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Between 1993 and 2003 the worldwide use of medications that treat ADHD increased almost threefold. Most ADHD medications are prescribed in the United States. In the 1990s, the US accounted for 90% of global use of stimulants such as methylphenidate and dextroamphetamine. By the early 2000s, this had fallen to 80% due to increased usage in other countries.[better source needed] In 2003, doctors in the UK were prescribing about a 10th of the amount per capita of methylphenidate used in the US, while France and Italy accounted for approximately one twentieth of US stimulant consumption. However, the 2006 World Drug Report published by the United Nations Office on Drugs and Crime indicated the US constituted merely 17% of the world market for dextroamphetamine. They assert that in the early 2000s amphetamine use was "widespread in Europe."

Stimulants

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Methylphenidate and amphetamine are the most common stimulants used for treating ADHD. Studies have shown that providing low doses of methylphenidate and amphetamine improves individuals' executive functioning and focus attention.[1] Individuals with ADHD have a weaker prefrontal cortex.[1] The prefrontal cortex is the target of the stimulants as it is what regulates individuals attention and behavior.[1] The stimulants have shown to increase the levels of norepinephrine and dopamine that are released into the prefrontal cortex.[1] Stimulants are often used multiple times a day and/or in combination with other treatments.

Methylphenidate is commonly used for treating ADHD, narcolepsy, and for cognitive enhancement.[2] It was first created by chemist Leandro Panizzon in 1944 and later patented in 1954 by a Swiss pharmaceutical company known as Ciba.[3] Methylphenidate was first introduced into the market as Ritalin in the 1950s.[2] Methylphenidate gradually gained attention for its effects in treating narcolepsy. The use of methylphenidate expanded in the 1960s when it was discovered to be effective in treating hyperkinetic disorder, now known as ADHD.[4]

Between 1993 and 2003 the worldwide use of medications that treat ADHD increased almost threefold.[5] Most ADHD medications are prescribed in the United States.[5] In the 1990s, the US accounted for 90% of global use of stimulants.[5] Although in the 2000s, trends and patterns in data show that there was a rise in the percentage of drug usage in other countries worldwide. Prevalence and incidence rates of the use of stimulants increased at a high rate worldwide after 1995 and continued to rise at a lower rate until it plateaued in 2008. The global usage of stimulants was rising at rates related to the high percentage used originally in the US. Many other countries began to see more prescriptions for stimulants as well as more usage of prescription stimulants such as methylphenidate and dextroamphetamine among children and adults.[6] From 1994-2000 as many as 10 countries saw a dramatic 12% increase in the use of stimulants. Australia and New Zealand became the third highest users of stimulants after the United States and Canada respectively.[7] By 2015 countries such as the UK saw a rise of stimulant prescriptions by 800%. The time period with the highest rise in percentage being from 1995-2003. [8]

Dextroamphetamine is a potent stimulant, commonly used to treat sleep disorders and ADHD. The medicine can be taken with or without food, and it is available in three different forms, Oral tablet, Oral extended-release capsule, and oral solutions. However, you cannot buy this medicine without a doctor's prescription. These stimulants are very effective for children who have difficulty concentrating. It can help them become more focused and reduce their impulsive behavior.[9]

The side effects are rare with dextroamphetamine. Taking this medication may affect a person’s thinking and make them believe things that are not true. This medication not only treats the symptoms of ADHD but also treats a sleep disorder called narcolepsy. It is highly recommended that the patient take this medicine during the day, as taking it at night may keep them awake and make it difficult to sleep.[10]

The side effects of this medicine can also contribute to headaches, dry mouth, and weight loss; as well as changes in sex drive or ability. Dextroamphetamine may make you dizzy and may also affect your vision. Patients can experience blurry vision while taking this medication. This medicine may negatively affect children's health since it is powerful. In addition to slowing growth in children and causing weight gain, this medicine also has other negative effects. It is also possible to experience high fever, depression, and aggressive behaviors after overdosing. In addition to seizure attacks, overdosing may also cause symptoms similar to a viral infection, such as vomiting, diarrhea, and body aches. There are very few warnings when taking this medicine, for example, a person shouldn't take it if they are addicted to drugs, or have heart disease or blood pressure problems. Besides this medicine should be taken very carefully if someone in a family has a a history of depression and mania.[11]

Dextroamphetamine is a round molecule related to the mirror image of the amphetamine molecule that can be found in two different kinds. D-amphetamine is the common name for dextroamphetamine; however many other names have been found to explain Dextroamphetamine; such as Dexedrine, Dextrostat, and (s)-(+)amphetamine. Those names are combined in the ADHD drug Adderall. Vyvanse comes before that, which is also used to treat ADHD. It is also a very active medicine, which helps in treating the symptoms of ADHD.[12]

Effectiveness

The use of stimulant medication for treatment of attention-deficit hyperactivity disorder (ADHD) is well-researched and considered one of the most effective treatments in psychiatry.[13] A 2015 study examined the long-term effects of stimulant medication for ADHD, and reported that stimulants are a highly effective treatment for ADHD in the short term when used properly.[13] The findings for long term effects were limited. However, this study concluded that stimulant medication is a safe and effective treatment for ADHD.

A 2017 review assessed the advantages and disadvantages of both behavioral therapies and pharmacological interventions for the treatment of ADHD.[14] It was reported that stimulants are a very effective treatment during the time period in which they are taken. While the short-term benefits were clearly demonstrated, the long-term benefits were less clear.

Another 2013 review aimed to identify the direct and indirect impacts of stimulant medication on the long-term outcomes of adults with ADHD.[15] It was found that medication was significantly more effective than placebos for treating adults. Additionally, after conducting longitudinal and cross-sectional studies, it was reported that stimulant treatment for ADHD is tolerated well, and has long term benefits.[15]


Potential for misuse

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Stimulants used to treat ADHD are classified as Schedule II controlled substances in the United States.[16] Schedule II controlled substances are substances that are highly likely to be abused.[17]

Methylphenidate has become a commonly used drug for people diagnosed with ADHD. Aside from its medical usage, it has gained popularity from people who aim to use the drug as a “study drug” or for a feeling similar to that of cocaine.[17] A 2005 study looked at 100 college students who used Methylphenidate of which, 30% of the subjects claimed to use Methylphenidate for studying purposes, and these students were less likely to partake in intranasal usage of the substance. The other 70% of the students were using it recreationally accompanied with other illicit substances, as well as more likely to partake in intranasal use of methylphenidate.[18]

There were about 6.4 million children who received a diagnosis for ADHD in 2011 according to the CDC.[17] Both children with and without ADHD abuse stimulants, with ADHD individuals being at the highest risk of abusing or diverting their stimulant prescriptions. Diverting medications can be attributed to peer pressure from family and friends of the individuals who have the substance.[19]

In 2008, between 16 and 29 percent of students who are prescribed stimulants report diverting their prescriptions.[20] And, between 5 and 9 percent of grade/primary and high school children and between 5 and 35 percent of college students have used non-prescribed stimulants.[20] Most often their motivation is to concentrate, improve alertness, get high, or to experiment. Stimulant medications may be resold by patients as recreational drugs, and methylphenidate (Ritalin) is used as a study aid by some students without ADHD.[21]

Non-medical prescription stimulant use by US students is high. A 2003 study found that non-prescription use within the last year by college students in the US was 4.1%.[22] A 2008 meta-analysis found even higher rates of non-prescribed stimulant use. It found 5% to 9% of grade school and high school children and 5% to 35% of college students used a non-prescribed stimulant in the last year.[20]

In 2009, 8% of United States Major League Baseball players had been diagnosed with ADHD, making the disorder particularly common among this population. The increase coincided with the League's 2006 ban on stimulants, which raised concern that some players were mimicking or falsifying the symptoms or history of ADHD to get around the ban on the use of stimulants in sport.[23]

References

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  1. ^ a b c d Arnsten, Amy F. T. (2006). "Stimulants: Therapeutic Actions in ADHD". Neuropsychopharmacology. 31 (11): 2376–2383. doi:10.1038/sj.npp.1301164. ISSN 1740-634X.
  2. ^ a b Challman, Thomas D.; Lipsky, James J. (2000). "Methylphenidate: Its Pharmacology and Uses". Mayo Clinic Proceedings. 75 (7): 711–721. doi:10.4065/75.7.711. ISSN 0025-6196.
  3. ^ Jane, U. (2015). "A brief history of methylphenidate: psychiatry-ADHD". The Specialist Forum. 15 (6): 24.
  4. ^ Conrad, Peter; Bergey, Meredith R. (2014). "The impending globalization of ADHD: Notes on the expansion and growth of a medicalized disorder". Social Science & Medicine. 122: 31–43. doi:10.1016/j.socscimed.2014.10.019. ISSN 0277-9536.
  5. ^ a b c "Global Use of ADHD Medications Rises Dramatically". NIMH. 6 March 2007. Archived from the original on 2013-05-12. Retrieved 2013-05-06.
  6. ^ Beau-Lejdstrom, R.; Douglas, I.; Evans, SJ.; Smeeth, L. (13 June 2016). "Latest Trends In ADHD Drug Prescribing Patterns in Children in the UK: Prevalence, Incidence, and Persistence". National Library of Medicine. 6 (6).
  7. ^ Berbatis, C.G.; Sunderland, V.B.; Bulsara, M. (2002). "Licit Psychostimulant Consumption in Australia, 1994-200: International and Jurisdictional Comparison". Medical Journal of Australia. 177 (10): 539–543.
  8. ^ Renoux, C; Shin, JY; Dell'Aniello, S; Fergusson, E; Suissa, S (September 2016). "Prescribing Trends of Attention-Deficit Hyperactivity Disorder (ADHD) Medications in UK Primary Care, 1995-2015". National Library of Medicine. 82 (3): 858–68.
  9. ^ Dextroamphetamine uses, Side Effects & Warnings. Drugs.com. (n.d.). https://www.drugs.com/mtm/dextroamphetamine.html
  10. ^ Dextroamphetamine uses, Side Effects & Warnings. Drugs.com. (n.d.). https://www.drugs.com/mtm/dextroamphetamine.html
  11. ^ U.S. National Library of Medicine. (n.d.). Dextroamphetamine and amphetamine: Medlineplus Drug Information. MedlinePlus. https://medlineplus.gov/druginfo/meds/a601234.html
  12. ^ Dextroamphetamine. (n.d.). https://www.bionity.com/en/encyclopedia/Dextroamphetamine.html
  13. ^ a b Craig, Stephanie G.; Davies, Gregory; Schibuk, Larry; Weiss, Margaret D.; Hechtman, Lily (2015-03-01). "Long-Term Effects of Stimulant Treatment for ADHD: What Can We Tell Our Patients?". Current Developmental Disorders Reports. 2 (1): 1–9. doi:10.1007/s40474-015-0039-5. ISSN 2196-2987.
  14. ^ Rajeh, Adnan; Amanullah, Shabbir; Shivakumar, K.; Cole, Julie (2017-02-01). "Interventions in ADHD: A comparative review of stimulant medications and behavioral therapies". Asian Journal of Psychiatry. 25: 131–135. doi:10.1016/j.ajp.2016.09.005. ISSN 1876-2018.
  15. ^ a b Fredriksen, Mats; Halmøy, Anne; Faraone, Stephen V.; Haavik, Jan (2013-06-01). "Long-term efficacy and safety of treatment with stimulants and atomoxetine in adult ADHD: A review of controlled and naturalistic studies". European Neuropsychopharmacology. Making IMPACT on adult ADHD – recent advances in neurobiology and treatment. 23 (6): 508–527. doi:10.1016/j.euroneuro.2012.07.016. ISSN 0924-977X.
  16. ^ "Psychiatric News -- Rosack 36 (21): 20". web.archive.org. 2003-09-02. Retrieved 2023-12-08.
  17. ^ a b c "Methylphenidate Abuse Symptoms, Signs and Addiction Treatment". DrugAbuse.com. Retrieved 2023-12-08.
  18. ^ Barrett, Sean P; Darredeau, Christine; Bordy, Lana E; Pihl, Robert O (2005-07). "Characteristics of Methylphenidate Misuse in a University Student Sample". The Canadian Journal of Psychiatry. 50 (8): 457–461. doi:10.1177/070674370505000805. ISSN 0706-7437. {{cite journal}}: Check date values in: |date= (help)
  19. ^ Marsh, Linda D.; Key, Janice D.; Payne, Tricia P. (2000-03). "Methylphenidate Misuse in Substance Abusing Adolescents". Journal of Child & Adolescent Substance Abuse. 9 (3): 1–14. doi:10.1300/J029v09n03_01. ISSN 1067-828X. {{cite journal}}: Check date values in: |date= (help)
  20. ^ a b c Wilens, Timothy E.; Adler, Lenard A.; Adams, Jill; Sgambati, Stephanie; Rotrosen, John; Sawtelle, Robert; Utzinger, Linsey; Fusillo, Steven (2008-01). "Misuse and diversion of stimulants prescribed for ADHD: a systematic review of the literature". Journal of the American Academy of Child and Adolescent Psychiatry. 47 (1): 21–31. doi:10.1097/chi.0b013e31815a56f1. ISSN 0890-8567. PMID 18174822. {{cite journal}}: Check date values in: |date= (help)
  21. ^ "CNN.com - Health - Ritalin abuse scoring high on college illegal drug circuit - January 8, 2001". edition.cnn.com. Retrieved 2023-12-08.
  22. ^ McCabe, Sean Esteban; Knight, John R.; Teter, Christian J.; Wechsler, Henry (2005). "Non-medical use of prescription stimulants among US college students: prevalence and correlates from a national survey". Society for the Study of Addiction. 1 (100): 96–106 – via Wiley.
  23. ^ Saletan, William (2009-01-12). "Doping Deficit Disorder". Slate. ISSN 1091-2339. Retrieved 2023-12-08.
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