Talk:Methylphenidate

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)

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)

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

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?