Ritalin, abuse effects

Martin WR, Sloan JW, Sapira JD, et al Physiologic, subjective, and behavioral effects of amphetamine, methamphetamine, ephedrine, phenmetrazine, and methylphenidate in man. Clin Pharmacol Ther 12 245-258, 1971 McCormick TC Jr, McNeil TW Acute psychosis and Ritalin abuse. Tex State J Med... 

Pentazocine (Talwin) (see also page 252) Street Names Crackers, poor man s h oin, T s and R s> Ts and Rits (all refer to combinations w/ Ritalin) (brands Talwin, Talwin Nx [CIV]) Use Medically used as opioid analgesic euphoria similar to heroin when mixed w/antihistamines combined w/ methylphenidate (Ritalin) is new abuse combination Actions Agonist-antagonist narcotic naloxone, a narcotic antagonist added to Talwin (Talwin NX) has reduced incidence of abuse Effects Euphoria, hallucinations, skin necrosis w/ illicit injection route... 

Ritalin is a mild stimulant. On the contrary, the studies found that Ritalin, although effective in treating the symptoms of ADHD, shows no clear long-term improvement on users and can have dangerous effects on health, including death. Because the effects of Ritalin on humans are virtually identical to those produced by cocaine, amphetamine, and methamphetamine (speed), the researchers noted that its abuse liability is high and can lead to marked tolerance and psychological dependence. 

Amphetamines are drugs that mimic the effects of epinephrine, or adrenalin. Because effects such as mental illness and brain damage can result from overuse of amphetamines, they currently have limited medical use. Metamphetamines are similar to amphetamines in structure and action but have fewer undesirable side effects. Ritalin (methylphemdate), commonly used to treat attention deficit disorder, has essentially the same mode of action as amphetamines. Ritalin abuse by middle and high school students has become a common concern. 

Even when effective in controlling behavior, Ritalin and other stimulants have side effects common with use of amphetamines. These include nervousness, insomnia, and perhaps some more long-term problems such as dependency, slowed growth, or depression. Critics sometimes note the similarity between cocaine and the active chemical ingredient in Ritalin, methylphenidate. Both stimulate the dopamine system of the brain, but cocaine does so quickly and methylphenidate does so slowly. The similarities show in the abuse of Ritalin for its pleasure-inducing qualities. 

The primary drug therapies are psychostimulants which are indicated for both emotional based sleep disorders (i.e., narcolepsy) as well as ADHD. The drugs of choice are Ritalin (methylphenidate), dextroamphetamine or Cylert (pemoline), all CNS stimulants that effect the monoamine systems. The current therapies provide symptomatic relief but the current medications are not without side effects, including abuse potential, cardiovascular effects, insomnia, appetite suppression, head and stomach aches, crying and nervous mannerisms. 

Ritalin became popular primarily because it was not an amphetamine. Amphetamines were known to have the potential for abuse and addiction. The potential for abuse of and addiction to Ritalin was still unknown. Ritalin was also preferred because it had been shown in many studies to have a rapid positive effect on children s performance, it remained in the bloodstream for only a few hours, and it had no negative effect after the children stopped taking the drug. 

Since 1971, the DEA has described Ritalin as a powerful stimulant that shares many of the pharmacological effects of amphetamine, methamphetamine, and cocaine. The American Psychiatric Association (APA) agrees. In its book Treatments of Psychiatric Disorders (1989), the association states that Ritalin is neuropharma-cologically similar to cocaine and amphetamines, and that all three drugs share the same abuse patterns. The Diagnostic and Statistic... 

Prescription drug abuse has infiltrated current teen culture. PATS data revealed that 37 percent of teens say they have close friends who have abused prescription painkillers like Vicodin and OxyContin. Some 29 percent say the same about prescription stimulants Ritalin and Adderall . Average teens demonstrate a remarkable sophistication and knowledge when it comes to prescription (Rx) medications, which must be subscribed and supervised by a doctor, over-the-counter (OTC) medications, which are available for general purchase and use, and all other drugs. Teens are familiar with brand names of a wide variety of medications and can accurately describe their effects. 

Ritalin—Trade name for the stimulant methylphenidate, used to treat attention-deficit/hyperactivity disorder. It is abused because its pharmacological effects are similar to those of other stimulants like amphetamines and cocaine. 

One of the most controversial CNS-acting drugs in contemporary society is methylphenidate (Ritalin ). This drug is structurally related to amphetamine and is a mild stimulant that has abuse potential similar to amphetamine. Methylphenidate is classified as a Schedule II controlled substance. It is effective in the treatment of narcolepsy and attention-deficit hyperactivity disorder (ADHD). Its use in ADHD has caused the greatest controversy. 

In 2000, in response to continuing drug company pressure to view Ritalin as a mild stimulant, the DEA s Christine Sannerud and Gretchen Feussner wrote an article asking Is Ritalin an Abused Drug Does It Meet the Criteria of a Schedule II Substance They documented that Ritalin is similar in its effects to amphetamine and cocaine ... 

Like amphetamine and cocaine, abuse of MPH [Ritalin] can lead to marked tolerance and severe psychologic dependence. The pattern of abuse is characterized by escalation in dose, binge use followed by severe depression, and an overpowering desire to continue to the use of the drug despite negative medical and social consequences. The abuser may alter the mode of administration from oral use to intranasal or intravenous use to intensify the effects of the drug. (p. 35)... 

Medications play an important part in the treatment of ADD. Stimulants are the mainstay of the treatment of ADD methylphenidate (Ritalin), dextroamphetamine (Dexedrine), and pemoline (Cylert). These differ in their half-lives, with Ritalin having the shortest and Cylert the longest. A warning has recently been issued about Cylert because of reports of sometimes fatal liver toxicity. Thus, it is recommended that it be used only if methylphenidate and dextroamphetamine are ineffective. There is individual variability in resporise, so that a person who does not respond to one may respond well to another. Other medications can also be effective in the treatment of ADD and may be useful, especially in residual ADD, where substance abuse may be an issue. These include tricyclic antidepressants (especially desipramine and imi-pramine) SSRIs, bupropion, venlafaxine, and clonidine. There are reports of antipsy-chotics and lithium being helpful in selected cases, as well. 

In summary, Ritalin s advocates view it as a nearly miraculous treatment for ADHD, whereas its detractors argue that it is a greatly overprescribed drug with substantial abuse potential. This controversy cannot be resolved here and is expected to be a major research focus in the next decade. Hopefiil developments are the introduction of new nonstimulant drugs, atomoxetine (Strattera) and modafinil (Provigil) that appear to be effective in the treatment of ADHD but may present fewer problems to the user (Waxmonsky, 2005). 

Controlled stimulants that are frequently abused include amphetamines, methylphenidate, metham-phetamine, and cocaine. Amphetamine, methamphet-amine, methylphenidate, and cocaine can be smoked, inhaled, ingested, and injected. Methamphetamine s effects can last up to 6 h. Methylphenidate (Ritalin) is a sustained release product and can last up to 12 h. Cocaine s effects last only about 1 h. These drugs have significant potential for abuse and addiction. 

Methylphenidate (Ritalin). Ritalin is a sympathomimetic agent with psychostimulant properties similar to S(+)-amphetamine. It is widely used to treat attention deficit hyperactivity disorder (ADHD) in children and adults. There has been increasing diversion and abuse of methylphenidate among children and adults for its stimulant and purported aphrodisiac properties. In overdose, the clinical effects of methylphenidate are similar to those of amphetamine. Relatively few cases of serious overdose have been reported. 

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