Methylphenidate: Difference between revisions

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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.

[[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.

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.

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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]], ~~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.

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.

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}}

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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 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.
+[[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.
 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]], 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.
+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.
 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===