Non-medical use of methylphenidate: a review (original) (raw)
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Methylphenidate - Appraisement of Clinical Indications and Contraindications
Medical journal of clinical trials & case studies, 2020
Introduction: The prescription of methylphenidate still generates controversies regarding the safety and risk. Objectives: To discuss the current use of methylphenidate, being under medical supervision or not. Methods: For this literature review, scientific articles were used as a basis, from sites such as SCIELO, PUBMED in the English and Portuguese languages, from the 1990s to the year 2020. Conclusions: Although some risks with their ingestion are reported, these end up not exceeding the benefits that the drug can provide in the treatment of people are reported with attention deficit and hyperactivity disorder.
Dikkat Eksikliği Hiperaktivite Bozukluğu tedavisi için yazılan metilfenidat reçetelerinin değerlendirilmesi Amaç: Metilfenidat, dikkat eksikliği-hiperaktivite bozukluğu (DEHB)'nun tedavisinde kullanılan ve kontrole tabi olan bir ilaçtır. Bu araştırmada metilfenidatın reçetelenmesine ait detayların araştırılması amaçlandı. Gereç ve Yöntem: İstanbul Sağlık Müdürlüğü arşivindeki 2009 yılı Ocak-Aralık dönemine ait seçilen örneklem üzerinden DEHB tanılı toplam 5681 metilfenidat içeren kırmızı reçete (MİKR) retrospektif olarak incelenerek ilaç kullanımının detayları değerlendirildi. İstatistiksel karşılaştırmalarda Ki kare testi kullanıldı ve p<0.05 olduğunda, istatistiksel olarak anlamlılıktan söz edildi. Bulgular: DEHB tanılı, MİKR'lerin büyük kısmında (%85.4) yaş bilgisinin bulunmadığı; bu bilgiye sahip olan reçetelerin ise %78.5'inin 18 yaş altı çocuklara ait olduğu saptandı. MİKR'lerin %73.7'si erkek hastalara aitti. MİKR'lerin %63'ünü çocuk ve ergen psikiyatri uzmanları ile çocuk sağlığı ve hastalıkları uzmanlarının yazmış olduğu görüldü. Çocukları tedavi eden hekimlerin yazdığı reçetelerin daha çok üniversite hastanelerinde (%64.5), erişkinleri tedavi eden hekimlerin yazdığı reçetelerin ise daha çok özel hastanelerde (%36.6) yazıldığı saptandı. Çocukları tedavi eden hekimler metilfenidat'ın doz bilgisini diğer hekimlerden daha fazla yazmışlardı (p<0.01). MİKR'leri çocuk yaş grubunu tedavi eden hekimler en çok kış, diğer hekimler ise en çok yaz mevsiminde yazmıştı (p<0.01). Sonuç: Metilfenidat, daha çok çocuk hastalara reçete edilmekle birlikte bu tedaviyi alan erişkin hasta oranının hiç de az olmadığı dikkati çekmektedir. Erişkinler için yazılan reçetelerde daha belirgin olmak üzere, MİKR'leri yazan hekimlerin bazı reçeteleme alışkanlıkları ile ilgili eksiklikleri önemsenmeli ve düzeltilmeye çalışılmalıdır. Anahtar sözcükler: Metilfenidat, dikkat eksikliği hiperaktivite bozukluğu, ilaç tedavisi, ilaç reçeteleri Kli nik Psikofarmakoloji Bülteni 2013;23(1):42-8 ABS TRACT:
einstein (São Paulo), 2020
Objective: To estimate the prevalence of and factors associated with the use of methylphenidate for cognitive enhancement among undergraduate students. Methods: Simple random sample of students of the Universidade Federal de Minas Gerais (n=438), invited to answer an online questionnaire about the use of methylphenidate. Data collection occurred from September 2014 to January 2015. The sample was described by means of proportions, means and standard deviations. A multivariate analysis was performed using the Classification and Regression Tree algorithm to classify the cases of use of methylphenidate for cognitive enhancement in groups, based on the exposure variables. Results: Out of 378 students included, 5.8% (n=22) reported using methylphenidate for cognitive enhancement; in that, 41% (9/22) in the 4 weeks prior to the survey. The housing situation was the variable most often associated with the use of methylphenidate for cognitive enhancement. Eleven students reported using methylphenidate for cognitive enhancement and other purposes 4 weeks prior to the survey, 27% of whom had no medical prescription to purchase it. Conclusion: The use of methylphenidate for cognitive enhancement is frequent among Brazilian undergraduate students and should be considered a serious public health problem, especially due to risks of harm and adverse effects associated with its use.
Methylphenidate use in children with attention deficit hyperactivity disorder
Revista de Saúde Pública, 2015
A Brazilian Health Technology Assessment Bulletin (BRATS) article regarding scientific evidence of the efficacy and safety of methylphenidate for treating attention deficit hyperactivity disorder (ADHD) has caused much controversy about its methods. Considering the relevance of BRATS for public health in Brazil, we critically reviewed this article by remaking the BRATS search and discussing its methods and results. Two questions were answered: did BRATS include all references available in the literature? Do the conclusions reflect the reviewed articles? The results indicate that BRATS did not include all the references from the literature on this subject and also that the proposed conclusions are different from the results of the articles chosen by the BRATS authors themselves. The articles selected by the BRATS authors showed that using methylphenidate is safe and effective. However, the BRATS final conclusion does not reflect the aforementioned and should not be used to support de...
From Clinical Application to Cognitive Enhancement: The Example of Methylphenidate
Methylphenidate (MPD) is a central nervous system (CNS) stimulant, which belongs to the phenethylamine group and is mainly used in the treatment of attention deficit hyperactive disorder (ADHD). However, a growing number of young individuals misuse or abuse MPD to sustain attention, enhance intellectual capacity and increase memory. Recently, the use of MPD as a cognitive enhancement substance has received much attention and raised concerns in the literature and academic circles worldwide. The prescribing frequency of the drug has increased sharply as consequence of the more accurate diagnosis of the ADHD and the popularity of the drug itself due to its beneficial short-term effect. However, careful monitoring is required, because of possible abuse. In this review different aspects concerning the use of MPD have been approached. Data showing its abuse among college students are given, when the drug is prescribed short term beneficial effects and side effects are provided; moreover studies on animal-models suggesting long lasting negative effects on healthy brains are discussed. Finally, emphasis is given to the available formulations and pharmacology.
Methylphenidate: Increased Abuse or Appropriate Use ?
Journal of the American Pharmaceutical Association (1996), 1999
To address the question of the significant increase in methylphenidate (MPD) prescriptions being written and to make rec• ommendations for health care providers involved in providing care for patients with attention deficit hyperactivity disorder (ADHDI and their families. Dsts Sources: MEDLINE search 1966-1998 for professional articles using the following search termsmethylphenidate, children, adolescents, abuse; Internet search using MPD, Ritalin, and ADHD; and Paper Chase search using methylphenidate. Dsts Extrsction: The available literature regarding potential abuse or diversion of MPD consists of case reports, review articles, newspaper articles, and a Drug Enforcement Administration (DEAl publication. All available literature sources were used. Dsts Synthesis: Although the media and DEA report significant abuse and diversion of prescribed MPD, a review of the avail• able literature did not reveal data to substantiate these claims. Nonetheless, there are reasons to suspect that abuse and diversion occur. A potential contributing factor to abuse is the reported similarities in pharmacodynamics and pharmacokinetics between MPD and cocaine. Recommendations are made to decrease the possibility of abuse and diversion of prescribed MPD. Conclusion: A bal• anced middle ground must be found regarding the benefits of MPD and its abuse potential. Education of clinicians, patients, and fami• Iy members is key in ensuring that MPD is used appropriately.
Psychological medicine, 2004
Data on the efficacy and safety of methylphenidate in adults with attention deficit/ hyperactivity disorder (ADHD) are lacking in Europe. This study was undertaken to report on the efficacy and safety of methylphenidate in an adult out-patient population with ADHD, and to compare results with US data. A double-blind randomized cross-over trial comparing methylphenidate and placebo in 45 adults with ADHD with childhood onset was performed in a dose-titration design. Methylphenidate was titrated from 0.5 mg/kg per day in week 1 up to 1.0 mg/kg per day in week 3. Response rates using methylphenidate varied between 38 and 51%, and using placebo between 7 and 18% (p<0.05), depending on outcome measure used. Although the overall percentage of subjects having any side effect on both methylphenidate and placebo was rather high, side effects on methylphenidate over and above those on placebo were few and mild. Methylphenidate proves to be an effective and well tolerated treatment for symp...
Value in Health, 2011
Mental and behavioural disorders are common in childhood and adolescence, but less than one-fifth of these children receive the necessary treatments. Psychotropic medications are recommended for the treatment of a variety childhood and adolescent mental disorders, and the use of such medications has recently increased in many countries. The aim of the study was to investigate the use of prescription psychotropic medication among children with developmental disorders and predictors for said use. A cross-sectional paediatric study based on a questionnaire that was answered by the children's parents and corroborated by clinical records was used. Type and frequency of psychotropic use, reasons for use, and the determining factors were the main measure. In total, 64% of children were receiving psychotropic medication; 40% of the drugs were prescribed in an off-label way, and 73% were meant to treat attention deficit hyperactivity disorder. The stimulant methylphenidate was the most commonly prescribed drug among both the diagnosed and undiagnosed children (89.6% and 60%, respectively), followed by the non-stimulant atomoxetine. Age (OR 3.7, 95% CI 1.1 to 12.3), diagnosis (OR 8.1, 95% CI 2.1 to 30.7) and the father being the head of the household (OR 5.8, 95% CI 1.2 to 29.0) were determinants of psychotropic medication use. The most common psychotropic medication prescribed to children in developmental disorder care centres is the stimulant methylphenidate. These drugs are frequently prescribed in an off-label way to children despite a lack of evidence regarding medication efficacy and safety.
Variables That Affect the Clinical Use and Abuse of Methylphenidate in the Treatment of ADHD
American Journal of Psychiatry, 2003
Objective : Methylphenidate, the most common treatment for attention deficit hyperactivity disorder (ADHD), increases extracellufar dopamine in the brain, which is associated with its reinforcing as well as its therapeutic effects. The authors evaluated variables that distinguish these two properties. Method : The brain imaging and clinical literatures were analyzed to identify variables that contribute to the abuse liability as well as to the clinical efficacy of methylphenidate. Results : Four variables were identified. 1) Dose-there is a threshold for methylphenidate-induced dopamine increases to be perceived as reinforcing and to produce therapeutic effects. 2) Pharmacokinetics-the reinforcing effects of methylphenidate are associated with rapid changes in serum concentrations and presumably fast dopamine increases (as achieved with intravenous injection or insufflation), whereas the therapeutic effects are associated with slowly ascending serum concentrations and presumablyi smoothly rising dopamine levels (a€ :. achieved with oral administration). 3) lri. http.-Iajp-psych iotryonline. org