Methylphenidate

Methylphenidate is chemically related to amphetamine and has a stimulating effect as a drug. It is also known under the trade name Ritalin®. The drug is mainly used for the treatment of attention deficit / hyperactivity disorder known as ADHD and narcolepsy.

What is methylphenidate?

Methylphenidate Like amphetamine, it has a short-term performance-enhancing and stimulating effect, with physical warning functions such as pain or exhaustion being suppressed. It also inhibits appetite.

In certain mental disorders, these properties can have short-term positive effects, so that methylphenidate can also be used as an element in the treatment of these disorders. Methylphenidate is quickly absorbed by the body. It is irrelevant whether it is ingested at the same time as food.

It is up to 30 percent bioavailable, with it reaching its maximum plasma concentration after about 2 hours. The half-life of its elimination from the plasma is again 2 hours. Methylphenidate unfolds its full effect for 4 hours before it is completely broken down again.

Pharmacological effect

The effect of Methylphenidate is based on its inhibitory influence on the transporters of the neurotransmitters dopamine and norepinephrine. These transporters are responsible for the reuptake of these neurotransmitters into the presynaptic nerve cells from the synaptic cleft.

Since the reuptake is inhibited under the influence of methylphenidate, the concentration of dopamine and noradrenaline in the synaptic cleft remains elevated for a long time. This also means that the two neurotransmitters can maintain their stimulating effect on the sympathetic nervous system during this time. The sympathetic nervous system in turn ensures that the body is more willing to perform, which is also associated with increased alertness.

Depending on the initial situation, different and apparently contradicting effects occur. In withdrawn people, the stimulation leads to increased activity, while in people who suffer from attention disorders and at the same time undirected hyperactivity, calming occurs with an increase in the ability to concentrate. Since the sympathetic nervous system is the antagonist of the parasympathetic nervous system, the body functions that are related to the activity of the parasympathetic nervous system are reduced. This affects the intestinal activity, the hunger center as well as the secretion and sweat glands.

Medical application & use

Methylphenidate is mainly used for two symptom complexes, ADHD and narcolepsy. While in ADHD the focus is on hyperactivity with an attention disorder, the main symptoms in narcolepsy are the extreme need to sleep and fatigue.

Both diseases can be positively influenced with methylphenidate in a modulating manner in combination with other treatment methods. Since the causes of both diseases are extremely complex, treatment with methylphenidate alone is not sufficient. Only symptoms can be treated, not the causes. ADHD is based e.g. B. on a dysregulation of the signal transmission through uncoordinated different activities of certain neurotransmitters in different areas of the brain.

Methylphenidate regulates and normalizes these activities during the time of its action. It should also be noted that on the basis of the drug-reduced symptoms, psychotherapeutic treatment of ADHD brings better results. Children aged 6 and over with symptoms of ADHD respond well to the combined treatment methods. By suppressing hyperactivity and increasing alertness, z. B. the school performance of these children can be improved, which in turn has a positive effect on their self-esteem.

Therefore, treatment of ADHD with methylphenidate can only be viewed in the overall context. For narcolepsy, methylphenidate is often prescribed to reduce daytime sleepiness.

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Risks & side effects

The taking of Methylphenidate must always be under medical supervision because its use can also cause many side effects. So it is necessary to adjust the dosage individually depending on the reaction to this drug. Narcolepsy patients can often experience difficulties concentrating, profuse sweating and sensitivity to noise.

In general, a variety of psychological and neurological side effects of various types can occur. Cardiovascular disorders such as cardiac arrhythmias, increased blood pressure and even heart attacks or strokes are observed.

The multitude of different, sometimes even contradicting, side effects indicates the complex processes that take place in the body when drugs influence the regulatory mechanisms.