What is Methylphenidate?

Ritalin is a brand name for a medication commonly used to treat ADHD. Methylphenidate (MPH) is the active ingredient in these medications and it is classified as a central nervous system (CNS) stimulant. It comes in different forms and doses.MPH is available as tablets of 5, 10, and 20 mg for oral administration and is prescribed as the first line of treatment for ADHD. It also has the slow release and extended-release options. Other trade names for MPH are Daytrana, Quillivant XR, Concerta, Metadate, Methylin, Penid, Tranquilyn, and Rubifen. It is estimated that in 2013, 2.4 billion doses of methylphenidate were taken worldwide

Two orange pills with a green background.

How does Methylphenidate work?

Methylphenidate is thought to work by inhibiting dopamine and norepinephrine reuptake by neurons. Dopamine is a neurotransmitter that affects pleasure, movement, and attention span. Norepinephrine increases heart rate and blood circulation. It increases blood sugar levels to provide more energy to the body. By increasing these two substances, MPH increases attention and alertness. In addition to MPH, it is used to treat narcolepsy.

Methylphenidate was invented in 1944. Methylphenidate was initially used to allay barbiturate-induced coma, narcolepsy, and depression, but became associated with AHDH in the early 2000s when the understanding of this condition was more comprehensive.

Internationally, methylphenidate is a Schedule II drug, which means that it is accepted for medical use but is considered to have high abuse potential. This also means that to buy MPH medications you will require a prescription.

 

Is Methylphenidate effective?

The medicine has been deemed effective in the treatment of ADHD, especially in the short term. Several reviews have established the safety and effectiveness of stimulants as a treatment. It is estimated that 70% of people who use methylphenidate see improvements in ADHD symptoms. It is also effective with Narcolepsy, a chronic sleep disorder characterized by overwhelming daytime drowsiness and uncontrollable sleep since it can increase energy and wakefulness. As mentioned above, the medicine was effective earlier in the treatment of depression and memory-related issues.

 

Methylphenidate side effects

Yet despite the said effectiveness, a great of controversy has surrounded stimulants such as Ritalin, especially when prescribed to children.

The most common side effects are :

  • excessive sweating
  • mood changes
  • feeling nervous or irritable
  • sleep problems (insomnia)
  • fast heart rate
  • pounding heartbeats or fluttering in your chest
  • increased blood pressure
  • headaches
  • appetite loss
  • dry mouth
  • anxiety
  • nervousness
  • nausea

More serious side effects include:

  • chest pain
  • trouble breathing
  • lightheadedness
  • hallucinations
  • new behavior problems
  • aggression
  • hostility
  • paranoia
  • numbness or pain in your fingers or toes
  • cold feeling in your fingers or toes
  • unexplained wounds
  • skin color changes (pale, red, or blue appearance) in your fingers or toes, 
  • penis erection that is painful or lasts 4 hours or longer

 

Methylphenidate addiction, overdose, and withdrawal

The medicine is highly addictive and can lead to dependency and abuse when taken for a long period. Dependency is characterized by impaired control over drug use despite harmful side effects. When dependency develops, the risk of overdose also increases since the user will lose control of their intake.

A mild overdose can cause vomiting, nausea, agitation, tremors, hyperreflexia, muscle twitching, euphoria, confusion, hallucinations, delirium, hyperthermia, sweating, flushing, headache, tachycardia, heart palpitations, cardiac arrhythmias, hypertension, mydriasis, and dryness of mucous membranes.

Yet, the overdose can be more severe and can lead to hyperpyrexia, sympathomimetic toxidrome, convulsions, paranoia, stereotypy (a repetitive movement disorder), rapid muscle breakdown, coma, and circulatory collapse. When mixed with other drugs, such an overdose can be fatal. The number of emergency room visits involving Adderall misuse increased from 862 visits in 2006 to 1,489 in 2011 according to data from the Drug Abuse Warning Network. Between 2005 and 2010, the number of emergency department (ED) visits involving attention-deficit/hyperactivity disorder (ADHD) stimulant medications increased from 13,379 to 31,244 visits

The number of ED visits involving ADHD stimulant medications increased significantly for adults aged 18 or older between 2005 and 2010, but no significant increases were seen among children younger than 18. Moreover, abruptly stopping the use of Methylphenidate can cause withdrawal symptoms. 

 

Methylphenidate Treatment

There has a huge deal of controversy regarding the use of MPH with children as it is considered a gateway drug. Nadine Lambert, Ph.D., director of the school psychology program at the University of California at Berkeley highlighted the relationship between both ADHD and the use of stimulants in childhood and dependence on tobacco and other stimulants as adults. A new study tested on rats by the National Institutes of Health (NIH) and McLean Hospital/Harvard Medical School proposes that the misdiagnosis of attention-deficit hyperactivity disorder (ADHD) coupled with prescription drug use in children may lead to a greater chance of developing depressive symptoms in adulthood. The tests conducted showed that animals who were given Ritalin experience less pleasure and reward hormones.

Whether it is effective or not, MPH abuse can lead to adverse and dangerous side effects. If you need help with addiction or dependency, have a look at our website here.

 

References

“Methylphenidate Hydrochloride Monograph for Professionals”. Drugs.com. AHFS. Archived from the original on 19 December 2018. Retrieved 19 December 2018.

March 2015, The Pharmaceutical Journal6. “Narcotics monitoring board reports 66% increase in global consumption of methylphenidate”. Pharmaceutical Journal. Archived from the original on 19 December 2018. Retrieved 19 December 2018.

“Methylphenidate”. www.drugbank.ca. Archived from the original on 31 January 2019. Retrieved 30 January 2019.

Noven Pharmaceuticals, Inc. (17 April 2015). “Daytrana Prescribing Information” (PDF). United States Food and Drug Administration. pp. 1–33. Archived (PDF) from the original on 23 June 2015. Retrieved 23 June 2015.

Morton WA, Stockton GG (2000). “Methylphenidate Abuse and Psychiatric Side Effects”. Prim Care Companion J Clin Psychiatry. 2 (5): 159–164. doi:10.4088/PCC.v02n0502. PMC 181133. PMID 15014637.

Panizzon L (1944). “La preparazione di piridile piperidil-arilacetonitrili e di alcuni prodotti di trasformazione (Parte Ia)”. Helvetica Chimica Acta. 27: 1748–56. doi:10.1002/hlca.194402701222.

Cowart VS. The Ritalin Controversy: What’s Made This Drug’s Opponents Hyperactive? JAMA. 1988;259(17):2521–2523. doi:10.1001/JAMA.1988.03720170007005

https://www.apa.org/monitor/jun01/ritalin

McCarthy, S., Neubert, A., Man, K.K.C. et al. Effects of long-term methylphenidate use on growth and blood pressure: results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). BMC Psychiatry 18, 327 (2018). https://doi.org/10.1186/s12888-018-1884-7