Methylphenidate Health Article

Definition

Methylphenidate is a mild, central nervous system stimulant. In the United States, the drug is sold under the brand name Ritalin.

Purpose

Methylphenidate is used primarily in the treatment of attention-deficit/hyperactivity disorder (ADHD) in children and adults. It also may be used to treat the sleep disorder, narcolepsy. In rare cases, it is used to decrease sedation and lethargy from opioid pain medications and to help improve the mood of a terminally ill person suffering from depression.

Description

The mode of action for methylphenidate is not fully understood. It presumably activates the brain stem arousal system and cortex to produce a stimulant effect. The brain stem arousal system increases levels of electrical activity in the brain. The effect of methylphenidate is to produce increased alertness and, although children with ADHD are overactive and have decreased attention spans, in these children, methylphenidate actually decreases motor restlessness and increases attention span. Tablets are available in 5-, 10-, and 20-mg strengths, as well as in an extended release, 20-mg tablet.

Recommended dosage

The recommended dosage of methylphenidate is determined by trial and error based on individual responses. Methylphenidate is usually administered in two or three separate doses each day, preferably 45 minutes before a meal. For children suffering from ADHD, the initial recommended dosage is 5 mg twice daily before breakfast and lunch, increased by 5–10 mg per week to a maximum of 60 mg per day. The average total dosage is 20–30 mg per day, although 10–60 mg is not uncommon. For narcolepsy in adults, the recommended dose is 5–20 mg two to three times a day, 30–45 minutes before meals.

The drug should be taken exactly as directed. Methylphenidate can become habit forming if taken in greater amounts or for longer periods than necessary. Individuals should take the last dose of the day before 6 P.M. to decrease sleep difficulties. The tablet should not be broken or crushed, as this changes the time for absorption. If the normal time of administration is missed, people should take the drug as soon as possible. However, two tablets should not be taken at the same time.