Ritalin (Methylphenidate) Addiction: Side Effects, Signs of Withdrawal, and Overdose

What is Ritalin (Methylphenidate)?

Ritalin is a brand name for methylphenidate, a central nervous system stimulant medication. As previously mentioned, it’s approved by the U.S. Food and Drug Administration (FDA) for the treatment of ADHD and narcolepsy.¹

When taken as prescribed for approved conditions, Ritalin is considered safe and effective. However, because many people misuse the drug—taking it in a way other than it was prescribed, taking someone else’s prescription, or taking the medication to get high—methylphenidate is classified as a Schedule II substance under the Controlled Substances Act.^3,4

Typically prescribed in a tablet form for oral administration, Ritalin comes in both immediate and extended-release versions.¹

While the precise therapeutic mechanism of prescription stimulants, including Ritalin, is not fully understood, Ritalin is known to influence various neurotransmissions—or chemical signals—within the brain. By increasing activity within both norepinephrine and dopamine neurotransmitter systems, Ritalin impacts the reward/reinforcement effects but because it is a stimulant and acts on norepinephrine, it also affects blood pressure, heart rate, and blood sugar.³

Common Side Effects of Ritalin

Like most prescription drugs, Ritalin use is associated with potential side effects, even when taken as directed. Common side effects include:¹

• Rapid  or abnormal heartbeat or palpitations.
• Headache.
• Sleep issues.
• Nervousness.
• Excessive sweating.
• Decreased appetite.
• Dry mouth.
• Nausea.
• Stomach pain.

Adverse Effects of Ritalin

People who misuse prescription medications, like Ritalin, are at an increased risk of adverse, potentially dangerous effects, including:^1,3,5

• Serious cardiovascular events. Though rare, there have been reports of sudden death, stroke, and heart attack in individuals with preexisting cardiac abnormalities, cardiomyopathy, and serious heart arrhythmias—even when Ritalin is taken at therapeutic doses. However, long-term, high-dose use has been associated with cardiac failure, irregular heartbeat, and high blood pressure.
• Adverse psychiatric reactions. Studies show that prescription stimulant medications, such as methylphenidate, may cause or worsen psychotic or manic symptoms in individuals with and without preexisting mental illness. Higher doses and other misuse can lead to the development of paranoia, anxiety, psychosis, hostility, aggression, and suicidal or homicidal ideation.
• Overdose. Taking too much methylphenidate at once can result in acute overdose. Combining Ritalin with other medications (prescription and over-the-counter drugs) or substances can increase the risk of overdose.
• Psychological and/or physiological dependence. Abrupt cessation or rapid dose reduction of Ritalin in someone who has become dependent from prolonged, high-dose use can lead to the manifestation of withdrawal symptoms, which can be extremely uncomfortable.

Is Ritalin Addictive?

As previously mentioned, Ritalin is classified as a Schedule II substance due to its high risk of misuse and dependence.^1,4 Long-term Ritalin misuse can increase an individual’s chances of developing a stimulant use disorder, the clinical term for a stimulant addiction.³

According to the American Society of Addiction Medicine (ASAM), addiction is a treatable, chronic medical disease characterized by compulsive and uncontrollable use despite the development of harmful consequences.⁶

Addiction, a brain disorder, develops due to functional changes in the brain that occur from ongoing substance use.⁷ One of the key chemicals involved with the development of addiction is dopamine. Scientists believe that surges of dopamine make individuals repeat pleasurable activities; thus, creating reinforcement. And as previously mentioned, stimulants, like Ritalin, result in increased levels of dopamine.⁸

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Signs of Ritalin Addiction

Qualified medical professionals diagnose Ritalin addiction as a stimulant use disorder  based on the criteria found in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5).¹⁰ While only a medical professional can provide a diagnosis, it can be helpful to know the diagnostic criteria so that you know when it might be time for you, or someone you care about, to consider seeking professional help.

The criteria for a stimulant use disorder diagnosis includes:¹⁰

• Taking the stimulant in larger amounts or over a longer period than was intended.
• Experiencing a persistent desire or unsuccessful efforts to cut down or control stimulant use.
• Spending a great deal of time obtaining, using, or recovering from the effects of the stimulant.
• Craving, or a strong desire or urge to use the stimulant.
• Failing to fulfill major role obligations at work, school, or home because of recurrent stimulant use.
• Continuing stimulant use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by it.
• Avoiding or cutting back on attending important social, occupational, or recreational activities because of stimulant use.
• Using stimulants in physically hazardous situations, such as while driving a car.
• Continuing stimulant use despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the stimulant.
• Developing tolerance, which is defined as either a need for markedly increased amounts of the stimulant to achieve intoxication, or a significantly diminished effect with continued use of the same amount of the stimulant.
• Experiencing withdrawal symptoms when stimulant use suddenly stops or is drastically reduced.

To receive a stimulant use disorder diagnosis, individuals need to meet at least 2 of above criteria within a 12-month period:¹⁰ Note that neither tolerance nor withdrawal count as criteria to support a diagnosis of stimulant use disorder in instances of those taking Ritalin or similar stimulant medications exclusively under appropriate medical supervision, such as prescribed for ADHD treatment.

Ritalin addiction can vary in severity, depending on the number of criteria a person displays. For example, someone who meets 2 or 3 of the above criteria may be diagnosed with a mild stimulant use disorder, 4 or 5 would likely be diagnosed as moderate in severity, and 6 or more would be a severe stimulant use disorder.¹⁰

According to the 2022 National Survey on Drug Use and Health, 1.8 million people aged 12 and older had a prescription stimulant use disorder.¹¹

Can You Overdose on Ritalin?

Yes, as previously mentioned, it is possible to overdose on Ritalin.¹ If too much Ritalin is taken at one time, acute overdose can occur. Symptoms associated with Ritalin overdose can include:¹

If you suspect that you or someone else may be experiencing a Ritalin (or other substance) overdose, call 911 and remain with the individual until medical help arrives.^1,12

Ritalin Withdrawal Symptoms

As previously mentioned, individuals, who become physiologically dependent on Ritalin can develop withdrawal symptoms if they suddenly stop or drastically reduce their use.¹⁰

Ritalin withdrawal is not typically a life-threatening condition, but it can be uncomfortable and unpleasant. Withdrawal symptoms may include:¹

• A depressed mood.
• Fatigue.
• Vivid nightmares.
• Insomnia (sleeping too little) or hypersomnia (sleeping too much).
• An increased appetite.
• Psychomotor retardation (slowed physical movements or thought processes) or agitation (heightened brain activity and physical activity).

Treatment for Ritalin (Methylphenidate) Addiction

While there are currently no FDA-approved medications to treat stimulant use disorder, some medications are being used on an off-label basis—depending on the stimulant—to help individuals reduce substance use and promote abstinence.¹³

Stimulant use disorder treatment typically involves behavioral therapies, which help individuals change their unhealthy patterns of thinking and behavior and teach them strategies to manage cravings and prevent relapse.¹⁴ A comprehensive treatment program can effectively help individuals safely stop using Ritalin, cultivate and maintain a substance-free lifestyle, and resume productive functioning in their lives.¹⁵

Ritalin addiction treatment may take place in different settings and involve one or more levels of care in an inpatient or outpatient rehab.¹⁵ Inpatient, which is sometimes referred to as residential treatment, means living at the facility for the duration of treatment. Outpatient treatment, on the other hand, allows an individual to live at home or in a sober living environment and, in most cases, continue with their daily home, work, or school responsibilities.¹⁵

The setting that is right for your needs is determined during a comprehensive evaluation, which takes into account all of your unique needs, including any associated medical, psychological, social, vocational, and legal problems, as well as your age, gender, ethnicity, and culture.^15,16

Generally speaking, individuals with more severe addictions and co-occurring disorders may benefit most from an inpatient setting. Outpatient rehab may be suitable for those with less severe addictions, who have access to reliable transportation, and have a strong support network.¹⁶

Regardless of the setting, individuals in treatment for stimulant use disorder participate in different types of therapies in individual and group settings. As previously mentioned, behavioral therapies are commonly used interventions and may include:^9,15

• Cognitive-behavioral therapy (CBT). CBT helps individuals examine the thoughts, emotions, and behaviors related to their substance use and helps them develop necessary skills to maintain long-term recovery.
• Contingency management (CM). CM uses positive incentives to motivate and reward a person when they achieve a desired behavioral outcome, like abstinence.
• Community reinforcement approach (CRA). CRA is a comprehensive and intensive 24-week outpatient therapy approach that helps individuals develop new life skills so they can maintain long-term abstinence and make a substance-free lifestyle more rewarding than a life that involves drug or alcohol use.
• Motivational interviewing (MI). MI focuses on examining and resolving an individual’s ambivalence to making changes to their substance use and associated behaviors and helps them develop the internal motivation they’ll need to carry out the desired changes.

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If you or a loved one struggle with Ritalin addiction, call American Addiction Centers at to speak to one of our knowledgeable and compassionate admissions navigators, who can listen to your story, answer your questions, explain your options, verify your insurance, and get you into a treatment center so you can start your recovery journey.

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