Does CBD Interact With Methylphenidate (Ritalin)?

Other Names For Methylphenidate

Methylphenidate is sold under many different names based on its duration of action, brand name, and route of administration. The most commonly used ones are Ritalin and Concerta. 

Other names for methylphenidate include:

• Adhansia
• Biphentin
• Concerta
• Cotempla
• Daytrana
• Foquest
• Ritalin

Similar Medications: CBD & Methylphenidate

Methylphenidate is classified as a CNS stimulant. CBD and CNS stimulants all share similar risks for interaction and side effects.

Here’s a list of similar medications that share a similar level of risk when combined with CBD:

• Amphetamine (Adderall)
• Dextroamphetamine Sulfate (Zenzedi & Dexedrine)
• Lisdexamfetamine Dimesylate (Vyvanse)
• Caffeine
• Cocaine
• Modafinil (Provigil & Nuvigil)
• MDMA (3,4-Methyl​enedioxy​methamphetamine)
• Atomoxetine (Strattera)
• Nicotine (Nicotrol)

Is It Safe to Take CBD & Methylphenidate Together?

CBD and methylphenidate (Ritalin) are generally considered safe when used in combination — however, it may become dangerous when either substance is used in high doses or for extended periods of time without a break.

If you’ve been given a prescription for Ritalin, it’s important to speak to your doctor about using CBD, THC, or other cannabinoids alongside it. 

Your doctor may advise you to use a smaller dose or direct you to separate your medications by about 2 hours to further limit the chances of negative interaction. 

Is CBD A Viable Alternative to Methylphenidate?

A few clinical trials show evidence of some benefits of using CBD for ADHD and its comorbidities, but the improvements were not significant enough for CBD to be considered an alternative to methylphenidate [5].

Many people will try natural supplements like CBD for treating ADHD first because of its impressive safety profile before trying prescription medications. It can take up to two weeks of daily use before the effects of CBD on ADHD become apparent. 

What is Methylphenidate (Ritalin)?

Methylphenidate is a chemical derivative of phenethylamine and benzylpiperazine [3]. It’s a stimulant drug primarily used for the treatment of ADHD and narcolepsy. It belongs to the drug class of CNS stimulants. Ritalin is the most commonly used brand name. 

Off-label uses of methylphenidate include treatment for fatigue in patients with cancer, refractory depression in the geriatric population, apathy in Alzheimer’s disease, and enhancing cognitive performance [4]. It acts on the central nervous system and inhibits the reuptake of neurotransmitters like dopamine and norepinephrine in the presynaptic neuron, hence increasing the amount of these neurotransmitters in the synaptic cleft. 

Methylphenidate undergoes metabolism by the liver to ritalinic acid through a process called de-esterification via carboxylesterase CES1A. The effect of these neurotransmitters, along with the dose-dependent action of methylphenidate is responsible for its therapeutic effects. 

Methylphenidate Specs:

What Does Methylphenidate Do?

Methylphenidate inhibits the reuptake of the neurotransmitters dopamine (DA) and norepinephrine (NE), increasing their availability on the synaptic cleft. 

Methylphenidate users can develop a dependence on this drug following long-term use. It can also cause withdrawal symptoms if stopped abruptly. The withdrawal symptoms may present as increased anxiety, irritability, insomnia, tremors, headaches, stomach pain, nausea, hallucinations, fatigue, depression, etc. 

Its side effect warrants precaution with its use. 

Ritalin should be avoided under the following conditions:

• Children less than six years of age
• Patients diagnosed with Bipolar disorder
• Patients diagnosed with tics/ Tourette syndrome
• Patients diagnosed with seizure disorders
• Patients with cardiovascular conditions
• Patient with a known history of anaphylaxis to methylphenidate or related compounds

Careful consideration should be given to the development of physical and mental dependence. Those who experience dizziness as a side effect are advised to avoid driving and other risky activities.

Side Effects of Methylphenidate

Headaches, rebound hyperactivity, and dependence are common side effects of methylphenidate. 

Other less common side effects of Ritalin include:

• Abdominal pain
• Nausea/ Vomiting
• Diarrhea/ constipation
• Xerostomia
• Anorexia
• Dizziness
• Tremors
• Seizures
• Palpitations
• Chest pain
• Hypertension 
• Cardiac arrest
• Skin rashes

Related: What Are the Side Effects of CBD?

Key Takeaways: Is it Safe to Take Methylphenidate With CBD?

Methylphenidate (Ritalin) is available with a doctor’s prescription to treat ADHD and narcolepsy. Its use for any other purpose is illegal.

It’s usually safe to take CBD with methylphenidate within the therapeutic dose. However, it’s best not to take these medications of your own accord and always talk to your prescribing physician first. 

CBD has already been shown to be useful in ADHD, and its potential as an effective modulator of catecholamines may allow it to one day be used in place of methylphenidate.

References

1. Al-Zoubi, R., Morales, P., & Reggio, P. H. (2019). Structural insights into CB1 receptor-biased signaling. International journal of molecular sciences, 20(8), 1837. 
2. Qian, Y., Gurley, B. J., & Markowitz, J. S. (2019). The potential for pharmacokinetic interactions between cannabis products and conventional medications. Journal of clinical psychopharmacology, 39(5), 462-471.
3. Walichniewicz, P., & Lew-Starowicz, M. (2021). Methylphenidate-induced psychosis in a young antipsychotic-naïve female patient. Wiedza Medyczna, 3(1), 28-31.
4. Trenque, T., Herlem, E., Abou Taam, M., & Drame, M. (2014). Methylphenidate off-label use and safety. Springerplus, 3(1), 1-8. 
5. Ayyash, H. F., Ogundele, M., Cartas, B. C., & Dahabra, M. (2020). G632 Effectiveness of Cannabidiol oil in the management of ADHD and its comorbidities: Review of the evidence. Archives of Disease in Childhood, 105(Suppl 1), A228-A228.