However, we do not want him combining stimulants with alcohol or illegal substances. Thus, we try to avoid using methylphenidate and the other Schedule II medications in individuals who are active substance abusers. If these are not effective, we are left with a dilemma. If the patient makes a commitment to stay clean and if we have a way of monitoring him, we can cautiously prescribe stimulants. This has been a matter for hot debate.
Some individuals have an incomplete response to stimulants.
Others cannot tolerate the stimulants. No 2, August 1999. Safer, et al, Increased Methylphenidate Usage for Attention Deficit Disorder in the 1990s. Pediatrics, Dec. 1996. Goodman and Gilman's The Pharmacological Basis of Therapeutics 9th Edition , Goodman, Limbird, Milnoff, Gilman and Hardman, McGraw Hill Publishers, 1996.