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Ritalin Withdrawal Timeline

Medically Reviewed By: Benjamin Caleb Williams RN, BA, CEN

Written By: Phillippe Greenough

Article Updated: 01/25/2021

Number of References: 23 Sources

Ritalin is a very common stimulant medication that is commonly used to treat ADHD and, more infrequently, narcolepsy. While it can be safe and effective for treating these disorders when used as prescribed, it can still be abused. The symptoms of Ritalin withdrawal, while rarely dangerous, can be quite uncomfortable. Even though they may be strictly psychological in nature, these symptoms can still present some indirect risks and make it very difficult for someone to quit using Ritalin. In this article, we will examine how, exactly, this drug works, the specific symptoms of Ritalin withdrawal, the timeline involved, and some effective treatment options.

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Ritalin Withdrawal Symptoms

Within hours of the last drug use, the symptoms of Ritalin withdrawal will begin to appear. These may be mild initially, but within the first few days of Ritalin cessation, they will have reached their peak intensity. Because Ritalin is a stimulant, the symptoms of Ritalin withdrawal are generally depressive in nature. Even though these symptoms may pose no direct, physical risk, they can still be extremely disruptive to someone’s life. Also, they may lead to secondary risks such as suicidal thoughts or suicide attempts, and this risk should be treated very seriously.

These symptoms can be very unpleasant and sometimes quite long-lasting. Depression and the risk of suicide are of particular note, as this can lead to fatal outcomes. Obtaining appropriate care is critical in reducing both the risks and the discomfort of Ritalin withdrawal symptoms. Entering a Ritalin detox center can provide the resources and trained medical professionals to help someone through this difficult period in the safest way possible. This may also provide the tools to give someone the best possible chances of achieving long-term recovery.

The timeline for Ritalin withdrawal symptoms can vary somewhat between people, although for the worst of the symptoms, it is usually no more than a week or two. That being said, less intense but more prolonged symptoms may persist for quite some time in the form of post-acute withdrawal symptoms. These are often mild but can last for months or even years after Ritalin use has ceased. Here we will look at a general timeline that may apply to most people over the first month of Ritalin withdrawal.

Depending on the exact formulation of Ritalin, it can have a different half-life and pharmacokinetic profile. The bounds of Ritalin’s half-life, among all formulations, is between 2.1 to 3.5 hours. That being said, extended-release formulations will introduce the drug into the body more slowly, so this could extend the half-life by ~12 hours. This is fairly short for a stimulant, and this means that usually within around 6 hours of the last use, someone will begin experiencing symptoms of Ritalin withdrawal.

Week 1

Within hours of the last use, symptoms will begin to appear. The initial phase, known as the “crash” phase will usually resolve within the first three days. This is a rapid appearance and escalation of withdrawal symptoms that will lessen and stabilize fairly soon. The most common symptoms to arrive first are sadness which usually deepens into depression, and a profound and rapidly escalating fatigue and lethargy. Someone may also begin sweating profusely within the first day, and the first night is usually characterized by excessive sleep. Anxiety, anhedonia, headaches, increased appetite, and cognitive difficulties may also be expected the next day. Tremors and cardiovascular fluctuations, such as intermittently rising and falling blood pressure, may be common during the first few days as well. These symptoms often stabilize around the middle of the first week and may begin resolving towards the seventh day.

Some symptoms of Ritalin withdrawal that may be experienced during the first week may include:

  • Deep Depression (with or without suicidal ideation)
  • Anxiety
  • Fatigue and Lethargy
  • Headaches
  • Increased Appetite
  • Diaphoresis (excessive sweating)
  • Cognitive Difficulties
  • Strong Cravings for Ritalin
  • Anhedonia (reduced ability to experience pleasure)
  • Cardiovascular Fluctuations (hyper- or hypotension)
  • Sleep Disturbances (usually hypersomnia followed by insomnia)
  • Shaking or Tremors
  • Priapism (prolonged, sometimes painful erections; uncommon)
  • Dystonia (movement disorders, usually involving the mouth; uncommon)

Week 2

The beginning of the second week often shows some improvement in symptom intensity. While the worst of the symptoms such as tremors, cardiovascular fluctuations, and headaches may be well on their way to resolution, the rest of the symptoms are often still present. Hypersomnia may resolve as the physical symptoms fade, and insomnia normally follows although its origins are psychological rather than physical. Anxiety, depression, and low energy levels often persist mostly unchanged throughout the week although cognitive issues may begin to improve as the week goes on.

Some symptoms of Ritalin withdrawal that may persist into the second week may include:

  • Deep Depression (with or without suicidal ideation)
  • Anxiety
  • Fatigue and Lethargy
  • Headaches
  • Increased Appetite
  • Cognitive Difficulties
  • Cravings for Ritalin
  • Anhedonia (reduced ability to experience pleasure)
  • Sleep Disturbances (usually insomnia by this point)

Weeks 3 & 4

By week three, the majority of symptoms have usually resolved. That being said, the more severe symptoms of depression, anxiety, and fatigue may have shown some improvement, but are often still quite disruptive. Cravings may also become more noticeable now as the memory of the intense crash and discomfort of early withdrawal fades. The fourth week often shows some lifting of anxiety and fatigue, although depression may still be present. Cravings are often still present and may persist for some time to come.

Some symptoms that may linger into the third and fourth week of Ritalin withdrawal may include:

  • Depression
  • Anxiety
  • Low Energy Levels
  • Minor Cognitive Difficulties
  • Cravings for Ritalin
  • Anhedonia (reduced ability to experience pleasure)
  • Sleep Disturbances

What Factors Influence the Intensity of Withdrawal?

The symptoms of Ritalin withdrawal can exhibit some substantial variability between people, and this can be due to a variety of factors. Some of these are based on a person’s Ritalin use habits and are therefore based on choices someone has made, while others have to do with mental health or genetics and are totally out of someone’s power to control. Depending on these factors, both the intensity and the duration of Ritalin withdrawal symptoms can be affected. While some people may recover fully and quickly from withdrawal, others may have severe and long-lasting symptoms that can persist for years.

Some of the largest contributing factors toward the intensity and duration of Ritalin withdrawal may include:

  • The amount of Ritalin someone regularly used
  • The length of time someone used Ritalin
  • Co-occurring mental health issues
  • A genetic predisposition to addiction

Certainly, the largest factor with regard to the intensity and duration of Ritalin withdrawal symptoms are a person’s specific use habits. The amount of Ritalin someone regularly used can directly impact the intensity of withdrawal symptoms. The more Ritalin someone uses, the more dopamine and norepinephrine receptor downregulation occurs. Once someone stops using Ritalin, the more severe the symptoms will be. Additionally, the longer someone uses Ritalin, the longer the withdrawal symptoms will last once they stop using the drug. Furthermore, after downregulation begins a further process of remodeling begins. The longer someone uses Ritalin, the more complete this remodeling process becomes. Remodeling will take time to produce noticeable effects and is a very slow process to complete and, subsequently, a slow process to reverse. The longer someone used Ritalin, the longer they can expect to experience withdrawal symptoms after they stop using the drug.

If someone had pre-existing mental health issues such as depression or anxiety, then they may have more severe depressive or anxious symptoms during Ritalin withdrawal. Additionally, these symptoms may be more persistent if there were co-occurring mental health issues. Since depression and anxiety are such common symptoms of Ritalin withdrawal, these two are especially relevant, but this could occur with a variety of mental illnesses.

Genetics also plays a factor in someone’s likelihood to suffer from addiction issues, although the way it may affect the symptoms of Ritalin withdrawal or the withdrawal timeline would be more indirect. If someone has a genetic predisposition for addiction, then they may be more likely to abuse Ritalin earlier in life, which could lead to developmental issues, and they may have a higher likelihood of rapidly increasing Ritalin use. In this way, genetics could impact someone’s experience with Ritalin withdrawal, but again, this would be in a very indirect manner.

More About Ritalin Addiction

The major psychoactive ingredient in the medication Ritalin is the drug methylphenidate. This is a stimulant drug and while producing very similar effects as amphetamines, is distinct from this class of drug, although they are very closely related. Ritalin’s mechanism of action, while not exactly clear, seems to be similar to those used by the amphetamines. By interacting with neurotransmitter transporter proteins, Ritalin can cause levels of certain excitatory neurotransmitters to build up in between neurons, leading to higher levels of excitatory signaling by prolonging the time that these neurotransmitters are able to signal before being removed by the reuptake process.

Known as reuptake inhibition, this process can produce dose-dependent effects, with low doses leading to enhanced concentration and high doses exhibiting the classic stimulant properties such as hyperactivity, euphoria, and impaired cognition. The two major neurotransmitters that Ritalin effects are dopamine and norepinephrine, although the strongest euphoric effects are due to dopamine. Dopamine is a major excitatory neurotransmitter in the brain that can influence cognition, motor control, feeling of reward, and motivation. Norepinephrine is both a neurotransmitter and a hormone and, in the brain, is responsible for attention, focus, and motivation among other things. In the blood acting as a hormone, norepinephrine can increase heart rate, elevate blood pressure, and cause blood sugar levels to spike.

Through chronic use of Ritalin, the brain will respond to the increased levels of these neurotransmitters in an attempt to maintain balance. This process, known as downregulation, is the act of the brain reducing its sensitivity to these neurotransmitters. This can first lead to tolerance to Ritalin, and with continued use will result in physical dependence. A further process known as neurological remodeling will begin after downregulation, and this is the brain making structural changes in an attempt to operate more effectively in a dopamine and norepinephrine downregulated environment. Once downregulation and remodeling have occurred due to chronic Ritalin use, someone will benign to feel mentally unwell when they go too long without using the drug.

The Importance of Ritalin Detox

The symptoms of Ritalin withdrawal can be an extremely difficult challenge to overcome alone. It often requires help, not only to make it through withdrawal but to avoid relapse and continue building a new life after Ritalin addiction. Entering a Ritalin detox center can provide medical supervision, medications, and clinical therapy to help reduce the physical and psychological discomfort, and help someone develop skills and tools to deal with life in a healthier way. After detox is completed, these centers can provide referrals or connections to further treatment programs or make introductions to members of the local recovery community. In the end, there is a much greater chance of someone achieving long-term recovery and building a better life if they have the resources of a Ritalin detox center to draw upon.

Related Guides

There are several other stimulant drugs that can produce uncomfortable or even dangerous withdrawal symptoms. We have more in-depth withdrawal guides for drugs such as:

Adderall Withdrawal Timeline

Vyvanse Withdrawal Timeline

Crystal Meth Withdrawal Timeline

Ecstasy Withdrawal Timeline

Cocaine Withdrawal Timeline

Article References (In Addition to 5 in-article references)

  1. 1 StatPearls: Methylphenidate
  2. 2 Molecular Psychiatry: Anti-Hyperactivity Medication - Methylphenidate and Amphetamine
  3. 3 Neuroscience & Biobehavioral Reviews: The Pharmacology of Amphetamine and Methylphenidate - Relevance to the Neurobiology of Attention-Deficit/Hyperactivity Disorder and Other Psychiatric Comorbidities
  4. 4 FDA Drug Safety Communication: Priapism and Methylphenidate
  5. 5 Journal of Pediatrics: Stuttering Priapism Associated with Withdrawal from Sustained-release Methylphenidate
  6. 6 International Archives of Health Sciences: Oromandibular Dystonia Secondary to Methylphenidate - A Case Report and Literature Review
  7. 7 Netherlands Pharmacovigilance Centre: Methylphenidate, Dexamphetamine, and Trismus
  8. 8 Primary Care Companion to the Journal of Clinical Psychiatry: Methylphenidate Abuse and Psychiatric Side Effects
  9. 9 PLOS One: Long Withdrawal of Methylphenidate Induces a Differential Response of the Dopaminergic System and Increases Sensitivity to Cocaine in the Prefrontal Cortex of Spontaneously Hypertensive Rats
  10. 10 Mayo Clinic: Priapism
  11. 11 Journal of Addiction Medicine: Dystonia in Methylphenidate Withdrawal - A Case Report
  12. 12 BMJ Case Reports: Neurological Adverse Effects of Methylphenidate May Be Misdiagnosed as Meningoencephalitis
  13. 13 Journal of Addiction Medicine: Prevalent Intravenous Abuse of Methylphenidate Among Treatment-Seeking Patients With Substance Abuse Disorders - A Descriptive Population-Based Study
  14. 14 Bulletin of Clinical Psychopharmacology: Long-Acting Methylphenidate Toxicity - A Case Report
  15. 15 The Journal of Neuropsychiatry and Clinical Neurosciences: Symptoms of Major Depression After Pseudoephedrine Withdrawal - A Case Report
  16. 16 Addiction & Health: Reporting a Case of Injecting Methylphenidate (Ritalin) Tablets, Intensified Symptoms of Schizophrenia, or Induce Separate Mental Disorder?
  17. 17 Swiss Medical Weekly: Severe Toxicity Due to Injected but Not Oral or Nasal Abuse of Methylphenidate Tablets
  18. 18 United Nations Office on Drugs and Crime: Treatment of Stimulant Use Disorders - Current Practices and Promising Perspectives

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