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Ritalin Withdrawal | Timeline, Symptoms, Detox

Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects 51 million people, in 2015. While an ADHD diagnosis was a subject of controversy as recently as the 1970s, as more studies were done, ADHD became more widely diagnosed, and medications were prescribed to treat it. And, while Adderall has become the drug most synonymous with ADHD treatment, Ritalin was among the first medications prescribed to counteract the effects of ADHD. 

Ritalin (methylphenidate) is a central nervous system stimulant approved to treat ADHD and narcolepsy. Research has found that people with ADHD don’t have enough neurotransmitter dopamine in their brains, which can impede numerous vital brain functions. Ritalin works by inhibiting the reuptake of dopamine and norepinephrine in the prefrontal cortex.

The use of Ritalin results in modest improvements in cognition, including working memory, episodic memory, and inhibitory control in healthy individuals.

When taken as prescribed, Ritalin can be extremely useful in improving cognitive performance in people with ADHD. However, it is still a stimulant and, therefore, carries the potential for addiction and abuse.

Ritalin calms people who need to take it and helps them focus. When someone who doesn’t need Ritalin uses it, they will experience it as a typical stimulant. They will feel more energetic, alert, and euphoric, due to an excess of dopamine in a brain that wasn’t lacking in it.
The majority of people do not associate it with “scarier” stimulants such as cocaine, and Ritalin can seem like a safer option to use recreationally. Nonetheless, nonprescription Ritalin use can quickly lead to abuse and eventual dependency.

What Are the Ritalin Withdrawal Symptoms?

Ritalin withdrawal is a bit of a tricky subject that is very dependent on various factors unique to each individual, which are explained in more detail in the next section. Many doctors have suggested that there are no actual withdrawal symptoms associated with Ritalin and that many people do not experience any when they stop using.

Despite these claims, there are still several proven cases of Ritalin withdrawal, including what is known as a “crash.” A crash happens when your brain has become accustomed to certain levels of dopamine provided by Ritalin to the point where it stops producing it on its own. So when you stop taking Ritalin, your body does not make enough dopamine on its own. It produces even less than it was making before being medicated, in fact, and that’s when users crash.

Symptoms of a crash include:

  • Irritability
  • Hyperactivity
  • Anxiety
  • Inability to focus

On the same note, the assertions of a lack of withdrawal symptoms most likely do not account for those who have developed a dependency and were regularly abusing Ritalin in large doses.

In those cases, there are, in fact, documented symptoms of Ritalin withdrawal, the most common of which are the reverse effects of the drug, including:

  • Fatigue
  • Difficulty concentrating
  • Depression
  • Mood swings
  • Dizziness
  • Increase in appetite
  • Headaches
  • Anxiety
  • Increased heart rate
  • Somnolence

While the physical symptoms of Ritalin withdrawal are reported as being relatively mild, the psychological ones are likely to be significantly more severe.

What Are the Stages of the Ritalin Withdrawal Timeline?

Ritalin has a very short half-life, only three to four hours. This means that it is in your system for less than 24 hours after your last dose, so you will likely begin feeling the effects of withdrawal fairly quickly. While the Ritalin withdrawal timeline will vary from person to person, a general estimation will run as follows:

24-72 hours: As Ritalin leaves your system, you will start to experience the physical symptoms of withdrawal, including cravings, fatigue, nausea, and an increased heart rate.

4 to 7 days: During this period, the physical symptoms will be at their peak and have been joined by mental symptoms such as depression, insomnia, irritability, and anxiety.

2 weeks: At this point, physical symptoms will typically either be mostly diminished or completely gone. However, depression, anxiety, and sleep disorders may linger.

3 weeks: Cravings should be greatly diminished, and most symptoms will have run their course. Depression, however, may still linger.

As previously mentioned, the length and intensity of Ritalin withdrawal are highly dependent on these primary factors:

  • How long someone has been using Ritalin
  • How often they were using Ritalin
  • Whether they taper off usage or quit cold turkey
  • What dosage of Ritalin they were taking

The dosage, in particular, plays a large role, as most people take Ritalin in doses that range between 10 and 60 milligrams, with an average daily dose of about 30 milligrams. People who have been abusing Ritalin to the point where they have built up a tolerance will most likely be taking more than 60 milligrams to experience any kind of high. 

Those who have only been taking lower doses of Ritalin, i.e., anything 30 milligrams or below, even if they have been misusing it, will most likely experience a mild withdrawal at the most. On the other hand, those who have been taking 60 milligrams or higher long-term will need to gradually taper their usage to avoid a more punishing withdrawal. 
Heavy users are also more likely to experience post-acute-withdrawal syndrome, or PAWS. A protracted withdrawal, usually just the psychological symptoms that can last months or sometimes even more than a year after they have stopped using. 

Many of those in this withdrawal period will experience PAWS, which may contribute to their relapse. The individual may feel that something is wrong with them when their dizziness persists for months. It can increase their anxiety, which can also lead them back into using Ritalin. In many cases, symptoms will lessen, but they never go away. New symptoms may appear months after someone has stopped using Ritalin, and last for quite some time. You must be under the care of doctors that can help you adjust in the event of this occurring.

Why Should I Detox?

Quitting drugs cold turkey may sound like a good idea, but it can be difficult, painful, and dangerous.

Given the difficult physical symptoms, withdrawing on your own without professional medical help can be very challenging. It’s important to find a professional, medically assisted detox program to support you during the process of Ritalin withdrawal.

Doing this will ensure that you are carefully monitored in a safe environment while your body goes through the difficult detoxification process. Participating in an addiction treatment program also gives you a better chance at lasting recovery as a result of the structured medical and emotional support you will receive.

What Is the Next Treatment Step?

A full continuum of treatment ensures the best opportunity for a successful recovery. Following a full continuum of treatment means starting with the medical detox process and then progressing gradually from an inpatient status to outpatient treatment. You will then have the opportunity to participate in an alumni program after the formal treatment program is completed. The stages of addiction treatment include:

The primary goal is medical stabilization during the first stage of withdrawal treatment, which is known as detox. Expect the detox stage to last from a few days up to a week. When you arrive, your medical team, which will include doctors, nurses, and support staff will complete your comprehensive medical assessment, which will help determine your level of addiction and additional medical needs you may have. The assessment includes a medical exam plus a urine screening for drugs.

Your medical team will monitor you 24/7 to help manage uncomfortable withdrawal symptoms and prevent dangerous Ritalin withdrawal symptoms.

Many people also experience anxiety, depression, and other emotional and psychological challenges during the detox period. Your treatment plan will also include comprehensive support to help you with these symptoms. A longer-term treatment plan will be put into place for you once you are medically stabilized.

If you and the treatment team determine that you need further medical treatment, you may continue the next stage of treatment on an inpatient basis, which might be because of co-occurring medical conditions or post-acute withdrawal symptoms. Inpatient treatment is intensive and includes 24/7 clinical monitoring. At this stage, you will start seeing a therapist regularly to help you process the emotional and psychological aspects of addiction and recovery.

Partial hospitalization (PHP) is in-between outpatient treatment and inpatient care. The goal of PHP is to stabilize your mental status and better prepare you for success once you return to independent living after you leave the treatment center. During this stage, you’ll live at a transitional living facility while undergoing a supportive and rigorous treatment program. This program will be five days a week for six hours each day. You will be able to participate in individual, group, and family therapy programs to help you address emotional and mental health needs.

Learning positive life skills, coping mechanisms, and techniques to help prevent relapse so that you will be prepared for long-term recovery will be the primary focus during PHP.

The next stage is the intensive outpatient program (IOP). An IOP allows you to live at home while also attending counseling and programs to help support your recovery. Depending on your treatment plan, you will participate in about nine or more hours of clinical therapy several times each week.

Intensive outpatient therapy will help you to continue learning new ways to manage cravings, stress, and other challenging issues that may arise once you live on your own again. After you complete the IOP stage, you will transition into the Outpatient and Alumni programs, which is also known as aftercare.

You will have the opportunity to meet other treatment center alumni during weekly support groups and social events after you complete the formal treatment program. These aftercare opportunities spent with other alumni members can help you develop new friendships and build social support with others who understand the recovery process.

Being a part of this supportive network can help you grow while focusing on your recovery and adjusting to life after the treatment program. It can also be a safe space to share relapse prevention strategies, new experiences, and techniques for stress management. Most of all, it can be a way to enjoy time with new friends.

Can I Detox At Home?

You may look online and find some home remedies that sound like they’ll work. In theory, it may seem like a good idea at the moment, but we suggest that you undergo detox that is monitored by professionals. 

You may be considering home remedies that have dangerous side effects. There are specific remedies, which include other medications to help ease your withdrawal symptoms. These are likely similar to medication that would be used under the direction of a physician. The safest option for you is to seek treatment for withdrawal under the care of professionals.

What Is the Next Treatment Step?

Detoxing from Ritalin is a crucial first step to your recovery. Still, it’s only the first step. A full treatment plan is essential to recover from addiction successfully. People who skip this part and don’t work to understand the behaviors and motivations behind their addictive behaviors will most likely be unable to change them and have a high risk of relapse. 

While every treatment program will vary based on what is most useful for each patient, psychotherapy will likely be a large element of it, as studies have shown it to be extremely helpful to people who struggle with stimulant abuse in particular.

Sources

Gottlieb, S. (2001, February 3). Methylphenidate works by increasing dopamine levels. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1119521

Ritalin (Methylphenidate) Withdrawal Symptoms Duration. (2015, October 30). Retrieved from https://mentalhealthdaily.com/2014/06/25/ritalin-methylphenidate-withdrawal-symptoms-duration/

Post Acute Withdrawal Syndrome: Causes, Symptoms, Treatment. (2015, June 12). Retrieved from https://mentalhealthdaily.com/2015/06/12/post-acute-withdrawal-syndrome-causes-symptoms-treatment/

National Institute on Drug Abuse. (n.d.). How can prescription drug addiction be treated? Retrieved from https://www.drugabuse.gov/publications/research-reports/misuse-prescription-drugs/how-can-prescription-drug-addiction-be-treated

Harvard Health Publishing. (n.d.). Treatment options for overcoming stimulant drug addiction, from the Harvard Mental Health Letter. Retrieved from https://www.health.harvard.edu/press_releases/treatment-options-for-overcoming-stimulant-drug-addiction-

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