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Biology 202, Spring 2005
First Web Papers
Our parents view Ritalin as a way to calm their overactive children, which doctors and psychiatrists simply hand out when they are approached with a kid who is unable to maintain an extended attention span. It is considered a "quick fix" by many adults, not a potentially harmful, habit-forming drug. Parents are often unaware of the drug's dangers because a great deal of research has been ignored or kept quiet by pharmaceutical companies to promote sales (3). On the other hand, to college-aged and high school students it is just another drug that can be taken recreationally. Because it is prescribed, and not illegal, many people do not see an addiction to Ritalin as a "real" drug issue; many believe that one cannot become "addicted" to it because it comes from a doctor's office. It is harmful when abused, and people need to realize that.
The active ingredient in Ritalin, methlphenidate, was initially introduced to Switzerland and Germany in 1954. The drug, created by Leandro Panizzon in 1944, was named "Ritalin" after his wife Marguerite, whom he called Rita (1). When Ritalin was placed on the United States market in 1956, it was classified as a light psycho stimulant (or a central nervous system stimulant) in the same class as amphetamines; the pills were originally sold described as a new type of drug that "acts more carefully and longer than caffeine and amphetamines and does not involve habituation" (1).
Methlphenidate is prescribed for people with ADHD/ADD, and targets parts of the brain which are used for attentiveness and ability to follow directions. It is also supposed to aid in decreasing hyperactivity and aggressiveness (2). These psychotropic substances, which are primarily prescribed to children to help them with school and extracurricular activities, include such drugs as: Dexadrine, Dextrostat, Adderall, Desoxyn, Gradumet, and Cylert (3).
A person with ADHD should become calm and more focused after ingesting Ritalin, but adverse affects occur when those who do not have the disorder take it (4). In a normal person's dopamine (DA) pathway, a transmitting neuron releases the neurotransmitter dopamine, which then binds to dopamine receptors on the receiving neuron. This reception propagates an action potential in the receiving neuron. After this has occurred, the dopamine reuptake transporters (DATs) of the transmitting cell pump the dopamine back into the cell to be used again.
As the term "psycho stimulant" suggests, when the drug is taken, Ritalin initiates a series of chemical activities inside the user's Central Nervous System (one without ADHD). Once the bloodstream has picked up the amphetamines and they have been carried to the brain, the methylphenidate binds to the transporters used for the reuptake of dopamine into the presynaptic neurons. This binding blocks the reuptake of dopamine, causing its levels to rise within the synapses. When part of the brain called the nucleus accumbens contains large quantities of dopamine, a "high" sensation is emitted (5). The drug also reduces the "background" firing of neurons, allowing a clearer signal to be transmitted through the brain, decreasing distractions (6).
This mental high is very similar to that of cocaine, as are the adverse physical effects, which makes its abuse more easily understandable. The physical side effects include: increased heart rate, elevated blood pressure, dilated pupils, dry mouth, perspiration, appetite loss, insomnia, and nervousness (8). Longer term side effects can consist of strokes and seizures as well. There have also been several deaths attributed to Ritalin abuse (9). When Ritalin is prescribed, it is to be introduced to the body in slow, steady doses, which simulates the brain's natural dopamine production. Research has shown that addiction seems to occur when large, fast amounts of dopamine are rushed to the brain (7). Users have reported feelings of "superiority" as well as the ability to accomplish short term goals (8). The elevated concentration and emotional high that occurs when the drug is taken is the desired affect among abusers, and because of this "caffeine-like jolt" its abuse has become especially prevalent on high school and college campuses (4). One is five students at the University of Wisconsin admitted to taking Ritalin recreationally (without a prescription) (8). Students have said that it helps them get their work done more efficiently and keeps them awake when they need to study late at night. One of the primary issues surrounding Ritalin abuse is its availability. It is not a street drug that one has to purchase from a dealer in an alley at night. It could be found in one's own medicine cabinet; users often take the pills from siblings or friends who have prescriptions.
The most common ways Ritalin is abused is by taking the pills orally or crushing and snorting them. People have also been known to dissolve the tablets in water and then inject the fluid into themselves (7). Because of the rates of observed abuse, distribution of Ritalin is now strictly controlled in pharmacies, federal law prohibits doctors from including refills with prescriptions, and doctors are not even allowed to call in orders of it (4).
Because the brain is physically altered when Ritalin abuse has been prolonged, the user cannot consciously command him/herself to stop wanting the drug. The number of dopamine receptors in the brain does not return after a long period of time, causing the user to develop a tolerance. This makes it especially difficult to treat the individual, but the best way to do so is through drug counseling. Ritalin has been on the market long enough to conduct studies on its effects. Clearly, there are quite a few negative aspects of its prescription, so the question remains as to whether or not it should be taken off the market to prevent these effects and should patients on it should be treated for ADHD with psychotherapy alone?
7. 7. http://www.nida.nih.gov/Infofax/ritalin.html
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