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Ritalin (methylphenidate), is a Central Nervous System (CNS) stimulant used in children and adults for attention deficit hyperactivity disorder (ADHD) or sometimes for narcolepsy. It helps to keep its users active and alert during their work or study. Ritalin has pharmacological effects like Amphetamines and cocaine. Ritalin is considered a safe drug when used according to the prescription and for the duration advised by the physician.

Despite being a prescription drug, Ritalin has a strong tendency to be abused or overdosed to stay active or to feel euphoric. When a person who is addicted to Ritalin abandons it abruptly, a withdrawal from the Ritalin appears. This is accompanied by several withdrawal symptoms from minor mood shifts to anxiety and depression. An abuser needs complete care at the hospital or rehab to get rid of these withdrawal symptoms and live a normal life. 

Ritalin can help its users get high. Ritalin has similar effects to that of Amphetamines due to which are also called “speed” or “uppers”. Ritalin is mostly used by students, professionals, and athletes to increase productivity as it increases alertness and concentration. As Ritalin is a prescription drug, it must be sold only over a prescription from a registered medical practitioner. But due to a wide range of benefits, the users start to give or sell their medicine to others who could get high due to the abuse of Ritalin

Ritalin is typically abused to enhance the stimulant effects it produces or to exacerbate some side effects such as euphoria that emerges only at higher doses of Ritalin. These effects do not usually occur when an ADHD patient uses Ritalin as it just tends to produce the therapeutic effects for which it was prescribed. The euphoric effect of Ritalin is usually more common in non-ADHD individuals. The negative effects of Ritalin have been faced by the people abusing this drug without a prescription, through inappropriate doses, snorting, or injecting it to get high. These negative side effects may include: 

  • Anxiety 
  • Chest pain 
  • Overdose 
  • Nausea 
  • Confusion 
  • Suppressed appetite 
  • Vomiting 
  • Hallucinations 
  • Seizures 
  • Headache 
  • Agitation insomnia 
  • Parasomnia 
  • Fatigue 
  • Nervousness 
  • Respiratory depression 
  • Hypersensitivity 
  • Panic attacks 
  • Altered heart rates 

The intensity of these side effects varies depending upon whether the individual is diagnosed with ADHD or not. If a person is taking Ritalin without ADHD diagnosis the side effects would be different and more intense. The symptoms may become more intense in people with mood disorders like bipolar disorder. Ritalin can trigger manic episodes in some individuals. 

Ritalin has a side effect of causing anxiety and depression. Ritalin when misused or overdosed to get euphoria or other pleasures, the user gets depressed. If you take Ritalin in a large dose, it makes a quick rise in the level of Dopamine in the brain. An increased level of Dopamine can produce a temporary feeling of euphoria. When you abruptly stop using Ritalin, it produces depression as a withdrawal symptom. It also worsens the symptoms of severe anxiety and agitation. 

The combination of Ritalin and Alcohol is an unsafe one. Ritalin is a CNS stimulant used to treat ADHD and narcolepsy while alcohol has sedating effects on the brain. Drinking alcohol while taking Ritalin can change the mechanism of action of Ritalin. For this reason, alcohol use is not considered safe while taking Ritalin. 

Interaction of Ritalin and Alcohol

Ritalin is a central nervous system (CNS) stimulant that works by increasing the levels of chemical messengers in the brain. These chemical messengers include dopamine and norepinephrine. Being a drug working on the CNS, it can also cause changes in the entire body. Ritalin can increase blood pressure, heart rate, breathing rate, and fever and also dilates pupils.  

Alcohol, on the other hand, is a CNS depressant. CNS depressants upon action, slow things down in the body. Alcohol makes it harder for you to talk or even causes you to slur your speech. It affects your coordination and impairs your balance. It has an impact on your thinking ability as well as controls impulses. Even though both Ritalin and alcohol have opposite effects, using them in a combination does not cause to cancel each other’s effects. Rather the effects of both these drugs combine to cause other complications. These complications include multiple side effects as well as the risk of a drug overdose, alcohol poisoning, and withdrawal of both the alcohol and Ritalin.  

Ritalin and Alcohol mixing side effects 

Combining Ritalin with alcohol can cause different problems which include:

  • Increases side effects of Ritalin and Alcohol 
  • Heart problems
  • Drug overdose 
  • Alcohol Poisoning 

Increased side effects 

Using alcohol along with Ritalin or drinking Alcohol after taking Ritalin causes an increase in the intensity of the side effects of both individual drugs. Alcohol changes the way the body deals with Ritalin. It can lead to higher amounts of Ritalin in the system which ultimately enhances the Ritalin side effects.    

The increased side effects can include: 

  • High blood pressure (Hypertension)
  • Racing heart rate
  • Sleep disorders
  • Mood problems (mood swings) 
  • Depression 
  • Anxiety 
  • Drowsiness 

Heart problems

Ritalin when in combination with alcohol cause or enhances several heart problems. These problems are intensified especially in those who already have heart problems. In serious cases, Ritalin and alcohol can cause 

  • Stroke 
  • Heart attack 
  • Sudden death 

Drug Overdose

When alcohol is used in combination with Ritalin, it increases the risk of a drug overdose. This is because alcohol causes a higher amount of Ritalin in the body. When you are drinking alcohol, Ritalin overdose can still be there if you are using the correct, prescribed dose.  

The risk of Ritalin overdosage is even higher when you take long-acting, extended-release dosage forms of Ritalin with alcohol. Due to ti alcohol, it can cause a rapid release of Ritalin from these extended-release forms at once.  

Alcohol Poisoning due to mixing Alcohol and Methylphenidate

Alcohol poisoning is yet another increased side effect of the Ritalin and Alcohol combination. As a CNS stimulant, Ritalin masks the CNS-depressant effects of alcohol. You may feel much more alert and be less likely to realize when you’ve had too much alcohol with Ritalin. In simple words, it makes it harder for you to tell how drunk you are. It may, as a result, let you drink more than usual leading to alcohol poisoning. This dangerous condition can lead to confusion, breathing problems, unconsciousness, and even death. 

Moreover, Ritalin and alcohol both have the potential for abuse, physical dependence, and a potency of addiction. Using both these substances together can cause significant damage to different organs of the body. Since Ritalin has a strong potential for abuse, people may be tempted to mix it with other substances like alcohol or other CNS drugs. 

Ritalin is used to stay alert and active during physical work. But due to its strong potential for abuse, Ritalin is misused and overdosed by the users. When a regular user of Ritalin makes an abrupt withdrawal from using it, severe withdrawal symptoms of Ritalin appear. 

Ritalin withdrawal symptoms 

Using alcohol and Ritalin together develops a physical dependency on both of these substances. It makes it essential for your body to take these substances regularly to work normally. So, when you stop using Ritalin or drinking alcohol you would face some withdrawal symptoms. Ritalin, being a CNS stimulant, causes psychological symptoms during its withdrawal. As Ritalin works by enhancing Dopamine levels in the brain, Ritalin withdrawal symptoms are related to reward, emotions, and energy level. You may feel different sorts of feelings like apathetic, depressed, anxious, irritable, and tired. Other withdrawal symptoms of Ritalin may include: 

  • Loss of focus 
  • Anxiety 
  • Tremors 
  • Irritability 
  • Fatigue 
  • Hyperactivity 
  • Nausea 
  • Dizziness 
  • Sweating 
  • Tiredness 
  • Mood swings 
  • Depression 
  • Sleeping problems
  • Changes in blood pressure 
  • Changes in heart rate 

Anhedonia: 

In some cases, depression caused by Ritalin withdrawal can lead to a condition called anhedonia. This is the inability to feel pleasure. It can be temporary or can even lead to suicidal thoughts or actions. Extreme depression symptoms or suicidal thoughts could be caused by a severe chemical imbalance.  

Methylphenidate withdrawal duration

Methylphenidate (Ritalin) when abandoned abruptly by regular users results in severe withdrawal symptoms. These symptoms are in a variety of both physical and mental complications. These symptoms last from a few days to even a month depending upon the severity of the symptoms and rehabilitation process being used. Ritalin withdrawal can occur in different stages.  

Stages of Ritalin Withdrawal Timeline 

  • 72 hours: After the last dose of Ritalin, the first symptom may show up within the first 72 hours. If you were a user of a high dose for a long time, these symptoms may appear during the first 24 hours. These initial and early symptoms may include sleep problems, irritability, and anxiety. Craving for drugs may also be observed.
  • 7 days: The intensity of the symptoms would increase over the first week of Ritalin withdrawal and the symptoms will likely reach their peak intensity when the withdrawal period is over. Symptoms during this phase can include insomnia, nausea, fatigue, and depression. 
  • 2 weeks: By the 2nd week, these withdrawal symptoms will start to subside. Psychological symptoms stay longer than the physical one and here come the anxiety and depression. Craving may become more intense.
  • I month: Certain symptoms like anxiety or depression may exist for more than a month. At this stage, there is a need to attend addiction treatments to cope with drug cravings and psychological symptoms.  

Ritalin withdrawal and overdose treatment are quite different from each other and require different procedures. People with a Ritalin addiction have brain cells that work best in the presence of Ritalin. No medication can be used for the treatment of Ritalin withdrawal but according to the National Institute of Drug Abuse withdrawal of Ritalin can be controlled by the following methods: 

Ritalin withdrawal Treatment

Treatment of Ritalin withdrawal is a long-term process. Following are the steps of treatment of Ritalin Withdrawal:

Detoxification process:  

Options for help to treat Ritalin withdrawal are also known as detoxification from Ritalin.The detoxification process is the initial step in quitting the illicit use of methylphenidate. There is no need for constant monitoring during the detoxification process. Withdrawal treatment of Ritalin can be competed either in an inpatient or outpatient, at a clinic, or in a hospital. Monitoring may be necessary if the patient is experiencing severe depression or suicidal thoughts. Inpatient rehab center: an inpatient program may be more beneficial when there is severe depression. If a person becomes so uncomfortable during the rehab process that he or she restarts abusing Ritalin. People who got troubled sticking with the detoxification process may benefit from the inpatient program.  

Addiction Treatment, and Recovery

After the detoxification, the long-term aspects of addiction treatment and recovery can be discussed. Similar to the detox phase, addiction treatment and recovery can also take place at an inpatient or outpatient rehab center t a clinic or hospital. Both rehab and recovery involve individual or group counseling. During the counseling sessions, different therapies are used including cognitive-behavioral therapy, user-specific techniques, and other psychological therapies are used. 

Ritalin Overdose Treatment

Ritalin when overdosed by a user needs immediate treatment to cope with the gradual addiction to the Ritalin as well as the immediate symptoms that may appear to be fatal. For a Ritalin overdose, the user may receive intravenous fluids and medication that calm can calm down the user, reduce their blood pressure, and stabilize the heart rate and rhythm. The user may be cooled down with ice packs, mists, and fans. In case the person starts to have seizures, additional treatment such as benzodiazepines may be given. Medications may also be given to reduce paranoia, delusions, and hallucinations. The patient may be given activated charcoal to absorb more of the drug.  

The other steps include: 

  • Medical detox (Residential or inpatient)
  • Recovery from an overdose 
  • Twelve-step rehab program

Thus the treatment from a Ritalin overdose is a long process and can be completed with essential care. 

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