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Ritalin (Methylphenidate): Pros and Cons

What is Ritalin?
Methylphenidate, usually known by the trade name Ritalin, is one medicine used to treat the symptoms of Attention Deficit Hyperactivity Disorder (ADHD). Some children with ADHD do well using behavior training methods, and may not need a medicine. For other children, Ritalin can improve attention, focus, goal-directed behavior, and organizational skills. As with any medicine, there are pros and cons to its use.

How does Ritalin work?
Ritalin is a stimulant medicine. Since children with ADHD are already over-stimulated, it is hard to understand how a stimulant drug will help to calm them down. Researchers think that the area of the brain that controls when to pay attention to certain activities and when to ignore other ones is immature and works poorly in people with ADHD. Ritalin stimulates those areas of the brain so that the child can better pay attention and focus on his activities.

What are the pros?
Ritalin works quickly so you'll know if it will help or not. The dosage may have to be adjusted by your health care provider. It is fairly inexpensive and has been used for many years. If your child is having problems with attention, focus, and being overactive in school, stimulant medicine may provide some relief. Benefits of Ritalin often include:

less trouble finishing classwork and homework
less fidgeting or squirming
better control of emotions
less impatience and impulsiveness
better relationship with family and friends
increased self-esteem.
What are the cons?
Many parents do not like the idea of medicating their child for any length of time. As with any medicine, Ritalin can have side effects. Some children will have few or no side effects. Other children may have to stop using Ritalin because of the side effects.

Some common side effects include:

decrease in appetite
headaches
insomnia
irritability
stomachaches.
Some children may become more active in the evening after the medicine has worn off. This can be an ordeal for families who are tired and stressed out at the end of the day. Some children will have problems sleeping.

Rarely, Ritalin causes high blood pressure, weight loss, or growth delays. One to two percent of children on stimulant medicine may make tics worse. Tics are twitching movements of muscles in the face. They go away if the medicine is stopped. A few children who take Ritalin don't like the way it makes them feel. Most, however, like being better able to concentrate on schoolwork and control their activity level.

About 25% of children with ADHD do not respond to Ritalin, although some of these children will benefit from other ADHD medicines.

Should my child take Ritalin?
There are several treatment approaches for ADHD other than medicine, such as:

changes to the child's education program
cognitive-behavioral therapy
parent education
social skills training.
Discuss the decision to medicate your child with your child's health care providers, school counselors, and teachers. Decide with your doctor if your child's symptoms are causing enough problems that a trial of this medicine is needed.

Ritalin is not a cure. There is no cure for ADHD, though medicine can help manage some of the symptoms. If you decide to try Ritalin, plan a 1 to 4 week trial period. Your child is usually given a small dose at first, so it may be necessary to increase the dose. Be sure to have several people that interact with your child complete rating scales that relate to ADHD behavior after your child has been on the medication for a few weeks. Even if you do decide to try Ritalin, be sure to seek educational and behavioral methods that may help your child as well.

Written by Robert Brayden, MD, Associate Professor of Pediatrics, University of Colorado School of Medicine.
Published by McKesson Provider Technologies.
Last modified: 2004-09-21
Last reviewed: 2004-08-10
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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