Methylphenidate

Methylphenidate is a stimulant that acts on the central nervous system. It is commonly prescribed for attention deficit hyperactivity disorder (ADHD) and for narcolepsy. It works by increasing the levels of two brain chemicals, dopamine and noradrenaline, which can improve attention and reduce impulsivity and hyperactivity. It is sold under several brand names. This is general information, not a prescription or medical advice. Methylphenidate should only be taken under the supervision of a qualified prescriber.

Medical uses

• ADHD: methylphenidate is often a first-line medication for managing ADHD symptoms in children and adults, as part of a wider treatment plan.
• Narcolepsy: it can reduce the excessive daytime sleepiness associated with narcolepsy.

Misuse and risks

Despite its benefits when prescribed, methylphenidate can be misused, particularly by adolescents and young adults. Some people misuse it to try to improve concentration or academic performance, some for its stimulant effects, and some to suppress appetite. Misuse carries real risks, including:

• Heart effects: increased heart rate and blood pressure, which can be dangerous.
• Psychiatric effects: anxiety, paranoia, and aggression.
• Dependence: with repeated misuse, psychological dependence and withdrawal symptoms when stopping.

Combining with other substances

Taking methylphenidate with other substances increases risk:

• With alcohol: the stimulant can mask alcohol's sedating effects, which can lead to drinking more and a higher risk of alcohol poisoning.
• With other stimulants: combining with drugs such as cocaine or amphetamines can cause overstimulation, including dangerous overheating, very high blood pressure, irregular heartbeat, seizures, or death.
• With some antidepressants: use with certain antidepressants may contribute to serotonin syndrome, a potentially fatal reaction.
• With sedatives or opioids: the stimulant may hide sedative effects, leading people to take more and raising the risk of dangerous breathing problems.
• With cannabis: can increase paranoia, anxiety, and, in some people, psychosis.

Why street sources are dangerous

Obtaining methylphenidate from non-medical or street sources is especially risky:

• Unknown contents: illicit tablets may be counterfeit or mixed with toxic substances, which can cause overdose.
• Injecting or snorting: crushing tablets to snort or inject can damage the body and, with shared needles, spread infections such as HIV and hepatitis.
• Escalation: illicit use is more likely to lead to rapidly increasing doses, dependence, and severe withdrawal, which can include depression and suicidal thoughts.
• Legal status: in Kenya, methylphenidate is a controlled substance regulated by the Pharmacy and Poisons Board. Possessing it without a prescription can lead to criminal charges.

If you or someone you know is misusing stimulants, support is available. Speak to a doctor or a mental health professional, and see our support page.