Ritalin

Ritalin is the prescription brand name of the drug methylphenidate, a stimulant of the central nervous system (the brain and spinal cord). Its effects lie somewhere between those of caffeine and those of amphetamine drugs: Ritalin improves concentration, decreases appetite, produces an elevated mood, and can interfere with sleep.

In the mid-1950s Ritalin was first sold as a mood enhancer and was described as having less abuse potential than amphetamine. However, within a few years medical journals published a number of dramatic reports of its abuse and toxicity . Like the amphetamines and other stimulant drugs, methylphenidate is a controlled substance. This means that, although it has medical uses, Ritalin also has substantial abuse potential.

The main medical use of Ritalin is in the treatment of attention deficit/hyperactivity disorder (ADHD). A child may be diagnosed with ADHD if he or she is extremely active and/or has difficulty in maintaining attention. Stimulant medications are often used to treat ADHD, and Ritalin is one such drug. Traditional formulations of Ritalin require a child to take two or three doses each day to control symptoms. A newly available form of Ritalin requires only a single daily dose. Ritalin can help calm children with ADHD, allowing them to focus and concentrate for longer periods of time. It can also help them control their impulsive behavior. Side effects of prescribed Ritalin can include insomnia (the inability to sleep), loss of appetite, and weight loss, all effects of stimulant drugs in general.

Ritalin is abused when it is taken by someone who has not been prescribed the medication, or when it is taken in a higher dose than was prescribed. Furthermore, some high-dose users begin by swallowing pills but often switch to injecting the drug so as to increase its effects and achieve the initial rush that is typical of intravenous drug abuse (injecting drugs directly into the veins). This can be particularly dangerous, because Ritalin pills contain talcum, a substance that does not dissolve in water. When the pills are dissolved in water and injected into the veins or under the skin, the talcum can create abscesses (pockets of infection) at the injection site. Untreated, these sores may lead to serious infection throughout the body. Talcum can also block small blood vessels, causing serious damage to the lungs and the retina of the eye.

Ritalin is frequently prescribed for young people with ADHD, and doses often need to be taken at school. As a result, Ritalin is often readily available at schools and may be sold, stolen, or given to others who use it for its nonmedical effects, which are similar to other amphetamines. Those who abuse Ritalin are usually seeking its stimulant effects, such as appetite suppression, wakefulness, and increased focus/attentiveness (for long nights of studying), and euphoria (a feeling of intense well-being). With continued use, tolerance to these effects can develop, so that users will often increase their doses to achieve the desired effects of their initial doses.

Ritalin abuse may result in serious side effects, including rapid heartbeat, increased blood pressure, chest pain, joint pain, and un- controlled movements of the body. When higher and higher doses are taken, serious side effects may occur, including changes in mood, confusion, delusions (false beliefs), depersonalization (feeling that self or surroundings are not real), and hallucinations (seeing, hearing, or feeling things that are not there). Overdose is also possible; signs of overdose include some of the above symptoms as well as agitation; severe confusion; convulsions (seizures); fast, pounding, or irregular heartbeat; fever; and vomiting. Continued use of high doses of Ritalin can result in toxic consequences: anxiety, sleeplessness, and eventually a mental disorder known as toxic paranoid psychosis. Ritalin can also be habit-forming in doses higher than prescribed for ADHD, so that unpleasant withdrawal symptoms occur when the user abruptly stops using it.

Ritalin abuse is still relatively uncommon in many areas, but it is clearly growing. For this reason Ritalin is on the Drug Enforcement Administration's list of Drugs of Concern. Most schools have established policies to keep drugs like Ritalin under control, such as locking cabinets where the drug is kept and carefully monitoring students' use of it as medication. However, such policies and systems are not foolproof and are not always practiced as intended. Those who seek to abuse Ritalin often find it relatively easy to obtain. A grave concern in schools today is that students who need their prescribed Ritalin will sell it, leading to wider abuse—as well as untreated students with ADHD.

see also Attention-Deficit/Hyperactivity Disorder.