ABOUT
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Methylphenidate (contracted from Methylphenylpiperidinyl acetate) abbreviated MP or MPH, sold under the trade name Ritalin, among others, is a stimulant drug used to treat attention-deficit/hyperactivity disorder (ADHD) and narcolepsy. It is a first-line medication for ADHD. It may be taken by mouth or applied to the skin, and different formulations have varying durations of effect.[1]
Common side effects of methylphenidate include difficulty sleeping, decreased appetite, anxiety, and weight loss. More serious side effects may include psychosis, prolonged erections, substance misuse, and heart problems. Abuse is also included.[1] Withdrawal symptoms include weakness and fatigue, dysphoria, anhedonia and loss of motivation. Methylphenidate is believed to work by blocking dopamine and norepinephrine reuptake by neurons.[5][6] Methylphenidate is a central nervous system (CNS) stimulant of the phenethylamine and piperidine classes.[1][7]
Methylphenidate was first synthesized in 1944 and was approved for medical use in the United States in 1955.[1][8] It was originally sold by Swiss company CIBA, now Novartis Corporation.[8] It is estimated that in 2013, 2.4 billion doses of methylphenidate were taken worldwide.[9] In 2018, it was the 45th most commonly prescribed medication in the United States, with more than 17 million prescriptions.[10][11] It is available as a generic medication.
How to use Methylin
Attention deficit hyperactivity disorder
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Methylphenidate is used for the treatment of attention deficit hyperactivity disorder.[13] The addition of behavioural modification therapy can have additional benefits on treatment outcome.[14][15] The dosage may vary and is titrated to effect.[16][17]
The short-term benefits and cost effectiveness of methylphenidate are well established.[18][19] A number of reviews have established the safety and effectiveness of the stimulants for individuals with ADHD over several years.[20][21][22] A 2018 review found tentative evidence that it may cause both serious and non-serious adverse effects in children.[23] The precise magnitude of improvements in ADHD symptoms and quality of life that are produced by methylphenidate treatment remains uncertain as of November 2015.[24] The World Health Organization, however, did not add methylphenidate to the World Health Organization Essential Medicines List as they found the evidence for benefits versus harms to be unclear in ADHD.[25]
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Approximately 70% of those who use methylphenidate see improvements in ADHD symptoms.[26][27] Children with ADHD who use stimulant medications generally have better relationships with peers and family members,[20][26] perform better in school, are less distractible and impulsive, and have longer attention spans.[20][26] People with ADHD have an increased risk of substance use disorders without treatment, and stimulant medications reduce this risk.[28][29] Some studies suggest that since ADHD diagnosis is increasing significantly around the world, using the drug may cause more harm than good in some populations using methylphenidate as a “study drug”.[30] This applies to people who potentially may be experiencing a different issue and are misdiagnosed with ADHD.[30] People in this category can then experience negative side-effects of the drug which worsen their condition, and make it harder for them to receive adequate care as providers around them may believe the drugs are sufficient and the problem lies with the user.[30] Methylphenidate is not approved for children under six years of age.[31][32] Immediate release methylphenidate is used daily along with the longer-acting form to achieve full-day control of symptoms
Side Effects
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The most common adverse effects include appetite loss, dry mouth, anxiety/nervousness, nausea, and insomnia. Gastrointestinal adverse effects may include abdominal pain and weight loss. Nervous system adverse effects may include akathisia (agitation/restlessness), irritability, dyskinesia (tics), lethargy (drowsiness/fatigue), and dizziness. Cardiac adverse effects may include palpitations, changes in blood pressure and heart rate (typically mild), and tachycardia (rapid heart rate).[56] Smokers with ADHD who take methylphenidate may increase their nicotine dependence, and smoke more often than before they began using methylphenidate, with increased nicotine cravings and an average increase of 1.3 cigarettes per day.[57] Ophthalmologic adverse effects may include blurred vision and dry eyes, with less frequent reports of diplopia and mydriasis.[58]
There is some evidence of mild reductions in height with prolonged treatment in children.[59] This has been estimated at 1 centimetre (0.4 in) or less per year during the first three years with a total decrease of 3 centimetres (1.2 in) over 10 years.[60][61]
Hypersensitivity (including skin rash, urticaria, and fever) is sometimes reported when using transdermal methylphenidate. The Daytrana patch has a much higher rate of skin reactions than oral methylphenidate