did differently was that with my oldest son, I allowed him to take the Ritalin generic. difficult child takes only the brand. I don't know if it makes a difference, but I know that I will keep both of them on these medications as long as they continue to help.

On other txs: oldest boy did bio-feedback, which I think was of some help and husband does not, he has also had social skills therapy.
difficult child was trialed on Metadate CD last summer so that we could try and avoid a PM dose, but it made him angry and aggressive physically so we stopped after 3 days.

Michele

 

Ah, Ritalin. My best friend.
My son is 8 and has been on ritalin since he was 4. We have tried Dexadrine, Adderal, Concerta and Ritalin, and the ritalin works the best for him. He has needed increased medications as he gets older. He does get a rebound at night, so he gets some clonidine at dinner to offset that so he can sleep. He also gets a little clonidine in the am to keep him calm enough to get his day started because we don't give medications till 8.
Alicia is on Concerta, which is a much better form of time-release ritalin. It only works in 80% of adhd kids. She is on the lowest dose and it works well with her.
The unfortunate thing about concerta is that it only comes in a few doses. If you kid needs an in-between dose, you have to switch them to regular 3 times a day ritalin.

Waht a huge difference it has made in my kids' lives. Without it, they would be in a hospital. No question.
Donna

 

[cullenowen]

Great idea, Fran -- glad you put in motion.

Our difficult child started on Ritalin at age 4. It worked well for a while but the effectiveness began to wear off. When the dosage was increased at around age 5, it increased difficult child's Obsessive Compulsive Disorder (OCD) symptoms (she picked at her nails and fingers until they all bled and became infected. That was all the evidence required for her Obsessive Compulsive Disorder (OCD) diagnosis. psychiatrist said that Ritalin will exacerbate Obsessive Compulsive Disorder (OCD) symptoms. When we discontinued the Ritalin, the Obsessive Compulsive Disorder (OCD) symptoms subsided. Otherwise, we had no bad side effects from Ritalin -- it just wasn't for her.

 

[Faithful-Heart]

Nate was tried on ritalin at age five...just turned five...was diagnosis with ADHD which now I believe he does not have....could be stess or anxiety or something more that triggers the hyperactivity. Nate had a bad reaction to ritialin. I am only posting this so someone who is trying it for the first time can watch out for these warning signs.

After the first dose kicked in Nate has pressured, rapid speech...literally could NOT stop talking. Stood there talking to me for over an hour the whole time one foot going up and down. He also had a mild rash on his chest and rapid heartbeat. I thought this was due to the fact he was also sick at the time..I was wrong..this can be a sign of an allergic reaction. The next hour he went the other way...I found him hidding behind a chair crying...he would NOT talk to me at all then.

By the third hour he was more normal. The second dose around noon he went through the same cycle all over again. Also had a bad rebound effect and could not get to sleep until midnight. By the third day I had cut his dose in half...made no difference. He seemed to be on speed at first, then so depressed or angry. By the next day...this had all happened over a holiday weekend...I called the dr who said stop the medication and would not even let me try Adderal due to Nate's reaction to this medication.

Nate also has had bad reaction to antiboics, steriods, over the counter medications. So I don't know if this was all just an allergic reaction or something more. There is a possiblty he could be bipolar. Stimulates can trigger a manic cycle in a bipolar child and from what I am reading if there is even a chance a child could be bipolar...like family history of it...stimulates should be avoided all together.

Now with my sister's son who is ADHD and very hyper..the ritalin worked well with him for a long time. Then later she was having problems with it wearing off in the evening so he was unable to focuse on his homework...he is now on Adderal and doing well with it. Oh and at first he did get headaches from it for some reason but that side effect is gone now. This is a child that you don't want to forget to give his medication to cause he gets SOOO Hyper and sooo implusive he is doing dangerous things cause he is just acting...not thinking first. So this medication has helped with that.

 

[EastCoastChris]

Good thread. We definately want pros and cons of each medication. A balanced view is important.

 

[gary s]

Rina started on 18 mg of Concerta in December of 2001. Her teacher noticed an improvement & asked me about it, although it seems to wear off around 1 or 2 in the afternoon, as this is when she has the most problems at school.

She is currently hospitalized, & just today I found out that she will get 5mg. Ritalin at noon, starting tomorrow. We are all anxious to see how this helps her. We had tried Ritalin last year, with some improvement noted at school, but, none at home. It also kept her awake at night, she had a decreased appetite, & horrible rebounds between doses.

Mary

 

[goinlooney4sure]

Hi,
Ritalin was good for about a week then he would need a higher dose and up until 60 mg at age 7. Found out that he was bipolar no wonder he got worse.

ADHD should be diagnosed only after bipolar disorder is ruled out. While these two conditions seem highly co-morbid, stimulants unopposed by a mood stabilizer can have an adverse effect on the bipolar condition. 65 percent of the children in our study had hypomanic, manic and aggressive reactions to stimulant medications. Parents wrote to us and described some of their children’s reactions to stimulants. They said things like: "He got sky-high on Ritalin and then violent"; "Ritalin caused physical aggression"; "She got psychotic on stimulants"; "He got suicidal and tried to get run over by a car"; "He went bonkers..."