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Brand-name Ritalin, manufactured by Novartis (formerly Ciba-Geigy), comes in the form of 5 mg, 10 mg, and 20 mg tablets, as does its generic counterpart, methylphenidate, produced by MD Pharmaceuticals. Despite claims from the ADD underground (encountered often on the Internet) of the brand-name drug's superiority, Ritalin and generic methylphenidate have been rated as bioequivalent in their actions by the Food and Drug Administration. Unless a family insists on Ritalin, I prescribe generic methylphenidate because it is less costly. (An article in the Journal of the American Academy of Child and Adolescent Psychiatry, the leading child psychiatry journal, reported on two children who responded differently to the two different preparations, but the psychiatrists could not account for the differences.) I have trouble accepting that the two versions of the drug really are different. If a child wasn't responding to methylphenidate, I would consider another medication entirely--say, Dexedrine--rather than switching to Ritalin

We don't know exactly why it produces the effects it does. Methylphenidate (Ritalin) was first synthesized in 1944 in an (unsuccessful) attempt to create a stimulant that would not induce addiction or tolerance. Ritalin is very closely related to amphetamine: similar in chemical structure, metabolization and clinical effects. This close connection is the chief reason Ritalin use raises concern among patients and others.

DOSAGE

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones above, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. Avoid taking this medication late in the day, as it may cause difficulty sleeping. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.