Overdoses of Ritalin

I hope this is advanced enough for this forum, but I have looked on my own, and can't find an answer. I know that people can die from low doses of injecting Ritalin from in inactive compounds forming blood clots. I've also read about a case (ref: pubmed) about a 19 yr old who overdosed on Ritalin by snorting it (I believe it was around 200mg). However, I can't find a single case of someone dying from an oral overdose of Ritalin. I've taken over 300 mg orally in one day, so I'm sure others have taken even more. I know there is the difference in time to reach the brain, but I would think massive oral quantities would lead to death from arrythmias. Any thoughts?

Methylphenidate only has an oral availability of between 10-20 percent due to 1st pass metabolism, so 300mg orally is only going to be equivalent to 30-60mg nasally

^ What he said.

Meanwhile, I'm quite confident people have died from oral methylphenidate overdoses.

^
patients who took their medication like prescribed probably died from it as well , uppers have this way of being dangerous without the situation really changing
(let's say you go for a run outside in the sun on your normal rit dose ...)

Of course anything can happen...it's just that I've never seen a (reputable) source or case of overdose from only oral Ritalin not a combination of other drugs. The above re: first pass metabolism makes sense though, I hadn't thought about that. Thanks for the answers.
P.S. There have been reports of overdoses on Adderall from oral doses alone (larger than prescribed, though).

fastandbulbous said:

Methylphenidate only has an oral availability of between 10-20 percent due to 1st pass metabolism, so 300mg orally is only going to be equivalent to 30-60mg nasally

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Reference?
Those numbers sure don't sound right at all, at least not for me. I'd say it's 2-3 times more potent snorted but then again it's gone faster too so it's probably not all that more effective, just faster...

edit: ah, off course part of what's in my nose goes to my stomach... So if I didn't snort it trough(let it sit in my nose) and let everything get absorbed by my nose it would be 5-10x as potent as taking it orally?

^^^you are learning young grasshopper. railing, sublingual, IV, and anal, all pass 1st pass liver metabolism and are more bioavailable than eating your chemical goods.

Sprinklervibes said:

Reference?
Those numbers sure don't sound right at all, at least not for me. I'd say it's 2-3 times more potent snorted but then again it's gone faster too so it's probably not all that more effective, just faster...

edit: ah, off course part of what's in my nose goes to my stomach... So if I didn't snort it trough(let it sit in my nose) and let everything get absorbed by my nose it would be 5-10x as potent as taking it orally?

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"Methylphenidate is rapidly and extensively absorbed from the tablets following oral administration; however, owing to extensive first-pass metabolism, bioavailability is low (approx. 30%) and large individual differences exist (11 to 52%)."

link

^While I can't find any sources at the moment, I have read of a few oral ritalin overdoses resulting in death. It definitely does happen, but there are other factors that come into play. Pre-existing heart conditions, and stuff like that. As a side note, I have taken over 500mg of methylphenidate in one day, boy what a day that was....

After reading what you wrote, I just realized that I've taken 540 mg in the past 16 hrs. Great that my doc prescribed a max of 60 mg/day. I'm supposed to take 3 20mg pills in one day, instead I took 27. That's almost one third of my prescription! Great, so now a 1 mo prescription will last ~ 3 days. Oh well. On the other hand, you described it as "what a day", whereas I've felt barely awake (I do also take benzos, but not much), and definitely not euphoric or more able to concentrate. I guess my tolerance may be just a little too high at this point...time to cut back. Thanks for the wake up call!

Edit: Sorry bout the question. i was really freaking out...and i couldnt stop myself from asking....

About Ritalin Bioavailability:

1. I second the 30%-statement upon oral administration. My ref: "General and Special Pharmacolgy and Toxocology"; W. Forth, D. Henschler, W. Rummel; 8th edition, 2001 (german textbook)

2. Alcohol increases significantly the oral bioavailability of d-methylphenidat (selectively!). Ref: Clin Pharmacol Therap 2007, 81, p.346

See here for a free available ref that reports about 2 ritalin-fatalities: http://www.ncbi.nlm.nih.gov/pubmed/...ez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
Further refs with fatality-reports:
- J Anal Toxicol 1986, 10(5), p.209: A case involving an accidental overdose fatality resulting from an intravenous injection of crushed Ritalin (methylphenidate) tablets is presented. The drug was quantified by gas chromatography/nitrogen-phosphorus detection and confirmed by gas chromatography/mass spectrometry. Concentrations of drug were as follows: blood, 2.8 mg/L; bile, 5.7 mg/L; kidney, 3.0 mg/kg; liver, 2.1 mg/kg; and stomach contents, 1.6 mg total. Other drugs and volatile substances were not detected.
- J Forensic Sci 1999, 44(1), p.220: A fatality in a teenager from the recreational intranasal abuse of methylphenidate (Ritalin) is reported. The prescribed use of methylphenidate (Ritalin) in the treatment of attention deficit and/or hyperactivity disorder is widespread. The intranasal abuse of methylphenidate (Ritalin) among teenagers is becoming increasingly more recognized. Previous deaths from the parenteral abuse of methylphenidate (Ritalin) have been reported. This fatality is the first reported from its intranasal abuse.

Peace! Murphy

To answer several posters question about "I took XXX mgs will I be alright?" we cannot tell you one way or the other. Tolerance is a major factor in overdoses so you are better at estimating than we are. If you feel high and happy chances are that you are quite far from an OD. Things will start to get sketchy when you really over doing it. But in any case its best not to severely abuse these stims as you will not be the same after extended periods of abuse (long term sluggishness and depression are likely to follow)

I maybe quite wrong here, but didn't Shulgin in his FdoA paper suggest reversed esters of ritalin as possible models?

I seem to remember US folks calling it 'ritalin tin tin' since it's sort of edgy, hollow and not that nice (I've never tried it so who am I to talk)

^^^phacetoperane?

Alcohol increases significantly the oral bioavailability of d-methylphenidate (selectively!)

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What doses are needed for ethylphenidate to form? Does it carry a higher risk for cardiotoxicity like cocaethylene?

Oral bioavailability often oscillates between roughly 10 and 30%.

Any small therapeutic dose of methylphenidate and alcohol will generate ethylphenidate.

future psychiatrist, your attitude towards methylphenidate is pretty reckless. i have no idea how you plan on continuing to use it, since your tolerance is absurdly high.

you are contributing to the difficulty for people who actually take their prescribed dose to acquire their medication. if your name has an ounce of sincerity in it, then this is one of the most unethical things you could do, let alone posting it on a board to be tabulated among the plethora of cases of people betraying the trust of their doctors. you're adding to the stigma of psychostimulants in mental health. you said you are prescribed a benzodiazapene. if you are taking it and the methylphenidate concomitantly, then you are doing nothing other than speedballing. and don't throw some ADHD diagnosis or anxiety disorder as a justification. it's practically unheard of to regimen more than 80mg/day methylphenidate.

and no this isn't an advanced drug discussion topic.

don't bother replying, i'm not going to read it.

^^^Considering the original post was made over three years ago, I doubt he will...

haha, classic! futurepsychiatrist would now be known as psychiatrist