Methylphenidate: Difference between revisions

Line 5:

It was first synthesized in 1944 and was approved for medical use in the United States in 1955. It was originally sold by Swiss company CIBA (now Novartis).<ref>{{cite journal | vauthors=((Lange, K. W.)), ((Reichl, S.)), ((Lange, K. M.)), ((Tucha, L.)), ((Tucha, O.)) | journal=ADHD Attention Deficit and Hyperactivity Disorders | title=The history of attention deficit hyperactivity disorder | volume=2 | issue=4 | pages=241–255 | date= December 2010 | url=http://link.springer.com/10.1007/s12402-010-0045-8 | issn=1866-6116 | doi=10.1007/s12402-010-0045-8}}</ref> It is approved for treatment of attention-deficit hyperactivity disorder (ADHD) and narcolepsy. It is often used by students with or without ADHD as a cognitive enhancer and study aid.

[[Subjective effects]] include [[stimulation]], [[focus enhancement]], [[motivation enhancement]], [[increased libido]], [[appetite suppression]], and [[euphoria]]. It is usually taken orally, but can also be [[Routes of administration|insufflated or administered rectally]]. The effects are comparable to those of amphetamine; however, it is reported to produce less euphoria and generally have less recreational value. Some users also report it produces a stronger comedown relative to amphetamine~~. [[Derealization|Derealisation]] is reported to be a more common effect with methylphenidate than most stimulants, though this usually only occurs at moderate to high doses~~.

[[Subjective effects]] include [[stimulation]], [[focus enhancement]], [[motivation enhancement]], [[increased libido]], [[appetite suppression]], and [[euphoria]]. It is usually taken orally, but can also be [[Routes of administration|insufflated or administered rectally]]. The effects are comparable to those of amphetamine; however, it is reported to produce less euphoria and generally have less recreational value. Some users also report it produces a stronger comedown relative to amphetamine.

It has moderate abuse potential. Chronic use (i.e. high dose, repeat administration) is associated with [[compulsive redosing]], escalating tolerance, and psychological dependence. It is highly advised to use [[harm reduction]] practices if using this substance.

Line 118:

In terms of its tolerance, methylphenidate can be used multiple days in a row for extended periods of time and is often prescribed to be used in this way. Tolerance to many of the effects of methyphenidate develops with prolonged and repeated use. This results in users having to administer increasingly large doses to achieve the same effects.<ref>{{cite journal | vauthors=((Swanson, J.)), ((Gupta, S.)), ((Guinta, D.)), ((Flynn, D.)), ((Agler, D.)), ((Lerner, M.)), ((Williams, L.)), ((Shoulson, I.)), ((Wigal, S.)) | journal=Clinical Pharmacology and Therapeutics | title=Acute tolerance to methylphenidate in the treatment of attention deficit hyperactivity disorder in children | volume=66 | issue=3 | pages=295–305 | date= September 1999 | issn=0009-9236 | doi=10.1016/S0009-9236(99)70038-X}}</ref>

In the case of acute (i.e. one-off) exposure, it generally takes about 3 - 7 days for the tolerance to be reduced to half and 1 - 2 weeks to be back at baseline (in the absence of further consumption).{{citation needed}} Methylphenidate presents cross-tolerance with all dopaminergic stimulants, meaning that after the consumption of methyphenidate all stimulants will have a reduced effect.{{citation needed}}

In the case of acute (i.e. one-off) exposure, it generally takes about 3 - 7 days for the tolerance to be reduced to half and 1 - 2 weeks to be back at baseline (in the absence of further consumption).{{citation needed}} Methylphenidate presents cross-tolerance with all dopaminergic stimulants, meaning that after the consumption of methyphenidate all stimulants will have a reduced effect."{{citation needed}}

As with other [[stimulant|stimulants]], chronic use of methylphenidate can be considered [[Addiction potential::moderately addictive with a high potential for abuse]] and is capable of causing psychological dependence among certain users. When addiction has developed, cravings and [[withdrawal effects]] may occur if a person suddenly stops their usage.

As with other [[stimulant|stimulants]], the chronic use of methylphenidate can be considered [[Addiction potential::moderately addictive with a high potential for abuse]] and is capable of causing psychological dependence among certain users. When addiction has developed, cravings and [[withdrawal effects]] may occur if a person suddenly stops their usage.

Methylphenidate has some potential for abuse due to its action on dopamine transporters. Methylphenidate, like other [[stimulant]]s, increases [[dopamine]] levels in the brain. However, at therapeutic doses this increase is slow and thus euphoria only rarely occurs even when it is administered intravenously.<ref name="Volkow1999">{{cite journal | vauthors=((Volkow, N. D.)), ((Wang, G. J.)), ((Fowler, J. S.)), ((Gatley, S. J.)), ((Logan, J.)), ((Ding, Y. S.)), ((Dewey, S. L.)), ((Hitzemann, R.)), ((Gifford, A. N.)), ((Pappas, N. R.)) | journal=The Journal of Pharmacology and Experimental Therapeutics | title=Blockade of striatal dopamine transporters by intravenous methylphenidate is not sufficient to induce self-reports of “high” | volume=288 | issue=1 | pages=14–20 | date= January 1999 | issn=0022-3565}}

Line 127:

The abuse potential is increased when methylphenidate is crushed and [[Routes_of_administration#Insufflation|insufflated]] (snorted) or [[Routes_of_administration#Intravenous|injected]].<ref name="Morton2000">{{cite journal | vauthors=((Morton, W. A.)), ((Stockton, G. G.)) | journal=Primary Care Companion to The Journal of Clinical Psychiatry | title=Methylphenidate Abuse and Psychiatric Side Effects | volume=2 | issue=5 | pages=159–164 | date= October 2000 | url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC181133/ | issn=1523-5998}}</ref>. It should be noted that due to the fillers in the pill, however, that this can be harmful to the nasal cavities, and intravenous use can cause [https://en.wikipedia.org/wiki/Emphysema emphysema] (a lower respiratory tract disease, aka [https://en.wikipedia.org/wiki/Emphysema#Ritalin_lung ritalin lung] when caused by Ritalin tablets). The intravenous use of [[methylphenidate]], commonly marketed as Ritalin and widely used as a stimulant drug in the treatment of attention deficit hyperactivity disorder, can lead to emphysematous changes known as [https://en.wikipedia.org/wiki/Emphysema#Ritalin_lung Ritalin lung].

The primary source of methylphenidate for abuse is the diversion from legitimate prescriptions rather than illicit synthesis. Those who use methylphenidate medicinally generally take it orally as instructed while intranasal and intravenous are the preferred means for recreational use.<ref>{{cite journal | vauthors=((Klein-Schwartz, W.)) | journal=Current Opinion in Pediatrics | title=Abuse and toxicity of methylphenidate: | volume=14 | issue=2 | pages=219–223 | date= April 2002 | url=http://journals.lww.com/00008480-200204000-00013 | issn=1040-8703 | doi=10.1097/00008480-200204000-00013}}</ref>

. The primary source of methylphenidate for abuse is the diversion from legitimate prescriptions rather than illicit synthesis. Those who use methylphenidate medicinally generally take it orally as instructed while intranasal and intravenous are the preferred means for recreational use.<ref>{{cite journal | vauthors=((Klein-Schwartz, W.)) | journal=Current Opinion in Pediatrics | title=Abuse and toxicity of methylphenidate: | volume=14 | issue=2 | pages=219–223 | date= April 2002 | url=http://journals.lww.com/00008480-200204000-00013 | issn=1040-8703 | doi=10.1097/00008480-200204000-00013}}</ref>

===Psychosis===

Line 141:

*'''[[MDMA]]''' - The neurotoxic effects of MDMA may be increased when combined with other stimulants.

Line 150:

Line 151:

*'''Austria''': Methylphenidate is legal for medical use under the AMG (Arzneimittelgesetz Österreich) and illegal when sold or possessed without a prescription under the SMG (Suchtmittelgesetz Österreich).{{citation needed}}

*'''Canada''': Methylphenidate is listed in Schedule III of the Controlled Drugs and Substances Act (along with LSD, psychedelic mushrooms, and mescaline).<ref>{{cite web|url=http://laws-lois.justice.gc.ca/eng/acts/C-38.8/page-32.html#h-28|title=SCHEDULE III|publisher=Department of Justice|access-date=December 24, 2019|archive-url=https://web.archive.org/web/20110416090043/http://laws-lois.justice.gc.ca/eng/acts/C-38.8/page-32.html#h-28|archive-date=April 16, 2011}}</ref> It is illegal to possess without a prescription pursuant to Part G (section G.01.002) of the Food and Drug Regulations under the Food and Drugs Act.

*'''China:''' Methylphenidate is a controlled Class I psychotropic substances.<ref>《麻醉药品和精神药品品种目录（2023版）》-国有资产管理处 (tjnu.edu.cn)</ref> Prescriptions for psychotropic substances in Class I are generally limited to a 1-day supply, but those for controlled release formulation like Methylphenidate are limited to a 7-day supply.<ref>卫生部关于印发《麻醉药品、精神药品处方管理规定》的通知　　麻醉药品、精神药品处方管理规定__2006年第28号国务院公报_中国政府网 (www.gov.cn)</ref> This kind of substance is strictly limited.

*'''Germany''': Methylphenidate is a controlled substance under Anlage III of the BtMG. It can only be prescribed on a narcotic prescription form.<ref>{{Citation | title=Anlage III BtMG - Einzelnorm | url=http://www.gesetze-im-internet.de/btmg_1981/anlage_iii.html}}</ref>

*'''New Zealand''': Methylphenidate is a 'Class B2 controlled substance'. Unlawful possession is punishable by six-month prison sentence and the distribution of it is punishable by a 14-year sentence.{{citation needed}}

@@ Line 5: / Line 5: @@
 It was first synthesized in 1944 and was approved for medical use in the United States in 1955. It was originally sold by Swiss company CIBA (now Novartis).<ref>{{cite journal | vauthors=((Lange, K. W.)), ((Reichl, S.)), ((Lange, K. M.)), ((Tucha, L.)), ((Tucha, O.)) | journal=ADHD Attention Deficit and Hyperactivity Disorders | title=The history of attention deficit hyperactivity disorder | volume=2 | issue=4 | pages=241–255 | date= December 2010 | url=http://link.springer.com/10.1007/s12402-010-0045-8 | issn=1866-6116 | doi=10.1007/s12402-010-0045-8}}</ref> It is approved for treatment of attention-deficit hyperactivity disorder (ADHD) and narcolepsy. It is often used by students with or without ADHD as a cognitive enhancer and study aid.
-[[Subjective effects]] include [[stimulation]], [[focus enhancement]], [[motivation enhancement]], [[increased libido]], [[appetite suppression]], and [[euphoria]]. It is usually taken orally, but can also be [[Routes of administration|insufflated or administered rectally]]. The effects are comparable to those of amphetamine; however, it is reported to produce less euphoria and generally have less recreational value. Some users also report it produces a stronger comedown relative to amphetamine. [[Derealization|Derealisation]] is reported to be a more common effect with methylphenidate than most stimulants, though this usually only occurs at moderate to high doses.
+[[Subjective effects]] include [[stimulation]], [[focus enhancement]], [[motivation enhancement]], [[increased libido]], [[appetite suppression]], and [[euphoria]]. It is usually taken orally, but can also be [[Routes of administration|insufflated or administered rectally]]. The effects are comparable to those of amphetamine; however, it is reported to produce less euphoria and generally have less recreational value. Some users also report it produces a stronger comedown relative to amphetamine.
 It has moderate abuse potential. Chronic use (i.e. high dose, repeat administration) is associated with [[compulsive redosing]], escalating tolerance, and psychological dependence. It is highly advised to use [[harm reduction]] practices if using this substance.
@@ Line 118: / Line 118: @@
 In terms of its tolerance, methylphenidate can be used multiple days in a row for extended periods of time and is often prescribed to be used in this way. Tolerance to many of the effects of methyphenidate develops with prolonged and repeated use. This results in users having to administer increasingly large doses to achieve the same effects.<ref>{{cite journal | vauthors=((Swanson, J.)), ((Gupta, S.)), ((Guinta, D.)), ((Flynn, D.)), ((Agler, D.)), ((Lerner, M.)), ((Williams, L.)), ((Shoulson, I.)), ((Wigal, S.)) | journal=Clinical Pharmacology and Therapeutics | title=Acute tolerance to methylphenidate in the treatment of attention deficit hyperactivity disorder in children | volume=66 | issue=3 | pages=295–305 | date= September 1999 | issn=0009-9236 | doi=10.1016/S0009-9236(99)70038-X}}</ref>
-In the case of acute (i.e. one-off) exposure, it generally takes about 3 - 7 days for the tolerance to be reduced to half and 1 - 2 weeks to be back at baseline (in the absence of further consumption).{{citation needed}} Methylphenidate presents cross-tolerance with all dopaminergic stimulants, meaning that after the consumption of methyphenidate all stimulants will have a reduced effect.{{citation needed}}
+In the case of acute (i.e. one-off) exposure, it generally takes about 3 - 7 days for the tolerance to be reduced to half and 1 - 2 weeks to be back at baseline (in the absence of further consumption).{{citation needed}} Methylphenidate presents cross-tolerance with all dopaminergic stimulants, meaning that after the consumption of methyphenidate all stimulants will have a reduced effect."{{citation needed}}
-As with other [[stimulant|stimulants]], chronic use of methylphenidate can be considered [[Addiction potential::moderately addictive with a high potential for abuse]] and is capable of causing psychological dependence among certain users. When addiction has developed, cravings and [[withdrawal effects]] may occur if a person suddenly stops their usage.
+As with other [[stimulant|stimulants]], the chronic use of methylphenidate can be considered [[Addiction potential::moderately addictive with a high potential for abuse]] and is capable of causing psychological dependence among certain users. When addiction has developed, cravings and [[withdrawal effects]] may occur if a person suddenly stops their usage.
 Methylphenidate has some potential for abuse due to its action on dopamine transporters. Methylphenidate, like other [[stimulant]]s, increases [[dopamine]] levels in the brain. However, at therapeutic doses this increase is slow and thus euphoria only rarely occurs even when it is administered intravenously.<ref name="Volkow1999">{{cite journal | vauthors=((Volkow, N. D.)), ((Wang, G. J.)), ((Fowler, J. S.)), ((Gatley, S. J.)), ((Logan, J.)), ((Ding, Y. S.)), ((Dewey, S. L.)), ((Hitzemann, R.)), ((Gifford, A. N.)), ((Pappas, N. R.)) | journal=The Journal of Pharmacology and Experimental Therapeutics | title=Blockade of striatal dopamine transporters by intravenous methylphenidate is not sufficient to induce self-reports of “high” | volume=288 | issue=1 | pages=14–20 | date= January 1999 | issn=0022-3565}}
@@ Line 127: / Line 127: @@
 The abuse potential is increased when methylphenidate is crushed and [[Routes_of_administration#Insufflation|insufflated]] (snorted) or [[Routes_of_administration#Intravenous|injected]].<ref name="Morton2000">{{cite journal | vauthors=((Morton, W. A.)), ((Stockton, G. G.)) | journal=Primary Care Companion to The Journal of Clinical Psychiatry | title=Methylphenidate Abuse and Psychiatric Side Effects | volume=2 | issue=5 | pages=159–164 | date= October 2000 | url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC181133/ | issn=1523-5998}}</ref>. It should be noted that due to the fillers in the pill, however, that this can be harmful to the nasal cavities, and intravenous use can cause [https://en.wikipedia.org/wiki/Emphysema emphysema] (a lower respiratory tract disease, aka [https://en.wikipedia.org/wiki/Emphysema#Ritalin_lung ritalin lung] when caused by Ritalin tablets). The intravenous use of [[methylphenidate]], commonly marketed as Ritalin and widely used as a stimulant drug in the treatment of attention deficit hyperactivity disorder, can lead to emphysematous changes known as [https://en.wikipedia.org/wiki/Emphysema#Ritalin_lung Ritalin lung].
-The primary source of methylphenidate for abuse is the diversion from legitimate prescriptions rather than illicit synthesis. Those who use methylphenidate medicinally generally take it orally as instructed while intranasal and intravenous are the preferred means for recreational use.<ref>{{cite journal | vauthors=((Klein-Schwartz, W.)) | journal=Current Opinion in Pediatrics | title=Abuse and toxicity of methylphenidate: | volume=14 | issue=2 | pages=219–223 | date= April 2002 | url=http://journals.lww.com/00008480-200204000-00013 | issn=1040-8703 | doi=10.1097/00008480-200204000-00013}}</ref>
+. The primary source of methylphenidate for abuse is the diversion from legitimate prescriptions rather than illicit synthesis. Those who use methylphenidate medicinally generally take it orally as instructed while intranasal and intravenous are the preferred means for recreational use.<ref>{{cite journal | vauthors=((Klein-Schwartz, W.)) | journal=Current Opinion in Pediatrics | title=Abuse and toxicity of methylphenidate: | volume=14 | issue=2 | pages=219–223 | date= April 2002 | url=http://journals.lww.com/00008480-200204000-00013 | issn=1040-8703 | doi=10.1097/00008480-200204000-00013}}</ref>
 ===Psychosis===
@@ Line 141: / Line 141: @@
 {{DangerousInteractions/Intro}}
 {{DangerousInteractions/Stimulants|self=methylphenidate}}
+*'''[[MDMA]]''' - The neurotoxic effects of MDMA may be increased when combined with other stimulants.
 {{DangerousInteractions/MAOI|nt=dopamine}}
@@ Line 150: / Line 151: @@
 *'''Austria''': Methylphenidate is legal for medical use under the AMG (Arzneimittelgesetz Österreich) and illegal when sold or possessed without a prescription under the SMG (Suchtmittelgesetz Österreich).{{citation needed}}
 *'''Canada''': Methylphenidate is listed in Schedule III of the Controlled Drugs and Substances Act (along with LSD, psychedelic mushrooms, and mescaline).<ref>{{cite web|url=http://laws-lois.justice.gc.ca/eng/acts/C-38.8/page-32.html#h-28|title=SCHEDULE III|publisher=Department of Justice|access-date=December 24, 2019|archive-url=https://web.archive.org/web/20110416090043/http://laws-lois.justice.gc.ca/eng/acts/C-38.8/page-32.html#h-28|archive-date=April 16, 2011}}</ref> It is illegal to possess without a prescription pursuant to Part G (section G.01.002) of the Food and Drug Regulations under the Food and Drugs Act.
+*'''China:''' Methylphenidate is a controlled Class I psychotropic substances.<ref>《麻醉药品和精神药品品种目录（2023版）》-国有资产管理处 (tjnu.edu.cn)</ref> Prescriptions for psychotropic substances in Class I are generally limited to a 1-day supply, but those for controlled release formulation like Methylphenidate are limited to a 7-day supply.<ref>卫生部关于印发《麻醉药品、精神药品处方管理规定》的通知　　麻醉药品、精神药品处方管理规定__2006年第28号国务院公报_中国政府网 (www.gov.cn)</ref> This kind of substance is strictly limited.
 *'''Germany''': Methylphenidate is a controlled substance under Anlage III of the BtMG. It can only be prescribed on a narcotic prescription form.<ref>{{Citation | title=Anlage III BtMG - Einzelnorm | url=http://www.gesetze-im-internet.de/btmg_1981/anlage_iii.html}}</ref>
 *'''New Zealand''': Methylphenidate is a 'Class B2 controlled substance'. Unlawful possession is punishable by six-month prison sentence and the distribution of it is punishable by a 14-year sentence.{{citation needed}}