Interaction of Ritalin With Alcohol

Ritalin is prescription medication that is classified as a stimulant. A stimulant is a substance that speeds up processes in our brain. One of the most common stimulants consumed is caffeine. With the increasing popularity of caffeinated alcoholic concoctions like espresso martinis and Irish coffees, the question remains whether or not it’s safe to mix stimulants like Ritalin with alcohol.

Despite how often alcohol and stimulants are mixed, the opposing mechanisms can be dangerous when combined. Since Ritalin is a prescription medication, the risks are even greater. Let’s get a better understanding of the direct interaction between alcohol and Ritalin. 

The Science Behind the Chemical “High”

Ritalin (methylphenidate) is a prescription drug that is FDA-approved to treat attention-deficit/hyperactivity disorder (ADHD) and narcolepsy. ADHD is a neurodevelopmental disorder characterized by unusual levels of hyperactivity and impulsive behaviors. Narcolepsy is a sleep disorder that is marked by the brain’s inability to control sleep-wake cycles — leading to excessive and overwhelming drowsiness during the day. 

Ritalin is classified as a central nervous system (CNS) stimulant. This means that it increases the levels of certain chemicals in the brain that speed up mental and physical processes. Specifically, Ritalin blocks reuptake of dopamine and norepinephrine. Dopamine is a neurotransmitter, or chemical messenger, that increases pleasure and is involved in motivation. Norepinephrine is a hormone that increases alertness. By increasing levels of dopamine and norepinephrine, Ritalin helps increase focus and attention. Those of us with ADHD often have difficulties producing and using dopamine, which is why Ritalin can be effective.

The medication comes in standard and extended-release forms and is prescribed based on a person's individual needs. Just like other prescription medications, Ritalin is associated with many side effects. 

• Headache
• Insomnia
• Loss of appetite
• Dry mouth
• Stomachache
• A general feeling malaise

More severe side effects include the following:

• Personality changes
• Thoughts of harming others or oneself
• Heart palpitations
• Hallucinations
• Facial tics

Ritalin may be effective in treating ADHD and narcolepsy, but what about if we have a drink or two while taking it?

Do Ritalin and Alcohol Interact?

Ritalin and alcohol have a direct interaction. Ritalin is a CNS stimulant, whereas alcohol is classified as a CNS depressant.

Our CNS controls messaging within our brain and between our brain and other parts of our body. Depressants slow down cognitive and motor function and stimulants excite mental and physical processes. Although opposites, they don’t just cancel each other out. Instead, alcohol affects the way our body processes Ritalin, which can alter the medication levels in our body — leading to unpredictable and dangerous effects.

Additionally, alcohol can indirectly affect Ritalin. The depressant effect of alcohol impairs functions such as our focus, memory, and thinking, all of which Ritalin is prescribed to help improve. 

Now that we know how alcohol and Ritalin interact, let’s take a look at what happens when we drink on the medication.

Can You Drink on Ritalin?

Drinking while taking Ritalin is not recommended. The direct interaction between alcohol and Ritalin can lead to dangerous side effects (which we'll get into shortly).

Ritalin and alcohol have opposite effects on the body, meaning that the medication may temporarily put a damper on the intoxicating effects of alcohol — causing us to drink more without noticing the effects until later. Drinking and Ritalin counteract each other, but what about other medications with methylphenidate? Is methylphenidate the same thing as Ritalin?

Is Ritalin the Same as Methylphenidate?

Methylphenidate is the generic form of Ritalin, and it is often used interchangeably in discussions about the drug. It’s also sold under other brand names.

• Concerta
• Contempla
• Daytrana
• Methylin

Although these medications all contain the active ingredient methylphenidate, they may differ in the dosage, form, and frequency at which they’re prescribed. However, as these medications all contain methylphenidate, they all directly interact with alcohol and may have consequences.

Consequences of Mixing Methylphenidate and Alcohol

The direct and indirect interaction between methylphenidate and alcohol can lead to dangerous effects that open the door to various complications:

• Enhanced side effects. Since alcohol affects the way our body processes methylphenidate, the level of medication in our body may increase. This increase can lead to more intense methylphenidate side effects, such as heart attack, stroke, alcohol poisoning, and mood fluctuations.
• Overdose. In addition to causing worsened side effects, excess levels of methylphenidate can lead to drug overdose. This can occur even if we’re taking the prescribed dosage. If we’re taking the extended-release form of methylphenidate, alcohol can promote immediate release of the drug into our body — increasing our risk of overdose.
• Alcohol poisoning. Methylphenidate can counteract some effects of alcohol — making us feel less intoxicated. However, that effect could lead to increased alcohol consumption, which may lead to alcohol poisoning. 
• Dependence and withdrawal. Both methylphenidate and alcohol have high risks of dependence. Since alcohol also has some stimulant effects, such as promoting the release of dopamine and serotonin, when we add it to stimulants, we heighten our risk of dependence. Dependence is a neurological change that can lead to withdrawal symptoms when stopping a substance. Withdrawal symptoms of alcohol include sweating, anxiety, headache, nausea, and more. Withdrawal symptoms of methylphenidate include fatigue, insomnia, and depression. 
• Negative effects on ADHD. Alcohol aggravates some ADHD symptoms, including impulsivity, impaired decision making, insomnia, and inattentiveness.

Mixing methylphenidate with alcohol can lead to a long list of consequences, but what about other ADHD medications? 

Can You Drink Alcohol While Taking Other ADHD Medications?

Generally, drinking while taking any ADHD medication isn’t recommended. Most other ADHD medications are also CNS stimulants, which interact directly with alcohol. Common ADHD medications such as Adderall or Vyvanse have similar risks when mixed with alcohol.

The only effective nonstimulant treatment for ADHD is Strattera, or atomoxetine. Since it isn’t a stimulant, it doesn’t carry the same risks as other ADHD medication do when combined with alcohol. However, mixing Strattera with alcohol increases the risk of liver damage. In general, alcohol should not be mixed with any ADHD medication. That said, does the amount of alcohol matter?

How Much Is Too Much?

When taking methylphenidate, alcohol consumption is not recommended even in minimal amounts. Since alcohol directly affects the way our body processes methylphenidate, even small amounts of alcohol can impact the level of the drug in our body. 

Simply put, the more alcohol we drink, the higher the risk of dangerous side effects and complications. But what about drinking after discontinuing the medication?

How Long After Taking Ritalin Can You Drink Alcohol?

The half-life of methylphenidate is approximately 2 hours but can range from 2 to 7 hours, which means that the medication levels found in our body decrease by half in that time period. However, drugs can take roughly 5 half-lives to be completely eliminated from our body. We’re advised to wait at least 35 hours after the last dose of methylphenidate to avoid direct interaction with alcohol. 

It’s also important to note that although waiting 35 hours after discontinuing methylphenidate will prevent direct interactions, alcohol can still negatively affect cognitive functions such as attention, memory, and focus, which the medication may have been used to treat. If choosing to drink after discontinuing the medication, it’s best to consult with a physician and follow moderate consumption guidelines. 

If we’re still taking methylphenidate and we accidentally drink alcohol, what should we do?

What To Do If You Mix Methylphenidate With Alcohol

Mixing methylphenidate with alcohol can be dangerous, but it’s important not to panic. Increasing our stress levels negatively affects our health, making the situation worse. If we accidentally drink while taking methylphenidate, we can follow these three steps. 

• Stop drinking. Stopping immediately can limit the extent of interaction between alcohol and Ritalin. It won’t reverse any damage done, but can prevent further consequences. Remember that the medication can lessen the intoxicating effects of alcohol, and, even if we don’t feel intoxicated, alcohol still interacts negatively with methylphenidate.
• Monitor effects. The interaction between methylphenidate and alcohol can cause mild to severe symptoms. Taking note of what side effects occur helps us determine if emergency medical attention is needed. 
• Seek medical attention. The combination of methylphenidate and alcohol can be hazardous, leading even to death. In the event of  a dangerous reaction, call 9-1-1 immediately to seek emergency medical treatment. 

Methylphenidate is often used as a long-term treatment. How can we navigate methylphenidate use and alcohol consumption safely?

A Mindful Approach to Alcohol and Ritalin

Ritalin, or methylphenidate, can be a short- or long-term treatment. When taking the medication for any amount of time, avoiding alcohol can be crucial for our safety. Let’s explore some tips to navigate Ritalin and alcohol safely.

• Discuss with a physician. Alcohol interacts directly with Ritalin — leading to dangerous effects. If we’re working through alcohol dependence, it’s important to discuss other medication options that may not negatively interact with alcohol. 
• Avoid alcohol. When taking Ritalin, avoiding alcohol is essential in preventing the dangerous effects of the interaction between alcohol and methylphenidate.
• Seek treatment. We can explore treatment options at any point in our journey to help us quit or cut back on alcohol. We can learn healthy coping strategies and identify the root cause of our alcohol use.
• Find alternatives. Non-alcoholic options can allow us to continue to participate in the social aspect of drinking while avoiding the negative consequences.
• Focus on other areas of well-being. ADHD and narcolepsy can require an exhaustive treatment approach. By improving other aspects of our health, we are supporting the management of the condition and our overall well-being.

A Clear Goal In Mind

Alcohol directly interacts with many prescription medications including Ritalin. The mechanism of the drug works by stimulating activity within our brain — directly opposing the mechanism of alcohol. While one doesn’t exactly cancel the other out, the two directly interact and can lead to dangerous effects. Alcohol also indirectly impacts Ritalin by exacerbating symptoms of ADHD and narcolepsy, which the medication is used to treat. While the idiom “Everything in moderation” can sometimes be applied to alcohol consumption, it doesn’t hold true for drinking while taking Ritalin. Avoid alcohol while on Ritalin to prevent risky side effects!