Methylphenidate
Return to Methylphenidate overviewIt makes me feel slower and helps me focus with my work
Please do not be worried by the side effects listed on this page. Many people take methylphenidate without any side effects or only a few mild side effects. If you think you might be getting a side effect from methylphenidate, then you should discuss this with your doctor, nurse, or pharmacist
There are some young people who cannot take methylphenidate because of other conditions they have, or their family history:
- Heart or blood circulation problems
- ‘Tics’ (movements they cannot control), or someone in your family has Tourette’s syndrome
- Young people who have been dependent in the past on drugs or alcohol
- Epilepsy
- Other mental health conditions, like low mood (depression), personality problems, mania or anorexia nervosa
- Feeing like they want to hurt or kill themselves
- Thyroid problems
- Increased pressure in your eye (glaucoma)
- A tumour in your adrenal gland (phaeochromocytoma)
- An allergy to methylphenidate or the other ingredients of the medicines
Methylphenidate can sometimes affect your growth
- Your doctor will check your height and weight at least every 6 months when you are on methylphenidate
- Up to 1 in 10 children and young people who take methylphenidate might not grow as fast as their friends
- If this happens to you, your doctor might stop the methylphenidate for a while
Methylphenidate is a safe medication but rarely it can cause some serious side-effects.
Some side-effects that do appear should get better after a few days. If they do not, you should go back to your doctor
If you get any side effects not listed here please look at the patient leaflet in the medicine pack or speak to your pharmacist or doctor.
There are many possible side-effects when you start taking methylphenidate. Some people will have no side-effects and some people will have a few – it is hard to say which you will get as everyone is different. Most will get better after a few days, but if they do not and they are affecting your life, you should go back to the doctor.
Very common (could affect more than 1 in 10 people)
- headache – try paracetamol or talk to your pharmacist about options to help
- feeling nervous
- not being able to sleep
Common (could affect up to 1 in 10 people)
- dry mouth
- feeling unusually sleepy or drowsy
- loss of appetite or decreased appetite
- itching, rash or raised red itchy rashes (hives)
- high blood pressure, fast heart beat (tachycardia)
- feeling dizzy, movements which you cannot control, being unusually active
- feeling aggressive, agitated, anxious, depressed, irritable and unusual behaviour
- stomach pain, diarrhoea, or feeling sick or being sick. These usually occur at the beginning of treatment and may be reduced by taking the medicine with food.
Although this list of side-effects can look scary, some people won’t get any side-effects at all. Speak to your pharmacist or doctor if you think you are having side-effects from risperidone.
- There are other side-effects that you can get when taking this medicine – we have only included the most common ones here.
- Please look at the paper leaflet inside your medicine box, or ask a doctor or pharmacist, if you want to know if you are getting a side-effect from your medicine.
- If you want to stop taking methylphenidate, speak to your doctor to talk through the options available to you.
If you do get a side-effect, please think about reporting it to the Yellow Card Scheme.
Methylphenidate can interact with some other medicines and drugs
Do not take methylphenidate if you are taking a medicine called a ‘monoamine oxidase inhibitor’ (MAOI) used for depression, or if you have taken an MAOI in the last 14 days. Taking an MAOI with methylphenidate may cause a sudden dangerous increase in your blood pressure.
If you are taking other medicines, methylphenidate may affect how well they work or may cause side effects. If you are taking any of the following medicines, check with your doctor or pharmacist before taking methylphenidate:
- other medicines for low mood (depression)
- medicines for severe mental health conditions
- medicines for epilepsy
- medicines used to reduce or increase blood pressure
- some cough and cold remedies which contain medicines that can affect blood pressure (ask the pharmacist if you are buying one)
- medicines that thin the blood to prevent blood clots.
If you are not sure whether any medicines you have are in this list, please ask your doctor or pharmacist.
Tell the doctor if you are going to have an operation – you may need to stop methylphenidate for that day
- Methylphenidate does not mix well with some anaesthetics used in surgery.
- You need to tell the people who are going to do your operation, before the day it takes place.
- They may ask you not to take your methylphenidate on that day.
- If you take both together, it may make your blood pressure rise to a dangerous level.
Stopping the medication causes the balance of chemicals in the brain to alter
- Once you start taking methylphenidate, the brain adjusts to having a new level of noradrenaline and dopamine around.
- If you stop taking methylphenidate all at once, the balance starts to change again.
- You could get some unwanted symptoms from the change.
Stopping this medicine quickly, or reducing the dose too much at once, may cause uncomfortable symptoms
You can stop taking it safely with your doctor’s help
- You may feel uncomfortable withdrawal symptoms if you stop methylphenidate suddenly.
- It is better to agree stopping with a doctor who will reduce you gradually.
- Your ADHD symptoms could return, or the sudden drop in noradrenaline and dopamine in your brain could bring on symptoms of low mood (depression).
Withdrawal symptoms usually come on in a few days then wear off
- Go and speak to your doctor if you have missed a few doses or have decided to stop taking your medication.
- Withdrawal symptoms should stop after a few days. If they do not, or they are stopping you getting on with your life, you might need the help of a doctor.
- When you agree with your doctor to stop the medicine, you will carry on with a lower dose for a few days. This will stop you getting withdrawal symptoms.
Reference sources
- Ritalin® tablets SPC last updated 23/07/14 https://www.medicines.org.uk/emc/medicine/1316 Accessed 14/2/14
- Ritalin® tablets PIL last updated 27/08/13 https://www.medicines.org.uk/emc/medicine/4093 Accessed 14/2/14
- Concerta® XL 18-36mg tablets last updated 17/03/14 https://www.medicines.org.uk/emc/medicine/8382 Accessed 29/11/14
- Taylor D, Paton C, Kapur S. Maudsley Prescribing Guidelines in Psychiatry, 11th edition. Oxford: John Wiley & Sons, 2012.
- British National Formulary (BNF) 66th edition. London: BMJ Group / Pharmaceutical Press, 2013.
- British National Formulary for Children (BNFc) 2013-2014. London: BMJ Group / Pharmaceutical Press, 2013.
- WADA Prohibited List 2014. Available at http://www.wada-ama.org/Documents/World_Anti-Doping_Program/WADP-Prohibited-list/2014/WADA-prohibited-list-2014-EN.pdf (Accessed 31st January 2014)
- Neal MC. Medical Pharmacology at a Glance (7th Edition). Oxford: John Wiley & Sons, 2012.
- Royal Pharmaceutical Society of Great Britain. Medicines Ethics and Practice (37th edition). London: RPS, 2013.
- www.choiceandmedication.org (accessed 05/11/2016; content usually available for free via your mental health trust).
Common (affects less than 1 in 10 people)
- uneven heartbeat (palpitations)
- mood changes or mood swings or changes in personality
Uncommon (affects less than 1 in 100 people)
- thinking about or feeling like killing yourself
- feeling, or hearing things that are not real
- uncontrolled speech and body movements (Tourette’s)
- signs of allergy such as rash, itching or hives on the skin, swelling of the face, lips, tongue or other parts of the body, shortness of breath, wheezing or trouble breathing
Rare (affects less than 1 in 1,000 people)
- feeling unusually excited, over-active and un-inhibited (mania)
Very rare (affects less than 1 in 10,000 people)
- heart attack
- fits (seizures, convulsions epilepsy)
- skin peeling or purplish red patches
- muscle spasms which you cannot control affecting your eyes, head, neck, body and nervous system –due to a temporary lack of blood supply to the brain
- paralysis or problems with movement and vision, difficulties in speech (these can be signs of problems with the blood vessels in your brain)
- decrease in number of blood cells (red cells, white cells and platelets) which can make you more likely to get infections, and make you bleed and bruise more easily
- a sudden increase in body temperature, very high blood pressure and severe fits (‘Neuroleptic Malignant Syndrome’). (They are not sure whether this side effect is caused by methylphenidate or other drugs that may be taken in combination with methylphenidate.)
Other side effects (how often they happen we don't know)
- unwanted thoughts that keep coming back
- unexplained fainting, chest pain, shortness of breath (these can be signs of heart problems)
Some side-effects that do appear should get better after a few days. If they do not, you should go back to your doctor.
Don't stop taking Methylphenidate until you talk to your doctor or you may get withdrawal symptoms as well.