Buy ritalin 10mg online with credit card.Methylphenidate, sold under the brand names Ritalin and Concerta among others, is a central nervous system (CNS) stimulant used medically to treat attention deficit hyperactivity disorder (ADHD) and, to a lesser extent, narcolepsy. It is a primary medication for ADHD (e.g. in the UK^[13]); it may be taken by mouth or applied to the skin, and different formulations have varying durations of effect, commonly ranging from 2–4 hours.^[2]

Common adverse reactions of methylphenidate include: tachycardia, palpitations, headache, insomnia, anxiety, hyperhidrosis, weight loss, decreased appetite, dry mouth, nausea, and abdominal pain.^[7] Withdrawal symptoms may include: chills, depression, drowsiness, dysphoria, exhaustion, headache, irritability, lethargy, nightmares, restlessness, suicidal thoughts, and weakness.^[2]

Methylphenidate is believed to work by blocking the reuptake of dopamine and norepinephrine by neurons.^[14]^[15] It is a central nervous system (CNS) stimulant of the phenethylamine and piperidine classes.

Uses

Methylphenidate is most commonly used to treat ADHD and narcolepsy.^[16]

Attention deficit hyperactivity disorder

Methylphenidate is used for the treatment of attention deficit hyperactivity disorder.^[17] The addition of behavioural modification therapy can have additional benefits on treatment outcome.^[18]^[19] The dosage may vary and is titrated to effect, with some guidelines recommending initial treatment with a low dose.^[20] Immediate-release methylphenidate is used daily along with the longer-acting form to achieve full-day control of symptoms.^[21]^[22] Methylphenidate is not approved for children under six years of age.^[23]^[24]

In children over age 6 and adolescents, the short-term benefits and cost effectiveness of methylphenidate are well established.^[25]^[26] A number of reviews have established the safety and effectiveness for individuals with ADHD over several years.^[27]^[28]^[29]

Approximately 70% of those who use methylphenidate see improvements in ADHD symptoms.^[30] Children with ADHD who use stimulant medications generally have better relationships with peers and family members, perform better in school, are less distractible and impulsive, and have longer attention spans.^[27] There is evidence to suggest that children diagnosed with ADHD who do not receive treatment will have an increased risk of substance use disorders as adults.^[31]^[32]

The precise magnitude of improvement in ADHD symptoms and quality of life produced by methylphenidate treatment remains uncertain as of March 2023.^[33] Methylphenidate is not included in the World Health Organization Essential Medicines List, as findings by the World Health Organization indicate evidence of benefit versus harm to be unclear in the treatment of ADHD.^[34] A 2021 systematic review did not find clear evidence for using IR methylphenidate (immediate-release) for adults.^[35]

Since ADHD diagnosis has increased around the world, methylphenidate may be misused as a “study drug” by some populations, which may be harmful.^[36] This also applies to people who may be experiencing a different issue and are misdiagnosed with ADHD.^[36] People in this category can then experience negative side-effects of the drug which worsen their condition.^[36]

Narcolepsy

Narcolepsy, a chronic sleep disorder characterized by overwhelming daytime drowsiness and uncontrollable sleep, is treated primarily with stimulants. Methylphenidate is considered effective in increasing wakefulness, vigilance, and performance.^[37] Methylphenidate improves measures of somnolence on standardized tests, such as the Multiple Sleep Latency Test (MSLT), but performance does not improve to levels comparable to healthy people.^[38]

Other medical uses

Methylphenidate may also be prescribed for off-label use in treatment-resistant cases of bipolar disorder and major depressive disorder.^[39] It can also improve depression in several groups including stroke, cancer, and HIV-positive patients.^[40] There is weak evidence in favor of methylphenidate’s effectiveness for depression,^[41] including providing additional benefit in combination with antidepressants.^[42] In individuals with terminal cancer, methylphenidate can be used to counteract opioid-induced somnolence, to increase the analgesic effects of opioids, to treat depression, and to improve cognitive function.^[43] A 2021 systematic review and meta-analysis found that all studies on geriatric depression reported positive results of methylphenidate use; the review recommended short-term use in combination with citalopram.^[44] A 2018 review found low quality evidence supporting its use to treat apathy as seen in Alzheimer’s disease in addition to slight benefits for cognition and cognitive performance