CBD (cannabidiol) has the opposite effects of methylphenidate (Ritalin). Some use CBD to alleviate the side effects of Ritalin, but is this safe?
Methylphenidate (Ritalin) is a stimulant drug used in the treatment of ADHD and narcolepsy. CBD (cannabidiol) is the exact opposite — it’s used as an anxiolytic and muscle-relaxant.
So what happens if these two substances are mixed? Is it safe?
Some people report taking both substances together on purpose in order to reduce some of the negative side effects of Ritalin (such as insomnia, anxiety, and muscle tension).
Others are concerned that CBD could negate the effects of Ritalin to the point where it can no longer do its job effectively.
Here, we’ll explore this combination in more detail.
Yes, CBD may reduce the stimulating effects of methylphenidate and could slow the elimination time of the drug.
Caution is advised with this combination — however, serious side effects aren’t expected from this combination.
The more often you use CBD and Ritalin, and the higher doses you use for each drug will affect your chances of experiencing adverse reactions.
CBD may interact with methylphenidate (Ritalin) by decreasing its effects, possibly negating its benefits, causing increased symptoms of the condition being treated. This essentially means that if you’re using Ritalin to improve focus and energy, CBD could, in theory, make Ritalin less effective. Symptoms would be similar to how you feel without taking Ritalin.
The severity of this interaction is considered mild and unlikely to cause significant side effects.
The cannabinoid receptors CB1 and CB2 are distributed throughout the body in areas like the brain, organs, connective tissue, glands, and the immune system. CBD acts through these receptors as a negative allosteric modulator. CBD also modulates neural circuits such as the dopaminergic mesocorticolimbic system, which is involved in addiction and drug-seeking behaviors.
Methylphenidate (Ritalin), on the other hand, is a psychostimulant drug. It increases the excitatory neurotransmitters — dopamine and norepinephrine — and produces effects like wakefulness, euphoria, increased libido, better attention span, fatigue resistance, and so on.
CBD may modify dopaminergic pathways via a secondary response mechanism to its effects on the endocannabinoid system. This modification, in turn, may attenuate the effects of methylphenidate, which chiefly exerts its effects through the neurotransmitter dopamine.
CBD may also interfere with the metabolism of methylphenidate (Ritalin).
Methylphenidate is metabolized by the enzyme carboxylesterase CES1A1 and has minor relation with CYP2D6.
Carboxylesterase 1 (CES1) is inhibited by CBD to a mild degree . CBD also acts as a competitive inhibitor of the enzyme CYP2D6. Therefore, when CBD is taken together with methylphenidate, it may decrease the metabolism of methylphenidate and increase the concentration of the drug in the body.
This mechanism is relevant when methylphenidate is taken in high doses with CBD. It may cause increased heart rate, arrhythmia, confusion, agitation, tremors, and muscle pain.
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:
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:
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.
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.
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 .
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.
Methylphenidate is a chemical derivative of phenethylamine and benzylpiperazine . 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 . 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.
|CYP Metabolism||CYP2D6 and CES1A1|
|Interaction with CBD||Antagonistic and Metabolic Competition|
|Risk of interaction||Mild|
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:
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.
Headaches, rebound hyperactivity, and dependence are common side effects of methylphenidate.
Other less common side effects of Ritalin include:
Related: What Are the Side Effects of 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.
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