Is Methylphenidate An Appropriate Medicine For ADHD?

ADHD, Featured | admin | November 25, 2009

Methylphenidate is a stimulant medication that aids in controlling the symptoms of ADHD. Only children who are at least six years of age and above are suitable for this medicine. Currently, in U.K., six branded and one unbranded forms of methylphenidate are currently available. In these forms, methylphenidate is an active ingredient of release in the body after the intake. These seven forms are:

Concerta XL by Janssen-Cilag
Ritalin by Novartis
Equasym and Equasym XL by UCB Pharma
Medikinet and Medikinet XL by Flynn Pharma
Generic methylphenidate (unbranded)

The Dos and Don’ts

Each human is physically different and so is its response to different medicines. This means that if a medicine is suitable for a child having ADHD, it would be wrong to think that the same medicine will be appropriate for other child having ADHD. Not only this, but also the age of your child and other situations plays an important role in deciding the suitability of any medicine. In a few cases of ADHD, it is found that instead of medications, behavioral and other therapies offer give good results. Therefore, there are certain dos and don’ts that need to be kept in mind for this medication.

The Dos

Use methylphenidate carefully when a single or a few of the following events/disorders has taken place.

A past of psychiatric disorder
A past of drug or alcohol addiction
High blood pressure
Epilepsy

The Don’ts

Methylphenidate should be avoided for children who:

Are under six years of age
Have anxiety or tension
Have personal or family history of involuntary muscle spasms (twitches or tics)
Have personal or family history of Tourette’s syndrome
Have hyperthyroidism or thyrotoxicosis
Have a tumor in the adrenal gland
Have compositional heart abnormalities
Have arrhythmia and severe chest pain
Have a disorder related to the heart and blood vessels
Have a disorder of brain’s blood vessels such as stroke and vasculitis
Have glaucoma (related to eyes)
Have a past of depression (even thinking of suicide)
Have a past of mania
Have type 1 bipolar disorder
Have past of mood disorders
Have a past of psychotic symptoms such as having abnormal thoughts or hearing something abnormal)
Have a history of schizophrenia
Have a psychopathic disorder
Have a past of anorexia nervosa
Have allergy to any items with which the tablet is made up of

Concerta XL and Equasym XL are not suitable for children who have difficulty swallowing, or who have any narrowing in their gastrointestinal tract, because the tablets must be swallowed whole.

Methylphenidate with Other Medications

Before the intake of this medicine, do not forget to inform your doctor about the other medicines that you must be giving to your child. These medications involve the ones that are used without any prescription, such as the herbal ones. In addition to this, you also need to consult your doctor or pharmacist before taking a new medicine if you have started the medication of dexamfetamine. Medicines that should not be taken with methylphenidate are:

Monoamine Oxidase Inhibitors (MAOIs)
These are antidepressants that are taken for treating depression and include phenelzine, tranylcypromine, isocarboxacid, and moclobemide that when given with methylphenidate inflicts negative conditions on the body. If methylphenidate needs to be given, it should be given only after 14 days from the last consumption of these antidepressants.
Cough and Cold Medications
Verify with the pharmacist before taking such medicines with methylphenidate, as they might contain certain ingredients that are not to be mixed with methylphenidate.

In addition, a low dose of the following medicines is necessary if they are to be taken with methylphenidate, as their level increases in the body due to methylphenidate.

Blood-thinning Medicines (Anticoagulants)
Warfarin
Antiepileptic Medicines
Phenytoin, Primidone, and Phenobarbital
Tricyclic Antidepressants
Imipramine

Side Effects of Methylphenidate

Like all medicines, methylphenidate too has side effects. However, it is not mandatory that all people taking it will experience these side effects. There are many side effects of methylphenidate. Listed are the side effects of methylphenidate, out of which the first five are the most common ones.

Difficulty in sleeping
Reduced appetite
Headache
Stomachache
Nervousness
Vomiting
Fever
Dry mouth
Dizziness
Drowsiness
Anxiety
Depression
Irritability
Hostility
Indigestion
High blood pressure
Increased heart rate
Scalp hair loss
Rashes or itching
Muscle twitches
Increased symptoms of ADHD
Loss in weight

This is not all. To be aware of all the possible side effects, you are required to go through the patient information leaflet that is obtained along with the medicine from a medical store. If you observe any of these side effects, consult your doctor without any delay.

Due to methylphenidate, your doctor needs to take care of the following aspects.

Weight Loss
Your child might lose weight temporarily, as this medicine results in reduced appetite. Therefore, as a precautionary measure, your child’s height and weight needs to be monitored.
Growth Issues
If in the long run, the growth is improper or the weight is not satisfactory, it is advisable to stop the intake of this medicine to cope up with growth problems.
Heart Issues
If there is any sign of chest pain when exercising, difficulty in breathing, or fainting with no obvious cause, immediately visit your doctor.
Blood Pressure Issues
There are chances of increase in the blood pressure or heart rate between the duration of taking this medicine. Therefore, as a precautionary measure, the blood pressure and pulse should be verified before the treatment and then continue checking it every six months or if there is a change in the dose.
Blood Cells Issues
The doctor might opt for blood tests on a regular basis to confirm that there is nothing wrong with the blood cells during the treatment.
Psychiatric Disorders
Children or adolescents must be monitored during the treatment with this medicine, as it is a cause of worst psychiatric disorders, such as depression, hostility, anxiety, psychosis, hallucinations, and mania. So, report any unusual changes in feelings, thoughts, and actions such as having thoughts of suicide, irritating others frequently, and frequent changes in mood to your doctor immediately.

It is necessary to avoid alcohol while taking this medicine.

Regular monitoring of children taking methylphenidate is necessary due to such critical side effects. It is recommended to the stop the intake of this medicine slowly after consulting to your doctor, as a sudden stop of intake can result in too much tiredness and depression. Actually, there is still a research going on the long-term effects of this medicine. So, the doctor might suggest you to stop the medicine at least once in a year and verify whether this medicine is further required.