Saturday, November 21, 2009

15. How Ritalin Works

In the United States, a popular drug to treat ADHD is Ritalin. It is estimated that as many as 10% of the children in the U.S. now take Ritalin or another stimulant [3], and the U.S. consumes 90% of the Ritalin being manufactured worldwide. Since ADHD children suffer from a reduced number of dopamine receptors in the brain [36], it is hypothesized that Ritalin is effective because it prevents the reuptake of dopamine and allows it to stay in the intercellular spaces for a substantially longer time.

Ritalin has a calming effect on ADHD children. This is understandable since Ritalin both increases the bioavailability of dopamine and suppresses insulin's ability to block fat release from storage sites; i.e., it accomplishes the same two goals that random movements try to accomplish. However, children on Ritalin complain that it results in an initial burst of energy with a racing heart, followed by a period of physical exhaustion ([3], p. 112). The energy burst is associated with the adrenaline rush, and the exhaustion is likely a consequence of depleted supplies of both fats and glucose, once the Ritalin has worn off.

Dopamine is a precursor to adrenaline, the "fight or flight" hormone. If dopamine is allowed to linger longer in a bioavailable state through the action of Ritalin, then adrenaline levels will go up. Adrenaline is a very powerful hormone with diverse effects on the body, mainly aimed at increasing fuel supply to the blood in the short term, i.e., to operate in crisis mode.

One crucial effect adrenaline has is to disable insulin's suppressive effect on the fat cells [24]. This allows them to release their fats even while insulin levels are high. Ritalin thus enables the brain to be simultaneously well supplied with glucose for fuel, fat for nerve fiber construction, and dopamine to control execution of the focus and memory consolidation tasks involved with learning new knowledge.

Through its effect of increasing adrenaline levels, Ritalin also suppresses appetite. In the "fight or flight" reaction, the digestive system is shut down, in order to conserve energy, since the digestion process itself consumes energy. Nearly all ADHD children on Ritalin lose weight, and many become dangerously thin over time. A positive effect of reduced appetite is that it likely leads to an increase in the bias towards glucose consumption and fat conservation, as I argued in the section on anorexia. However, in the long term, the depleted fat reserves eventually further aggravate the original problem of insufficient fat supply.


Serg said...

I think that there are some herbal remedies that can be take in consideration, ritalin is now available as easy as to buy viagra, parents should be open to new remedies.

Talahasee said...

Well said. I was diagnosed with ADD as an adult and found Ritalin to be so powerful I am in awe that they give it to children. One who is familiar with anatomy and physiology would understand that if you take enough methylphenidate one will experience a referred pain emanating in the mid back from the kidneys both filtrating and possibly having increased demand on the beta-adrenal glands. I've experienced it personally, at it goes away, however I am aware that Ritalin is the culprit. Also, it keeps you up forever, as a consequence of the adrenaline... So, I could see it being used as a stay-awake for narcoleptic's, pilots, or shift workers as well. It's a strange drug that has strange affects at different dosages, meaning anywhere from 40mg to 140 mg in a day, which I have experienced personally. At a high dose it can make you so apathetic yet anxious, but once thrusted upon a task or in public one can acclimate quickly, being very involved and useful. I find it curiously likable in the sense that it is not addictive physiologically, being I have never experienced a withdrawl or need that caused me to search it out or feel physically ill. I feel it can benefit people who are overweight in respect to its strong affect on not needing or felling one needs to eat when not hungry, even if the affect is induced, because some people simply don't need the calories they are intaking. It's a great drug for those seeking to focus, stay awake, be more aware or even lose weight. It's more a lifestyle drug than it is a medication for a disease in my opinion. It's not for everyone and it's not silver bullet, but if it helps, it helps. If one doesn't experience any deleterious side effects, and doesn't feel dependent upon it, it can be very beneficial. I like it.