Ritalin and Other Methylphenidates - Effects on the Body

Effects on the Body

The effect of methylphenidate on the user depends on the amount of drug used and the way it is taken. Researchers are studying possible long-term effects of the misuse and long-term use of methylphenidate on a person's brain and behavior.

The Role of Neurotransmitters

Methylphenidates increase the levels of a natural substance in the brain called dopamine. Dopamine is a neurotransmitter, a substance that helps nerve cells communicate with one another. Dopamine plays a critical role in motivation and feelings of pleasure. It is involved in naturally pleasurable activities such as eating good food and being sexually aroused. Methylphenidate is similar to other addictive drugs, such as cocaine and alcohol, in that they all increase dopamine levels.

Research published in the January 2001 issue of the Journal of Neuroscience found that relatively small amounts of methylphenidate increase dopamine levels in the brain. The study, led by Dr. Nora Volkow at the Brookhaven National Laboratory, used the same amounts of methylphenidate that are typically prescribed for children. Through brain-imaging techniques, the study found that men who took a dose of Ritalin an hour before the test had higher dopamine levels than those who did not. Dr. Volkow, a psychiatrist who became head of the National Institute on Drug Abuse (NIDA) in 2004, said in a press release that by increasing free dopamine levels, "you can activate … motivational circuits and make the tasks that children are performing seem much more exciting."

Concerns about Addiction

Both cocaine and methylphenidate increase dopamine levels in the brain. Cocaine is a very addictive drug, but methylphenidate is generally not addictive when taken by prescription at the recommended dosage. Oral doses of methylphenidate take about sixty minutes to reach the brain. This length of time prevents the drug from causing the kind of high produced by many illicit, or illegal, drugs that release dopamine. When snorted or injected, however, methylphenidate has the potential to be addictive. In both of these methods, the drug reaches the brain more rapidly than when swallowed in pill form.

The most frequently observed side effects of Ritalin and other methylphenidates (when used appropriately) are difficulty sleeping, loss of appetite, and nervousness. Less common side effects include skin rash, fever, weight loss, dizziness, headaches, stomach pain, irregular heartbeat, difficulty breathing, and feelings of anxiety. It is possible that long-term use of methylphenidate causes slowed growth in children.

Some parents fear that children who take methylphenidate in childhood may become substance abusers in their teens. They note that ADHD drugs such as Ritalin are listed as Schedule II stimulants, which is the same designation used for cocaine. In her testimony to Congress in 2002, Presley noted: "Suicide is the major complication of withdrawal from Ritalin and similar drugs." On its Web site, the Citizens Commission for Human Rights features various stories of young adults who have turned to harder, illegal drugs allegedly as a result of taking prescribed ADHD drugs in childhood.

However, CHADD's "Evidence-Based Medication Management for Children and Adolescents with ADHD" presents a different perspective. Researchers concluded that the proper use of stimulant medicines did not increase a person's risk for later substance abuse. They suggest that when children with ADHD receive the appropriate drug treatment, their risk of later drug or alcohol problems is about the same as that of any other non-ADHD individual.

Schedule II Drugs

Some parents and children are concerned about drugs such as Ritalin because they are listed as Schedule II stimulants. Schedule II drugs are those that have a high potential for addiction, but have accepted medical uses. Parents worry that their children will become addicted to these drugs and might want to try more dangerous drugs later in life.

Methylphenidate Used to Get High

The health consequences of methylphenidate abuse depend on the method used to deliver the drug into the body. When injected, the drug moves quickly into the body and bypasses many of the body's natural defenses against environmental contaminants. Dust, bacteria, or other substances can get into the solution and cause serious harm to the user. Users who inject methylphenidate risk health problems like blood clots, infections, and drug overdoses. Those who share needles increase their chances of contracting hepatitis, a liver disease, and HIV (the human immunodeficiency virus), which can lead to AIDS (acquired immunodeficiency syndrome). Snorting methylphenidate can seriously damage a user's nasal passages, causing open sores in the nose, frequent nose bleeds, and a burning sensation in the nose.

The abuse of methylphenidate can lead to a number of more general health problems, as well. Methylphenidate that is abused gives the user a high, which is addictive and leads to the desire for greater amounts of the drug. Higher doses can bring on agitation, uncontrollable shaking, and high blood pressure. Methylphenidate abusers may also see things that are not real, have strange ideas that are not true, and act in a bizarre manner. Severe consequences, including death, have been reported.