Talk:Methylphenidate

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Former featured article candidate Methylphenidate is a former featured article candidate. Please view the links under Article milestones below to see why the nomination failed. For older candidates, please check the archive.
January 27, 2010 Featured article candidate Not promoted

Recent NYT source[edit]

I found a recent NYT source about this:

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?[edit]

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)

IUPAC synonyms.[edit]

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)

Restructuring[edit]

This article would do well to use/cite the current drug label of any type of FDA-approved methylphenidate prescribing information (e.g., [1]) for medical information on adverse effects, overdose, and medical uses. Same goes for the INCHEM entry on methylphenidate (this: [2])

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

Seppi333 (Insert ) 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 ) 07:35, 23 June 2015 (UTC)

Additional comments[edit]

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 ) 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 ) 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[edit]

References

  1. ^ Noven Pharmaceuticals, Inc. (17 April 2015). "Daytrana Prescribing Information" (PDF). United States Food and Drug Administration. pp. 1–33. Retrieved 23 June 2015. 
  2. ^ Heedes G, Ailakis J. "Methylphenidate hydrochloride (PIM 344)". INCHEM. International Programme on Chemical Safety. Retrieved 23 June 2015. 

On the issue of capitalizing "pms"[edit]

This refers to the following edits:

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[edit]

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[edit]

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. tmax is always less than t1/2... tmax typically occurs around ~2hrs, while t1/2 is typically around ~2-3hrs. When comparing multiple sample sets, you can see that when t1/2 changes, so does tmax - and in every case t1/2 > tmax. 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)