Methylphenidate: what it is, what it is for and side effects

In recent decades, the diagnosis of attention deficit hyperactivity disorder, which is related to deficits in executive functions, has become widely popular. The drug of first choice to treat ADHD is methylphenidate.

In this article we will describe what methylphenidate is, what are its applications in the ADHD and narcolepsy, what side effects it most commonly causes and in which cases this drug is contraindicated.

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What is methylphenidate?

Methylphenidate is a stimulant drug which has effects similar to amphetamines and is mainly used to treat symptoms of attention deficit hyperactivity disorder (ADHD), as well as those of narcolepsy.

On the other hand, methylphenidate is marketed under various names; some of the best known are Ritalin, Concerta, Aradix and Rubifen.

Although it began to be used in the 1960s, its use became popular in the 1990s as a result of the increase in the number of ADHD diagnoses. At present its use for the treatment of this disorder is widely extended.

The mechanism of action of methylphenidate consists of the inhibition of dopamine and norepinephrine reuptake: blocks the transporters of these catecholamines, increasing their concentration in the synaptic space and therefore their neurotransmission effects. It also slightly enhances the function of the serotonin.

The effects of methylphenidate are especially strong in the prefrontal cortex. The increase in the activity of this brain region favors executive functions such as reasoning, planning, and behavioral inhibition. This stimulation of the central nervous system also manifests itself in improved alertness and attention.

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Methylphenidate and ADHD treatment

Attention deficit hyperactivity disorder It is a neurological disorder of childhood onset that is related to problems in executive functions. Despite the controversy surrounding the existence of this alteration, most of Clinicians believe that it has a clear biological basis, although there is a certain tendency to overdiagnosis.

ADHD has been associated with dysfunctions in the transmission of dopamine and norepinephrine in the central nervous system; the agonist effects of methylphenidate make it possible to compensate for these deficits functional. Treatment with methylphenidate is successful in about 70% of cases, but it can have significant side effects.

The recommended treatment for ADHD is a combination of methylphenidate and cognitive behavioral therapy. focused on the training of coping strategies for symptoms, both for the child and for their caregivers.

Use in cases of narcolepsy

Narcolepsy is a neurological disorder that causes disturbances in sleep-wake cycles. Among the most prominent symptoms of narcolepsy are daytime hypersomnolence, episodes of cataplexy and intrusions of REM sleep in wakefulness, especially hallucinations hypnagogic.

In the case of this disorder, methylphenidate and other psychostimulants, such as modafinil and some antidepressants, are used to increase the level of alert; These drugs reduce drowsiness and improve performance.

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Side and adverse effects

The most common side effects of methylphenidate are anxiety and nervousness, nausea, dry mouth, and loss of appetite, which in turn leads to weight loss; in the long term, these effects sometimes lead to slightly lower physical development, which is maintained as long as the drug is consumed.

Among the gastrointestinal symptoms that methylphenidate can produce, we find abdominal pain, heartburn and vomiting. Sometimes cardiovascular symptoms also occur, particularly tachycardias and mild palpitations, changes in blood pressure and Raynaud's phenomenon.

Other common side effects are emotional instability, irritability, hyperhidrosis or excessive sweating, dryness of the eyes, blurred vision, and bruxism, which consists of continued clenching of the jaws or teeth.

Adverse reactions to methylphenidate They include symptoms such as akathisia (severe agitation and discomfort), dyskinesia (involuntary movements of the muscles), seizures, chest pain, or breathing difficulties. The appearance of these and other serious symptoms should be understood as a sign that the medication should be reviewed.

Warnings and Contraindications

People with cardiovascular disorders, such as hypertension or structural heart abnormalities, should be especially cautious when taking methylphenidate. Likewise, it is contraindicated if certain psychological disorders occur, such as psychosis, mood disorders, anxiety problems, anorexia nervosa and substance addictions.

Drinking alcohol increases the probability that the side effects that we have described appear and aggravates them when they are already present. Methylphenidate is also contraindicated in people with glaucoma, pheochromocytoma, hyperthyroidism or a history of depression.

It is not recommended to consume methylphenidate during pregnancy because the possible consequences have not been sufficiently studied; some preliminary research suggests that can induce respiratory and circulatory problems in the fetus.