Methylphenidate can be used to decrease sedation and lethargy from opioid pain medications. In addition, methylphenidate may improve the mood of a cancer patient suffering from feelings of depression, often raises a patient's energy level, and may improve his or her appetite. This drug is also used to treat attention deficit disorder in children and the sleep disorder narcolepsy.
Exactly how methylphenidate acts in the brain is not clear. It is believed to trigger arousal systems or increase the release of brain chemicals. It produces added alertness.
How the patient responds to treatment will determine the recommended dose. The usual dose for adults when methylphenidate is ordered with opiate pain medication is 2.5 mg. to 15 mg., daily or twice per day. This drug should be taken exactly as directed. It can become habit-forming if taken in greater amounts or for longer periods than is necessary. Patients should take the last dose of the day before 6 P. M. to decrease sleep difficulties. Patients should not crush or break this medication. If a dose is missed, the patient should take it as soon as possible. Patients should not take two pills at the same time.
Methylphenidate can produce physical and mental dependence. Patients should not suddenly stop taking it. A sudden discontinuation of the drug can cause withdrawal symptoms, including depression, paranoid feelings, thoughts of suicide, anxiety, agitation, and sleep disturbances.
Methylphenidate should not be given to patients with extreme anxiety, tension, agitation, severe depression, instability, or a history of alcohol or drug abuse. It is not indicated for use in those with Tourette's syndrome, people with tics, glaucoma, or some mental-health conditions. This drug should be used cautiously in patients with high blood pressure, those with a history of seizures, and women who are breastfeeding. Methylphenidate is not typically ordered for women during their childbearing years, unless the doctor determines that the benefits outweigh the risks. Methylphenidate should not be ordered for patients less than six years of age. Its safety has not been determined in this age group.
The most common side effects are nervousness, sleep difficulties, a rapid heartbeat, and increased blood pressure. Reducing the dose or changing the time the drug is taken may reduce some side effects. Patients should discuss any adverse reactions with their doctor. Patients should receive regular blood pressure and pulse
Debra Wood, R.N.
—Disorder that causes people to suddenly fall asleep
—Remedy containing or derived from opium, or any drug that induces sleep