Stimulants Ritalin

When used regularly, Ritalin produces tolerance, psychological dependence, and withdrawal symptoms—the three characteristics that define addiction. As with other stimulants, Ritalin addiction is particularly rapid. In fact, individuals who abuse stimulants may become addicted in a much shorter period of time than abusers of alcohol or sedative drugs. 

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. 

Amphetamines (speed sulph, sulphate, uppers, wake-ups, billy whizz, whizz, whites, base) are synthetic stimulants which as medicines have been formed into a variety of tablets. Their current medical use is very limited and in fact only dexamphetamine sulphate, Dexedrine, is now available for use solely in the treatment of narcolepsy. The only other amphetamine available for medical use is methylphenidate (Ritalin) for the treatment of attention deficit syndrome in children. As a street drug, amphetamine usually comes as a white, grey, yellowish or pinky powder. The purity rate of street powders is less than 10%, the rest being made up of milder stimulants such as caffeine, other drugs such as paracetamol or substances like glucose, dried baby milk, flour or talcum powder. 

MPH is an amphetamine-like prescription stimulant commonly used to treat Attention Deficit Hyperactivity Disorder (ADHD) and narcolepsy in children and adults. LC/APCI-MS enantiomeric separations of racemic MPH (Ritalin ) were reported using a commercially available vancomycin CSP [111-113]. 

Stimulating Neurotransmitter Release. Psychostimulants, such as methylphe-nidate (Ritalin), can directly trigger the release of certain neurotransmitters (e.g., dopamine and norepinephrine) from the neuron s axon terminal. 

Methylphenidate (Ritalin, Concerta, Focalin). Methylphenidate was introduced in the late 1950s and is now the most widely used prescription stimulant. It was first used to treat ADHD in children but is also effective for narcolepsy. Like dextroamphetamine, methylphenidate should be started at 5 mg per dose given two to three times each day with meals. The average effective dose is 20-30 mg/day, but some patients require as much as 60 mg/day. The benefit of methylphenidate should also be apparent on the first day or so, and the dose can be increased every 5-7 days as needed. Focalin dosing is approximately half that of methylphenidate. 

Stimulants. Methylphenidate (Ritalin) and dextroamphetamine (Dexedrine) are the most widely used and perhaps the most effective medications when treating post-TBI apathy. They act by enhancing the activity of dopaminergic, noradrenergic and, to a certain extent, serotonergic brain systems. Stimulants act quickly to relieve the core symptoms of apathy, and they may also improve the impairments in attention and short-term memory that often follow TBl. Please refer to Chapter 8 for more information about the stimulants. 

Dopamine activity can be enhanced in one of four main ways. Medications can stimulate dopaminergic nerve cells to release dopamine into the synapse. This is the way that stimulants such as methylphenidate (Ritalin), dextroamphetamine (Dexe-drine), and dextroamphetamine/amphetamine (Adderall) work. In addition, certain drugs of abuse, notably cocaine and methamphetamine, act in part in this way. Providing more of the raw material that nerve cells use to manufacture dopamine can also increase dopamine activity. This is the approach that neurologists use when they prescribe L-DOPA (Sinemet) to patients with Parkinson s disease. Nerve cells convert L-DOPA into dopamine. L-DOPA otherwise has little place in the treatment of psychiatric disorders. Dopamine activity can also be increased by medications that directly stimulate dopamine receptors. Bromocriptine, another medication used to... 

Methylphenidate is a CNS stimulant similar to amphetamine however, in usual doses it has a more expressed action on mental activity rather than physical or motor activity. In therapeutic doses it does not raise blood pressure, respiratory rate, or increase heart rate. All of these effects as well as a number of others are associated with general excitement of the CNS. Tremor, tachycardia, hyperpyrexia, and a state of confusion can result from using large doses. It is used in treating moderate depression and apathetic conditions, and also as an adjuvant drug for treating attention deficit disorder in children.Synonyms of this dmg are meridil, ritalin, and others. 

Methylphenidate, Oral (Concerto, Ritalin, Ritalin SR, Others) [Cll] [CNS Stimulant/Piperidine Derivative] WARNING w/Hx... 

Disorders of adult personality and behaviour (ICD 10 codes F60-F69), mental retardation (ICD 10 codes F70-F79), disorders of psychological development (ICD 10 codes F80-F89), behavioural and emotional disorders with onset usually occurring in childhood and adolescence (ICD 10 codes F90-F98) and unspecified mental disorder (ICD 10 code F99) are all often non-specific and/or cannot be treated with conventional psychopharmacological medicaments. For example, disorders of sexual behaviour have been treated with hormone therapies or antagonists and hyperkinetic disorders and other disruptive behaviour disorders in children have been treated with stimulants such as methylphenidate (Ritalin ). 

Many psychomotor stimulants possess activities similar to those of amphetamine and have been discussed previously (see Chapter 10). Of primary importance to our discussion of the psychomotor stimulants are amphetamine Adderall, Benzedrine, Dexedrine), methampheta-mine (Desoxyn), and methylphenidate (Concerta, Ritalin, Metadate, Methylin). 

The primary class of stimulants for which there is a tremendous addiction problem is the sympathomimetic stimulants, which include cocaine, amphetamine, metham-phetamine (Desoxyti), methylphenidate Ritalin), and phenmetrazine. 

The recently introduced product Concerta is a once-a-day administration MPH delivery system called OROS (osmotically released). This delivery system creates an ascending plasma level pattern instead of the peak-and-valley pharmacokinetic profile seen in the IR preparations. Similar extended-delivery bead-technology, double-pulse preparations have been introduced for Metadate-CD at 10, 20, and 30 mg (Green-hill et ah, 2002, in press) for the spheroidal technology of Ritalin-EA, and for Adderall-XR preparations (McGough et ah, 2002, in press). Beaded stimulant preparations mix IR and delayed-release beads in a capsule. The patient can swallow the capsule whole or sprinkle the contents in food if pill taking is difficult for the child. 

Another major safety concern in the treatment of youth with SUD is abuse of prescribed medications. Particular controversy has arisen around the use of stimulant medication in youth with SUD and ADHD. In one controlled study of adults, the use of methyl-phenidate (Ritalin) did not increase cocaine use or craving for cocaine (Grabowski et ah, 1997), suggesting that the abuse potential of stimulants may be overestimated. Riggs et al. (1996) did not report any difficulties with abuse when administering pemoline (Cylert) to a group of adolescents with SUD and ADHD. While Riggs and associates have observed that... 

Russell V, de Villiers A, Sagvolden T, et al Differences between electrically, Ritalin-, and D-amphetamine-stimulated release of pH]dopamine from brain slices suggest impaired vesicular storage of dopamine in an animal model of attention-deficit hyperactivity disorder. Behav Brain Res 94 163-171, 1998... 

The best-known products come from the amphetamine group (see Table 1.12) Dexedrine1 1 (generic name d-amphetamine) and Pervitin 1 (methamphetamine) were particularly used in the 1950s and 1960s as stimulants and also as appetite suppressants, but today play hardly any role in medical practice. Ritalin (methylphenidate) has some relevance its psychostimulant action is said to be weaker than that of amphetamines and it is apparent ) less abused than the latter. Because methylphenidate also possesses mild antidepressant activity, in some countries it is used to combat not only narcolepsy and ADHD but also mild depressions without suicide risk (Satel and Nelson, 1989). 

Critics of Ritalin and other stimulants say that overdiagnosis and overprescription results from the broad form of the symptoms. Many symptoms such as restlessness and impulsiveness characterize most children but moderate or disappear with age. Some children—boys in particular—show more... 

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 most commonly abused prescription drugs are opioids and opiates such as oxycodone and morphine, central nervous system depressants such as barbiturates and benzodiazepines, and stimulants such as dextroamphetamine and methylphenidate. Brand-name painkillers such as Vicodin and OxyContin, depressants such as Valium and Xanax, and stimulants such as Ritalin and Dexedrine are commonly abused (as are some OTC cough remedies). Although helpful and safe when used appropriately, these drugs can cause serious harm when taken in unapproved ways. 

Stimulants (amphetamines [Adderall, Dexedrine] and methylphenidate [Concerta, Ritalin]) increase alertness, attention, and energy. They also increase blood pressure and heart rate, constrict blood vessels, increase blood glucose, and open up the pathways of the respiratory system. Historically, stimulants were prescribed to treat asthma and other respiratory problems, obesity, neurological disorders, and a variety of other ailments. As their potential for abuse and addiction became apparent, the prescribing of stimulants by physicians began to wane. Now, stimulants are prescribed for treating only a few health conditions, most notably ADHD, narcolepsy, and, in some instances, depression that has not responded to other treatments. 

Stimulants. Nonmedical use of stimulants is broken up by the type of stimulant used amphetamines, methamphetamine, or Ritalin. For all three stimulants surveyed, rates have decreased significantly among 8th-, 10th-, and 12th-graders in 2001-2008. 

Leandro Panizzon, working for Ciba in Basel Switzerland, synthesizes methylphenidate, administers it to his wife Rita as a stimulant, and names the compound Ritaline (Ritalin) after her. 

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. 

METHYLPHENIDATE Ritalin a stimulant drug choice for the treatment of attention deficit hyperactivity disorder (ADHD). 

There have been a number of anecdotal reports of illicit use of Dexedrine, Adderall, Ritalin (methyl-phenidate), and other ADHD stimulants among college students in recent years. In 2000, University of Wisconsin health officials estimated that one in five of their students were using ADHD stimulant medications without a doctor s prescription. 

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