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Methylphenidate is a medication prescribed for individuals (usually children)

who have attention-deficit hyperactivity

disorder (ADHD), which consists of a persistent pattern of abnormally high levels

of activity, impulsivity, and/or inattention

that is more frequently displayed and

more severe than is typically observed in

individuals with comparable levels of

development. The pattern of behavior usually arises between the ages of 3 and 5,

and is diagnosed during the elementary

school years due to the child’s excessive

locomotor activity, poor attention, and/or

impulsive behavior. Most symptoms

improve during adolescence or adulthood, but the disorder can persist or present in adults. It has been estimated that

3–7 percent of school-age children have

ADHD. Methylphenidate also is occasionally prescribed for treating narcolepsy.

Health Effects ———

Methylphenidate is a central nervous system (CNS) stimulant. It has effects similar

to, but more potent than, caffeine and less

potent than amphetamines. It has a

notably calming and “focusing” effect on

those with ADHD, particularly children.

Recent research at Brookhaven National

Laboratory may begin to explain how

methylphenidate helps people with ADHD.

The researchers used positron emission

tomography (PET—a noninvasive brain

scan) to confirm that administering normal

therapeutic doses of methylphenidate to

healthy, adult men increased their

dopamine levels. The researchers speculate that methylphenidate amplifies the

release of dopamine, a neurotransmitter,

thereby improving attention and focus in

individuals who have dopamine signals

that are weak.1

Methylphenidate is a valuable medicine, for adults as well as children with

ADHD.2, 3, 4 Treatment of ADHD with stimulants such as Ritalin and psychotherapy

help to improve the abnormal behaviors

of ADHD, as well as the self-esteem, cognition, and social and family function of

the patient.2 Research shows that individuals with ADHD do not become addicted

to stimulant medications when taken in

the form and dosage prescribed by doctors. In fact, it has been reported that

stimulant therapy in childhood is associated with a reduction in the risk for subsequent drug and alcohol use disorders.5, 6

Also, studies have found that individuals

with ADHD treated with stimulants such as

methylphenidate are significantly less likely than those who do not receive treatment to abuse drugs and alcohol when

they are older.7

Methylphenidate (Ritalin)
Because of its stimulant properties, however, in recent years there have been

reports of abuse of methylphenidate by

people for whom it is not prescribed. It is

abused for its stimulant effects: appetite

suppression, wakefulness, increased

focus/attentiveness, and euphoria.

Addiction to methylphenidate seems to

occur when it induces large and fast

dopamine increases in the brain. In contrast, the therapeutic effect is achieved by

slow and steady increases of dopamine,

which are similar to the natural production by the brain. The doses prescribed by

physicians start low and increase slowly

until a therapeutic effect is reached. That

way, the risk of addiction is very small.8

When abused, the tablets are either taken

orally or crushed and snorted. Some

abusers dissolve the tablets in water and

inject the mixture; complications can arise

from this because insoluble fillers in the

tablets can block small blood vessels.

Trends in Ritalin

Abuse ———

Monitoring the Future (MTF)

Survey*

Each year, MTF assesses the extent of

drug use among adolescents and young

adults nationwide. MTF 2004 data on

annual** use indicate that 2.5 percent of

8th-graders abused Ritalin, as did 3.4

percent of 10th-graders and 5.1 percent

of 12th-graders.

Other Studies ———

ADHD has been more frequently reported

in boys than in girls; however, research

published in 2002 noted that the frequency among girls had increased.9

A large survey at a public university

showed that 3 percent of the students had

used methylphenidate during the past

year.10

Other Information

Sources ———

Because stimulant medicines such as

methylphenidate do have potential for

abuse, the U.S. Drug Enforcement

Administration (DEA) has placed stringent, Schedule II controls on their manufacture, distribution, and prescription. For

example, DEA requires special licenses

for these activities, and prescription refills

are not allowed. The DEA Web site is

www.usdoj.gov/dea. States may impose

further regulations, such as limiting the

number of dosage units per prescription.

Treatment ———

For more information on treating ADHD,

visit the Web site for the National Institute

of Mental Health, National Institutes of

Health, at www.nimh.nih.gov.

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* These data are from the 2004 Monitoring the Future Survey, funded by the National Institute on Drug Abuse, National

Institutes of Health, DHHS, and conducted by the University of Michigan’s Institute for Social Research. The survey has

tracked 12th-graders’ illicit drug use and related attitudes since 1975; in 1991, 8th- and 10th-graders were added to the

study. The latest data are online at www.drugabuse.gov. 

** “Lifetime” refers to use at least once during a respondent’s lifetime. “Annual” refers to use at least once during the year

preceding an individual’s response to the survey. “30-day” refers to use at least once during the 30 days preceding an

individual’s response to the survey.

References

1 Volkow, N.D., Fowler, J.S., Wang, G., Ding, Y., and Gatley, S.J. (2002). Mechanism of action of methylphenidate:

insights from PET imaging studies. J. Atten. Disord., 6 Suppl. 1, S31–S43.

2 Konrad, K., Gunther, T., Hanisch, C., and Herpertz-Dahlmann, B. (2004). Differential Effects of Methylphenidate on

Attentional Functions in Children With Attention-Deficit/Hyperactivity Disorder. J. Am. Acad. Child Adolesc. Psychiatry,

43, 191–198.

3 Faraone, S.V., Spencer, T., Aleardi, M., Pagano, C., and Biederman, J. (2004). Meta-analysis of the efficacy of

methylphenidate for treating adult attention-deficit/hyperactivity disorder. J. Clin. Psychopharmacology, 24, 24–29.

4 Kutcher, S., Aman, M., Brooks, S.J., Buitelaar, J., van Daalen, E., Fegert, J., et al. (2004). International consensus statement on attention-deficit/hyperactivity disorder (ADHD) and disruptive behaviour disorders (DBDs): Clinical implications

and treatment practice suggestions. Eur. Neuropsychopharmacol., 14, 11–28.

5 Biederman, J. (2003). Pharmacotherapy for attention-deficit/hyperactivity disorder (ADHD) decreases the risk for substance abuse: findings from a longitudinal follow-up of youths with and without ADHD. J. Clin. Psychiatry, 64 Suppl.

11, 3–8.

6 Wilens, T.E., Faraone, S.V., Biederman, J., and Gunawardene, S. (2003). Does stimulant therapy of attentiondeficit/hyperactivity disorder beget later substance abuse? A meta-analytic review of the literature. Pediatrics, 111,

179–185.

7 Mannuzza, S., Klein, R.G., and Moulton, J.L., III (2003). Does stimulant treatment place children at risk for adult substance abuse? A controlled, prospective follow-up study. J. Child Adolesc. Psychopharmacol., 13, 273–282.

8 Volkow, N.D. and Swanson, J.M. (2003). Variables that affect the clinical use and abuse of methylphenidate in the treatment of ADHD. Am. J. Psychiatry, 160, 1909–1918.

9 Robison, L.M., Skaer, T.L., Sclar, D.A., and Galin, R.S. (2002). Is attention deficit hyperactivity disorder increasing

among girls in the US? Trends in diagnosis and the prescribing of stimulants. CNS Drugs, 16, 129–137.

10 Teter, C.J., McCabe, S.E., Boyd, C.J., and Guthrie, S.K. (2003). Illicit methylphenidate use in an undergraduate student

sample: prevalence and risk factors. Pharmacotherapy, 23, 609–617.

National Institutes of Health – U.S. Department of Health and Human Services

This material may be used or reproduced without permission from NIDA. Citation of the source is appreciated.