Methylphenidate

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Pronunciation: meth-ill-FEN-i-dait

Chemical Abstracts Service Registry Number: 113-45-1. (Hydrochloride form 298-59-9)

Formal Names: Concerta, Metadate CD, Metadate ER, Methylin, Ritalin

Informal Names: Pellets, Rities, West Coast. Combination with pentazocine: Crackers, 1s & 1s, Poor Man's Heroin, Ritz & Ts, Sets, Ts & Rits, Ts & Rs. Combination with heroin: Speedball

Type: Stimulant (amphetamine class). See page 12

Federal Schedule Listing: Schedule II (DEA no. 1724)

USA Availability: Prescription

Pregnancy Category: C

Uses. Methylphenidate became available in the 1940s. The drug is fast acting and long lasting. Although not a true amphetamine, methylphenidate has properties similar to dextroamphetamine (including appetite suppression and sleep disruption) but is less potent.

Methylphenidate's prime medical use is for managing attention deficit hyperactivity disorder (ADHD), a condition in which people are so excitable that they have severe problems with social interactions. The affliction is more common in children than adults, and methylphenidate seems more effective against ADHD in children, though one study finds the drug to have little influence on long-term outcome. Limited success is seen in experimental usage of the drug to help autistic children. A case report says a regimen of that drug and the antidepressant sertraline (Zoloft) cured a young kleptomaniac. Among adults methylphenidate is typically prescribed for narcolepsy and has also been used successfully against apathy and depression. Despite the drug's occasional tendency to increase blood pressure, studies find the substance promising for rehabilitation of persons recovering from stroke and other brain injuries, not only improving mood but also helping ability to move.

In volume of use, methylphenidate has been called the predominant medically prescribed psychoactive drug among American juveniles. A survey of approximately 200,000 prescription records of preschool children found about 1% of them to be receiving stimulants in the 1990s, and almost all those prescriptions were for methylphenidate. By the decade's end, two medical authorities put the school-age population's stimulant prescription figure as high as 6%. In the mid-1990s approximately 1.5 million American school-age children were taking stimulant medications just for ADHD, compared to 50 children receiving methylphenidate for any purpose in Great Britain in 1991. Another comparison: A 1999 report said 1.65% of students in one South African urban area were receiving methylphenidate, but none of these children were Afrikaans. Such dramatic differences in prescribing practices suggest strong cultural influence on what is considered acceptable medical treatment. During the mid-1980s great debate arose in the United States about the custom of routinely prescribing methylphenidate to juveniles. The debate was based on ethical values rather than strictly medical concerns, with some persons arguing that the drug was being used as an agent of social control instead of treating disease. After a flurry of lawsuits, the controversy eased.

A review of 23 studies evaluating ADHD drug effectiveness found little distinction among methylphenidate, dextroamphetamine, and pemoline.

Drawbacks. Children with ADHD may also experience muscle tics, which methylphenidate and other stimulants can worsen. Such a dual condition is challenging, but in short-term usage, methylphenidate has been found effective for lessening ADHD without increasing tics, even though one study found that almost 10% of ADHD children may develop temporary tics when taking methylphenidate. A case report notes that a child began stuttering when dosage started, with the stutter ceasing when dosage ceased.

Amphetamine class drugs can promote psychosis and other psychiatric disability, and such unwanted results have been observed with methylphenidate, including paranoia and hallucinations. In youngsters methylphenidate has been known to bring on obsessive-compulsive behavior.

Among juveniles the compound has caused skin rash, stomach distress, mild headaches, and sleep difficulties. In juveniles the compound can at least temporarily reduce appetite, although in elderly users the drug has been observed to increase appetite. Controversy exists about whether the drug affects growth. The substance is associated with stroke suffered by two boys.

Methylphenidate is not recommended for persons suffering from seizures. The drug has been reported to cause anemia and is suspected of worsening allergies. The substance has been known to impair vision and is not recommended for persons with glaucoma. Methylphenidate tends to increase immune system activity; in theory that might affect vaccinations and also harm HIV (human immunodeficiency virus)-positive persons. In some humans abnormal liver activity has been seen, but whether the drug caused or revealed the problem is uncertain. The drug appears to cause heart damage in rats and mice, and a human case has been reported.

Despite potential drawbacks, however, with proper precautions the drug is considered generally safe for medical utilization.

Abuse factors. In primates cocaine and methylphenidate seem to work in similar ways; indeed, some illicit substance users have been unable to tell whether they received a dose of cocaine or methylphenidate. Although meth-ylphenidate is a Schedule II substance, abuse of the drug is uncommon. Demand is small enough that the U.S. Drug Enforcement Administration reports no illicit manufacturing. A large review of scientific literature covering the years 1966 to 1998 was unable to substantiate news media claims about wide

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Understanding And Treating ADHD

Understanding And Treating ADHD

Attention Deficit Disorder or ADD is a very complicated, and time and again misinterpreted, disorder. Its beginning is physiological, but it can have a multitude of consequences that come alongside with it. That apart, what is the differentiation between ADHD and ADD ADHD is the abbreviated form of Attention Deficit Hyperactive Disorder, its major indications being noticeable hyperactivity and impulsivity.

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