Expert: Dr Billy Levin - 9/20/2008

Question
Dear Dr. Levin,
In an adult who is on Ritalin and has high blood pressure, is it OK to use beta blockers such as Coreg to control blood pressure and heart rate?

I know beta blockers has a paradoxical effect on people who use stimulants, but is it also true for Ritalin?

Thanks

Answer
Firstly Ciba pharmaceuticals  (now known as Novartis) marketed Serpacil many years ago to treat hypertension. It worked very well  but caused depression. They researched and produced an antidepressant to counter the depressive effects of Sepacil.  The name of the product....Ritalin. Thus if it was acceptable then  to use Ritalin for hypertensive patients it is still acceptable now, provided the hypertension is controlled.
   Ritalin has no paradoxical action and neither do beta blockers. However beta blockers may be used in patients with ADHD who are on Ritalin for their hypertension, if needed. Beta blockers can also be used for the same ADHD  type of patient  where the is no hypertension, but  where exam nerves or aggression is a problem.
   Obviously both the dose of Ritalin and beta blocker must be regularly monitored to ensure optimal effect.