Methylphenidate (Concerta, Ritalin, Methylin, Daytrana, and other names) is prescribed to patients who have been diagnosed with attention deficit hyperactivity disorder (ADHD) after extensive psychological testing. Dosing generally begins in childhood and may continue into adulthood.

Methylphenidate or MPD is a central nervous system (CNS) stimulant, doing its work by changing the chemistry in the brain. Even though this drug stimulates the brain, it should not be used with alcohol. This especially applies if you are taking a long-acting chewable such as Quillichew ER or Contempla XR-ODT, which are long-acting tablets that disintegrate in your mouth.

What is Methylphenidate?

MPH helps people with ADHD, by changing how much of some neurotransmitters are active in the brain. By making this change, MPH helps you to focus better on one activity. You may also be able to improve your ability to listen to others, organize planned work, and control behavior problems you may have had in the past.

If you use this medication for recreational purposes or as a study buddy, you may become psychologically dependent on it. Doctors who prescribe this medication to patients who have a history of alcoholism or drug addiction are cautious with how they prescribe. MPH can be dangerous when it is abused and withdrawal can cause depression.

For patients who are trying to stop taking the medication after using it therapeutically, they may see their ADHD symptoms returning which will require follow up by their doctor.

Common Side Effects of MPH

As with most prescribed medications, you may experience several side effects:

  • Anger, agitation
  • Abdominal pain
  • Anxiety
  • Blurry vision
  • Irregular heartbeat
  • Brain bleeds
  • Chest pain
  • Lowered appetite
  • Constipation
  • Dry mouth
  • Feeling dizzy
  • Erectile dysfunction
  • Fast heartbeat
  • Excessive sweating
  • High blood pressure
  • Headache
  • Fast or slow pulse
  • Insomnia
  • Tight muscles
  • Numb and tingling feeling
  • Shortness of breath
  • Seizures
  • Peeling skin
  • Toxic psychosis
  • Weight loss

Other side effects have been attributed to MPH:

  • Severe liver injury
  • Nervous system disorders
  • Prolonged erection
  • Growth is suppressed long-term
  • Developing a dependence on the medication

Interactions of Alcohol and Methylphenidate

Mixing alcohol, which is a CNS depressant with MPH, which is a stimulant. Rather than just drunk, you’ll be an alert drunk. This increases the risk of acute liver damage and both substances have potentially severe effects if they are overused or abused for an extended time.

Combining alcohol and MPH increases the levels of methylphenidate in your blood by close to 40 percent. After this happens, the drug’s normal effects are multiplied; you experience an added sensitivity to the effects of both stimulation and euphoria or happiness. If you combine both substances for an extended time, your chances of becoming dependent on both of them increase exponentially.

Each drug’s negative effects are multiplied when you take them in combination. This means that, when you try to stop using, you’re going to experience withdrawal symptoms from both substances, making withdrawal even more dangerous.

Alcohol Poisoning and MPH Overdose

An overdose of methylphenidate is potentially dangerous. If a friend or loved one is experiencing overdose symptoms, call 911 and get emergency medical help immediately.

Symptoms include:

  • Nausea and vomiting
  • Diarrhea
  • Restlessness
  • Blurry vision, dizziness, or fainting
  • Breathing too fast
  • Feeling anxious or agitated
  • Feeling happy at an inappropriate time
  • Twitchy muscles or uncontrolled shaking of a part of their body
  • Seizures
  • Unconscious
  • Confusion
  • Hallucinations
  • Flushed
  • Sweating
  • Fever
  • Headache
  • Heartbeat is fast, irregular, or pounding
  • Nose or mouth are dry
  • Dark urine
  • Fatigue
  • Muscle weakness

Overdosing on methylphenidate may be an indication that someone has become dependent or addicted to the drug.

If you use methylphenidate and take it with alcohol, the above side effects are even worse. Symptoms of alcohol poisoning are may be more likely because you may choose not to control your desire to drink after including MPH. If you overdose, you may experience suicidal ideations, hallucinations, seizures, high blood pressure, and psychosis. Long-term substance abuse with both of these drugs means you run the risk of permanent liver damage and closely related organs.

Treatment

Alcohol poisoning is potentially fatal. Someone suffering from this condition requires immediate medical help. Anyone suffering from alcohol poisoning should be treated by medical professionals. They may be given a breathing tube to help them breathe, have their stomach pumped to remove excess toxins before they enter their bloodstream, and any remaining alcohol will be neutralized with activated charcoal.

Long-term treatment will require anyone suffering from addiction to admit they have a problem with alcohol. Treatment may include group and/or individual therapy. Peer-support groups help all residents to help each other.

A methylphenidate overdose includes:

  • Agitation
  • Nausea and vomiting
  • Delirium
  • Headache
  • Twitchy muscles
  • Sweating
  • Flushing
  • Feeling restless

Withdrawal from MPH may not be particularly dangerous if that’s all you were taking but withdrawing from two substances at once can be a dangerous proposition, especially when the other substance is alcohol. As with most drugs, detox should happen under the supervision of medical professionals. Long-term treatment for an addiction to methylphenidate may include cognitive behavioral therapy, which helps the person to learn new ways of coping with ADHD symptoms without using medication and group therapy, to help support the patient as they learn to cope with their cravings.

Sources:

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3547134/)

  • https://medlineplus.gov/druginfo/meds/a682188.html

  • https://www.rxlist.com/consumer_methylphenidate_ritalin_concerta/drugs-condition.htm

  • https://www.alcohol.org/mixing-with/methylphenidate/

  • https://www.mayoclinic.org/diseases-conditions/alcohol-poisoning/symptoms-causes/syc-20354386

  • https://www.burningtree.com/alcoholism-long-term-treatment-2/