What Are Ritalin Withdrawal Symptoms?

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What Is Ritalin Withdrawal?

Ritalin (methylphenidate) is a central nervous system stimulant commonly prescribed for attention-deficit hyperactivity disorder (ADHD) and narcolepsy. It can produce effects similar to cocaine when misused, and it has a high potential for abuse.1 Long-term use can result in dependence and withdrawal symptoms upon quitting.

Additional Withdrawal Timelines


Ritalin Withdrawal Symptoms

Ritalin withdrawal can last anywhere from a few days to several weeks.10,11

Common effects include:3,8

  • Fatigue.
  • Hunger.
  • Insomnia or hypersomnia.
  • Depression.
  • Vivid dreams or nightmares.
  • Cravings.
  • Inability to feel pleasure (anhedonia).

Even those who do not take the drug regularly may experience a crash when the drug wears off. A Ritalin crash may consist of the following symptoms: 9

  • Exhaustion
  • Excessive sleep
  • Depression
  • Increased appetite

Ritalin withdrawal symptoms can vary in intensity depending on individual physiology, as well as how large the last dose was and how long the person took Ritalin.

Withdrawal Risks

Ritalin withdrawal is not life-threatening.9 However, withdrawal effects can be physically and psychologically uncomfortable, and people may relapse to ease symptoms. People may also experience depression and suicidal thoughts when withdrawing from Ritalin.2,3,8


Causes of Withdrawal

fatigue caused by ritalin withdrawal

Ritalin may be abused by students trying to improve their grades, athletes trying to enhance performance, or those who want to stay awake, avoid sleep, or achieve a high.3 Users may binge on the drug over several hours or days or engage in chronic, daily use.

People who abuse Ritalin can develop a tolerance, which means that they require increasingly higher doses of the drug to achieve the same effects they experienced at lower doses. This type of repeated, regular use can lead to physical dependence and addiction. Heavy users and those who use the drug intravenously are even more likely to become dependent. 7

People who become dependent on Ritalin or chronically abuse it often experience withdrawal symptoms when use is stopped.3


Treatment for Withdrawal

Detox from Ritalin can take place on an outpatient basis in milder cases of dependence. Those with more severe cases of addiction may require medical supervision at a detox center or treatment facility to maximize chances of recovery and prevent a possible relapse.

However, recovery does not stop at detoxification. Often, the presence of withdrawal symptoms indicates a larger problem with Ritalin abuse that goes beyond occasional, recreational use. Seeking ongoing treatment can decrease the risk of relapse and other consequences of abuse.

Common treatments for Ritalin abuse and addiction may include:

  • Detox centers: These facilities are set up to manage withdrawal symptoms and usually do not provide intensive recovery services. Medical staff monitor your withdrawal symptoms, prescribe medications, and treat any complications during the detox period.
  • Inpatient treatment programs: Inpatient rehabilitation typically includes some combination of individual counseling, group therapy, medically assisted detox, and 12-step or other support group meetings. Treatment takes place in a 24/7 residential facility for a designated period of time, typically ranging from 28 days to 90 days, though some programs may last 6 months or longer in severe cases.
  • Outpatient treatment programs: Outpatient rehabilitation includes many of the same types of treatment as inpatient facilities, but treatment takes place on a part-time basis. Participants live at home, and many continue to carry out their normal activities. This type of treatment may be a good fit for those who must remain active in their daily lives as well as those who have less severe addictions.
  • 12-step programs: Twelve-step programs such as Narcotics Anonymous and Pills Anonymous offer a linear, step-by-step process toward recovery and sobriety among the support of peers who are dealing with similar addictions. Most of these programs focus on surrendering to a higher power to recover. Non-12-step programs, such as SMART Recovery, are also available.
  • Dual diagnosis: Dual diagnosis treatment addresses addiction as well as any underlying mental health conditions that may be related to drug dependence. Because many people are prescribed Ritalin for ADHD, it is common for Ritalin addiction treatment to include ADHD behavioral coaching and therapy as well. Therapists may help recovering users learn how to manage ADHD without the use of the drug.

Therapies

CBT teaches strategies for managing cravings.

Therapies used to treat addiction to stimulants such as Ritalin include: 5,6

  • Cognitive behavioral therapy (CBT): This type of therapy helps users recognize how their thoughts contribute to their behaviors and teaches strategies for managing cravings and implementing new, healthier behaviors as an alternative to drug use.
  • Contingency management: This approach provides rewards such as vouchers for positive behaviors, such as passing a urine drug screening. These vouchers can be used to purchase certain items that usually promote health and wellness.
  • Matrix Model: The Matrix Model is designed to help people who are addicted to stimulants such as Ritalin. It combines group and individual therapy, relapse prevention, substance abuse education, and family therapy.
  • Individual counseling: Counseling can help users come to terms with their drug use and address any underlying emotional or psychological issues that may be related to their addiction.
  • Group counseling: Group counseling allows people to explore the psychological and social aspects of their addiction within the support of a group. Many addiction professionals consider group therapy essential to the recovery process.

Medications

There are not currently any FDA-approved medications for the treatment of Ritalin dependence. However, physicians may prescribe medications to manage the symptoms of withdrawal such as depression, headaches, and nausea.


Sources

  1. U.S. Drug Enforcement Administration (DEA). Drug Fact Sheets: Methylphenidate
  2. Morton, W. & Stockton, G. (2000). Methylphenidate Abuse and Psychiatric Side Effects. The Primary Care Companion to the Journal of Clinical Psychiatry, 2(5), 159–164.
  3. NIH: National Institute on Drug Abuse. (2014). DrugFacts: Stimulant ADHD Medications: Methylphenidate and Amphetamines
  4. SAMHSA: Substance Abuse and Mental Health Services Administration. (2015). Treatment for Substance Use Disorders.
  5. National Institute on Drug Abuse. (2014). Treating Addiction to Prescription Stimulants.
  6. National Institute on Drug Abuse. (2012). Principles of Drug Addiction Treatment: A Research Based Guide. Behavioral Therapies.
  7. Ries, R. K., Fiellin, D. A., Miller, S. C., & Saitz, R. (2014). The ASAM Principles of Addiction Medicine: Fifth Edition. New York: Lippincott Williams & Wilkins.
  8. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition.
  9. Kuhn, C., Swartzwelder, S., & Wilson, W. (2014). Buzzed: The Straight Facts About the Most Used and Abused Drugs from Alcohol to Ecstasy. New York: W. W. Norton & Company.
  10. Australian Government Department of Health. (2004). The amphetamine withdrawal syndrome.
  11. Center for Substance Abuse Treatment. (2006). Detoxification and substance abuse treatment. Treatment Improvement Protocol (TIP) Series, No. 45, HHS Publication No. (SMA) 15-4131, Rockville, MD.

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