Stimulant ADHD Medications: Methylphenidate and Amphetamines

Stimulant medications including How Are Prescription Stimulants amphetamines (e.g., Adderall) and Used? methylphenidate (e.g., Ritalin and Concerta) are often prescribed to treat Prescription stimulants have a calming children, adolescents, or adults diagnosed and “focusing” effect on individuals with attention-deficit hyperactivity with ADHD. They are prescribed to disorder (ADHD). patients for daily use, and come in the form of tablets or capsules of varying People with ADHD persistently have more dosages. Treatment of ADHD with difficulty paying attention or are more stimulants, often in conjunction with hyperactive or impulsive than other psychotherapy, helps to improve ADHD people the same age. This pattern of symptoms along with the patient’s self- behavior usually becomes evident when a esteem, thinking ability, and social and child is in preschool or the first grades of family interactions. elementary school; the average age of onset of ADHD symptoms is 7 years. Many people’s ADHD symptoms improve during Prescription stimulants are sometimes adolescence or as they grow older, but the abused however—that is, taken in disorder can persist into adulthood. higher quantities or in a different manner than prescribed, or taken by ADHD diagnoses are increasing. those without a prescription. Because According to the U.S. Centers for Disease they suppress appetite, increase Control and Prevention, as of 2011, 11 wakefulness, and increase focus and percent of people ages 4–17 have been attention, they are frequently abused diagnosed with ADHD. for purposes of weight loss or performance enhancement (e.g., to help study or boost grades in school; see box).

Stimulant ADHD Medications • January 2014 • Page 1 Because they may produce euphoria, When taken in doses and via routes these drugs are also frequently other than those prescribed, abused for recreational purposes (i.e., prescription stimulants can increase to get high). Euphoria from stimulants brain dopamine in a rapid and highly is generally produced when pills are amplified manner (similar to other crushed and then snorted or mixed drugs of abuse such as with water and injected. methamphetamine), thereby disrupting normal communication between brain cells and producing euphoria and, as a Do Prescription Stimulants result, increasing the risk of addiction. Make You Smarter? A growing number of teenagers and What Are the Other Health Effects of young adults are abusing prescription Prescription Stimulants? stimulants to boost their study performance in an effort to improve Stimulants can increase blood pressure, their grades in school, and there is a heart rate, and body temperature and widespread belief that these drugs decrease sleep and appetite. When they can improve a person’s ability to learn are abused, they can lead to (“cognitive enhancement”). malnutrition and its consequences. Repeated abuse of stimulants can lead Prescription stimulants do promote to feelings of hostility and paranoia. At wakefulness, but studies have found high doses, they can lead to serious that they do not enhance learning or cardiovascular complications, including thinking ability when taken by people stroke. who do not actually have ADHD. Also, Addiction to stimulants is also a very research has shown that students real consideration for anyone taking who abuse prescription stimulants them without medical supervision. actually have lower GPAs in high Addiction most likely occurs because school and college than those who stimulants, when taken in doses and don’t. routes other than those prescribed by a doctor, can induce a rapid rise in dopamine in the brain. Furthermore, if How Do Prescription Stimulants stimulants are abused chronically, Affect the Brain? withdrawal symptoms—including fatigue, depression, and disturbed sleep All stimulants work by increasing patterns—can result when a person dopamine levels in the brain— stops taking them. Additional dopamine is a neurotransmitter complications from abusing stimulants associated with pleasure, movement, can arise when pills are crushed and and attention. The therapeutic effect injected: Insoluble fillers in the tablets of stimulants is achieved by slow and can block small blood vessels. steady increases of dopamine, which are similar to the way dopamine is naturally produced in the brain. The doses prescribed by physicians start low and increase gradually until a therapeutic effect is reached.

Stimulant ADHD Medications • January 2014 • Page 2 Learn More Do Prescription Stimulants Affect a Patient’s Risk of For more information on prescription Substance Abuse? stimulants, visit Concerns have been raised that www.drugabuse.gov/publications/ stimulants prescribed to treat a child’s research-reports/prescription- or adolescent’s ADHD could affect an drugs/director. individual’s vulnerability to developing later drug problems— either by increasing the risk or by providing a degree of protection. The studies conducted so far have found no differences in later substance use for children with ADHD who received treatment and those that did not. This suggests treatment with ADHD medication appears not to affect (either negatively or positively) an individual’s risk for developing a substance use disorder.

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