Friday September 30th 2016

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Can you die from taking Ritalin?

While uncommon, Ritalin may cause sudden death, heart attack or stroke in people with heart defects or serious heart problems. But what about overdose effects? How can you minimize the risks, even if you are taking Ritalin to get high?

More here on serious adverse side effects of Ritalin. Then, we invite your questions about Ritalin in the comments section at the end.

How Ritalin is typically used

Ritalin contains methylphenidate, a central nervous system stimulant drug that has become the primary drug of choice in treating Attention Deficit Hyperactivity Disorder (ADHD) in children. Paradoxically, the stimulant actually CALMS people diagnosed with ADHD. Side effects are usually mild and are generally well tolerated.

However, along with increases in prescribing frequency, the potential for abuse has increased. Intranasal abuse produces effects rapidly that are similar to the effects of cocaine in both onset and type. So, can these effects be serious enough to kill? Can you overdose from Ritalin and what are the symptoms?

Dangers of Ritalin ingredients

As the term “psycho stimulant” suggests, when the drug is taken, Ritalin (methylphenidate) initiates a series of chemical activities inside the user’s central nervous system. Once the bloodstream has picked up the amphetamines and they have been carried to the brain, the methylphenidate binds to the transporters used for the reuptake of dopamine into the presynaptic neurons. This binding blocks the reuptake of dopamine, causing its levels to rise within the synapses.

When part of the brain called the nucleus accumbens contains large quantities of dopamine, a “high” sensation is emitted. The drug also reduces the background firing of neurons, allowing a clearer signal to be transmitted through the brain, decreasing distractions. This mental high is very similar to that of cocaine. But with a high also comes possible adverse physical effects. Possible physical side effects of Ritalin include:

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  • appetite loss
  • dilated pupils
  • dry mouth
  • elevated blood pressure
  • increased heart rate
  • insomnia
  • nervousness
  • perspiration

Longer term side effects can consist of strokes and seizures as well. There have also been several deaths attributed to Ritalin abuse.

Ritalin and fatalities

Methylphenidate may cause sudden death in people diagnosed with heart defects or serious heart problems. This medication also may cause heart attack or stroke. Talk to your doctor about the risks of taking this medication.

FDA warnings about Ritalin

The FDA has warned that methylphenidate products can cause serious adverse side effects. Tell your doctor if:

  1. You have been diagnosed with heart related problems.
  2. You have experienced/are experiencing mental problems such as bipolar illness, aggressiveness, or psychotic symptoms.
  3. You experience circulation problems in fingers or toes.

In rare instances cause prolonged and sometimes painful erections known as priapism. Based on a recent review of methylphenidate products, the FDA updated drug labels and patient Medication Guides to include information about the rare but serious risk of priapism. If not treated right away, priapism can lead to permanent damage to the penis.

Signs of Ritalin overdose

Acute toxicity due to Ritalin (methylphenidate) overdose results in symptoms similar to those of acute amphetamine intoxication. Reports of psychiatric symptoms that have occurred include euphoria, delirium, confusion, toxic psychosis, and hallucinations. Such symptoms should not be unexpected as methylphenidate’s pharmacologic effects are basically the same as those of amphetamines. Cases of psychosis with methylphenidate abuse have been reported when the drug is used in “runs,” similar to amphetamine abuse.

Psychiatric symptoms of stimulant overdose may include hallucinations, delusions, paranoia, confusion, disorientation, and loose association of ideas. Psychotic symptoms usually arise with chronic abuse, but may also appear acutely with large doses of stimulants. These psychiatric and physical side effects resolve over a period of hours to weeks. The dose required to produce psychic or motor disturbance varies considerably. Some abusers may experience increasing effects after multiple doses (similar to sensitization), while others experience severe effects from small doses (reverse tolerance).

How to treat Ritalin overdose

Q: Can you OD on Ritalin?

A: Yes.

In case of overdose, call your local Poison Control Center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Serious adverse side effects of Ritalin

The methylphenidate found in Ritalin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • decreased sexual desire
  • diarrhea
  • difficulty falling asleep or staying asleep
  • dizziness
  • drowsiness
  • dry mouth
  • headache
  • heartburn
  • loss of appetite
  • muscle tightness
  • nausea
  • nervousness
  • numbness, burning, or tingling in the hands or feet
  • restlessness
  • stomach pain
  • uncontrollable movement of a part of the body
  • vomiting

Some other side effects can be serious. If you experience any of the following symptoms, call your doctor immediately or get emergency medical treatment:

  • abnormally excited mood
  • agitation
  • believing things that are not true
  • blistering or peeling skin
  • changes in vision or blurred vision
  • chest pain
  • depression
  • difficulty breathing or swallowing
  • erection that lasts longer than 4 hours
  • excessive tiredness
  • fainting
  • fast, pounding, or irregular heartbeat
  • feeling unusually suspicious of others
  • fever
  • frequent, painful erections
  • hallucinating (seeing things or hearing voices that do not exist)
  • hives
  • hoarseness
  • itching
  • mood changes
  • motor tics or verbal tics
  • numbness, pain, or sensitivity to temperature in the fingers or toes
  • rash
  • seizures
  • shortness of breath
  • skin color change from pale to blue to red in the fingers or toes
  • slow or difficult speech
  • swelling of the eyes, face, lips, mouth, tongue, or throat
  • unexplained wounds on the fingers or toes
  • weakness or numbness of an arm or leg

Are you taking too much Ritalin?

Methylphenidate can be habit-forming. Do not take a larger dose, take it more often, take it for a longer time, or take it in a different way than prescribed by your doctor. If you take too much methylphenidate, you may find that the medication no longer controls your symptoms, you may feel a need to take large amounts of the medication, and you may experience unusual changes in your behavior. If you or your child takes too much RITALIN or overdoses, call your doctor or poison control center right away, or get emergency treatment.

Help for Ritalin use or misuse

The use of methylphenidate by anyone other than the patient to whom it was prescribed needs to be addressed. The extreme consequences of abuse and addiction, resulting in legal repercussions, psychiatric symptoms and disorders, as well as death and homicide, need to be discussed seriously with a doctor, psychiatrist, or psychologist.

Prevention of methylphenidate abuse is a shared responsibility between a medical practitioner, parents, loved one and the patient. All participants in therapy need to be educated about the abuse potential of methylphenidate. Doctors need to address such issues as the consequences of excessive use or intranasal use as well as other abuse patterns.

Questions about Ritalin fatality

If you have any further questions about the dangers of using Ritalin, please leave them in the comments section. We will do our best to provide you with quick, personal answer.

Reference Sources: FDA: Medication Guide – Ritalin
FDA: Methylphenidate ADHD Medications: Drug Safety Communication – Risk of Long-lasting Erections
MedlinePlus: Methylphenidate
NCBI: Methylphenidate Abuse and Psychiatric Side Effects

Photo credit: Nemo

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