Methylphenidate

Methylphenidate, sold under the trade name Ritalin among others, is a stimulant medication used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy. It is a first line medication for ADHD. It is taken by mouth or applied to the skin. Different formulations have different durations of effect. Common side effects include trouble sleeping, anxiety, and weight loss. More serious side effects may include psychosis, allergic reactions, prolonged erections, abuse, and heart problems. Methylphenidate is believed to work by improving the action of catecholamines in the brain. It achieves this by blocking dopamine and norepinephrine reuptake by neurons. Methylphenidate is a central nervous system (CNS) stimulant of the phenethylamine and piperidine classes. Methylphenidate was first made in 1944 and was approved for medical use in the United States in 1955. It was originally sold by CIBA, now Novartis Corporation. It is estimated that in 2013 2.4 billion doses of methylphenidate were taken worldwide. About 80% of this was taken by people in the United States making it the 47th most prescribed medication in that country. It is available as a generic medication. In the United States the wholesale cost of the immediate release formulation is less than US$0.30 per dose as of 2018. Methylphenidate is most commonly used to treat ADHD and narcolepsy. Methylphenidate is used for the treatment of attention deficit hyperactivity disorder. The addition of behavioural modification therapy can have additional benefits on treatment outcome. The dosage may vary and are titrated to effect. The short-term benefits and cost effectiveness of methylphenidate are well established. A number of reviews have established the safety and effectiveness of the stimulants for individuals with ADHD over several years. A 2018 review found that it may cause both serious and non-serious adverse effects in children and adolescents. The precise magnitude of improvements in ADHD symptoms and quality of life that are produced by methylphenidate treatment remains uncertain as of November 2015. Approximately 70% of those who use these stimulants see improvements in ADHD symptoms. Children with ADHD who use stimulant medications generally have better relationships with peers and family members, generally perform better in school, are less distractible and impulsive, and have longer attention spans. People with ADHD have an increased risk of substance use disorders, and stimulant medications reduce this risk. 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'. This applies to people who potentially may be experiencing a different issue and are misdiagnosed with ADHD. 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. Methylphenidate is not approved for children under six years of age. Immediate release methylphenidate is used daily along with the longer-acting form to achieve full-day control of symptoms.:722 Narcolepsy, a chronic sleep disorder characterized by overwhelming daytime drowsiness and uncontrollable sleep, is treated primarily with stimulants. Methylphenidate is considered effective in increasing wakefulness, vigilance, and performance. Methylphenidate improves measures of somnolence on standardized tests, such as the Multiple Sleep Latency Test (MSLT), but performance does not improve to levels comparable to healthy controls.