Methylphenidate !
A stimulant for ADHD and narcolepsy that blocks dopamine and noradrenaline reuptake. It is a controlled substance because it can be abused.
Updated 2026-11-01
The figure shows dexmethylphenidate (the active enantiomer of methylphenidate) in the human dopamine transporter.
Mechanism of action
Methylphenidate blocks the dopamine and noradrenaline transporters, so these neurotransmitters stay longer in the synapse. Higher catecholamine signalling in the prefrontal cortex improves attention and impulse control; the same action in reward circuits explains its abuse potential.
- Methylphenidate blocks DAT and NET
- Dopamine and noradrenaline stay longer in the synapse
- Prefrontal cortex: better attention and impulse control
- Reward circuits: risk of abuse
Pharmacokinetics
- Absorption
- Taken by mouth; immediate- and extended-release forms exist
Indications
- Attention-deficit/hyperactivity disorder (ADHD) in children aged 6 and older and adults
- Narcolepsy
Adverse effects
Common
- Reduced appetite and weight loss
- Insomnia
- Headache and abdominal pain
- Nervousness and irritability
- Faster heart rate and higher blood pressure
Contraindications
- Use of an MAO inhibitor now or within the previous 14 days
- Hypersensitivity to methylphenidate
Key interactions
- MAO inhibitors
- Hypertensive crisis: contraindicated
- Antihypertensives
- Weaker blood-pressure lowering
What is monitored
- Blood pressure and heart rate
- Height and weight in children
- Signs of abuse or diversion
- Mood, psychotic or manic symptoms
Administration and safety
- Immediate- and extended-release products are not interchangeable one-for-one; each product is given as its own label directs
- Controlled substance: counted, stored securely and documented
Nursing care
- Measures blood pressure, heart rate, height and weight before starting and during treatment
- Asks about heart disease, fainting and family history of sudden death before starting
- Teaches safe storage and disposal and warns against sharing the medicine
- Teaches to report cold, pale or bluish fingers or toes
- Teaches that a painful or prolonged erection needs urgent care
Pregnancy and breastfeeding
Human data are limited; use in pregnancy weighs the benefit for the mother against possible risks to the fetus.
Test yourself
Think of the answer, then tap the question to see it.
What is the mechanism of methylphenidate?
It blocks the dopamine and noradrenaline transporters, increasing these neurotransmitters in the synapse.
Which growth measure is followed in children on methylphenidate?
Height and weight, because stimulants can reduce appetite and slow growth.
Which drug class is contraindicated with methylphenidate and why?
MAO inhibitors (now or in the last 14 days), because of the risk of hypertensive crisis.
Related drugs
← Back to the class: ADHD medicines
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: DailyMed - METHYLPHENIDATE HYDROCHLORIDE tablet (DailyMed (U.S. National Library of Medicine), 2026); Methylphenidate: MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2026).
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Representative model, for educational purposes only.