Known brand names include Ritalin.
A stimulant tablet (Schedule II controlled substance) for ADHD in children 6 and older and adults, and for narcolepsy. It raises dopamine and norepinephrine activity in the brain, and it carries a boxed warning for abuse, misuse, and addiction.
Methylphenidate stops nerve cells from taking back two chemical messengers, dopamine and norepinephrine, after they are released. It also pushes more of both messengers out into the space between nerve cells, so their signals grow stronger. The tablet is a mix of two mirror-image forms of the drug, and one of them, the d-form, does most of the work. The label notes that exactly how this improves ADHD and narcolepsy is not known.
Taken by mouth, it reaches its highest level in the blood about 2 hours after a dose, and food does not change how much is absorbed. The body breaks most of it down into an inactive form that leaves in the urine. Because it stimulates the nervous system, it raises blood pressure and heart rate and can make it hard to sleep. It can also be misused and lead to addiction, and the risk of overdose and death rises at higher doses or when it is snorted or injected.
Methylphenidate treats attention deficit hyperactivity disorder (ADHD), a condition in which a person has trouble paying attention, controlling behavior, and staying still or quiet. It also treats narcolepsy, a sleep disorder that causes heavy daytime sleepiness and sudden attacks of sleep. It belongs to a group of medicines called central nervous system stimulants.
The tablets are taken by mouth by adults and by children 6 years and older with ADHD. For ADHD, it is used within a larger treatment program that may also include counseling and special education. It has not been shown to be safe or effective in children younger than 6, and it has not been studied in older adults. If symptoms do not improve after about a month of dose adjustments, the label says to stop it.
Trouble sleeping, less appetite and weight loss, stomach pain, nausea, headache, dry mouth, sweating, anxiety, and a fast or pounding heartbeat are the most common effects. In children, long-term use can slow growth in height and weight. The label's boxed warning is about abuse, misuse, and addiction, which can lead to overdose and death. It also warns about sudden death in people with serious heart problems, higher blood pressure, new psychosis or mania, painful erections that will not go away, poor blood flow to the fingers and toes, eye pressure problems, and new or worse tics.
This is the boxed warning, the warning the FDA label prints first.
Abuse, misuse, and addiction. Methylphenidate has a high potential for abuse and misuse that can progress to a substance use disorder, including addiction. Misuse can cause overdose and death, with higher risk at higher doses or when snorted or injected. Assess abuse risk before prescribing, teach patients and families about safe storage and disposal, and keep reassessing and monitoring for signs of misuse throughout treatment.
Sources: [1]