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Ethylphenidate and Ritalin
Ethylphenidate Formation in Human Subjects after the Administration of a Single Dose of Methylphenidate and Ethanol
November 15, 2022
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Mixing Ritalin and alcohol can create ethylphenidate.
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This molecule is believed to have caused at least two deaths in individuals who were drinking.
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Ethylphenidate has psychoactive properties and has also been used as an illicit drug.
Mixing drugs and alcohol is often times not a great idea.
This can be particularly dangerous for those on ADHD medication.
Ritalin, or methylphenidate, has been linked to several deaths in individuals who may have taken it with alcohol.
One potential reason may be a chemical called ethylphenidate, a potentially toxic chemical produced by your body when you take Ritalin with alcohol.
This is particularly concerning given the higher rates of heavy drinking and alcoholism among those with ADHD:
What is ethylphenidate?
Ethylphenidate is a molecule that’s closely related to Ritalin. It has gathered some attention because it’s been associated with several overdose deaths.
In some of these cases, individuals were found to have taken Ritalin and alcohol simultaneously.
Scientist suspect that this combination may have led to chemical reactions that generated ethylphenidate in the body.
Methylphenidate and Alcohol combine to form ethylphenite
When you take medication, your body eventually gets rid of the medication. Otherwise, it will stick around for a long time.
One of the ways that your body does this is by chemically reacting with the medication until it becomes something that your body can easily remove.
The chart above shows how ethylphenidate gets created as your body breaks down Ritalin.
Ethylphenidate production after drinking
To confirm that Ritalin and alcohol together can produce methylphenidate, researchers conducted a small study on six adults.
They provided these adults with Ritalin followed by a moderate amount of alcohol, similar to the amount of alcohol you may drink on a night out.
They found that they could detect ethylphenidate in their blood almost immediately.
The study was one of the first to confirm that Ritalin combined with alcohol can create toxins in your body.
Ethylphenidate becomes detectable in the bloodstream almost immediately after drinking alcohol with Ritalin.
How dangerous is ethylphenidate?
Ethylphenidate is not a very well studied drug. We are just starting to realize how dangerous it can potentially be.
We know that it has been linked to a series of deaths across Europe in individuals who have been taking it recreationally along with other drugs.
There is a single case report of a death associated with ethylphenidate in Germany, and a case series of 19 deaths in the East of Scotland, but otherwise, the contribution of ethylphenidate to death is poorly documented.
Maskell at Al, University of Huddersfield
In some ways, its effects are similar to Ritalin and other stimulants. However, it comes with some potentially nasty side effects that may be contributing to its risks.
The effects of ethylphenidate that have been reported by users (stimulation, euphoria, an increase in focus, improved concentration, increased sociableness, empathy) are similar to those observed with other stimulants. These “positive” effects are counteracted with the side-effects (anxiety; paranoia; hallucinations; increased heart rate blood pressure and body temperature; peripheral vasoconstriction; insomnia; sweating and nasal pain on insufflation) that are again commonly seen with other abuse stimulants
Maskell at Al, University of Huddersfield
What does this mean for patients on Ritalin?
It is usually not a good idea to mix alcohol and stimulants. The presence of ethylphenidate provides a further reason not to mix alcohol and Ritalin in particular.
One of the primary concerns about ethylphenidate is that we just don’t understand very well.
It is not a substance that has been shown to be safe for human consumption. The little bit of data that we have comes from patients who have gotten very sick or have died from ethylphenidate.
There are other potential risks to mixing alcohol and ADHD medication, including potential rare cases of sudden death: