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Psychotropic Drugs in Children: Methylphenidate (Ritalin)

Psychotropic Drugs in Children: Methylphenidate (Ritalin)

Table 2 Prescribing Information for Methylphenidate (Ritalin ®)  
Optimum Dosage
0.6 mg/kg
Usual maximum 60 mg/day
Drug Interactions
Diphenylhydantoin
Phenobarbital
Primidone
Tricyclic antidepressants
Monoamine oxidase inhibitors
Diazepam
Anticholinergics
 
Minor Short-Term Transient Side-Effects
Anorexia (over 20 mg/day)
Weight loss (over 20 mg/day)
Abdominal pain (give just before meals)a
Insomnia
Headache a
Urticaria a
Minor tachycardia (8 beats/min)
Minor increase in blood pressure (6 mm)
 
Contra-indications
Anxiety, tension, agitation
Thyrotoxicosis
Tachyarrhythmias
Presence of motor tics
Gilles de la Tourette’s syndrome
Family history of Tourette’s
 
Major Side-Effects
Growth suppression (not significant); insure drug holidays
Tics (responds to haloperidol)
Lowering of seizure thresholdb
Tactile hallucinationsa, b
Severe regressiona, b
Drug Withdrawal Effects
Depression
Over-activity
 
Concurrent Treatment and Alternatives
Behaviour modification
Cognitive therapy
Remedial education
Environmental manipulation
 
a. Rare.
b. Reversible if medication is discontinued.
 

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