Children with ADHD become calmer and can concentrate better with methylphenidate. When should Ritalin, Medikinet or other methylphenidate products be used to treat ADHD, how do they help and are side effects to be expected?
- Ritalin, Medikinet and other medicines with the active ingredient methylphenidate are very effective in the pharmacological therapy of the symptoms of ADHD.
- © iStockphoto.com/nensuria
Ritalin is the drug of choice in the treatment of Attention Deficit Hyperactivity Disorder (ADHD). Ritalin and Medikinet are commercial names for drugs whose main active ingredient is methylphenidate. It has a stimulating effect and promotes concentration and performance. How does Ritalin work with ADHD and are side effects to be expected?
At a glance:
Brain: myths and surprising facts
Methylphenidate: what is Ritalin?
Methylphenidate is a prescription, stimulating drug that has a positive effect on stimulus processing and thus increases cognitive performance. Because of their performance-enhancing effects, methylphenidate supplements such as Ritalin are prescribed for ADHD. About one percent of children and adolescents are treated with methylphenidate preparations. The number of prescriptions is increasing, especially in the treatment of ADHD in adolescents and adults.
Methylphenidate is also used to combat daytime sleepiness in the sleeping sickness narcolepsy.
Effect: How does Ritalin work?
Methylphenidate stimulates the sympathetic nervous system, thus increasing performance – both physically and mentally. Methylphenidate in drugs such as Ritalin or Medikinet blocks dopamine and norepinephrine reuptake. This increases the dopamine level. Dopamine is a neurotransmitter in the brain that is used, among other things, for
- Concentration,
- Perception and
- Ability to learn
important is.
Taking dopamine in its pure form is not worth it. Because the neurotransmitter cannot cross the blood-brain barrier and therefore cannot work in the brain. We are therefore solely dependent on the dopamine that the body forms in the nerve cells themselves. Dopamine is constantly being built up and broken down here. Only when the breakdown is slowed down, such as by taking methylphenidate, does the dopamine level increase and the performance increases.
How long does methylphenidate work?
The effect of methylphenidate occurs within about 40 minutes and reaches the highest concentration in the blood after about two hours. The normal duration of action of methylphenidate is only three to four hours, which necessitates repeated administration throughout the day. In the meantime, prolonged-release medications have become established that are taken once to a maximum of twice a day. They are suitable for children as well as for teenagers and adults.
When to treat ADHD with Ritalin?
ADHD is defined as a behavioral and emotional disorder. Parents of affected children recognize them by, among other things, "not being able to sit still" and a lack of ability to concentrate on one thing for longer. If left untreated, these factors can lead to massive problems both at home and at school, as well as in social behavior.
In Germany, drugs with methylphenidate are usually only given when the symptoms are pronounced and other treatment measures – including psychoeducative, psychosocial and psychotherapeutic – have not been sufficiently successful or have not been able to be implemented.
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How parents can tell whether their child's hyperactivity or lack of concentration is still normal or is already a sign of ADHD.
to the ADHD test
Hyperactive children, adolescents and adults can sit quietly and concentrate for a few hours by taking Ritalin. This means that normal attention in school lessons or everyday work is possible again. Those affected also find it easier to connect socially. In addition, behavioral therapy measures can often be carried out more effectively with drug administration in some cases.
In a randomized-controlled study from 2011 to 2014, neurofeedback therapy and the effects of physical activity were compared with the effectiveness of methylphenidate therapy. For three and a half years, the effects of the therapy methods used alone were assessed by the parents and teachers of the test subjects. The results showed that the drug therapy module – at least when the treatments are viewed individually – is the most effective at alleviating the symptoms of ADHD.
Another study has shown that methylphenidate is also superior to pure psychotherapy, but especially the combination of psychotherapy and drug ADHD treatment can best alleviate symptoms in children and adults (multimodal therapy).
The use of the drug that interferes with the brain metabolism should nevertheless be carefully considered individually, since serious side effects – especially with overdose – can occur.
How does Ritalin work in ADHD?
The active ingredient does not address the causes of ADHD, but can only suppress the symptoms. People with Attention Deficit Hyperactivity Disorder have a brain metabolism disorder, and therefore a dopamine and norepinephrine signaling disorder. The effect of methylphenidate compensates for this deficit and makes it easier for those affected to concentrate normally.
Methylphenidate must never be discontinued on your own
The taking of Ritalin and other medications with the active ingredient methylphenidate must not be stopped automatically or suddenly or stopped. Otherwise there is a risk of a rebound. This means that after stopping a drug, the symptoms of the disease become more pronounced. In ADHD, the rebound goes about with increased movement and restlessness hand in hand. In addition, mood swings up to depressive mood can appear.
Where can you get Ritalin?
Ritalin is not easy to buy in pharmacies. The active ingredient methylphenidate falls under the Narcotics Act and is therefore subject to a prescription. In Germany, these drugs are approved for the supplementary treatment of ADHD in children from the age of six.
The active ingredient methylphenidate contained in Ritalin belongs to the group of amphetamines. The pharmacist Leandro Panizzon, who first synthesized methylphenidate in the 1940s, tested every newly developed substance on himself and his wife Rita. This is said to have been so enthusiastic about methylphenidate that Ritalin was chosen as the trade name. Today there are many other drugs with the active ingredient methylphenidate besides Ritalin, for example:
- Medikinet
- Concerta
- Equasym
- Metadata
- various generics
Since methylphenidate promotes concentration and thus memory and learning ability, Ritalin has also established itself as a drug. The transition from medication to drug is fluid. There is a risk of addiction if Ritalin is intentionally overdosed.
Side effects of Ritalin
In rare cases, methylphenidate can trigger side effects – even when used by the doctor. These include:
With improper, too high dosage – for example, if methylphenidate is misused as a drug or for brain doping – the following side effects can occur:
The amounts that are recommended for children with ADHD are largely harmless and are completely sufficient for the desired effect.
Important:
If the patient is taking it continuously, an outlet attempt should be made once a year in consultation with the treating doctor to check whether the preparation is still working.
Methylphenidate should never be discontinued on your own and the dosage should only be changed under medical supervision.
In addition, methylphenidate should not be taken during pregnancy and lactation, as possible negative effects on the unborn or newborn cannot yet be excluded.
