Talk:Methylphenidate/Archive 3

Long term effects & Psychosis

If psychosis is not a likely long term effect, it should not be in the long term effects section. This is misleading. — Preceding unsigned comment added by 168.18.83.47 (talk) 06:56, 8 November 2013 (UTC)

Possible bias and wording

I have noted elsewhere my concerns about a negative skew to this article, and I have a question related to the way things are phrased. I am wondering if there are any guidelines on this. For example: "Methylphenidate is not approved for children under six years of age." could also be written "Methylphenidate is approved for children six years of age and older." Both are correct, but one is written in the negative and the other in the positive. Are there any rules or guidance for how to handle language in such situations? Writing the same thing both ways would be redundant, but one seems to point toward danger and the other toward efficacy. Dgray xplane (talk) 17:05, 24 November 2011 (UTC)

Regarding the statement: "There have been no placebo controlled trials investigating the long term effectiveness of methylphenidate beyond 4 weeks thus the long term effectiveness of methylphenidate has not been scientifically demonstrated." One four-week study was followed by a 13-month maintenance phase, with the result that "data indicate that most children with ADHD improve on methylphenidate in the short term and maintain their improvement without intolerable adverse events for at least 13 months."[1] Dgray xplane (talk) 19:01, 24 November 2011 (UTC)

Pharmacokinetics

This section does not discuss pharmacokinetics at all and is actually an introduction to the pharmacodynamics! —Preceding unsigned comment added by 138.38.193.7 (talk) 08:42, 22 March 2010 (UTC)

Related to pharmacokinetics, I see a problem with the following passage: "Both of these methods increase bioavailability ... however the overall duration of action tends to be decreased by any non-oral use of drug preparations made for oral use." If parenteral use of MPH increases the bioavailability, then it should also increase the duration of action. The method of ingestion doesn't affect the rate of clearance. The current citation is to a newspaper article, which is not a reliable source of technical information. — Preceding unsigned comment added by Nburns1980 (talk • contribs) 05:37, 2 April 2011 (UTC)

True, the reference is poor. However, the statement is correct. Both in the IV and inhalation route the liver (reponsible for first-pass metabolism after oral administration) is bypassed. It's a general principle of PK that Mean Residence Times (MRTs) of drugs are additive. If you shorten the Mean Absorption Time, the MRT in the central circulation will be shorter as well. Alfie↑↓© 01:56, 31 December 2011 (UTC)

New Formulations, Patches like HRT and Pain Relief Issue

In the opening paragraph, it mentions new formulations for methylphenidate saying that this patch is similar to other things used in patches, like hormone replacement therapy and pain relief. After pain relief, it lists to drugs used in such formulations- Fentanyl and Morphine.

Does that catch anyone elses eye? It should. Morphine has not and never will be available in a transdermal patch. Morphine is actually pretty weak compared to other opioids, a starting oral dose is usually between 5 and 10mg. A "morphine patch" would have to be insanely large to even possibly be effective. It is interesting that methylphenidate is available this way, because it's not very potent either, but it's solubility certainly makes it a better candidate for this sort of use. I suspect diacetylmorphine, heroin, might possibly work, but then again, it might just hydrolyze to morphine just inside the skin and be useless.

Anyway, enough tangent, I'm removing the reference to morphine, since there is no morphine patch formulation, even if fentanyl patches are sometimes sold on the street as morphine patches. —Preceding unsigned comment added by 68.190.131.233 (talk) 18:12, 23 November 2008 (UTC)

price and daily dose for an adult

1. What would be the range of a typical dose for an adult? The German article mentions a range of 5-60mg. 2. What does that stuff actually cost? I'm living in a country where you can't buy it, only prescriptions (as far as I know) and I'm having trouble to find reliable (not fishy online offers) prices for it. Any help would be appreciated. Might be interesting for the article as well, no? Apologies if I missed them. 134.106.199.5

ok dude firstly im brittish and get it free with such a prescription, secondly its a prescription drug because it has side effects that arnt good. u aint gonna get high on it and it will give you some seriously bad effects if you take it at all if you take it in a 5 mg dose and youv never had it before it wil increace your concentration and alertnes as well as prevent you from feeling hunger by loss of apitite and give you mild insomnia for the evening if you take any larger doses without building up a tolerence first it can be bad, cause a thinning of the blood, total lack of sleep, make you not want any food at all, give you headaches, make you feel sick, its not a drug like ones that make you feel beter such as morphene. if you dont actually need to take the drug to get your school work done or increase your concentration at work. do not take it. thats the advice of a student with ADD and 9 years of experience with the drug and a high tolerence to it. —Preceding unsigned comment added by 144.82.218.235 (talk) 23:18, 15 January 2008 (UTC)

Well price would be 5.20 Euros per 20mg x 30 box. i.e. a box with 30 tablets containing 20mg ritalin. I would say the german article is right although doses as low as 5mg or even 10mg seem a bit odd, I would have said 20mg - 60mg would be more realistic. --Mountviewenterprises (talk) 00:34, 13 February 2008 (UTC)

Criticism summery

The assertion that the problems associated with methylphenidate were made of by Scientologists take up a very small portion of the controversy article and does not deserve to be mentioned in the summery. As it stands, it implies that the criticism has primarily come from Scientologists, which is not the case. Unless we're going to run through the numerous sources of criticisms contained in the controversy article, I don't see any way to include this in the summery in a balanced fashion. Neitherday (talk) 04:41, 26 January 2008 (UTC)

I don't know how you can justify removing well cited secondary sources. The article doesn't "imply"...you do. If the wording is suggestive, change it. It is ironic that you state that, "I don't see any way to include this in the summery in a balanced fashion". I contend that there is no balance. We have a secondary citation that demonstrates a party went to great lengths to contrive a controversy, it should be added to the page. Please don't remove this addition again without consensus. --scuro (talk) 16:26, 26 January 2008 (UTC)

Would you be okay with me moving other parts of the criticism article over to give them more equal WP:WEIGHT? This is a very small part of the criticism section (and one newspaper articles assertion) being given more weight in the summer than any one of the actual criticisms. Neitherday (talk) 16:40, 26 January 2008 (UTC)

Additionally, by adding new content, per WP:BRD you are the one who needs to gain consensus. Neitherday (talk) 16:45, 26 January 2008 (UTC)

I'm concerned that you rpeatedly, and unilaterally remove properly cited material. Try an edit here in talk with the material included.--scuro (talk) 04:55, 28 January 2008 (UTC)

There is no example given. I will revert to the last pervious version without further input.--scuro (talk) 11:43, 31 January 2008 (UTC)

I recommend reading Wikipedia:Reliable_sources_(medicine-related_articles)#Popular_press. Newspapers are NOT and never have been considered good secondary sources especially for medicine related articles. Infact they are generally discouraged. Since this newspaper reference is disputed I would recommend finding a good peer reviewed secondary source which confirms what the journalist states otherwise it should be deleted. If what the journalist says is true then it should not be difficult to find a peer reviewed secondary source to confirm this.--Literaturegeek | T@1k? 10:33, 15 April 2009 (UTC)

I read the reference and the journalist stated that

Major news organizations--including The Times--devoted extensive coverage to whether youngsters were being turned into emotionally disturbed addicts by psychiatrists and pediatricians who prescribed Ritalin.

They don't really cite any evidence that confirms that scientology was the group that triggered controversy "almost single handedly" over the use of stimulants for ADHD other than citing exerpts from the scientology magazine (which only scientologists would read) and their call for parents to sue doctors. The above quoted text actually suggests that most of the controversy was triggered by "Major news organisations" who "devoted extensive coverage" alledging stimulants may turn kids into emotionally disturbed addicts and not scientology. Clearly the general public is much more likely to read mainstream media than a scientology magazine, so the LA Times article actually debunks itself. This is why newspaper sources in general are poor sources for medical articles. That is not to say they should never be used but if they are challenged or if they are given undue weight or undue prominance then they will need to be deleted. I deleted a dubious quote from the methylphenidate article. Please find a better and more reliable source i.e. a peer reviewed secondary source before readding it back in. I would even settle for a peer reviewed primary source.--Literaturegeek | T@1k? 11:53, 15 April 2009 (UTC)

Effects of Citris, particularly Grapefruit, on the effects.

There's evidence that taking any citrus and that in particularly grapefruit interferes and reduces the effects of Methylphenidate. Should this be added to some section? —Preceding unsigned comment added by 12.11.224.4 (talk) 19:45, 30 January 2008 (UTC)

Could be...do you have a citation? --11:43, 31 January 2008 (UTC) —Preceding unsigned comment added by Scuro (talk • contribs)

Well, it's true because ionized species can't cross cell membranes (phospholipid bilayer) and if you study conjugate acids/bases in ochem, and later go to pharm school--drugs that aren't soluble in their protonated form (such as the pH of the intestinal track when you drink fruity liquids such as orange juice) then the drugs have lesser bioavailability. recall that bioavailability is only 100% for iv. If you take the pcat, there is an acronym called POAUC and IVAUC which means the amount of concentration of the drug plotted against time. I'm not personally going to add it, because no one would benevolently put the information onto this page. If you want a source, just download some pharmacology notes. Drugs have to pass the think membrane lining of the intestinal tract, which ain't gonna happen if the drug is ionized or polar. If you take the choice, it's all on you my friend. 71.54.173.193 (talk) 17:19, 11 March 2009 (UTC)

New to the article

I just read the article, and am wondering how it is that what the kids are calling Vitamin R, and about which I'm watching a documentary on its use as a recreational drug the Discovery Health channel, has only half a sentence at the bottom of the article about its abuse. I don't have time for figuring out who on this talk page has been working to suppress this info right now, but I'm going to check back in later. Oh. and let me say this; even if you think that its abuse is overstated or whatever, the article must address all the coverage Ritalin abuse gets. Paddy Simcox (talk) 10:21, 2 March 2008 (UTC)

Do you have any idea how much all the coverage is? If you find a source, please put it in. If someone else removes it, please discuss it on the talk page, and if they ignore you--add it back in. If they remove it a second time, post it to wp:an where a trusted user can block the vandal. 71.54.173.193 (talk) 17:21, 11 March 2009 (UTC)

Could Ritalin pose a risk of cancer?

In her book THE SECRET HISTORY OF THE WAR ON CANCER, toxicologist/epidemiologist Devra Davis references peer-reviewed research showing the rapid occurrence of cell changes in children after they have been put on Ritalin. I interviewed Davis for my radio show, Writer's Voice, and I would like to post the audio to the part of the interview discussing this issue: http://www.writersvoice.net/2008/01/web-extra-devra-davis-on-aspartame-and-ritalin/ For the record, I worked for 25 years as an occupational and environmental health educator. I've published several articles in the New Solutions: A Journal of Environmental and Occupational Health Policy and I wrote the OSHA report under Jimmy Carter that led the establishment of the major federal grant program for community-based occupational health education, The New Directions Grant. Davis called my interview the "most informed one" she had had.--Francesca Rheannon (talk) 16:49, 4 March 2008 (UTC)

Seems that research has not been colaborated. See the wiki adhd article.--scuro (talk) 15:48, 16 April 2008 (UTC)

can someone clarify what derkaderka syndrome is?

it's under the side-effects, and as much as I've looked it up all I can find is quotes from Team America World Police and general racism. I don't see anything that even remotely suggests such a syndrom exists. If it doesn't, it should probably be taken out.

148.64.136.99 (talk) 19:05, 12 March 2008 (UTC)A Psycology Student

derkaderka syndrome is clearly a Team America World Police joke. This vandalism nees to be removed from the article!! —Preceding unsigned comment added by 24.158.37.50 (talk) 02:00, 18 August 2008 (UTC)

There are no Concerta 72 mg tablets..

"CONCERTA tablets are currently available in 18 mg, 27 mg, 36 mg and 54 mg strengths. There is no 72 mg tablet. While physicians will determine how the medication should best be taken by adolescents for whom it is prescribed, it is believed CONCERTA. 72 mg will most often be taken as a once-a-day morning dose of two CONCERTA 36 mg tablets. " http://www.medicalnewstoday.com/articles/15568.php 77.190.2.237 (talk) 20:20, 24 March 2008 (UTC)

Ritalin Positives?

I feel like the negative aspects of ritalin are far overblown in this article. Being a self-medicating Ritalin user myself, I find that there are many positive things to say about the drug, and my thoughts are being under represented. I must say, I couldn't really read this article through without starting to worry about getting psychosis. RITALIN ISN'T ALL BAD, IT IS USED TO HELP MEDICATE A REAL DISORDER AND IT REALLY WORKS. —Preceding unsigned comment added by Ngoah89 (talk • contribs) 12:00, 15 April 2008 (UTC)

I got it on prescription, safe to say this is incredibly relieving when you constantly feel like you have 5000 cups of coffee in you, some people get psychosis the first days because the body takes some time to get used to the effects, so when doc gives you 40 mg twice a day, start of with 5 mg and raise the bar slowly. Yeah I used my dose today, and here I am sitting 1:00 of clock unable to get to sleep because I cannot even seem to direct my thoughts at that direction. So yeah... one can safely say, that Ritalin has some excellent effects for us that really need them. If you take them, and feel hyper, you are on the wrong drug, if you feel calm as if you have NOT been taking 5000 cups of coffee, then congrats, you finally get some peace of mind prepare for a great change in your life. At this moment my thoughts sound LOUD, some would yell PSYCHOSIS! But know that this is merely temporary side effects, after all, this is a drug. In theory this drug should be getting more and more effective to find calm, and less effective as a antidepressant and generally getting "trips". I hope this is true, as I have a highly evolved form. Why I am typing all this? Why dont you ask my little friend adhd? _yes this is my signature_ —Preceding unsigned comment added by 84.48.72.203 (talk) 00:12, 20 February 2010 (UTC)

Relation to Mohr's Disease (Mohr Syndrome?)

I can find no references (not sourced from this article) to "Mohr's Disease" and no connecting references between the similarly named "Mohr Syndrome" and Ritalin. I've flagged it for a citation, but I suspect that connection should be removed; most references to the history of Ritalin indicate that the use for focus/concentration was identified during rodent trials, long before they'd have been testing a drug for specific human purposes.

Mohr Syndrome seems to be entirely physical abnormalities, so stimulants wouldn't apply. Can anyone provide any citation for the *existence* of a "Mohr's Disease," let alone a connection to Ritalin? —Preceding unsigned comment added by 38.117.134.222 (talk) 18:23, 10 July 2008 (UTC)

Apologies for the subsequent minor edits. I ended up leaving everything as it was, aside from the added "citation needed". —Preceding unsigned comment added by 38.117.134.222 (talk) 18:28, 10 July 2008 (UTC)

On history of Methylphenidate...

MPH was first synthetised in 1944 by the chemist Dr. Leandro Panizzon, working for Ciba in Riehen, Switzerland, among some other analogues (2-aryl-2-piperidin-2-ylacetic acid esters). These substances were screened for pharmacological activity by Ciba laboratories in the late 1940s and it has been found out, that methylphenidate shows distinct, amphetamine-like, yet milder psychostimulant effects. Before launching the commercial product in 1954, researchers were doing self-experiments with the substance (not uncommon that time), and, while Dr. Panizzon didn't found the effect of methylphenidate particulary benefical for himself, his wife Margueritte (Rita) found it to be pleasant and took it on occassions (stated that she took some time to time before tennis matches); hence the trade name of the drug Ritalin arose as a little "insider joke" (after Rita Panizzon). This isn't speculative (well it looks so without reference, I know), nor original research. It is stated and quoted in a monography on methylphenidate. Unluckily, I get this monography in a month or later, so I can refer this whole story then, at least... Ow, I almost forgot, the monography is Schulte-Markwort, MJ.: Methylphenidat, Thieme, 2004 (in german). ISBN 313133441X. Cheers, --84.163.114.126 (talk) 22:12, 8 August 2008 (UTC)

The IUPAC name is wrong

Novartis (current owner of the Ritalin® brand name) calls it methyl alpha-phenyl-2-piperidineacetate in the FDA pamphlet.

Other names emphasize that this is a methyl ester of a substituted acetic acid. The name given on the page suggests that it is a salt of acetic acid.

I suggest a change to the Ritalin® prescibing information name: methyl alpha-phenyl-2-piperidineacetate. —Preceding unsigned comment added by 24.158.37.50 (talk) 01:41, 18 August 2008 (UTC)

Just thought I should point out that the terms 'acetic acid' and 'acetate' are not systematic. The correct IUPAC terms are 'ethanoic acid' and 'ethanoate'. What the manufacturer or brand owner calls this drug is of no relevance whatever to a discussion of its systematic name. I took a degree in chemistry in the 1980s and even that long ago the terms 'acetic acid' and 'acetate' were being discouraged, and yet their usage persists. They're not 'wrong' as such, they're just not systematic. I note that the term 'acetate' appears under the heading 'systematic IUPAC name'. I'm sorry, as I have just said 'acetate' is not a systematic name. Johnpretty010 (talk) 01:33, 1 July 2011 (UTC)

All of these goddamned articles on stimulants are loaded with bullshit opinions and light on proven facts

The fucking people who write this shit are either manic or abusers of amphetamine, cocaine, methamphetamine, methylphenidate or both manic and abusing CII stimulants.

Most of the medical and pharma articles here are JAMA quality. But when you get to ritalin, lsd, anything trailer-dwelling methheads are using the articles cite Erowid and urban legends like that "lsd accumulates forever in your spinal cord". "Vitamin C makes you trip harder."

It all reminds me of an anti-HIV poster demonstrating the method of bleach sanitization of syringe and needle. The poster warned the addicts that it wasn't advocating INJECTING BLEACH ! Like, duh, but this is the mentality you are dealing with in half the authors in this article. My apologies for the cursing, but I am sure most of the other half here feel as angry at this trash as I do.

These loopy vandals need to be run off and reported to the narcotics police. —Preceding unsigned comment added by 24.158.37.50 (talk) 02:08, 18 August 2008 (UTC)

Your a fucking idiot, first of all Erowid is not an urban legend, it actually is a biased site on psychoactives that normally have a negative stigma, second, what does 'abusing' stimulants have to do with poor quality? It's idiots that make poor quality articles, doesn't matter weather they are on amphetamine, crack, or magnesium, they are idiots, third, stop complaining and get off your ass and fix it. Thank you :)(By the way, sign your post next time ritalin kid) 68.238.226.149 (talk) 04:46, 1 September 2008 (UTC)

Read my words. I never said Erowid was an urban legend. I said "Erowid and urban legends like ...". I am perfectly aware of what Erowid is. It is a website that panders to reckless abusers of psychotomimetics. Although Alexander Shulgin is a open proponent of human experimentation and investigational use of psychotomimetics, he is without doubt an authority and presents information as such. Shulgin is probably quoted often in Erowid but not the other way round. As for poor quality correlating with stimulant abuse I can only cite anectdotal common knowledge. However, I imagine that the sections in the DSM on paranoia, mania and cocaine abuse overlap.24.158.33.251 (talk) 19:56, 22 September 2008 (UTC)

What is the means of creating the mode of action in methylphenidate?

The enantiomers and the relative psychoactive effects and CNS stimulation of dextro- and levo-methylphenidate is analogous to what is found in amphetamine, where dextro-amphetamine is considered to have a greater physchoactive and CNS stimulatory effect than levo-amphetamine (levamfetamine is sold legally OTC in Vick's inhalers).

OK, so does it phosphorylate the dopamine transporter like amphetamine does then to create the effect of inhibiting its reuptake? If it does the article should say so.

Otherwise, since it is closer in structure to cocaine than amphetamine is (note *than...is*, it is itself still closer to amphetamine than cocaine, just closer to cocaine than amphetamine is, note the difference: methylphenidate is in the middle but nearer to amps) is it closer somehow for the reason that such a structure ends up simply binding to the dopamine transporter, like cocaine does, to slow it rather than to phosphorylate it?

That would make sense as it would be theoretically less neurotoxic and more useful for legal / therapeutic purposes. If not then I am surprised that they haven't used something like troparil for an ADD/ADHD mediciation; being as it has netiher the cardiotoxicity of cocaine (from local anesthetic effects) nor the neurotoxicity of amphetamine (and methylphenidate?) (from phosphorylization effects). Nagelfar (talk) 08:32, 7 October 2008 (UTC)

I guess a broader but not directly related (if the answer is no) question would be: do all phenyltropane stimulants function by simply binding to the DAT1 receptor and (more importantly) do all phenethylamine stimulants function by phosphorylating the DAT1 receptor? Nagelfar (talk) 08:56, 7 October 2008 (UTC)

"Paradoxical"

The line about the "paradoxical" mode of action is important, because it strikes at a common (mis)understanding of the mechanism. However, the sentence is too short, such that a person without foreknowledge of the debate will not be able to recognize the reference. I have minimally expanded the line, in a way that I hope does not elicit disagreement.Gaedheal (talk) 17:21, 7 November 2008 (UTC)

It is commonly asked why a stimulant should be used to treat hyperactivity, which seems paradoxical. However, CTs of ADHD brains show decreased activity in the brain centers critical to concentration and goal-directed activities.[citation needed]

I don't know how a point as central as this can be left as "citation needed". Phaser501 (talk) —Preceding undated comment was added at 10:33, 3 February 2009 (UTC).

Misdiagnosis and Confounding Symptomology

Psychiatry is a difficult field in which many conditions have overlapping symptoms, and only occasionally mutually exclusive diagnostic criteria. A prime example of this is the case for AD(H)D and type II bipolar. This is confounded by the fact that methylphenidate (et c.) often treat the symptoms of a condition, and not the cause, and therefore treatment with the drug in question often relieves some symptoms of mutually exclusive conditions, complicating further (and more accurate) diagnosis when success of a chemotherapy is used as confirmation of the diagnosis. I would like to see some discussion of the conditions commonly mistaken for eachother. This might be better in the ADHD article, or other controversy articles, but a reference to it in this article may be well placed. Are there any objections to its inclusion here? Gaedheal (talk) 18:53, 7 November 2008 (UTC)

Redundant side effect lists

The list of side effects in the article mimics the list on the right of the article. The list in the article disrupts the flow of the article and ought to be condensed into prose (not bullet points) or removed entirely. Since there is some controversy over editing this article, I thought I would state my support for this change and wait for consensus, or barring disagreement, wait a bit and change it myself. Letsgoridebikes (talk) 17:28, 8 January 2009 (UTC)

Insomnia is listed twice, once as a serious side effect, and once as a less serious one. I can't fix it, because i don't know which one is true. —Preceding unsigned comment added by Krisztián Pintér (talk • contribs) 23:48, 8 January 2009 (UTC)

Well, it seems like nobody wanted to comment, so I removed the table on the right side because most of the information contained within was redundant (except the contraindication info that was merged into the article). I haven't seen a similar table in any other medication articles, so I felt justified in removing it. Letsgoridebikes (talk) 03:14, 19 February 2009 (UTC)

Scheduling and abuse potential

The first sentence of this section cites a reference which does not actually go as far as to factually state what is claimed.

I suggest that a new section solely on "Abuse and Addiction" be started and that an appropriately qualified expert sift through the claims in what has been a large area of controversy over some time in this topic and indeed throughout the "terrestrial" world. This may help to clear up claims that for example two molecules that are similar must have a similar pharmacological effect. —Preceding unsigned comment added by 58.175.50.29 (talk) 14:51, 5 February 2009 (UTC)

PFC of rats?

The team studied PFC neurons in rats under a variety of methylphenidate doses

Rats don't really have a "prefrontal cortex", this information is very misleading or at least technically incorrect. I'm going to try to find information to back this up before fixing it. —Preceding unsigned comment added by Mderezynski (talk • contribs) 17:10, 9 March 2009 (UTC)

What is with this gigantic run-on sentence? What early research???

Early research began in 2007-8 in some countries on the effectiveness of methylphenidate as a substitute agent in refractory cases of cocaine dependence; the fact that it can satisfy cravings for cocaine in a way which is subjectively and pharmacologically equivalent but longer-lasting as well as easier on the body and somewhat safer and easier to manage has long been part of the 'street lore' associated with stimulants in many parts of the world in much the same way that other substitutionmittel drugs such as methadone, buprenorphine, butorphanol, extended-release oral morphine, dihydrocodeine, and clonidine were amongst opioid users in various times over the past century.

==Lastly, can the Chevelle song be taken off the article? Won't people just search for wiki:Vitamin_R== 71.54.173.193 (talk) 17:59, 9 March 2009 (UTC)

References in pop culture

There was a reference to "Ritalin" in Eminem's first single "We Made You" off of his upcoming album The Relapse

He states in the song:

"lets cut out the middle man Forget him or your gonna end up in hospital again And this time it wont be for the ritalin binge" —Preceding unsigned comment added by 207.72.177.17 (talk) 00:41, 9 April 2009 (UTC)

Exactly the kind of pop-culture reference that should not be added to an article: Such entries should have a non-trivial value to the reader, have encyclopedic value, and not be a dime a dozen.88.77.156.108 (talk) 07:54, 22 November 2009 (UTC)

well popculture tends to understand the unorthodox uses and uncommon side effects better than science seems to at times, i think its fine because it shows its abuse potential probably better than these long paragraphs of language only a doctor could understand. —Preceding unsigned comment added by 76.226.6.197 (talk) 20:08, 26 March 2011 (UTC)

Methylphenidate Side Affects

What Are The Side Affects Of This Drug? Im Being Put On It Soon And Im wondering If Weightloss Is common In All A.D.H.D Drugs —Preceding unsigned comment added by 69.233.2.58 (talk) 01:32, 23 April 2009 (UTC)

I have ADHD as a teen and when I took Concerta when I was 5, the mood swings were just unbelievable! I'm on Adderall (sp?) now.

I gained weight on Ritalin because it had made me depressed since i was not sleeping and got chronic headaches. but often your appetite leaves you, and your ability to sleep soundly. —Preceding unsigned comment added by 76.226.6.197 (talk) 20:06, 26 March 2011 (UTC)

Psychosis

The risk of psychosis was off by a power of ten. The paper did not describe this as a very low incidence therefore removed OR. If the rate of psychosis is 0.1% over a few weeks and one takes it for 50 * a few weeks ie a few years one quickly see that you could easily get a rate of 5%. Now 5% is anything but low IMO. But that to is OR :-) --Doc James (talk · contribs · email) 21:45, 28 April 2009 (UTC)

Oops, I was editing from memory and got mixed up. Thank you for fixing, I fixed the errors in the other ADHD entries as well. I think the higher rate of psychosis with long term use is due to distortion of brain chemistry or function with long term use, due to either tolerance, rebound or perhaps even a degree of neurotoxicity, which is one reason why I made the comment on other talk page about the problems of clinical trials taking data from short term clinical trials and applying it to effects of long term use.--Literaturegeek | T@1k? 22:32, 28 April 2009 (UTC)

Okay, so I've been on Concerta for about 4 years, and I've been developing symptoms of psychosis for a while. I didn't think anything of it the first time I had an audio hallucination, so I don't remember exactly when it started. I should have seen someone earlier, but I can't regret that now. Anyways, I'm getting quite confused here. Is it only with abuse of the drug that you start developing psychotic symptoms? Because I know I don't have a tolerance to it, since it still does what it's supposed to under the same dosage of 60mg. Also, can this be a cause of Major Depressive Disorder with psychotic symptoms? Because I may have either of the two. I really hope I don't have the second but...we'll see. - Croft —Preceding unsigned comment added by 98.169.208.221 (talk) 06:02, 1 June 2010 (UTC)

ritalin

can u drink on ritalin??? —Preceding unsigned comment added by 86.44.91.228 (talk) 20:34, 29 April 2009 (UTC)

I have been prescribed concerta and my doctor very strongly recommended that I not drink any booze at all while taking the drug. But, on the other hand, I have no desire to drink now and my productivity and happiness has escalated considerably. —Preceding unsigned comment added by 130.234.68.129 (talk) 00:28, 6 May 2009 (UTC)

Drinking while on methylphenidate forms the compound ethylphenidate Sincerely, C6541 (T↔C) at 19:06, 6 July 2009 (UTC)

Methylphenidate and Clairtin D

The article says methylphenidate can mix with clairtin D to form methamphetamine like substances, then gives an example of a racecar driver. However, the racecar driver used adderall XR (amphetamine) not methylphenidate. Amphetamine is obviously more similar to methamphetamine than is methylphenidate. It also claims that the two drugs combine in vivo, which is highly unlikely. The more likely explaination is the the metabolities of the pseudoephedrine in claritin D when seen in conjunction with the metabolites of amphetamine (adderall), provides a false positive for methamphetamine, which may produce both metabolites on its own. This section cites no sources and should be rewritten or removed. —Preceding unsigned comment added by 65.185.139.46 (talk) 22:24, 28 June 2009 (UTC)

Odd choice of links

The conditions it treats are not links, but the names of countries are? That's an ... odd choice. —Preceding unsigned comment added by 68.28.137.233 (talk) 04:38, 15 September 2009 (UTC)

Misstatement in first paragraph -- Methylphenidate is not Adderal.

Today the first paragraph of the Methylphenidate article says "... In North America it is most commonly known as the brand name Adderal, which is an instant-release racemic mixture, ...". That is wrong and also misleading. First, Adderal is not methylphenidate; it is a combination of amphetamine and dextroamphetamine salts (see http://www.rxlist.com/cgi/generic/amphet.htm). Second, it is misleading since Ritalin-brand methylphenidate is available in both instant-release and long-acting ("LA") formulations. This is a serious error since mis-naming medications could lead patients to request an incorrect medication (and an inappropriate dose) from their doctor. Some doctors trust some patients to provide correct information when they request prescriptions.

Methylphenidate is *not* an amphetamine derivative.

Template:Dopaminergics & Template:Stimulants both list methylphenidate as a "piperidine" class drug, which is distinctly separate from the 'phenethylamine' class of drugs to which amphetamine is a more specific sub-variety thereof. Therefore methylphenidate is not only not a derivative of amphetamine, but belongs not even to the umbrella category (phenethylamine) to the class of drugs amphetamine belongs to. Talk:Troparil#Removed content: methylphenidate overlap to troparil, etc. shows even that a phenyltropane class drug, (the phenyltropane class in general being closer to piperidines than to phenethylamines) shows that Troparil, a phenyltropane created from the pyrolysis of cocaine freebase (crack smoke), can be overlapped with methylphenidate and match methylphenidate (troparil & methylphenidate) nearly to a "T". Methylphenidate is closer related to cocaine than to amphetamine. 4.242.174.64 (talk) 11:28, 4 October 2009 (UTC)

Unclear: "and though it is less potent"

The following sentence in the beginning of the article is unclear: "MPH possesses structural similarities to amphetamine, and though it is less potent, its pharmacological effects are even more closely related to those of cocaine."

Does it mean that MPH is less potent than amphetamine or than cocaine or both?

83.233.152.179 (talk) 19:25, 28 November 2009 (UTC)

"abuse potential" section self-contradicting

Methylphenidate is actually more potent than cocaine in its effect on dopamine transporters. Methylphenidate should not be viewed as a weak stimulant as has previously been hypothesised

................

However, cocaine has a slightly higher affinity for the dopamine receptor in comparison to methylphenidate

Which is correct? These are both stated in the very same section under "abuse potential". 70.59.140.179 (talk) 15:52, 29 November 2009 (UTC)

I also noticed this and came to the talk page to discuss 156.34.70.81 (talk) 06:25, 22 August 2012 (UTC)

Ritalin in Lebanon

You need approval from the Ministry of Health if you want to buy this drug in Lebanon. —Preceding unsigned comment added by 82.198.19.131 (talk) 10:32, 10 December 2009 (UTC)

Methylphenidate facilitates learning-induced amygdala plasticity - Nature Article

I was doing some research on Ritalin for a school project and I happened to find this article, published on nature neuroscience. [2]

Using this as a reference for the pharmacology of Ritalin would probably be a good idea, although I would prefer to leave that task to people who have more experience than me in the field (of both neuroscience, and editing Wikipedia articles). I just wanted to point this article out to people. Bolmedias (talk) 16:52, 13 March 2010 (UTC)

Excessive comparisons with illegal drugs

This article makes mention of the fact that methylphenidate is similar to cocaine and amphetamines no fewer than 13 times. While this statement is true, repeating it 12 times outside of the context of scientific or pharmacological discussion is either an indicator of extremely poor writing or a not-entirely subtle attempt to bias the reader. —Preceding unsigned comment added by Benjamin.blue (talk • contribs) 07:04, 1 April 2010 (UTC)

I think you're right, that does seem quite biased. —Preceding unsigned comment added by 76.226.6.197 (talk) 20:04, 26 March 2011 (UTC)

--

I am certainly no expert, but while doing my own research I compared this Wikipedia entry with the description at the National Institute of Mental Health:

The NIMH description does say that Methylphenidate is a stimulant but does not compare the drug to cocaine or amphetamines. From the article:

"Are stimulant medications safe? Under medical supervision, stimulant medications are considered safe. Stimulants do not make children with ADHD feel high, although some kids report feeling slightly different or "funny." Although some parents worry that stimulant medications may lead to substance abuse or dependence, there is little evidence of this."

A quick comparison between the Wikipedia entry and the NIMH description feels quite different. The Wikipedia entry feels skewed toward the negative. I am unaware why people might want to do this but it seems the concerns have been mentioned here by others so maybe there is a pattern here that I am not aware of. For example, the following quotes [My comments in brackets]:

"Methylphenidate possesses structural similarities to amphetamine and its pharmacological effects are more similar to those of cocaine, though MPH is less potent and longer in duration of action."

[Specifically, structural "similarities" and "similar" effects. Similar is a vague and relative term. Men are similar to women. They are also similar to apes. Human DNA is similar to rat DNA. I'd like the "similarity" in this context to be defined. Especially when compared to the quote below, I find this claim of similarity suspicious]

"Methylphenidate has shown some benefits as a replacement therapy for individuals dependent on methamphetamine.[25] Cocaine and methamphetamine interfere with the protein DAT, over time causing DAT upregulation and lower cytoplasmic dopamine levels in their absence. Methylphenidate and amphetamine have been investigated as a chemical replacement for the treatment of cocaine dependence[26][27][28][29] in the same way that methadone is used as a replacement for heroin. Its effectiveness in treatment of cocaine or other psychostimulant dependence has not been proven and further research is needed.[30]"

[This paragraph almost seems designed to sow fear, uncertainty and doubt. For example, "Cocaine and methamphetamine interfere with the protein DAT..." Wait a second, this article is not about Cocaine and methamphetamine, it's about an entirely different drug. When compared with the quote about "similarities" the statements seem connected. Yet the nature of the "similarities" is not precisely defined. So I fail to see how statements directly referring to other "similar" drugs are relevant. For example, Sudafed is "similar" to methamphetamine, yet there are significant differences, and people routinely take Sudafed without fear of addiction.

In addition, is the fact that something "has been investigated" relevant if nothing has been found or proven? The statement that something "has been investigated" as a treatment for drug addiction but "has not been proven" feels to me like saying a politician has been "investigated for spouse abuse, although nothing has been proven."

The primary issue for me is the extreme difference in tone and feeling between this article and the NIMH article, which is what prompted me to comment here.

Dgray xplane (talk) 02:36, 23 November 2011 (UTC)

Hi Dgray. This article is an encyclopedic entry about methylphenidate the drug in general, not 'methylphenidate for children with ADHD'. The NIMH article is about methylphenidate and other drugs for ADHD, so yes the articles will differ significantly. The men/woman, human/mouse dna comparison is apples and oranges; these are not pharmacodynamic actions and are not fair comparison's in this case. Methylphnidate is a stimulant; all the article is doing is describing methylphenidate as a stimulant in comparison with other stimulants and describing a therapeutic application for methylphenidate and like it or not, there has been a fair amount of research attention as well as media attention, given to methylphenidate in the treatment of stimulant dependence such as methamphetamine or cocaine dependence and this makes it notable.

Wikipedia entries tend to be more comprehensive than other sites being that it is an encyclopedic entry; the nih entry is not an encyclopedic article. Also the NIH entry is describing this drug in relation to ADHD, this article is not about ADHD but is about the drug in general. I think this is the mistake you are making in that you think this article is meant to be geared to methylphenidate only as a therapeutic agent when it is about the drug in general. I hope that this helps.--Literaturegeek | T@1k? 08:09, 23 November 2011 (UTC)

Literaturegeek Caffeine is also a stimulant, far more common than cocaine or methamphetamines, yet it is not mentioned. Why not? Is methylphenidate "more similar" to cocaine than caffeine? If so how? A more comprehensive article would be more clear about what is meant by "similar." The statement

"Methylphenidate possesses structural similarities to amphetamine and its pharmacological effects are more similar to those of cocaine..." is supported by three references.

The first reference does make a comparison between Ritalin and Cocaine. It also states "Ritalin is not addictive when taken as prescribed by doctors." The article concludes

"Because of Ritalin's similarity to cocaine, some believe Ritalin could be a 'gateway drug'. A gateway drug is defined as a drug that may lead to the use of other more addictive drugs. But studies show that Ritalin-takers are actually far less likely to experiment with other drugs unlike those with ADHD who are not medicated."

The second reference is a generic reference to stimulants that mentions methylphenidate and compares it most directly to to pedaline, used to treat attention deficit disorders and modafinil, used to treat narcolepsy. Neither of these drugs is mentioned in the Wikipedia article.

The third reference has as its headline "Why isn't methylphenidate more addictive?" and includes a subheading "Why methylphenidate works." It also contains statements like

"From a pharmacological standpoint, methylphenidate is the drug that most resembles cocaine. Yet, despite the fact that methylphenidate is frequently abused, users do not become severely addicted or exhibit the desperate binges that can sometimes lead cocaine users to take the drug every half hour for days at a time."

It concludes:

"All of this translates to the desired therapeutic effect... Thus, a previously “boring” homework assignment seems more appealing—and gets finished."

A comparison of the statement and the references seems to reveal a significant difference between the intent and meaning of the sources and the most likely interpretation of the statement here on Wikipedia.

Dgray xplane (talk) 18:55, 23 November 2011 (UTC)

The pharmacodynamics of caffeine are quite different from methylphenidate, working as an adenosine antagonist as well as an inverse agonist at benodiazepine receptors. There are no similarities in how it is used therapeutically, recreationally etc; that is why it is not mentioned and reliable sources do not mention it as such.

Sometimes ip addresses and people change referenced text or misrepresent references. If a reference has been unfairly misrepresented then you can correct it. You are coming across quite, shall we say energetic, as if you are outraged. Relax. :) No one said the article is perfect and I am not responsible for the content of the article, I have added some material a long time ago though.--Literaturegeek | T@1k? 19:23, 23 November 2011 (UTC)

I'm not outraged :) I am not a frequent contributor to Wikipedia but I am a frequent user, financial supporter, and I defend it often when it's criticized as an unreliable source. I tend to trust Wikipedia as a source, although I am familiar with some of its inherent biases -- for example, a bias against legitimate sources that do not exist online, and a bias in favor of topical coverage in certain areas that enjoy lots of geek love. [3] I don't look to Wikipedia very often for medical information, which is why I became concerned at what I perceive to be somewhat skewed coverage. My concern is as a reader looking for a neutral point of view that this article seems to lack. I did see that you have some drug expertise and very much appreciate your input here. As I said I am not a medical expert of any kind, just a concerned reader, so suggestions about how I might help improve the article are much appreciated. Dgray xplane (talk) 19:35, 23 November 2011 (UTC)

The statement "Methylphenidate has high potential for abuse and addiction due to its pharmacological similarity to cocaine and amphetamines." is supported by two references:

The first is from "Alternative Medicine Review" which is published by a company that sells dietary supplements. Although they claim it is an independent, peer-reviewed journal, it also states that the journal since inception has "promoted the practice of alternative therapies." [4] "Promoted" is the word that concerns me here.

The second reference is from a NIH site and appears (to my uneducated eye) to be more legitimate. Although it mentions MPH and states "MPH also has some abuse liability because of its stimulant properties" it also states that "the abuse of MPH in humans is substantially lower than that of cocaine."

While both references use the word abuse, neither mention addiction and indications from other sources seem to indicate that it is not. [5]

I remain concerned about the neutrality of this article. Dgray xplane (talk) —Preceding undated comment added 19:27, 23 November 2011 (UTC).

Sometimes ip addresses and people change referenced text or misrepresent references. If a reference has been unfairly misrepresented then you can correct it. :-@)--Literaturegeek | T@1k? 19:30, 23 November 2011 (UTC)

Well, not being a medical expert, I am reluctant to edit an article like this. Although with a bit of encouragement I wouldn't mind spending a bit of time trying to restore some balance. As I look at the literature cited here there do appear to be some beneficial effects that are under-represented. Dgray xplane (talk) 19:38, 23 November 2011 (UTC)

Okay, I took a stab at it -- removed the words "and addictive" from the above statement. Citation #3 in the article appears to indicate that although MPH can be abused,it is not particularly addictive.[6] — Preceding unsigned comment added by Dgray xplane (talk • contribs) 19:46, 23 November 2011 (UTC)

Literaturegeek, thank you for your encouragement. I am going to attempt some edits to bring a little balance to the article. I would appreciate your taking a look at my edits and your suggestions, as I am not a medical expert or an experienced Wikipedia editor. Thank you! Dgray xplane (talk) 00:46, 24 November 2011 (UTC)

I found an interesting study demonstrating that subjects given pharmacological treatment for ADHD were less likely to develop addictions later in life than those who were not medicated. [7] Where would be the best place in the article to insert a statement to that effect? — Preceding unsigned comment added by Dgray xplane (talk • contribs) 17:32, 24 November 2011 (UTC)

Concerta... should it get its own article?

Concerta redirects here. Concerta is a specific dosage form version of Methylphenidate made for long term release. Might a separate article be necessary for describing the way Concerta works and history of it's development? I'm not sure that a section here specifically for Concerta would be appropriate... —Preceding unsigned comment added by 74.179.99.71 (talk) 14:08, 16 April 2010 (UTC)

I agree. Concerta is chemically the equivalent of Ritalin, but its delivery method is important, both as a way to smooth the effect of the drug and as a way to prevent abuse. As you can see from the picture here, http://www.addadhdblog.com/wp-content/uploads/Generic_Concerta_Canada.gif if you attempt to ingest concerta through the nose, you get a nose full of plastic. 67.226.171.123 (talk) 12:54, 25 June 2012 (UTC)

Information Erosion and Concerted Efforts to increase prescription rates

If you all read properly there is significant lack of research on a great amount of things concerning it. Long term effects, and over all theraputic value for an individual's development to name a couple. PMA has a long history of falsifying test results and hiding important facts. Their pockets are extremely deep and the free promotional gifts and bonuses for the number of precriptions handed out by doctors are some of the most lucritive of any industry with health care professionals enjoying significant degrees of +% to their annual income in bonuses alone. They have one of the most powerful lobby groups on the capitol to keep their affairs legal and quiet and the have not lost money in a single year of operation yet.

It is bad enough that they still produce marginal quality drugs, for huge profits and unknown health effects like vioxx, but there is nothing to deter them. If it is that similar to other stimulants, it should repeated again and again. If there are no studies proving its actual real effectiveness (remembering that the PMA sponsors most of the studies and give away a free hawaii vacation with each published report of the results) why is prescribed like water? Health care practitioners do not have your interests at heart only greedy eyes for money or bows to peer pressure. —Preceding unsigned comment added by 198.103.221.51 (talk) 16:55, 15 June 2010 (UTC)

Not as addictive as cocaine?

The link associated with this claim (#3) is dead. Does anyone have anything for this, one way or the other?http://www.neuropsychiatryreviews.com/feb02/adictive.html —Preceding unsigned comment added by Zenblend (talk • contribs) 08:26, 16 September 2010 (UTC)

Link updated to archive.org copy.

well i mean that seems pretty obvious to me. it just made me feel like a giant turd. i think its possibly the opposite of addicting. it was a disgusting thing to me i hated it. Adderall however, might as well as be SUPER-cocaine. that stuff was messed up. i used to abuse a lot of drugs and adderral, which was prescribed to me, was by far the best. These are horrible medications that we should be more careful with. shouldnt mistake happiness for ADHD like they did with me and ruin peoples lives with drugs, i know this isnt the place for this but ims ure a lot of people would agree with me. i think we overdiagnose problems like adhd. though they do exist. —Preceding unsigned comment added by 76.226.6.197 (talk) 20:14, 26 March 2011 (UTC)

Thank you for the updated link. As for obviousness, personal experience isn't worth that much, seeing as how I find Adderala more addictive than other, more recreational stimulants. Studies are goo; that page looks good. Thanks. Zenblend (talk) 05:48, 7 April 2011 (UTC)

Neural Insult

In the first section, what does the term Neural Insult mean? Cannot find a definition neither on Wikipedia nor elsewhere. Would say it'd be better not to use such unclear and exotic terms. If no one objects, I will remove it. O.mangold (talk) 09:00, 23 September 2010 (UTC)

Certain important side-effect of Ritalin which seems to be being ignored here.

Bruxing is a known side-effect of amphetamines and general, and specifically Methylphenidate. I know I'm not alone in saying that taking Ritalin has caused me severe and permanent bruxing [Teeth grinding] which has taken years to even diminish slightly. I've looked it up and found many discussion pages of others saying the same things have occured with them when or after taking Ritalin, this seems like an important risk for others to be aware of, but most doctors don't even seem to be aware of it. There used to be a large paragraph regarding this, but it is no longer presented here. It is a known, and at least probable, side-effect which used to be listed but for unknown reasons has been removed, many people i know who have taken Ritalin are suffering permanently from this side-effect, includng myself, and i know if i had known about it iw ould never have taken Ritalin, so i think it is important to list, as long as there can be references made to this problem, maybe even to the discussion pages where this issue has come to light in the first place. It certainly should never have been removed, there's no reason for that other than to disguise the more dangerous side-effects of Ritalin use. Even the rarest side-effects should be presented as a possibility, especialy when the problem, like severe bruxing, is much more serious than the original issue. My grades while dealing with chronic headaches were certainly much worse than when dealing with hyperactivity, and this is the case with more than one of my friends who had also taken Ritalin. —Preceding unsigned comment added by 76.226.6.197 (talk) 20:01, 26 March 2011 (UTC) and this is a very small observation, but it seems to occur more often with blondes. maybe this is just because of overdiagnosis in blondes because of public perception of blondes as being more fun-loving, but so far, all the people ive seen who have suffered from the same problems i have with Ritalin were blonde or had blue eyes or both.76.226.6.197 (talk) 20:42, 26 March 2011 (UTC)

My older brother was never on meds, but he had problems with teeth grinding at night. Blue eyes and blond hair. Weird. You're free to put something up if you think it's relevant and can be backed up. Zenblend (talk) 05:49, 7 April 2011 (UTC)

I'm not sure how to add to wikipedia or show sources but that suprises me as well. There must be something to it. I can find plenty of pages linking both ADHD and ritalin individually to bruxing, but i dont think anyon else has notice the high prevalence of blondes with this problem. very interesting. ~~ — Preceding unsigned comment added by 76.226.5.218 (talk) 16:36, 8 June 2011 (UTC)

Proper Labeling of Non-credentialed Critics

Neither Neil Bush nor Gary Null has any medical credentials of any kind. Their inclusion is puzzling. Bush could rightfully claim a place in an article about his famous relatives but has no other qualifications. Any other fame he has arises from various accusations of misdeeds chronicled in his Wikipedia entry, including the S&L Crisis, improper government grants from a program initiated by his brother as US President, and insider trading.

Gary Null, on the other hand, is a self-styled alternative health guru who has been widely deemed as a crackpot by the medical establishment and mainstream media as can be seen on the Wikipedia page covering him. He has even denounced his own products and insisted that there is no proof for the link between HIV and AIDS.

Wouldn't it make more sense to have a paragraph stating the following?

Some celebrities have drawn attention by criticizing Ritalin, such as Neil Bush and Gary Null. These criticisms have not been addressed in medical literature.

Then, after this paragraph, there could be links to relevant articles. This approach would prevent the mistaken perception that these people are part of any instrumental public debate, while not directly addressing the issue of whether they are dangerous publicity hounds or sincere laypeople.

76.226.73.229 (talk) 21:39, 5 February 2012 (UTC)

I agree and I have deleted text regarding Gary Null and trimmed the Neil Bush text down to a single sentence. Let me know what you think. Thanks.--Literaturegeek | T@1k? 22:06, 5 February 2012 (UTC)

Alfie↑↓© 10:34, 6 February 2012 (UTC)

"Similar to heroin" Stop the false claims using false citations.

"The abuse pattern of methylphenidate is very similar to heroin and amphetamines"

Really? Reread page 407 of your cited source. It doesn't say it has an abuse potential similar to heroin. Yet this baseless claim occurs twice in the methylphenidate entry.

What it says is:

"Methylphenidate also has potential for abuse, and the abuse pattern is very similar to cocaine and amphetamines."

That comment itself cites:

Breggin P, Breggin G. The hazards of treating ADHD with Ritalin. J Coll Stud Psychother 1995;10:55-72. http://www.breggin.com/index.php?option=com_content&task=view&id=123

The closest Breggin comes to comparing methylphenidate to heroin is:

"The Food and Drug Administration (FDA) classifies methylphenidate in a high-addiction category, Schedule II, which also includes amphetamines, morphine, opium, and barbiturates."

But there's a difference between abuse potential and abuse patterns. (Regardless, not even your source's source mentions heroin, which BTW is Schedule I.)

Aside from this outright dishonesty, the methylphenidate entry is again being loaded down against methylphenidate. Statements are made as dire and shocking as possible and repeated. Every potential side effect is listed and detailed in ways you never see for other drugs whose side effects are more common. It clearly resorts to fear mongering.

The logical thing to consider, if this gets more lopsided again, like before re contraversies, is to create completely new entries for, say, the unabridged listing of side effects and abuse potential of methylphenidate.

For now I'm removing this heroin comment leaving the amphetamine part. Please don't reenter the false heroin statement again. You've been warned.

Box73 (talk) 11:59, 11 February 2012 (UTC)

I know this is from months ago, but you have no right saying "You've been warned." Wikipedia isn't an autocracy where you can tell others what to do and intimidate through comments such as that. In the future, just state your disagreement in a pleasant manner. C6541 (T↔C) 18:17, 29 August 2012 (UTC)

Likewise, time wise... Forgive my reaction but if an editor continues to repost copy equating Ritalin to heroin, then just passively accept that it might continue to happen? Let me repeat that he/she reposted the "Ritalin is like heroin" comments in the article text, which amounts to baseless fear mongering. How often have you read through the credible looking pseudoscientific references? I did in this case and it takes time. Others don't, but given a citation, accept it as true. It's the stuff of antipsychiatry and intelligent design and many other flavors of nonsense.

In the future please try to first appreciate the overall situation and understand an allusion ("you've been warned") re reporting an editor for such behavior. (Here's another rather autocratic sounding intimidating phrase: "Content that violates any copyrights will be deleted.")

Wikipedia isn't an autocracy but there is authority or else there will anarchy. I appreciate what you're saying about being cordial but appreciate what I'm complaining about.

Box73 (talk) 23:56, 8 April 2014 (UTC)

Euphoria an "adverse effect"?

On the list of adverse side-effects, euphoria is listed as one of them. While some people (especially drug prohibitionists) would consider euphoria as an "adverse effect", describing it as such is an oxymoron. While euphoria may be followed by dysphoria or other unpleasant symptoms, the euphoria itself cannot be adverse, as part of the word means "well." I doubt any patient taking it for a medical condition (even if they abhor taking drugs to get high) would claim the possible euphoria induced with the drug is as bad as some of the other entries on the list. The only thing I recommend is that "euphoria" be removed from that list, as it is very confusing. Eridani (talk) 17:33, 20 February 2012 (UTC)

It may seem odd from a rational perspective, but those that conduct clinical trials on pharmaceuticals consider euphoria to be an adverse effect. I believe that this is because it can prevent the drug from being a safe and effective treatment. Google will find you a bunch of examples of this, but here's one:

http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/EndocrinologicandMetabolicDrugsAdvisoryCommittee/UCM292317.pdf

-Exercisephys

As a clinical outcome, euphoria is an unwanted side effect in a drug intended for long-term. You're right that euphoria itself is not adverse but its presence can encourage abuse of the medication. An expectation of euphoria can lead the patient to believe that the drug in losing its effect when the euphoria is not present, as will be the case with rising tolerance.

Methylphenidate can have some mood-lifting benefit for ADHD patients with co-mordbid depression however the aim there is to return the patient to the normal range rather than push them into the positive. That's not to say that patients are not to feel good but, as is the case with healthy, unmedicated people, these feelings, especially euphoria, should come as a response to events and improvements in their life and outlook rather than the medication. 92.24.205.0 (talk) 10:55, 25 July 2014 (UTC)

Deletion of comment about "piperidine class"

I deleted the statement that methylphenidate belongs to the piperidine class of compounds because there really is no such thing, unless one is referring to simple alkyl-substituted piperidines like coniine. The presence of the phenyl ring and the carbomethoxy group in the structure of methylphenidate are just as important as the piperidine ring, and one could as easily (and equally meaninglessly) say that methylphenidate belonged to the "phenylacetate" class. More importantly, though, the structural parallels between cocaine and methylphenidate should not be over-emphasized: what happens to the pharmacological properties of methylphenidate if you add a methyl group to the nitrogen (increasing the similarity to cocaine)? What happens to the properties of cocaine if you substitute a piperidine ring for the tropane ring-system? Unless you can answer these questions, then pointing out these similarities in structure is not useful, as it has no predictive value. I might add in passing that meperidine also contains a piperidine ring and a phenylacetate moiety. Does this mean that meperidine shares pharmacological/clinical properties with cocaine and methylphenidate? Sure, they're all CNS-active drugs.Xprofj (talk) 00:07, 1 July 2012 (UTC)

Having done a bit more reading, I have to modify my own comments, above. Apparently, if you make certain piperidine analogs of cocaine, you still have significant DAT activity (even if there isn't much locomotor action). See: A. Kozikowski et al. (1998) J. Med. Chem. 41 1962-1969. I haven't followed up this now 14 year-old paper, so some clinical pharmacology may have been done on the compounds since it was published.Xprofj (talk) 17:09, 1 July 2012 (UTC)

I don't really have much to comment about the other stuff, but pethidine has pharmacological similarities to cocaine, they are both DNRIs (granted cocaine has affinity for serotonin too) and pethidine fully substitutes for cocaine. C6541 (T↔C) 19:18, 1 July 2012 (UTC)

Bioequivalence of Concerta and Teva-methylphenidate ER-C (Canadian generic)

I have just edited one section that stated Concerta is bioequivalent to Teva-methylphenidate ER-C. This is actually not the case, as their delivery mechanisms are not even remotely close to each other. Some governments (notably the province of Ontario) consider them to be interchangeable, but that is based on a requirement that the release of the active ingredient falls within 80-125% of the original drug over time. Under this definitition, even the original Ritalin SR could be considered equivalent to Concerta. Bottom line is, people in provinces that allow substitutions between these two drugs need to be very careful. Personally, I switched to the generic for a month last year, and it was probably the worst I've ever been since I started taking medication for my ADHD at about age 7. — Preceding unsigned comment added by 137.186.43.205 (talk) 06:25, 20 November 2012 (UTC)

This blog is reliable because it is written by a respected, practicing psychiatrist in Oakville, Ontario (the homepage for his practice is available at http://www.drhandelman.com/). — Preceding unsigned comment added by 137.186.43.205 (talk) 08:51, 20 November 2012 (UTC)

At the very least, I don't think the page should definitively state that the drugs are equivalent, when every province but Ontario does not consider them as such in their provincial forumlaries. — Preceding unsigned comment added by 137.186.43.205 (talk) 09:00, 20 November 2012 (UTC)

Overhaul

My edit (difference in revisions)
My edit (as oldid)

Okay this article was getting way too long and large (in data size) and was very messy reading. Some of the problems I noticed:

1. The lede was way too long, it shouldn't be any bigger than two paragraphs
2. There was a lot of redundant information, for example I found a paragraph explaining methylphenidate's mode of action about 5 times repeated throughout the article
3. The sections were not really organized well
4. Paragraphs read like a giant block of text, they needed to be broken up. This is one of Wikipedia's biggest issues with pages like this
5. A couple things read like an essay
6. As aforementioned, the article was getting too long. 107,082 bytes is extremely large for an article, I cut it down to 88,175 bytes which is still large but it should be more manageable.
7. Some parts seemed needlessly technical, remember to always strive for simplicity when explaining something.

Anyway I hope some others will look over my change and see what further needs to be done. I'd recommend against expanding the article again until issues are worked out with how the page reads, there is still a lot of room for improvement in prose and paragraph structuring. Best regards, C6541 (Talk ↔ Contribs) 06:21, 28 November 2012 (UTC)

Legitimacy of source

How do people feel about this source?

"Attention deficit/hyperactivity disorder (ADHD) in children: rationale for its integrative management"

It's currently used in three places, but it's in an alternative medicine journal and seems biased. — Preceding unsigned comment added by Exercisephys (talk • contribs) 01:07, 2 December 2012 (UTC)

How is all alternative medicine treated in regards to Wikipedia:Identifying reliable sources (medicine)? In general I do not think AltMed stuff should be used for citations unless it is being used in reference to an actual alternative practice. With the one [39] citation which talks about how methylphenidate treatment should not be indefinite, well I think this is a common recommendation by doctors. C6541 (Talk ↔ Contribs) 01:09, 3 December 2012 (UTC)

Weak Coverage of Neurobiology

The neurological effects of methylphenidate are discussed very briefly in this article in the subsection "ADHD and stimulant dynamics in general", and not with much clarity. I don't know enough about the subject in general to develop an accurate and concise description, but it's definitely needed. Here's one source to get the ball rolling:

http://www.ncbi.nlm.nih.gov/pubmed/21029780

Exercisephys (talk) 01:22, 2 December 2012 (UTC)

These things could use a total re-write, if I can get around to it I will. C6541 (Talk ↔ Contribs) 01:10, 3 December 2012 (UTC)

Isomer - comment moved from image page

Hi all, I'm not a scientist but while looking at the image page for the skeletal diagram I found the following comment and decided to move it here where it could be addressed. It's been there since 2009! -

"This is an ISOMER of methylphenidate! The ACTUAL formula is the same molecular formula, only the double-bonded oxygen is over the benzyl group, and the methoxy group is directly above the nitrile group (like a mirror image of the top portion of the image already shown)."

Thanks, Lithoderm 22:47, 30 December 2012 (UTC)

Hi Lithoderm! The comment at commons was made by an IP (as his/her only SCREAMING contribution to WP). Actually there are four steroisomers of MPH (to the right). In a simple skeleton formula (without specifying stereochemistry and conformation) it's irrelevant how the formula is drawn. BTW, even if stereochemistry is of concern, the double-bonded oxygen is never "over the benzyl group" (whatever that means). ;-) Alfie↑↓© 14:03, 1 January 2013 (UTC)

Restricted rotation analog (of methylphenidate)

Is there a name for the following substance?: http://pubs.acs.org/doi/abs/10.1021/jm061354p

Image:

Http://pubs.acs.org/appl/literatum/publisher/achs/journals/content/jmcmar/2007/jmcmar.2007.50.issue-11/jm061354p/production/images/medium/jm061354pn00001.gif

If so a page should be made on it. 24.20.95.50 (talk) 04:00, 15 January 2013 (UTC)

Rescheduled in the UK

As Class B. See http://webarchive.nationalarchives.gov.uk/+/http://www.homeoffice.gov.uk/drugs/drugs-law/Class-a-b-c/ I've updated the article accordingly but it doesn't seem to be linking to the page for Class B as it does with other articles, even though I appear to be doing exactly as they have done (they don't actually link the class B page (e.g. The page on Dextroamphetamine) 198.61.226.43 (talk) 10:57, 24 January 2013 (UTC)

Abreaction?!

In subsection "Treatment emergent psychosis" it states, "Normally any abreaction will show within 3 hours.[74]" where the reference -- 74 -- is to a text on methylphenidate toxicity. Abreaction -- the psychodynamic cathartic phenomenon -- in the context a section on drug adverse reactions? Surely not? Did the editor mean "an adverse reaction" and foolishly assumed that 'abreaction' == 'adverse reaction'. Is using a dictionary that painful? 114.76.75.113 (talk) 08:15, 11 April 2013 (UTC)

Apologies

My apologies about the "Hydrochloride" addition, I was wrong. Well... it's called Methylphenidate Hydrochloride, but only in certain circumstances. Jakebarrington (talk) 12:14, 14 May 2013 (UTC)

No problem. ;-) All salts dissociate in solution and only the base (or acid of other drugs) permeate through membranes and reach the systemic circulation. That's why we have only the bases'/acids' CAS numbers etc. linked in the drugbox. Though currently all formulations of methylphenidate contain the hydrochloride, this may change in the future and is irrelevant from a pharmacological point of view. If a reader searches for methylphenidate hydrochloride she will end up here anyway (since we have a redirect in place). Alfie↑↓© 15:31, 19 May 2013 (UTC)

Certainly off-topic.

In the chapter of text called "substance dependence" the second part is describing some research done +5 years ago about possibly suitable agents to be used as replacement therapy for cocaine dependence. The text goes, as per my judgement, a bit astray when it goes on about researched substituted benztropine analogs which is of little intrest to anyone wanting information about methylphenidate. The text is also very difficult to read and too rich in insignificant details to be easily understood. This part should be scrubbed, heavily edited and/or moved to another page entirely ("cocaine" page?)

The first sentence of the second part of this text covers three rows of text, contains 60 words, and an impressive 6 ","-signs. Perhaps the author should stay away from the methylphenidate.

(excuse my poor english, iḿ Swedish).

"Ex.Ritalin"

Means "Example Ritalin"? Pubserv (talk) 19:39, 30 July 2013 (UTC)

Probably (was introduced by this edit without a summary). However, this is not consistent with drug articles in general. Removed. Alfie↑↓© 18:35, 31 July 2013 (UTC)

NRI mediated behavior

I don't see how the behavioral effects could be primarily mediated via noradrenaline reuptake inhibition when dopamine/phenethylamine are greatly affected by methylphenidate, along with effluxion in other neurotransmitter systems of the CNS (ex: acetylcholine, glutamate). Even ignoring the reductionist component, it's probably not true considering a large body of research indicates ADHD involves dopaminergic (technically, phenethylaminergic) hypofunction.

I'm leaving the text in for a few days, after which I'll delete it unless someone can find a recent secondary medical source. Seppi333 (talk) 06:55, 11 September 2013 (UTC)

Peripheral cortex?

In the introduction, it is stated that "ADHD and other similar conditions are believed to be linked to sub-performance of the dopamine, norepinephrine, and glutamate processes in the brain, primarily in the prefrontal cortex and peripheral cortex". What is the "peripheral cortex" of the brain? — Preceding unsigned comment added by 62.195.45.181 (talk) 08:30, 11 September 2013 (UTC)

Comparison to cocaine

I've censored the text relating mph to cocaine in the lead because they have distinct pharmacology and neuroplasticity-related effects. The comparison with cocaine also serves to relate its stigma with methylphenidate. This material could be explained just as well without any comparison to other drugs; if someone could rewrite this and then decensor it, the article quality would be better.Seppi333 (talk) 18:11, 6 October 2013 (UTC)

I agree that can can be a stigmatization tactic, but you have to remember that the two drugs are nearly indistinguishable pharmacologically. I may revert your censor because of how much vital information it removes. Exercisephys (talk) 19:19, 6 October 2013 (UTC)

The simplest reason I can think of for not making that comparison is that unlike cocaine, MPH isn't a topical anaesthetic. For pharmacological differences, as far as I know, mph doesn't modulate AMPA receptors during prolonged use like cocaine does. It's true that they both ultimately affect catecholamine neurotransmission via their mechanism of action, but that mechanism isn't the same for (but not limited to) the reasons I just mentioned. I'll probably just edit out the comparison myself now since I have time to do so.Seppi333 (talk) 20:53, 6 October 2013 (UTC)

Edit: I just realized I also unwittingly censored the entire medical uses section - that wasn't intentional. In any event, I've changed the relevant text and removed the censor.Seppi333 (talk) 21:07, 6 October 2013 (UTC)

Nikpapag edit

"Methylphenidate possesses some pharmacological similarities to cocaine. When injected intravenously, it has similar euphoria to that of both caffeine and cocaine but a much longer half life duration than cocaine."

Comments:

• neuropsychiatryreviews.com Not a reliable source for medical content, please see WP:MEDRS
• http://learn.genetics.utah.edu/content/addiction/issues/ritalin.html Not a reliable source
• Psychiatric nursing: contemporary practice whilst this is potentially a reliable source, it doesn't contain anything about IV methylphenidate, or state any comparison with caffeine or cocaine. The sources must support the content you enter, otherwise it is basically wp:Vandalism. If you continue to add medical content which is based on unreliable sources, or sources which do not support the content, you will get banned. Lesion (talk) 10:53, 8 October 2013 (UTC)

The utah.edu page seems like a perfectly acceptable tertiary source, though perhaps a little less informative and neutral than is desirable. The NpsychReview page appears to be down to me, and the Contemporary nursing book does not appear to support the claim.

"Methylphenidate possesses some pharmacological similarities to cocaine

Would be quite acceptable to me for inclusion within the article. The comment about half life could easily be cited elsewhere. The comments about IV use should be supported, especially regarding caffeine.Testem (talk) 12:02, 8 October 2013 (UTC)

• Rm these sources from the lead, where it is especially important to have reliable sources. Whether peripheral cortex is supported or not by the emedicine source I can't comment on, because I can't access it. Can someone verify this please. Nikpapag, you appear to have a loose interpretation of how sources can be used to support content, so I am questioning when you say that it is not supported by the source. Lesion (talk) 11:46, 8 October 2013 (UTC)

Neuropsych reviews is a dead link, but the same source can be found on google ([8]). It is personal opinion, unreferenced, self published. Neuropsychiatry reviews is not a PubMed listed journal. Secondary sources listed on Pubmed or textbooks required for MEDRS imo. For the same reasons, I also think the utah.edu page is not suitable: no references, not a publication in a peer review journal ... and someone previously agreed with me because it was already tagged with unreliable medical source. The textbook does not mention IV administration, or compare half life with cocaine or caffeine. Something went wrong at some point there, and the sources might have got confused. Feel free to add the content "Methylphenidate possesses some pharmacological similarities to cocaine" back in, but I would encourage you to tag the source for eventual replacement with a MEDRS source, especially if it is to go in the lead section. Lesion (talk) 12:50, 8 October 2013 (UTC)

I concur Testem (talk) 12:55, 8 October 2013 (UTC)

Regarding the wikilinking, The old content was:

"concentration/executive functions of reasoning"

Being changed to:

"concentration/[[executive functions]] of [[verbal reasoning|reasoning]]"

This might be WP:Original research, when interpreting "reasoning" as verbal reasoning. Lesion (talk) 12:59, 8 October 2013 (UTC)

I definitely agree that http://learn.genetics.utah.edu/content/addiction/issues/ritalin.html is an unreliable source - the comparison between cocaine and ritalin is based upon chemical structure and drug class, even though every substance in this list is structurally similar to ritalin (cocaine isn't on this list btw) and the vast majority have DA-reuptake effects "like cocaine" (or rather, like any other drug in the enormous classes with DA-reuptake inhibitory effects (DRI, DNRI, SDNRI, etc).Seppi333 (talk) 17:09, 8 October 2013 (UTC)

References

Neuropharmacology

To explain why cocaine is markedly pharmacologically distinct from virtually all (if not all) substituted phenethylamines, and consequently why a cocaine vs methylphenidate comparison is moot and highly misleading to the general readership:

This was published by The lancet

Cocaine is a nonspecific voltage gated sodium channel blocker. This explains why it is an anaesthetic, as Nav1.7, Nav1.8 and Nav1.9 are involved in cellular communication of nociception. Specifically, hypo-functional sodium channelopathies of Nav1.7 result in reduced pain sensation - and blocking this channel is how cocaine produces anaesthesia. However, because it is a nonspecific sodium channel blocker, it blocks Nav1.1 through Nav1.6 as well. Consequently, in high doses, it possesses the effects of tetrodotoxin, in addition to other channelopathy-related symptoms, and can lead to sudden cardiac death from channelopathy of Nav1.5. In contrast, amphetamine, methylphenidate, and even methamphetamine do not affect sodium channels, and so cocaine in high doses closely resembles tetrodotoxin and other lethal voltage-gated sodium channel neurotoxins, rather than pure CNS stimulants (like methylphenidate+amphetamine).
So to repeat that, blockade of Nav1.5 is precisely what makes cocaine so much more dangerous in high doses than any phenethylamine (that I know about) and the class of CNS stimulants in general.
The cardiac risks of cocaine have virtually nothing to do with its effects on catecholamines - as both amphetamine and mph are not associated with increased cardiac risks (UNLESS there is an underlying cardiac problem in the first place) - see amphetamine physical side effects if you want (three recent FDA) citations for that.

In light of that information, whoever wrote http://web.archive.org/web/20090330105926/http://www.neuropsychiatryreviews.com/feb02/adictive.html has no clue what they're writing about, as they wrote "From a pharmacological standpoint, methylphenidate is the drug that most resembles cocaine," which is false for the reasons I just gave on voltage-gated sodium channels (note that the pharmacokinetics are entirely different from cocaine, but the clinically relevant pharmacology argument is about pharmacodynamics).

 Note: If you want an external source for this information, see the CNS stimulant section and sodium channels/channelopathies section of this text:

Robert Malenka, Eric Nestler, Steven Hyman. Molecular Neuropharmacology : A Foundation for Clinical Neuroscience 2nd ed. New York: McGraw-Hill Medical, 2009. Print. ISBN 978-0-07-148127-4

or this wp:medrs - quality review: PMID 20573078 (full article at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2856043/?report=classic)

Seppi333 (talk) 18:38, 8 October 2013 (UTC)

From the viewpoint of drug abuse or just medicating ADHD, nothing is more close to methylphenidate than cocaine. And it is unusually close. Meth is better than speed but its not as good and not so much alike. Whatever scientific reasons there are to invalidate that comparison, they are largely irrelevant to the aforementioned application if you are sane about it. As a person with ADHD and former drug addict, and all the many people of that kind I have spoken to, I made that conclusion merely by experience. And that is probably where the whole argument stems from. C0NPAQ (talk) 09:41, 18 February 2014 (UTC)

"nothing is more close to methylphenidate than cocaine [in terms of how it feels, for me]". What about ethylphenidate? Perhaps among common drugs you are correct, but this isn't entirely suprising given that cocaine and methylphenidate are the only two common DRIs. Regardless of how they make you feel, Seppi333 has made it clear why that's unimportant above. Testem (talk) 14:24, 18 February 2014 (UTC)

Cocaine, lidocaine, benzocaine, dibucaine, prilocaine, procaine, chloroprocaine, and analogous "-caine" suffixed alkaloids constitute a drug class. Last I checked, methylphenidate wasn't spelled methylphencaine. Seppi333 (Insert 2¢ | Maintained) 17:57, 18 February 2014 (UTC)

Bias

This article has become a bias nightmare in its discussion of methylphenidate's medical uses. I don't know who is responsible for this, but I would really appreciate some assistance in cleaning it up as I have very limited time. Thanks so much. Exercisephys (talk) 16:58, 15 October 2013 (UTC)

Aggression and Criminality - "indicate"

See this edit

I agree with the labeling of indicated but I don't think it's correct to say that "studies suggest that mph is indicated", as they are indicating it, rather than suggesting that it is indicated by someone else. Testem (talk) 10:24, 17 October 2013 (UTC)

Previous wording was confusing an IP enough to want to rephrase it. I still don't like the wording "newer studies" which sounds a bit wp:weasel (see also WP:RELTIME). As an aside, note that Lichenstein et al. appears to be a primary source (WP:MEDRS). Not sure it is appropriate to detail the results of a primary study, no matter how large. Lesion (talk) 10:50, 17 October 2013 (UTC)

I get that but I don't think the current wording is representative. I think linkifying "indicated" should be enough to avoid someone thinking there is a typo, which is distinct from confusion about the meaning in my opinion. I don't have a problem with the use of a primary source in this case.Testem (talk) 12:14, 17 October 2013 (UTC)

Respectfully, I have tweaked the wording slightly again. I cannot explicitly express what was wrong with that sentence, but it did not roll off the tongue well. Revert if you wish, I don't feel strongly about this page. Lesion (talk) 15:46, 17 October 2013 (UTC)

Looks good to me, thanks for your help. Testem (talk) 16:14, 17 October 2013 (UTC)

References

Pictures

I'll probably get around to this at some point, but I'll post here as a reminder: Wikimedia has a lot of pictures that are relevant to this article, and we should insert some of them, consider how few there currently are. It would help alleviate the wall-o'-text that is the middle of this article. Exercisephys (talk) 19:46, 24 October 2013 (UTC)

Searches for methylphenidate, concerta and ritalin didn't reveal anything? Testem (talk) 19:58, 24 October 2013 (UTC)

Check the link at the bottom of the article. Exercisephys (talk) 21:10, 24 October 2013 (UTC)

Psychosis and Withdrawal - Tolerance section

I read the listed studies top to bottom and none of them said anything about Methylphenidate withdrawal causing psychosis. The specific section also mentions "rebound symptoms" can cause withdrawal. The first study listed only acknowledged the existence of rebound symptoms in one sentence. The other two studies never even referred to such a reaction.

Therefore, I have removed everything about Methylphenidate causing psychosis and other symptoms when withdrawaled from, or "rebounded" from. I believe Methylphenidate has withdrawal symptoms, however, the studies listed do not state what those are. The only symptoms that the studies mentioned where "possible side-effects of prolonged use."

I've left the information about Methylphenidate causing withdrawals, only due to the fact that Methylphendiate withdrawal is well documented. However, studies need to be cited. I would look myself, but I have other things to do at the moment. I will dedicate some time to doing so when I am able to.

For the sake of Wikipedia, don't make stuff up. It was very obvious that none of these studies mentioned what whoever wrote that section was trying to "prove". I monitor this article and specifically look for misconceptions. This was one of them. Unless you can cite two medical studies that both concluded Psychosis and the other symptoms mentioned could occur from Methylphenidate withdrawal/rebound causing them - this will always be removed.

Best regards SwampFox556 (talk) 00:15, 7 November 2013 (UTC)

EDIT:

Actually, I just noticed that the information provided in the "Tolerance" section is totally unnecessary. Withdrawal information with studies is cited a couple times throughout the article. I've just gone ahead and removed the entire section.

SwampFox556 (talk) 00:15, 7 November 2013 (UTC)

I think the information about tolerance is worthy of remaining in the article but the baby's been thrown out with the bathwater there. Testem (talk) 11:22, 7 November 2013 (UTC)

I actually thought that myself and I was planning on adding it back into the "adverse effects" section. However, it doesn't need to be it's own section. That's overkill and ultimately just confuses the reader.SwampFox556 (talk) 01:46, 9 November 2013 (UTC)

Great Drug Interaction Source

http://www.gjpsy.uni-goettingen.de/gjp-article-nevels.pdf

That's a really thorough source. I'll try to incorporate it if/when I have time. If anyone else does, I'd really appreciate the help.

Exercisephys (talk) 22:00, 22 November 2013 (UTC)

Uses#ADHD

This "A meta analysis of the literature concluded that methylphenidate quickly and effectively reduces the signs and symptoms of ADHD in children under the age of 18 in the short term but found that this conclusion may be biased due to the high number of low quality clinical trials in the literature." isn't cited; it should be fairly easy to cite. I think we should remove this sentence until it has been cited. Is this (http://www.cmaj.ca/content/165/11/1475.long) possibly the meta analysis mentioned? It mentions the publication bias ("We also detected a substantial amount of publication bias that, when used to adjust the estimates of efficacy, decreased the teacher- defined hyperactivity index estimate by 21%") and opens the interpretation section with "We have shown that short-acting methylphenidate quickly and efficaciously reduces most of the clinical manifestations of ADD in children aged 18 years and less".

It also ends with "To conclude, we found that short-acting methylphenidate was an effective short-term treatment option for children diagnosed with ADD. Yet, this finding may not be robust or completely valid." and "Finally, there is a lack of long-term randomized trial evidence. " Looking at these quotes, I think that this is the meta analysis.

77.99.153.47 (talk) 19:16, 13 February 2014 (UTC)

Should this article be semiprotected?

@Seppi333: @Boghog: Opinions? Amphetamine is, and this thing gets vandalized incessantly. Exercisephys (talk) 15:25, 10 March 2014 (UTC)

Yeah, it's pretty common and the attacks are by IP accounts so it does make sense. Testem (talk) 10:03, 11 March 2014 (UTC)

Thats more up to the reviewing admin than community consensus. Seppi333 (Insert 2¢ | Maintained) 14:16, 14 March 2014 (UTC)

dopamine neuron loss

http://www.plosone.org/article/info:doi/10.1371/journal.pone.0033693

Someone with understanding of the subject may want to incorporate the above link into the article.

50.0.205.237 (talk) 22:59, 3 September 2014 (UTC)

It's a primary source involving rats, so we can't use it. It appears that neuron loss only occurred with huge overdoses (10mg/kg) in the rats though, so it's probably just dopamine autoxidation that damaged the neurons. Seppi333 (Insert 2¢ | Maintained) 23:42, 3 September 2014 (UTC)

Extra (unnecessary?)comments on IV abuse

There are three comments on IV use all citing the same study "injection (particularly arterial) has sometimes led to toxic necrosis and amputation at the point of injection" and "adding a cautionary note that serious or severe outcomes such as necrosis, abscess and amputation had occurred as a result of severe toxicity at the injection site in 3 cases of abuse via arterial injection" and "A Swiss study in 2011 also concurred, noting similar findings in several studies and national analyses in that country, but noted that these findings were potentially inapplicable to the few cases of abuse via crushed MPH injection, which was the sole situation where "serious" or "severe" local toxicity was observed, leading in their study to pain, necrosis and partial limb or digit amputation in two of 14 adult cases over 8 years (14%) who mistakenly injected arterially, and inguinal abscess and fever in one who injected intravenously.[64] I believe those are results of ANY substance injected as a recreational drug. These statement would be very fitting on an article on Addiction, IV Drug Abuse or such. But they seem rather extraneous and not encyclopedic on an article about methylphenidate, however. They seem more like cautionary warnings from someone with an agenda. Only two recorded cases? I respect that some sort of cautionary might be worthwhile and maybe morally correct, but does it really belong here? The tone seems wrong to me. Are there similar statements on other medications which are subject to rare IV abuse? Does the article really benefit from the story of a couple of abusers who "mistakenly injected arterially?" I'm not sure that's really encyclopedic information.

Tumacama (talk) 19:39, 10 September 2014 (UTC)

Agree. Perhaps sweep them into a section along the lines of "like most drugs, methylphenidate can cause complications with improper intravenous use." Testem (talk) 17:24, 16 September 2014 (UTC)

Reversion of constructive edit

@Materialscientist: Regarding this reversion, I do not think it should have been marked as minor because it was not vandalism and was made in good faith. I am not even certain it should have been reverted at all. Testem (talk) 12:45, 5 December 2014 (UTC)

Given the text formatting, that looks like a WP:COPYANDPASTE copyright violation from published journal article; that's probably why he marked it as minor. Seppi333 (Insert 2¢ | Maintained) 19:16, 5 December 2014 (UTC)

Misprescriptions

Does anybody know what happened to all the kids that were prescribed ritalin when there is nothing wrong with them, some Doctors were dishing out ritalin because they decided a kid had a traumatic life event, so probably grazed knees too. Anyone know if there is any information on line on what it does to kids when they have nothing wrong with them.

This is a highly controversial topic, very much dependent on the definition of "have nothing wrong with them". I trust any contributions to the article will be reliably sourced.D Anthony Patriarche (talk) 22:54, 10 September 2017 (UTC)

Recent NYT source

I found a recent NYT source about this:

• Sroufe, L. Alan. "Ritalin Gone Wrong." (Opinion) The New York Times. January 29, 2012.

WhisperToMe (talk) 11:39, 31 January 2012 (UTC)

@WhisperToMe:

That NYT opinion piece contains major flaws, according to a rebuttal by clinical psychologist John Grohol.

Wikipedia:Identifying reliable sources#News organizations says: "News reporting" from well-established news outlets is generally considered to be reliable for statements of fact (though even the most reputable reporting sometimes contains errors). But it adds: The popular press is generally not a reliable source for biomedical information in articles: please see "Wikipedia:Identifying reliable sources (medicine)".

Good medical journals tend to do "peer review": they take draft articles and run them by a panel of subject experts in order to get a second, third, and fourth opinion. Unfortunately, the NYT doesn't seem to have done that before publishing Grohol's opinion piece.

Still, thank you for bringing the source to our attention: you meant well!

Have I now successfully convinced you that we shouldn't cite mainstream newspapers like The New York Times when writing medical/drug articles? :)

Regards, —Unforgettableid (talk) 17:40, 19 September 2016 (UTC)

@Unforgettableid: that's a good point. Since the time I made the post I learned about the different (for a good reason!) medical citation/referencing guidelines. I usually work in the social sciences, not medicine. The mainstream media does get science wrong :( WhisperToMe (talk) 23:17, 19 September 2016 (UTC)

We have a dexmethylphenidate page, but why not a subsection about the active isomers?

Which, for instance, is the most commonly used isomer in 'scripts? I know R-R-methylphenidate is the most active (or am I mistaken?) but that S-R-, & S-S-methylphenidate are also active. Can't the Ki values of these differing isomers at least be given on this page or the dex-methylphenidate page? 66.96.79.221 (talk) 23:52, 27 January 2015 (UTC)

Really good question, although 'most commonly used' needs further definition. I personally just switched from 1 brand to another and noticed (I think) a difference in strength. I will do some online research, but those with access to journals may do better. D Anthony Patriarche (talk) 22:52, 17 April 2017 (UTC)

IUPAC synonyms.

alpha-Phenyl-2-piperidineacetic acid methyl ester
Methyl alpha-phenyl-alpha-(2-piperidyl)acetate
Methyl alpha-phenyl-alpha-2-piperidinylacetate

All work in chemicalize.org, but in the first one the nitrogen is off. I found them here. Nagelfar (talk) 23:23, 21 March 2015 (UTC)

None of them is a correct IUPAC name, because of "alpha" spelled out. —Mykhal (talk) 12:20, 2 January 2019 (UTC)

Restructuring

This article would do well to use/cite the current drug label of any type of FDA-approved methylphenidate prescribing information (e.g., ) for medical information on adverse effects, overdose, and medical uses. Same goes for the INCHEM entry on methylphenidate (this: )

@Doc James: This article needed a lot of work. It still has some issues, but I'm wondering what you thought about:

• Special:diff/668231600/668231714 - retaining any of this content
• Methylphenidate#Controversy - moving this section, which, to me, seems more relevant to ADHD controversy than a methylphenidate controversy

Seppi333 (Insert 2¢) 03:15, 23 June 2015 (UTC)

• • Some discussion of overdose would be useful.
  • As the first drug in this class there is more controversy surrounding it than others. Sort of like the Prozac case. Thus do not see an issue with having it covered here in brief and then linking to ADHD controversies. Doc James (talk · contribs · email) 07:13, 23 June 2015 (UTC)

K, ill cut the template. ty for taking a look.
What did you have in mind for overdose in particular? Not really sure what to add to it. Seppi333 (Insert 2¢) 07:35, 23 June 2015 (UTC)

Additional comments

Thank you Seppi333 for your edits, great stuff, way better implementation of WP:BOLD than I'd have dared to do. Also, quick question -- can someone clearly explain the whole med name bolding stuff to me? I'd love to strip out the bold on at least a few specific articles, but I thought it was always considered justified, and the documentation out there on that really sucks.

So I tore apart and rebuilt the adverse events section. I feel like the previous one was complete garbage, potentially approaching the level of propaganda (the list was really really really bad). I used Wikipedia:WikiProject_Pharmacology/Style_guide and a number of major drug articles in order to determine how to best handle the adverse event data. It's a bit rough and scattered, especially with the last three paragraphs just getting thrown there from the previous text, but I think that I managed to communicate side effects in a way that is much more useful and accurate. I spent a lot of time reviewing data from multiple sources in order to ensure accuracy. (edit: I don't think basing things solely off of monographs is a good idea, multiple sources were invaluable here. Garzfoth (talk) 15:08, 23 June 2015 (UTC))

I may have accidentally screwed up with a few side effects that commonly appear at similar rates in both methylphenidate and placebo groups. Trying to handle that with multiple data sources was obviously a nightmare. Headache is the primary example -- you see a lot of headaches in the active drug groups, but the placebo groups are also getting lots of headaches. In general, most trials seem to have nowhere near statistically significant differences in headache rate between the two groups. The part I'm not sure how to handle is if you can seriously say "headache is a commonly observed potential adverse event" when it's no different from a sugar pill. Even if we say headache rate alone is significant, we're comparing against placebo, what's the headache rate in a population receiving no treatment? The end conclusion I reached is that because we can't show an increase, we can't assume that the headache rate is a unique medication-specific adverse event at all irregardless of how frequently it occurs. If it's a universal placebo effect, then it will happen with all meds, so who cares! What's the headache rate in ADHD patients anyways? Anyways, I just want to double check that my logic is sound here. It actually puts some insignificant side effects in a different light when you realize that they aren't driven by the med... I think the end result is sound, but it could be flawed.

I'm not quite sure how to deal with the "Uses" section, I'm not quite ready to start tearing that apart like I did with the adverse events section, but it seems to really...suck. It's scattered, packed with information that may be better placed elsewhere (or even not on the page at all), "Aggression and criminality" is inexplicably a separate subsection when it belongs under the ADHD subsection, the "Narcolepsy" subsection really sucks, "Other" is unclear and scattered, and I'm not sure that "Performance-enhancing" should have been laid out like that. I may end up changing some limited stuff and improving the "Narcolepsy" subsection, but I'm not sure what to do about the rest. Thoughts? Garzfoth (talk) 15:04, 23 June 2015 (UTC)

If there's any reason to doubt a side effect is caused by a medication (based upon clinical trial data and/or reasonable justification), it's generally okay to remove something like that. Monographs are a good place to start because they're sets of aggregated data; however, I agree that there's a need to "fine-tune" this information with higher quality sources like current medical reviews, when available.

Several statements and/or sections were imported from the amphetamine article a while back. Some related content seems to have been added around the imported sections since then. In general, if something seems completely tangential to methylphenidate or too technical, removing it should be fine.

I'll look through the article again a little later though; I didn't have enough time to go through the whole thing yesterday. Fixing the overdose section, removing the excessive number of references to the term "abuse", and adequately covering its involvement in an addiction were the main issues I was focused on addressing. Seppi333 (Insert 2¢) 22:50, 23 June 2015 (UTC)

Forgot to add: anything that isn't cited by a WP:MEDRS-quality source – i.e., a fairly recent (~5-10 years) medical literature review or academic/professional medical textbook – can and usually should be deleted if it cites a medical claim, although sometimes it's worth looking for a better source to use to cite a statement. Bolding is covered by the manual of style under MOS:BOLD. Seppi333 (Insert 2¢) 23:16, 23 June 2015 (UTC)

Thanks! The bold info is good to know, I was unhappy about how horrible it looked but didn't think I could touch it. Fine-tuning information and sticking to literature reviews can be difficult for some subjects, actually it can be difficult for a lot of them. I understand and support the intent behind it, but I feel it doesn't really apply universally, and is quite situational. It just worries me a bit not to know if I've stepped over that line. I'm a bit perfectionistic, so things like this are annoying to deal with. Did I overstep with my rewrite? Am I being misleading in some way? Did I leave out too much, or put too much in? Are my sources actually good enough? What benefit does this list serve, and is it addressing it better now? It can just be unclear where to go with Wikipedia's rules on content being complex and varied, especially when existing content can be so horrible (previous adverse effects list for example!), but persist so long... In general I'm finding myself very frustrated with articles like this, this is a huge site, we need to be providing neutral, accurate, detailed, and clear information... But we're falling short of that, and nobody steps up to fix it because it's "good enough". I'm getting off track here. Thanks again! Garzfoth (talk) 09:26, 25 June 2015 (UTC)

Section references

References

On the issue of capitalizing "pms"

This refers to the following edits:

• https://en.wikipedia.org/w/index.php?title=Methylphenidate&oldid=673554926
• https://en.wikipedia.org/w/index.php?title=Methylphenidate&oldid=673642615
• https://en.wikipedia.org/w/index.php?title=Methylphenidate&oldid=673731903
• https://en.wikipedia.org/w/index.php?title=Methylphenidate&oldid=673849049

The issue at hand is that Unforgettableid believes that the drug name should be "PMS-Methylphenidate ER" instead of the "pms-Methylphenidate ER" previously used.

The term pms stands for Pharmascience, a major generic drug manufacturer in Canada. Across a wide variety of mediums, drugs from Pharmascience have been consistently stylized as "pms-drugname" rather than "Pms-drugname" or "PMS-drugname". A wide number of generic drugs across numerous manfacturers in Canada use the naming system of "shortname-drugname", with the "shortname" conforming to a certain consistent style of capitalization that is rarely formatted in all-caps. Apotex uses "Apo", Novopharm uses "Novo", Pharmel uses "phl", Pharmascience uses "pms", Mylan uses "Mylan" or sometimes "Myl", NT Pharma uses "NTP", Teva uses "Teva", JAMP Pharma uses "Jamp", Pro Doc uses "Pro" or omits the "shortname-" part entirely, Riva uses "Riva", Ratiopharm uses "ratio", Ranbaxy uses "Ran", GenMed uses "GD", and there are a ton more examples not covered here. There are exceptions, but not enough to claim that this is not the universally accepted method in widespread use (and the most common exception is just replacing the dash with a space).

My point with this list is to illustrate that the capitalization is something that each generic company defines as they wish, and that this capitalization standard is adhered to across a broad variety of uses irregardless of generic or context, with the exception of certain places that capitalize everything (as in PMS-METHYLPHENIDATE, not PMS-Methylphenidate, and even then this may still be somewhat improper usage). This demonstrates that "this is a style already in widespread use" or "is done universally by sources", which means that MOS:TMRULES says this is the proper way to use the names (as far as I am aware the entire "Trademarks that begin with a lowercase letter" section should not apply here given that these are shorthand names used to identify and differentiate between different company-specific generics and not normal english usage).

So, in short, following those guidelines, we should adhere to the correct naming stylization standards defined by the manufacturer. For most Canadian drugs, these naming stylization standards can be easily found in the list of pharmaceuticals published by the RAMQ, and can be easily verified elsewhere if necessary. Garzfoth (talk) 22:44, 30 July 2015 (UTC)

Footnote 146 broken link

nih.gov The page you’re looking for isn’t available

footnote 146 states

  - New Research Helps Explain Ritalin's Low Abuse Potential When Taken As Prescribed – 09/29/1998. Nih.gov. Retrieved on 30 April 2011 

clicking on footnote 146 forwards to

  - NIH page that displays "It’s possible that the page is temporarily unavailable, has been removed or renamed, or no longer exists"  — Preceding unsigned comment added by 67.173.184.49 (talk) 22:22, 31 October 2015 (UTC) 

Pharmacokinetics

It seems strange that the peak plasma concentration time can exceed the half-life (always important to distinguish serum half-life from protein-bound and biological h-l). But then I got a C- in differential equations. Any experts on pharmacokinetics out there? D A Patriarche, BSc (talk) (talk) 23:35, 2 January 2017 (UTC)

I'm not sure that I understand you. t_max is always less than t_1/2... t_max typically occurs around ~2hrs, while t_1/2 is typically around ~2-3hrs. When comparing multiple sample sets, you can see that when t_1/2 changes, so does t_max - and in every case t_1/2 > t_max. Btw the half-life in the cited study is the elimination half-life, it also looks at some other PK parameters but they are of less usefulness here. If you were confused over the duration of peak action, please note that this roughly refers to the duration of time that the dose is effective for in terms of clinical effects (which will not be perfectly uniform over this time), which for single doses of IR methylphenidate is usually the portion of time that serum levels are above a certain threshold (it gets complicated fast when you introduce multiple dosing and complex release mechanisms due in no small part to the phenomenon of acute tolerance to methylphenidate, which was discovered during the Concerta design studies). Garzfoth (talk) 01:32, 3 January 2017 (UTC)