Ritalin Side Effects

One of the concerns in the use of stimulants like Ritalin is that they often have side effects, the most commonly reported being the loss of appetite, serious weight loss, insomnia, depression, headaches, stomachaches, bed-wetting, irritability and dizziness. Reports also indicate severe psychological effects. A large percentage of children become robotic, lethargic, depressed, or withdrawn on stimulants, and withdrawal from them can cause emotional suffering, including depression, exhaustion, and suicide. According to the DSM III-R, published in 1987, “suicide is the major complication” of withdrawal from Ritalin and similar drugs.

In 1995, Denmark's Cooperative Institute for Medical Drug Dependence reported the following withdrawal symptoms from psychotropic drug dependence: “Emotional changes: fear, terror, panic, fear of insanity, failing self-confidence, restlessness, irritability, aggression, an urge to destroy, and, in the worst cases, an urge to kill.”

Psychotic episodes and violent behavior are also associated with chronic Ritalin abuse. Even the manufacturer warns in its information leaflet, “frank psychotic episodes can occur” with abuse.

The history of violence by teens who have been subjected to psychiatric drugs cannot be ignored. Consider the following examples:

• November 20, 1986: Rod Mathews, 14, beat a classmate to death with a bat in the woods near his house in Canton, Massachusetts. Rod was put on Ritalin when he was in third grade.

• February 19, 1996: Timmy Becton, 10, grabbed his three-year-old niece as a shield and aimed a shotgun at a sheriff's deputy who accompanied a truant officer to his Florida home. Becton had been taken to a psychiatrist in January to cure his dislike of school and was put on a psychiatric drug, Prozac. His parents said that when the dosage of the drug was increased, Timmy had violent mood swings and that he would “get really angry…”

• May 21, 1998: Kip Kinkel, a 15-year-old at Thurston High School in Springfield, Oregon, murdered his parents and then proceeded to school where he opened fire on students in the cafeteria, killing two and wounding twenty-two. Kinkel had been prescribed both Ritalin and Prozac.

• April 16, 1999: Shawn Cooper, a 15-year-old-sophomore at Notus Junior-Senior High School in Notus, Idaho, was taking Ritalin when he fired two shotgun rounds, narrowly missing students and school staff.

• May 20, 1999: T.J. Solomon, a 15-year-old at Heritage High School in Conyers, Ga., was being treated with Ritalin for depression when he opened fire on and wounded six classmates.

In his book Talking Back to Ritalin, psychiatrist Peter Breggin documents other side effects, which he claims have been confirmed by scientific studies but are ignored by the advocates of Ritalin. He states that Ritalin can retard growth in children by disrupting the cycles of growth hormone released by the pituitary gland. According to Breggin, the drug routinely causes gross malfunctions in the brain of the child. There is research evidence from a few controlled studies that Ritalin can cause shrinkage (atrophy) or other permanent physical abnormalities in the brain. And studies of amphetamine show that short-term clinical doses produce brain cell death, he says.

Perhaps the most controversial theme in the Ritalin debate is the question if its use can lead to psychological drug dependence in the long run. A study in the Archives of General Psychiatry titled “Is methylphenidate like cocaine?” concluded that indeed it was. Its lead author, Nora Volkow, director of nuclear medicine at the Brookhaven National Laboratory in Upton, N.Y., used positron emission tomography scans to look at where and how quickly Ritalin acts in the brain. In Volkow's study, eight healthy male volunteers were injected with the drug. Their scans were then compared with those subjects in previous studies who had been injected with cocaine. The authors reported that the distribution of Ritalin in the human brain was “almost identical to that of cocaine.” The drugs' effects also peaked at almost the same time — between four and ten minutes in the case of Ritalin, and two to eight minutes for cocaine. Even the highs were similar.

When Ritalin was given to cocaine users, they said it was “almost indistinguishable.” The only significant difference was that Ritalin took more than four times as long — ninety minutes — to leave the body. “We're dealing with a drug that does have properties very similar to cocaine,” Volkow concluded.

Although taking a stimulant orally is very different from injecting or snorting it, there are warnings that, even when taken orally, its use has the potential of creating long-term drug dependence. According to psychopharmacologist Susan Schenk of Texas A&M University, children treated with Ritalin are three times more likely to develop a taste for cocaine. She reached this conclusion after teaming up with Nadine Lambert, a developmental psychologist at the University of California, Berkeley, who followed five thousand children with ADHD from adolescence to adulthood.

The Ritalin debate took a new turn in March 2000, when a teenager's fatal heart attack raised troubling questions about the safety of this drug. A medical examiner in Pontiac, Michigan, has released findings strongly linking long-term use of Ritalin to the death of 14-year-old Matthew Smith. The teen died at home while playing on his skateboard. Initially, it was thought that he had injured himself in a fall, but the medical examiner found the cause of death to be cardiac arrest secondary to blockage of coronary arteries that supplied blood to his heart. Such changes in the blood vessels are not ordinarily found in children so young, but are typical of the damage seen in adults who chronically abuse stimulants. The boy had been taking Ritalin for ADHD under a doctor's prescription for eight years. The medical examiner believed that no other reason could account for the changes in the child's heart. At least two other children who were taking Ritalin have also died, in Texas and Ohio.