It’s never safe to mix alcohol with Ritalin (methylphenidate). Ritalin is prescribed for children and adults diagnosed with Attention Deficit Hyperactivity Disorder or ADHD. When taken as prescribed, side effects are mild and possibly short-term.

When Ritalin is abused and combined with alcohol, you are entering an area where the effects aren’t always known or understood. Alcohol is a central nervous system depressant; Ritalin is a stimulant. When prescribed to patients with ADHD, its stimulant effects actually help them to focus and slow down. Mixing Ritalin and alcohol increases the drug’s side effects, possibly placing your life in danger.

What is Ritalin?

ADHD has been identified as one of the most commonly occurring neurological issues affecting children and adults both. This condition makes it difficult for children to think through their impulses before acting on them; it also makes it difficult for these children to focus on tasks at hand, such as schoolwork or homework. The children who suffer the most severe symptoms are more active than normal and may not grow out of their behaviors as they grow.

Ritalin, which normally stimulates the central nervous system, is identified as an effective medical treatment of ADHD. It takes a paradoxical effect, slowing your thinking down so you can function. If you have ADHD, you’ll usually take your medication with food. Once it gets into your bloodstream, you’ll find that you can think clearly, stay focused, and interact with others more appropriately. Because of the calming effects on ADHD symptoms, those who use it may feel drowsy for a short time after taking it.

Common Side Effects of Ritalin

Some people who receive a prescription for this Schedule 2 drug may feel several symptoms:

  • Quickened heartbeat (common)
  • Joint pains
  • Chest pain
  • Fever
  • Hives or skin rashes

(Rare side effects)

  • Bloody urine or stools
  • Tar-like, black stools
  • Skin problems (flaking, crusting, or dryness)
  • Scaling, swelling, soreness, or severe redness of skin
  • Changes in vision, such as blurring
  • Tiny (pinpoint) red spots on skin
  • Unusual bruising or bleeding
  • Muscle cramps
  • Seizures
  • Vocal outbursts that can’t be controlled
  • Tics (uncontrollable, repeated body movements)

There are some side effects to this medication that are mild enough not to need medical attention. They will eventually subside as your body gets used to the medication.

  • Headache
  • Skin is unusually warm
  • Nervousness
  • Less of an appetite
  • Trouble getting to see
  • Stomachache
  • Stuffy nose

Some side effects are less common, but not much of a problem unless they interfere with functioning:

  • Decreased appetite
  • Nausea
  • Vomiting
  • Dizziness
  • Drowsiness
  • irritability, anger
  • Fear
  • Achy muscles
  • Runny nose
  • Hair loss on the scalp
  • Feeling excited, acting and talking in an excited manner

Interactions of Alcohol and Ritalin

It’s never a good idea to mix alcohol and Ritalin. Although you may think that, even when you’re drunk, you’ll be more alert or aware, taking both together means that you’ll run a high risk of alcohol poisoning or overdosing on Ritalin. Both of these drugs are risky to use on their own if you don’t do so with caution, so mixing them is understandably a bad idea. When Ritalin is used as prescribed, serious side effects are rare and low to moderate use of alcohol also has a low risk of side effects.

Alcohol abuse can change your moods and behavior, lower your inhibitions, make it difficult for you to control your movements, and increase your mental confusion.

Some people may decide to combine alcohol and Ritalin because of their opposite effects on the body. They want to lessen the effects of alcohol. Or, if they are taking too much Ritalin, they want the alcohol to lessen the stimulant effects of the drug. When they add alcohol to their abuse of Ritalin, more of the drug is sent into their bloodstream. Over time, their bodies depend more and more on the drug, making dependence and withdrawal even more of a risk. One long-term risk of Ritalin abuse is the development of heart disease (this may manifest as blood vessel damage) and the increased risk of strokes.

Alcohol Poisoning and Ritalin Overdose

When you mix alcohol with Ritalin, you aren’t an “alert drunk”. You’re someone running the real risk of alcohol poisoning, which may kill you. It’s never a good idea to combine alcohol with Ritalin. You aren’t lessening the effects of either drug, only making it less apparent how each one is affecting you.

When you drink alcohol to excess without taking Ritalin, you feel the dangerous effects of those drinks on your system. Eventually, your breathing is going to slow down to dangerous levels. You may experience seizures, aspirate your vomit, or slip into a coma. If your friends can’t wake you up, you’ll need swift medical intervention to reverse the dangerous effects of your alcohol overdose.

Drinking alcohol while with Ritalin in your bloodstream will cause the side effects of the medication to be enhanced to dangerous levels. Your heartbeat will rise dangerously, as will your blood pressure.

Withdrawal

If you have been drinking alcohol to excess for several weeks or years, it is dangerous to stop cold turkey. Because your brain and central nervous system have gotten used to the presence of alcohol, they aren’t able to function properly when you stop drinking suddenly.

You may experience:

  • Shaking hands
  • Anxiety
  • Nausea and vomiting
  • Headache
  • Sweating
  • Insomnia

Twelve to 24 hours later, you may develop hallucinations and seizures. DTs (delirium tremens) can develop 48 to 72 hours later. You may also experience a racing heart, confusion, fever, heavy sweating, and high blood pressure.

As your brain withdraws from Ritalin, you may experience the following symptoms:

  • Depression (related to a drop in dopamine production)
  • Fatigue
  • Interrupted sleep patterns
  • Quick return of your ADHD symptoms (related to how long you have been taking or abusing Ritalin and the dose you have been taking)

Withdrawal from Ritalin isn’t life-threatening, though you’ll likely want to start taking the drug again, once you are alcohol-free.

Treatment

Combining alcohol and Ritalin means that the effects of each will be more intense.

The side effects from both drugs include:

  • Loss of appetite
  • Stomach pain
  • Dizziness
  • Pulse changes and change in blood pressure
  • Nausea
  • Headaches
  • Possible psychosis

These symptoms are much more intense when you take both drugs in large quantities. Mentally and emotionally, you may experience suicidal thoughts, seizures, high blood pressure, and psychosis. If your desire for alcohol is strong enough, and you’ve taken enough Ritalin to overcome the normal drowsiness associated with drinking high quantities of alcohol, you run the risk of alcohol poisoning.

Treatment begins with a period of detox, using less risky medications to lessen physical withdrawal symptoms. As you begin to realize the depth of your dependence or addiction, you may not want to discuss how you feel, or you may be aggressive toward others. In the early stages of your treatment, you may not want friends or family to become involved. However, you’ll need all the support you can get, so it’s important to find a long-term treatment program or plan that will work for you.

Sources:

  • https://www.drugs.com/sfx/methylphenidate-side-effects.html

  • https://www.webmd.com/mental-health/addiction/alcohol-withdrawal-symptoms-treatments#1

  • https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/diagnosis-treatment/drc-20369250