&lt;h1 data-start=&quot;353&quot; data-end=&quot;415&quot;&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;&lt;strong data-start=&quot;355&quot; data-end=&quot;415&quot;&gt;ADHD, Narcolepsy, and Methylphenidate (Ritalin&amp;reg;)&lt;/strong&gt;&lt;/span&gt;&lt;/h1&gt;
&lt;hr /&gt;
&lt;h2 data-start=&quot;417&quot; data-end=&quot;428&quot;&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;&lt;strong&gt;Overview&lt;/strong&gt;&lt;/span&gt;&lt;/h2&gt;
&lt;p data-start=&quot;429&quot; data-end=&quot;800&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong data-start=&quot;429&quot; data-end=&quot;480&quot;&gt;Attention Deficit Hyperactivity Disorder (ADHD)&lt;/strong&gt; is a neurodevelopmental condition characterised by persistent &lt;strong data-start=&quot;543&quot; data-end=&quot;590&quot;&gt;inattention, hyperactivity, and impulsivity&lt;/strong&gt;. It affects both children and adults and may significantly interfere with academic, occupational, and social functioning. ADHD arises from a combination of &lt;strong data-start=&quot;747&quot; data-end=&quot;799&quot;&gt;genetic, neurological, and environmental factors&lt;/strong&gt;.&lt;/span&gt;&lt;/p&gt;
&lt;p data-start=&quot;802&quot; data-end=&quot;994&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong data-start=&quot;802&quot; data-end=&quot;816&quot;&gt;Narcolepsy&lt;/strong&gt; is a chronic neurological sleep disorder marked by &lt;strong data-start=&quot;868&quot; data-end=&quot;900&quot;&gt;excessive daytime sleepiness&lt;/strong&gt; and disrupted sleep&amp;ndash;wake regulation. Treatment often requires long-term, individualised care.&lt;/span&gt;&lt;/p&gt;
&lt;p data-start=&quot;802&quot; data-end=&quot;994&quot;&gt;&amp;nbsp;&lt;/p&gt;
&lt;h2 data-start=&quot;1001&quot; data-end=&quot;1057&quot;&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;&lt;strong&gt;Methylphenidate (Ritalin&amp;reg;): Indications and Mechanism&lt;/strong&gt;&lt;/span&gt;&lt;/h2&gt;
&lt;hr /&gt;
&lt;p data-start=&quot;1058&quot; data-end=&quot;1350&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong data-start=&quot;1058&quot; data-end=&quot;1077&quot;&gt;Methylphenidate&lt;/strong&gt; is a prescription stimulant used to treat ADHD and, in selected cases, narcolepsy. It is marketed under brand names such as &lt;strong data-start=&quot;1202&quot; data-end=&quot;1257&quot;&gt;Ritalin&amp;reg;, Concerta&amp;reg;, Focalin XR&amp;reg;, and Medikinet MR&amp;reg;&lt;/strong&gt;.&lt;/span&gt;&lt;br data-start=&quot;1258&quot; data-end=&quot;1261&quot; /&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong data-start=&quot;1261&quot; data-end=&quot;1322&quot;&gt;Ritalin&amp;reg; and methylphenidate refer to the same medication&lt;/strong&gt; &amp;mdash; Ritalin&amp;reg; is a brand name.&lt;/span&gt;&lt;/p&gt;
&lt;p data-start=&quot;1352&quot; data-end=&quot;1536&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Methylphenidate increases the availability of &lt;strong data-start=&quot;1398&quot; data-end=&quot;1440&quot;&gt;dopamine, noradrenaline, and serotonin&lt;/strong&gt; in the brain. In individuals with ADHD, this helps reduce excessive sensory input and supports:&lt;/span&gt;&lt;/p&gt;
&lt;ul&gt;
&lt;li data-start=&quot;1539&quot; data-end=&quot;1577&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Improved attention and concentration&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;1580&quot; data-end=&quot;1619&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Reduced impulsivity and hyperactivity&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;1622&quot; data-end=&quot;1652&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Better organisational skills&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;
&lt;p data-start=&quot;1654&quot; data-end=&quot;1711&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;In narcolepsy, it may help improve &lt;strong data-start=&quot;1689&quot; data-end=&quot;1710&quot;&gt;daytime alertness&lt;/strong&gt;.&lt;/span&gt;&lt;/p&gt;
&lt;p data-start=&quot;1654&quot; data-end=&quot;1711&quot;&gt;&amp;nbsp;&lt;/p&gt;
&lt;h2 data-start=&quot;1718&quot; data-end=&quot;1753&quot;&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;&lt;strong&gt;Other Medications for Narcolepsy&lt;/strong&gt;&lt;/span&gt;&lt;/h2&gt;
&lt;hr /&gt;
&lt;p data-start=&quot;1754&quot; data-end=&quot;1800&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong&gt;Alternative treatments for narcolepsy include:&lt;/strong&gt;&lt;/span&gt;&lt;/p&gt;
&lt;ul&gt;
&lt;li data-start=&quot;1803&quot; data-end=&quot;1886&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong data-start=&quot;1803&quot; data-end=&quot;1828&quot;&gt;Modafinil (Provigil&amp;reg;)&lt;/strong&gt; and &lt;strong data-start=&quot;1833&quot; data-end=&quot;1859&quot;&gt;Armodafinil (Nuvigil&amp;reg;)&lt;/strong&gt;, which promote wakefulness&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;1889&quot; data-end=&quot;1979&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong data-start=&quot;1889&quot; data-end=&quot;1916&quot;&gt;Sodium oxybate (Xyrem&amp;reg;)&lt;/strong&gt;, which improves nighttime sleep and reduces daytime sleepiness&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;
&lt;p data-start=&quot;1981&quot; data-end=&quot;2161&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;These medications differ in mechanism, dosing, and side-effect profile. Selection depends on symptom pattern and patient response and should be guided by a healthcare professional.&lt;/span&gt;&lt;/p&gt;
&lt;p data-start=&quot;1981&quot; data-end=&quot;2161&quot;&gt;&amp;nbsp;&lt;/p&gt;
&lt;h2 data-start=&quot;2168&quot; data-end=&quot;2203&quot;&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;&lt;strong&gt;Onset, Duration, and General Use&lt;/strong&gt;&lt;/span&gt;&lt;/h2&gt;
&lt;hr /&gt;
&lt;ul&gt;
&lt;li data-start=&quot;2206&quot; data-end=&quot;2318&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong data-start=&quot;2206&quot; data-end=&quot;2226&quot;&gt;Onset of effect:&lt;/strong&gt; ~30 minutes after oral administration&lt;/span&gt;&lt;br data-start=&quot;2264&quot; data-end=&quot;2267&quot; /&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;(up to 2 hours for extended-release formulations)&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;2321&quot; data-end=&quot;2373&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong data-start=&quot;2321&quot; data-end=&quot;2334&quot;&gt;Duration:&lt;/strong&gt; ~4&amp;ndash;8 hours, depending on formulation&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;
&lt;p data-start=&quot;2375&quot; data-end=&quot;2588&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;When used as prescribed, methylphenidate is generally well tolerated. Common side effects include reduced appetite, sleep disturbance, mild headache, and gastrointestinal discomfort, which often improve over time.&lt;/span&gt;&lt;/p&gt;
&lt;p data-start=&quot;2375&quot; data-end=&quot;2588&quot;&gt;&amp;nbsp;&lt;/p&gt;
&lt;p style=&quot;-qt-block-indent: 0; text-indent: 0px; margin: 0px;&quot;&gt;&amp;nbsp;&lt;/p&gt;

&lt;p&gt;&amp;nbsp;&lt;/p&gt;
&lt;h1 data-start=&quot;2595&quot; data-end=&quot;2649&quot;&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;&lt;strong&gt;Safety, Mixed Use, and When to Seek Help&lt;/strong&gt;&lt;/span&gt;&lt;/h1&gt;
&lt;hr /&gt;
&lt;h2 data-start=&quot;2651&quot; data-end=&quot;2688&quot;&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;&lt;strong&gt;Administration and Mixed Use Risks&lt;/strong&gt;&lt;/span&gt;&lt;/h2&gt;
&lt;ul&gt;
&lt;li data-start=&quot;2691&quot; data-end=&quot;2837&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong data-start=&quot;2691&quot; data-end=&quot;2749&quot;&gt;Intravenous use of methylphenidate is contraindicated.&lt;/strong&gt; Tablet fillers may cause &lt;strong data-start=&quot;2775&quot; data-end=&quot;2787&quot;&gt;embolism&lt;/strong&gt;, including pulmonary or cerebral vessel blockage.&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;2840&quot; data-end=&quot;2955&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong data-start=&quot;2840&quot; data-end=&quot;2858&quot;&gt;Intranasal use&lt;/strong&gt; may damage nasal tissue and increase infection risk; harm-reduction guidance should be followed.&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;2958&quot; data-end=&quot;3039&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong data-start=&quot;2958&quot; data-end=&quot;2969&quot;&gt;Alcohol&lt;/strong&gt; may increase agitation, impaired judgment, and cardiovascular strain.&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;3042&quot; data-end=&quot;3173&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Mixing with &lt;strong data-start=&quot;3054&quot; data-end=&quot;3101&quot;&gt;other stimulants or serotonergic substances&lt;/strong&gt; (e.g. MDMA, amphetamines) increases the risk of &lt;strong data-start=&quot;3150&quot; data-end=&quot;3172&quot;&gt;serotonin syndrome&lt;/strong&gt;.&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;
&lt;p&gt;&amp;nbsp;&lt;/p&gt;
&lt;h2 data-start=&quot;3180&quot; data-end=&quot;3217&quot;&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;&lt;strong&gt;Contraindications and Interactions&lt;/strong&gt;&lt;/span&gt;&lt;/h2&gt;
&lt;hr /&gt;
&lt;ul&gt;
&lt;li data-start=&quot;3220&quot; data-end=&quot;3371&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong data-start=&quot;3220&quot; data-end=&quot;3296&quot;&gt;Do not combine methylphenidate with monoamine oxidase inhibitors (MAOIs)&lt;/strong&gt;. Serious reactions may occur up to &lt;strong data-start=&quot;3332&quot; data-end=&quot;3370&quot;&gt;14 days after MAOI discontinuation&lt;/strong&gt;.&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;3374&quot; data-end=&quot;3503&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Caution is advised when combined with &lt;strong data-start=&quot;3412&quot; data-end=&quot;3438&quot;&gt;psychedelic substances&lt;/strong&gt;, as stimulant effects may worsen anxiety and intrusive thoughts.&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;3506&quot; data-end=&quot;3603&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong data-start=&quot;3506&quot; data-end=&quot;3541&quot;&gt;Avoid combination with tramadol&lt;/strong&gt;, as both agents increase the risk of &lt;strong data-start=&quot;3579&quot; data-end=&quot;3602&quot;&gt;seizures and stroke&lt;/strong&gt;.&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;
&lt;p&gt;&amp;nbsp;&lt;/p&gt;
&lt;h2 data-start=&quot;3610&quot; data-end=&quot;3648&quot;&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;&lt;strong&gt;When to Seek Emergency Medical Help&lt;/strong&gt;&lt;/span&gt;&lt;/h2&gt;
&lt;hr /&gt;
&lt;p data-start=&quot;3649&quot; data-end=&quot;3780&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong&gt;Seek urgent medical care if any of the following occur after methylphenidate use, particularly with high doses or mixed substances:&lt;/strong&gt;&lt;/span&gt;&lt;/p&gt;
&lt;ul&gt;
&lt;li data-start=&quot;3784&quot; data-end=&quot;3819&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Chest pain or irregular heartbeat&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;3822&quot; data-end=&quot;3843&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Shortness of breath&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;3846&quot; data-end=&quot;3881&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Seizures or loss of consciousness&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;3884&quot; data-end=&quot;3932&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Severe agitation, confusion, or hallucinations&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;3935&quot; data-end=&quot;3981&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;High fever, excessive sweating, or shivering&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;3984&quot; data-end=&quot;4051&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Sudden weakness, numbness, vision changes, or difficulty speaking&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;
&lt;p data-start=&quot;4053&quot; data-end=&quot;4102&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;&lt;strong data-start=&quot;4053&quot; data-end=&quot;4102&quot;&gt;Possible signs of serotonin syndrome include:&lt;/strong&gt;&lt;/span&gt;&lt;/p&gt;
&lt;ul&gt;
&lt;li data-start=&quot;4105&quot; data-end=&quot;4135&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Muscle rigidity or twitching&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;4138&quot; data-end=&quot;4156&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Rapid heart rate&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;4159&quot; data-end=&quot;4166&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Fever&lt;/span&gt;&lt;/li&gt;
&lt;li data-start=&quot;4169&quot; data-end=&quot;4191&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Altered mental state&lt;/span&gt;&lt;/li&gt;
&lt;/ul&gt;
&lt;p&gt;&amp;nbsp;&lt;/p&gt;
&lt;h2 data-start=&quot;4198&quot; data-end=&quot;4221&quot;&gt;&lt;span style=&quot;color: #ff99cc;&quot;&gt;&lt;strong&gt;Clinical Safety Note&lt;/strong&gt;&lt;/span&gt;&lt;/h2&gt;
&lt;hr /&gt;
&lt;p data-start=&quot;4222&quot; data-end=&quot;4519&quot;&gt;&lt;span style=&quot;color: #99ccff;&quot;&gt;Methylphenidate is effective for many patients when used under medical supervision. &lt;strong data-start=&quot;4306&quot; data-end=&quot;4383&quot;&gt;Polysubstance use and non-medical use significantly increase health risks&lt;/strong&gt;. Patients should inform their healthcare provider of all medications and substances they are using to support safe treatment decisions.&lt;/span&gt;&lt;/p&gt;
&lt;p data-start=&quot;4222&quot; data-end=&quot;4519&quot;&gt;&amp;nbsp;&lt;/p&gt;

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