Starting Ritalin what to expect as an adult

Have you been diagnosed with adult attention deficit hyperactivity disorder (ADHD)? Are you exploring first-time or new medication options? Maybe your healthcare provider is suggesting starting Ritalin (methylphenidate), and you’re wondering when starting Ritalin what to expect as an adult.

In this post, we cover everything you need to know about starting Ritalin as an adult, including:

• How Ritalin works
• Ritalin’s effects on the body
• What taking Ritalin to manage ADHD symptoms feels like
• Potential side effects of Ritalin
• Possible drug interactions with other medications
• How to use Ritalin properly to manage your ADHD symptoms

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How Ritalin works

Ritalin is a neuro-stimulant medication that was first U.S. Food and Drug Administration (FDA)-approved to treat ADHD in adults in the mid-1950s. Ritalin is proven safe and effective and considered the first-line drug for treating ADHD.

Ritalin increases the levels of dopamine and norepinephrine in your brain. These 2 neurotransmitters are essential chemical messengers partially responsible for regulating motivation, action, and cognition.

What does dopamine do?

Dopamine is a critical neurotransmitter in the reward system of the brain. As a result, dopamine levels directly affect a person’s motivation, memory, and ability to learn, alongside other factors. Dopamine also plays a smaller role in your body’s fight-or-flight response.

Dopamine helps regulate the following:

• Pleasurable reward and motivation
• Behavior and cognition
• Sleep and arousal
• Mood
• Learning
• Attention
• Movement
• Memory

What does norepinephrine do?

Norepinephrine is both a hormone and a neurotransmitter. It plays a vital function all over the body, helping trigger the fight or flight response across multiple organ systems. 

As a neurotransmitter, norepinephrine helps regulate:

• Wake and sleep cycles
• Alertness
• Increasing attention and maintaining focus
• Memory storage
• Mood 

As a hormone, norepinephrine helps your body physically adapt to stress:

• Dilates pupils
• Increases heart rate and blood pressure
• Increases blood flow and oxygen to muscles
• Deepens breathing
• Improves energy

The effects on the body from Ritalin in adults

Even though Ritalin works primarily by increasing neurotransmitter levels in your brain, its effects are felt throughout the body due to norepinephrine and dopamine’s role in regulating the fight or flight response across multiple organ systems. 

Central nervous system effects from Ritalin 

In adult ADHD patients, Ritalin improves concentration, decreases restlessness, and increases attention span. It can, however, increase irritability and anxiety in some patients and may lead to depression.

Stimulants, including Ritalin, may cause you to experience blurry vision. The stimulant effects of Ritalin can also cause insomnia and lead to daytime drowsiness. If you experience any of these unwanted side effects, be sure to let your doctor know immediately. 

Circulatory system effects

Increased body temperature, heart rate, and blood pressure can happen when taking Ritalin. If you have a known heart condition or a history of hypertension (high blood pressure), you may not be able to use Ritalin. These side effects are typically temporary for patients without these conditions and will subside after a few weeks. 

If you notice that your toes and fingers are cold or have bluish discoloration, it may indicate that Ritalin is causing peripheral circulatory problems. Let your doctor know immediately.

Digestive system effects when starting Ritalin as an adult

Ritalin can decrease appetite, which may lead to unintentional weight loss. Some patients initially develop nausea and diarrhea when starting Ritalin; however, these side effects typically subside with continued medication use.

Respiratory system effects

Rapid breathing can be common when you start Ritalin but should diminish within a few days of starting Ritalin. If rapid breathing persists, talk to your healthcare provider.

Muscular and skeletal system effects

Ritalin can cause muscle weakness and pain as well as joint discomfort. These symptoms usually happen if you’re using too much Ritalin, which may mean your Ritalin dose needs adjusted or you should stop taking it.

Reproductive system effects from Ritalin in adults

After prolonged use of Ritalin or when the dose is increased, some men can have long, painful erections. This condition, known as priapism, may require medical intervention. 

Starting Ritalin — what to expect as an adult

Adult ADHD patients starting Ritalin typically describe feeling focused, in control, and having a sense of clarity. As a stimulant, Ritalin can make you feel “up,” alert, awake, filled with a sense of euphoria, or more talkative. All of these feelings can be helpful to carry out daily activities and tasks and make you more efficient and effective. 

On the other hand, note if you become agitated, irritable, or aggressive, your skin feels tingly, or you feel like electricity is running through you. You may be “overstimulated” and should discuss these symptoms with a board-certified ADHD-trained medical provider.

Ritalin side effects in adults

As with all medications, Ritalin can cause side effects. Most of these side effects are temporary and can be safely managed with the help of your healthcare provider. Side effects when taking or starting Ritalin as an adult include:

• Fast heart rate
• Headache
• Trouble sleeping
• Anxiety
• Excessive sweating
• Weight loss
• Decreased hunger
• Dry mouth
• Irregular heartbeat
• Nausea
• Stomach pain
• High blood pressure
• Painful erections 
• High blood pressure
• Unexplained wounds appearing on fingers or toes

Ritalin is habit-forming and can lead to substance use disorder if misused

As a Schedule II stimulant, Ritalin and generic methylphenidate are classified as a controlled substance by the Drug Enforcement Administration (DEA). This means it has the potential for abuse and dependence. 

Though Ritalin is effective for managing the symptoms of ADHD, it should only be used as prescribed and under the guidance of a healthcare professional.

Signs of Ritalin dependence may manifest in different ways. Individuals may find that they require higher doses of the medication to achieve the desired effects over time, or they might experience withdrawal symptoms when they stop taking Ritalin. 

Ritalin isn’t the only Schedule II stimulant that carries these risks. Other stimulant medications in this class include: 

• Concerta (methylphenidate): a stimulant medication, like Ritalin, that’s chemically different from amphetamines but has similar effects.
• Adderall (amphetamine/dextroamphetamine): a stimulant used for both ADHD and narcolepsy
• Dexedrine (dextroamphetamine): an amphetamine medication used for ADHD and narcolepsy.
• Vyvanse (lisdexamfetamine): a prodrug that remains inactive until metabolized in the body and is prescribed for ADHD and binge eating disorder.
• Desoxyn (methamphetamine): a potent central nervous system stimulant is used in rare instances to treat ADHD and obesity treatment.

Fortunately, when used as directed by a healthcare professional, the risk of developing a Ritalin dependence is reduced. It’s important to be open with your healthcare providers when being prescribed Ritalin to ensure this medication is the best one for you.

Ritalin withdrawal

You can have Ritalin withdrawal symptoms if you stop taking Ritalin or generic methylphenidate abruptly. Symptoms of withdrawal can include:

• Fatigue and lethargy
• Depression or anxiety
• Irritability or agitation
• Difficulty sleeping or insomnia
• Increased appetite
• Headaches
• Difficulty concentrating or remembering
• Flu-like symptoms such as muscle aches and pains, chills, and sweating

Symptoms of withdrawal can vary in severity depending on your dosage of Ritalin and the length of time you’ve taken it. You’re more likely to have symptoms of withdrawal if you’ve been on high doses for a long time and have developed some tolerance.

The best way to minimize potential withdrawal is to gradually lower your dose with your healthcare provider’s guidance. This lets your body adjust to the lower dosage of Ritalin more slowly and may help reduce the severity of withdrawal symptoms.

Drug interactions to know about before starting Ritalin

• Antidepressants: some antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs), can increase the levels of Ritalin in the body, which can lead to a greater risk of side effects, like high blood pressure, heart palpitations, and insomnia.
• Blood pressure medications: certain blood pressure medications, such as beta-blockers, can interfere with the effectiveness of Ritalin and decrease its ability to control symptoms of ADHD.
• Antipsychotics: Antipsychotic medications can interfere with the effectiveness of Ritalin and decrease its ability to control symptoms of ADHD.
• Seizure medications: some seizure medications, such as phenytoin and carbamazepine, can increase the metabolism of Ritalin, which can lower its effectiveness.
• Antacids: antacids can increase the absorption of Ritalin, leading to higher levels of the drug in the body and an increased risk of side effects.
• Monoamine oxidase inhibitors (MAOIs): When taken with Ritalin, MAOIs can increase the effects of Ritalin and lead to potentially life-threatening side effects, such as high blood pressure, fever, seizures, and coma. Ritalin shouldn’t be taken with MAOIs or within 14 days of stopping MAOI treatment, as there may be a risk of a dangerous drug interaction.

It’s important to talk to your healthcare provider about any medications or supplements you take, including over-the-counter products, to ensure they are safe to take with Ritalin and other central nervous system stimulants.

Your provider can help you avoid drug interactions and adjust your medication regimen.

Talk to a board-certified ADHD-trained medical provider about Ritalin

Starting any new medication requires self-education and preparation. Before taking Ritalin or another ADHD treatment to manage your ADHD symptoms, you want to talk to an ADHD specialist who can help you create an effective treatment plan.

On Klarity Health, find an ADHD-trained mental health provider who can diagnose and prescribe ADHD treatments like Ritalin in 24 hours or less.* Find an ADHD provider now.