The Side Effects Of Common Psychiatric Drugs: Psychostimulants
BRAND NAMES (generic names):
1. Adderall (amphetamine and dextroamphetamine)
2. Benzedrine (amphetamine sulfate)
3. Concerta (methylphenidate)
4. Cylert (pemoline – removed from the market)
5. Daytrana (methylphenidate – skin patch)
6. Desoxyn (methamphetamine hydrochloride)
7. Dexedrine (dextroamphetamine sulfate)
8. Dextrostat (dextroamphetamine)
9. Equasym (methylphenidate)
10. Focalin (dexmethylphenidate)
11. Metadate (methylphenidate)
12. Methylin (methylphenidate hydrochloride)
13. Provigil (modafinil)
14. Ritalin (methylphenidate)
15. Vyvanse (lisdexamphetamine)
SIDE EFFECTS:
1. Abdominal pain
2. Aggressive or hostile behavior
3. Agitation
4. Angina (sudden acute pain)
5. Anorexia
6. Blisters or rash
7. Blood pressure and pulse changes
8. Changes in sex drive or ability
9. Changes in vision or blurred vision
10. Chest pain
11. Depression
12. Diarrhea
13. Difficulty falling asleep or
14. staying asleep
15. Dizziness or faintness
16. Drowsiness
17. Dry mouth
18. Fast, pounding, or irregular heartbeat
19. Fever
20. Hallucinations
21. Headaches
22. Heart attack
23. Hives
24. Hypersensitivity
25. Impotence
26. Increased irritability
27. Insomnia
28. Involuntary tics and
29. twitching
30. Itching
31. Liver problems
32. Loss of appetite
33. Mania
34. Mental/mood changes
35. Muscle or joint tightness
36. Nausea
37. Nervousness
38. Painful menstruation
39. Psychosis
40. Purple blotches under the skin
41. Restlessness
42. Seizures
43. Slow or difficult speech
44. Sore throat
45. Stomach pain
46. Stroke
47. Stuffed or runny nose
48. Stunted growth
49. Sudden death
50. Suicidal thoughts
51. Swelling inside the nose
52. Swelling of the eyes, face, tongue, or throat
53. Tourette’s Syndrome*
54. Toxic psychosis
55. Unusual bleeding or bruising
56. Unusual sadness or crying
57. Unusual weakness or tiredness
58. Violent behavior
59. Vomiting
60. Weakness or numbness of an arm or leg
61. Weight loss
62. “Zombie” demeanor1

Suicide is a major complication of withdrawal from Ritalin and similar amphetamine-like drugs.2
Note: The U.S. Drug Enforcement Administration (DEA) classifies methylphenidate, the generic name for Ritalin, Concerta, Metadate and Methylin, as a Schedule II narcotic in the same abuse category as morphine, opium and cocaine.3
Methylphenidate is amphetamine-like because it is very similar in chemical structure to amphetamine and how it affects the body. The DEA says that it is structurally and pharmacologically similar to cocaine. An amphetamine’s chemical structure resembles natural stimulants in the body, like adrenaline. However, as a drug, it alters the natural system and can reduce appetite and fatigue and “speed” you up. A stimulant (psychostimulant) refers to any mind-altering chemical or substance that affects the central nervous system by speeding up the body’s functions, including the heart and breathing rates. Stimulants are
most often prescribed to children for the so-called condition Attention Deficit Hyperactivity Disorder (ADHD). In children, however, stimulants appear to act as suppressants, but psychiatrists and doctors have no idea why. A 1999 study published in Science Journal, determined: “The mechanism by which psychostimulants act as calming agents…is currently unknown.”4
NON-STIMULANT “ADHD” Drugs:
Celexa (citalopram), Strattera (atomoxetine) and Wellbutrin (buproprion HCL) are
all antidepressants prescribed to treat “ADHD” and are covered in the section on new
antidepressants (page 8). Strattera is the only one the FDA has approved for treating ADHD
and carries serious warnings (page 15).
GENERAL WARNINGS AND STUDIES ON PSYCHOSTIMULANTS:
June 28, 2005: The Food and Drug Administration (FDA) identified possible safety concerns
with methylphenidate (Ritalin, Adderall, Concerta, etc.) drug products. Specifically
noted were psychiatric adverse effects when prescribed to treat “ADHD,” such as visual
hallucinations, suicidal ideation, psychotic behavior, aggression and violent behavior.5
September 13, 2005: The Oregon Health & Science University, Evidence-Based Practice
Center published the findings of its review of 2,287 studies—virtually every study ever
conducted on ADHD drugs—and found that no trials had shown the effectiveness of these
drugs and that there was a lack of evidence that they could affect “academic performance,
risky behaviors, social achievements, etc.” Further, “We found no evidence on long-term
safety of drugs used to treat ADHD in young children” or “adolescents.”6
January 5, 2006: The FDA said it had received reports of sudden deaths, strokes, heart
attacks and hypertension (high blood pressure) in both children and adults taking ADHD
drugs and asked its Drug Safety and Risk Management advisory committee to examine the
potential of cardiovascular (heart) risks of the drugs.7
February 4, 2006: A University of Texas study published in Pediatric Neurology reported
cardiovascular problems in children taking stimulants.8
February 9, 2006: The FDA’s Drug Safety and Risk Management Advisory Committee
urged that the FDA’s strongest “black box” warning be issued for stimulants because they
may cause heart attacks, strokes and sudden death.9
March 22-23, 2006: Two FDA advisory panels held hearings into the risk of stimulants and
another new ADHD drug called Sparlon (Provigil). Between January 2000 and June 30,
2005, the FDA had received almost 1,000 reports of kids experiencing psychosis or mania
while taking the drugs. The first panel recommended stronger warnings against stimulants,
emphasizing these should appear on special handouts called “Med Guides” (Medication
Guides) that doctors must give to patients with each prescription. The second committee
recommended against approval of Sparlon.10
March 28, 2006: The Australian Therapeutic Goods Administration reported 400 adverse
reactions to stimulants in children taking them, including strokes, heart attacks and
hallucinations.11
December 2007: A study in the journal Pediatrics concluded: “[S]timulants were associated
with an increase in cardiac emergency department visits.”12
February 2008: A study in Arthritis & Rheumatism, entitled, “Association between
treatment with central nervous system [CNS] stimulants and Raynaud’s Syndrome [RS*]
in children: a retrospective case-control study of rheumatology [disorder of the muscles,
tendons, joints, bones, or nerves, characterized by discomfort and disability] patients,”
concluded: “[T]here is a significant association between development of RS and therapy
with CNS stimulants used for the treatment of ADHD.”13 [*RS: Discoloration of the fingers
and/or toes after changes in temperature or emotional events due to abnormal spasms of the
blood vessels resulting in lost blood supply to the area.]
Abuse of Stimulants:
The FDA requires stimulants such as Ritalin and Adderall to carry a boxed warning that
states the drug is “a federally controlled substance because it can be abused or lead to
dependence. Keep RITALIN [Adderall] in a safe place to prevent misuse and abuse.”
August 2001: A study published in the Journal of the American Medical Association
concluded that methylphenidate is chemically similar to cocaine.14 Children who took
stimulants were more likely to start smoking or use cocaine and continue these habits into
adulthood.15
April 2005: Partnership for a Drug-Free America released the findings of its survey, which
determined that 10% (2.3 million) of teens had abused Ritalin and Adderall.16
February 25, 2006: A study in the journal Drug and Alcohol Dependence revealed that
seven million Americans were estimated to have abused stimulant drugs and a substantial
amount of teenagers and young adults appeared to show signs of addiction.17
WARNINGS AND STUDIES ON SPECIFIC PSYCHOSTIMULANTS:
ADDERALL (amphetamine and dextroamphetamine):
Adderall is an amphetamine mixture that has been linked to violent behavior when, in
1999, a North Dakota judge acquitted 24-year-old Ray Ehlis of murdering his 5-week-old
daughter after two independent psychiatrists testified he was suffering a severe psychosis
induced by Adderall.18
June 2004: The FDA ordered that the packaging for Adderall include a warning about
sudden cardiovascular deaths, especially in children with underlying heart disease.19
February 9, 2005: Health Canada, the Canadian counterpart of the FDA, suspended
marketing of Adderall XR (Extended Release, given once a day) due to reports of 20
sudden unexplained deaths (14 in children) and 12 strokes (2 in children) in patients taking
Adderall or Adderall XR. However, in August 2005, Health Canada agreed to reinstate the
marketing authorization with a number of revisions to the labeling to warn against the use
of Adderall XR in patients with structural heart abnormalities and advised about the dangers
of misusing amphetamines.20 The FDA warned that as Adderall is an amphetamine, it has a
“high potential for abuse. Taking amphetamines for long periods of time may lead to drug
addiction.” Further, Adderall should never be taken in conjunction with antidepressants in
the (MAOI) Monoamine Oxidase Inhibitor class.21 (See page 17)
CYLERT (pemoline):
September 1997: Britain removed Cylert from the market after reports of death related
to liver toxicity in people taking it. Cylert posed a threat of serious liver complications,
including liver failure resulting in death or liver transplantation.22
September 1999: Canada removed Cylert from the market after reports of death related to
liver toxicity in people taking it.23
October 24, 2005: The FDA finally withdrew Cylert from the market because of its
“overall risk of liver toxicity” and liver failure.24
METADATE CD (methylphenidate):
Metadate is a reformulation of Ritalin for extended delivery over several hours and carries
the same warnings as Ritalin and potential for abuse. Metadate should not be taken if:
“You have significant anxiety, tension, or agitation since METADATE CD may make
these conditions worse…you have glaucoma, an eye disease, you have tics or Tourette’s
Syndrome (condition manifesting in involuntary physical and vocal tics.)”11
Provigil (modafinil):
Provigil was approved to treat daytime sedation as a means to keep people awake. Its
manufacturer, Cephalon, unsuccessfully attempted to get FDA approval for the drug’s use
in treatment of ADHD under the trade name Sparlon. However, this does not mean that
psychiatrists or physicians will not prescribe Provigil for ADHD, even though it is not FDA
approved for this use or for any pediatric use.
September 2007: Cephalon sent a letter to health care professionals informing them of new
warnings: “1. Provigil can cause life-threatening skin and other serious hypersensitivity
reactions…. 2. Provigil is not approved for use in pediatric patients for any indication. 3.
Provigil can cause psychiatric symptoms.”25
RITALIN (methylphenidate):
The Physicians’ Desk Reference (PDR) warns, “psychotic episodes can occur” with abuse.
Suicide is the major complication of withdrawal from Ritalin and similar drugs.26
The DEA says Ritalin could lead to addiction and that “psychotic episodes, violent behavior
and bizarre mannerisms have been reported” with its use.27
October 17, 2007: In Japan, the Health, Labor and Welfare Ministry panel (similar to
the FDA) removed Ritalin from its list of approved medicines to treat depression. It was
considered that it could exacerbate the already significant amount of Ritalin abuse in the
country.28
2008: The current FDA Medication Guide warns of heart-related problems with Ritalin and
other stimulants, including, “sudden death in patients who have heart problems or heart
defects; stroke and heart attack in adults; increased blood pressure and heart rate.” Further,
for all patients, “new or worse behavior and thought problems…new or worse aggressive
behavior or hostility” and in children and teens, “new psychotic symptoms (such as hearing
voices, believing things that are not true, are suspicious) or new manic symptoms.”29
*Tourettes’s Syndrome: a neurological disorder characterized by recurrent involuntary movements,
including multiple neck jerks and sometimes vocal tics, as grunts, barks, or words, esp. obscenities.
References
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31 Dr. Candace B. Pert, Letter to the Editor, TIME Magazine, 20 Oct. 1997, p. 8.
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46 “FDA Proposes New Warnings About Suicidal Thinking, Behavior in Young Adults Who Take Antidepressants,” FDA News, 2 May 2007.
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48 Yan Chen, et al., “Risk of Cerebrovascular Events [CVE] Associated with Antidepressant Use in Patients with Depression: A
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49 “Implementation of warnings on suicidal thoughts and behaviour in antidepressants,” MHRA, 5 February 2008.
50 Irving Kirsch, et al., “Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug
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51 “Antidepressant drug use and risk of venous thromboembolism,” Pharmacotherapy, Vol. 28, No. 2, 28 Feb. 2008.
52 Thomas Laughren, M.D., Letter to GlaxoSmithKline Attn: Randal L. Batenhorst, Food and Drug Administration, Jan. 2009.
53 Benedict Carey, “Treatment of Depression in Pregnancy Affects Babies,” The New York Times, 4 Feb. 2005.
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56 Steve Mitchell, “Analysis: SSRIs’ risk to infants,” United Press International, 6 Feb. 2006.
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58 Maria Bishop, “Use of Antidepressants in Pregnancy Affects Neonatal Outcomes: Presented at AACAP,” Doctor’s Guide, 29 Oct.
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59 “Paxil, Prozac, Zoloft and Other SSRI Antidepressants Tied to Premature Birth,” News Inferno, 6 May 2008.
60 “Duloxetine hydrochloride (marketed as Cymbalta) information,” FDA information sheet, 30 June 2005.
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63 “Paroxetine,” FDA Public Health Advisory, 8 Dec. 2005.
64 Benedict Carey and Gardiner Harris, “Antidepressant May Raise Suicide Risk,” The New York Times, 12 May 2006.
65 Corrado Barbui, M.D., et al., “Effectiveness of paroxetine in the treatment of acute major depression in adults: a systematic reexamination
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66 “New Warning for Strattera,” FDA Talk Paper, 17 Dec. 2004.
67 “Attention Drug to Get New Warning,” Los Angeles Times, 18 Dec. 2004.
68 “Strattera to Get New Risk Label,” The Washington Post, 18 Dec. 2004.
69 “New Drugs in Pipeline,” Psychiatric News, 21 Dec. 2001.
70 “Lilly to add suicide warning to Strattera,” ABC News, 29 Sept. 2005.
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74 Op. cit., Prozac Truth website.
75 Alice Park, “More Drugs To Treat Hyperactivity,” TIME Magazine, 10 Sept. 2001.
76 Op. cit., Prozac Truth website.
77HealthScoutNews Reporter.
78 Op. cit. Physicians’ Desk Reference, http://www.pdrhealth.com.
79 “Suicidality in Children and Adolescents Being Treated With Antidepressant Medications,” FDA Public Health Advisory, 15 Oct.
2004.
80 Op cit.New Zealand Ministry of Health.
81 Italian Official Gazette, No. 224, 26 Sept. 2005.
82 “Depression in Children and Young People,” National Institute for Health and Clinical Excellence, Sept. 2005, pp. 16, 18 and 28.
83 FDA, “Antidepressant Use in Children, Adolescents, and Adults,” www.fda.gov/CDER/Drug/antidepressants?default.html, updated
2 May 2007.
84 Op. Cit.Maria Bishop.
85 “Antidepressant drug use and risk of venous thromboembolism,” Pharmacotherapy, Vol. 28, No. 2, 28 Feb. 2008.
86 Physicians’ Desk Reference, http://www.pdrhealth.com; “ABILIFY Rx Only (aripiprazole) Tablets,” Package Insert, revised Mar.
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How the Chemical Imbalance Model of Modern Psychiatry has Failed its Patients, (Kevco Publishing, California, 2001), p. 106.
87 Robert Whitaker, Mad in America: Bad Science, Bad Medicine, and the Enduring Mistreatment of the Mentally Ill, (Perseus
Publishing, New York, 2002), pp. 182, 186.
88 Op. cit., Robert Whitaker, p. 208.
89 George Crane, “Tardive Dyskinesia in Patients Treated with Major Neuroleptics: A Review of the Literature,” American Journal of
Psychiatry, Vol. 124, Supplement, 1968, pp. 40-47.
90 Michael J. Burns, “The Pharmacology and Toxicology of Atypical Antipsychotic Agents,” Journal of Toxicology, 1 Jan. 2001.
91 Ibid.
92 “FDA: Antipsychotic Drugs, Diabetes Linked,” Associated Press Online, 18 Sept. 2003.
93 “Atypical antipsychotics and hyperglycaemia,” Australian Adverse Drug Reactions Bulletin, Vol. 23, No. 3, June 2004.
94 Jeffrey A. Lieberman, M.D., et al., “Effectiveness of Antipsychotic Drugs in Patients with Chronic Schizophrenia,” The New England Journal of Medicine, Vol. 353, No. 12, 22 Sept. 2005.
95 Philip S. Wang, et al., “Risk of Death in Elderly Users of Conventional vs. Atypical Antipsychotic Medication,” The New England
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96 Marilyn Elias, “New antipsychotic drugs carry risks for children; Side effects can lead to bigger health problems,” USA Today, 2
May 2006.
97 Peter Tyrer, et al., “Risperidone, haloperidol, and placebo in the treatment of aggressive challenging behaviour in patients with
intellectual disability: a randomized controlled trial,” The Lancet, Vol. 371, 5 Jan. 2008.
98 Wilma Knol, M.D., et al., “Antipsychotic Drug Use and Risk of Pneumonia in Elderly People,” The American Geriatrics Society, Vol.
56, No. 4, pp. 661-666, Apr. 2008.80
99 Hugo Lovheim, M.D., Stig Karlsoon, R.N., Ph.D., et al., “The use of central nervous system drugs and analgesics among very old
people with and without dementia,” Pharmacoepidemiology and Drug Safety, 9 Apr. 2008.
100 Paula A. Rochon, M.D., MPH, FRCPC, et al., “Antipsychotic Therapy and Short-term Serious Events in Older Adults With
Dementia,” The Archives of Internal Medicine, Vol. 168, No. 10, 26 May 2008.
101 “Information for Healthcare Professionals Antipsychotics,” FDA, June 2008; “US FDA expands antipsychotic drug warning,”
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103 MedicineNet.com, Last Editorial Review: 9/8/04.
104 “Abilify Information,” Pharma-Help.com.
105 “The New Anti-Psychotic Drug Aripiprazole (ABILIFY),” Public Citizen’s eLetter, Apr. 2003.
106 Op. cit., “ABILIFY Rx Only (aripiprazole) Tablets,”
107 “Clozapine and Achy Breaky Hearts,” MedSafe, May 2008.
108 Watching Briefs, MedSafe, June 2008.
109 “Information for Healthcare Professionals Haloperidol (marketed as Haldol, Haldol Decanoate and Haldol Lactate),” FDA ALERT,
17 Sept. 2007.
110 Jeff Swiatek, “Uncertainty was Driver in Zyprexa Deal,” IndianapolisStar.com, 11 June 2005.
111 Op. cit., Jeffrey A. Lieberman, M.D., et al.
112 “Study: New drugs little better for schizophrenia,” St. Petersburg Times, 20 Sept. 2005.
113 “Important Safety Information about ZYPREXA® (olanzapine),” Eli Lilly and Company, 5 Oct. 2007; “Lilly Announces Updates
to the Zyprexa and Symbyax U.S. Labels,” PRNewswire, Bio-Medicine, 5 Oct. 2007.
114 ZYPREXA Safety Information, www.zyprexa.com.
115 Physicians’ Desk Reference, http://www.pdrhealth.com.
116 Tracey McVeigh, “Tranquilizers ‘more lethal than heroin,’” The Observer, 5 Nov. 2000.
117 Matt Clark, Mary Hager, “Valium Abuse: The Yellow Peril,” Newsweek, 24 Sept. 1979; Dr. Patrick Holford, “How to Quit
Tranquilizers,” www.patrickholdford.com, 2008.
118 Ibid.
119 Op. cit., Tracey McVeigh.
120 “Elderly On Long-Acting Anxiety, Insomnia Drugs Have More Car Crashes,” Doctor’s Guide citing Journal of American Medical
Association, 30 June 1997.
121 “Agression, Violence & Bezodiazapines,” Benzo.org.uk, citing British National Formulary, 2001.
122 Benzo.org.uk, citing Professor C. Heather Ashton, Benzodiazepines: How They Work and How To Withdraw, Feb. 2001.
123 “The Influence on the Pharmaceutical Industry,” House of Commons, UK, Health Committee, Vol. 1, Mar. 2005. p. 65.
124 Tarja-Brita R. Wahlin, et al., “Falls and fall risk among nursing home residents,” The Journal of Clinical Nursing, Vol. 17, pp. 126-
134, Jan. 2008.
125 “Europe-wide review recommends updates to product information for varenicline (brand name Champix),” MHRA, 14 Dec. 2008.
126 “Early Communication About an Ongoing Safety Review Varenicline (marketed as Chantix),” FDA, 20 Nov. 2007.
127 “Varenicline (marketed as Chantix) Information,” FDA Alert, 1 Feb. 2008.
128 Op. cit., House of Commons, UK, Health Committee, p. 65.
129 Anna Maria Dademan, “Flunitrazepam and violence—psychiatric and legal issues,” Department of Clinical Neuroscience,
Occupational Therapy and Elderly Care, Research Division of Forensic Psychiatry, Karolinska Institute, Sweden, 2000, p. 43.
130 “Zolpidem (‘Stilnox’) – Updated information – February 2008,” Theraputic Goods Administration, 21 Feb. 2008; “Club Drugs: An
Update,” Drug Intelligence Brief, Drug Enforcement Administration, Sept. 2001.
131 “FDA Safety Changes: Ambien, Primazin IM/IV, Hepsera,” Medscape, 28 Aug. 2008.
132 Peter Breggin, Toxic Psychiatry, (St. Martin’s Press, New York, 1991) p. 245.
133 Jerrold F. Rosenbaum, et al., “Emergence of Hostility During Alprazolam Treatment in Borderline Personality Disorder,” The
American Journal of Psychiatry, Vol. 141, No. 6 (June 1984), pp. 792-793.
134 David L. Gardner and Rex W. Cowdrey, “Alprazolam-Induced Dyscontrol in Borderline Personality Disorder,” The American
Journal of Psychiatry, Vol. 142, No. 1 (Jan. 1985), pp. 98-100.
135 “Xanax addiction extremely tough to kick,” MSNBC News Online, 2001.
136 Statement by Joseph A. Califano, Jr., Chairman and President, “Under the Counter: The Diversion and Abuse of Controlled
Prescription Drugs in the U.S.” The National Center on Addiction and Substance Abuse at Columbia University, July 2005.
137 Physicians’ Desk Reference, (Medical Economics Company, New Jersey, 1998), pp. 2822-2823; David L. Richman, M.D., Leonard
Roy Frank, and Art Mandler, Dr. Caligari’s Psychiatric Drugs (Alonzo Printing Co., Inc., California, 1984), p. 39.
138 Op. cit., David L. Richman, M.D., et al., pp. 38-39.
139 Ibid.

Source: http://www.cchrint.org/pdfs/The_Side_Effects_of_Common_Psychiatric_Drugs.pdf

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There were 16,694 alcohol-related fatalities in 2004 – 39 percent of the total traffic fatalities for the year. Of the 16,694 people who died in alcohol-related crashes in 2004, 14,409 (86%) were killed in crashes where at least one driver or non-occupant had a BAC (Blood Alcohol) of .08 or higher. The legal limit for BAC is currently .08 in all states in the US.
Traffic fatalities in alcohol-related crashes fell by 2.4 percent, from 17,105 in 2003 to 16,694 in 2004. Although this is definitely an improvement, it is still a lot of dead fellow citizens. To put this in perspective, it is equivalent to a fully loaded Boeing 747 crashing, and leaving no survivors, every nine days all year long – over 39 airplanes in total.
The 16,694 fatalities in alcohol-related crashes during 2004 represent an average of one alcohol-related fatality every 31 minutes.
NHTSA estimates that alcohol was involved in 39 percent of fatal crashes and in 7 percent of all crashes in 2004.
In 2004, 21 percent of the children age 14 and younger who were killed in motor vehicle crashes were killed in alcohol-related crashes. An estimated 248,000 people were injured in crashes where police reported that alcohol was present — an average of one person injured approximately every 2 minutes.
The rate of alcohol involvement in fatal crashes is more than 3 times higher at
night than during the day (60% vs. 18%). The highest percentage of drivers in fatal crashes who had BAC levels of .08 or higher was for males and drivers ages 21 to 24.
The percentages of drivers with BAC levels of .08 or higher in fatal crashes in 2004 were 27% for motorcycle operators, 22% for passenger cars, and 21% for light trucks. The percentage of drivers with BAC levels .08 or higher in fatal crashes was the lowest for large trucks (1%).
In 2004, 85 percent (11,791) of the 13,952 drivers with BAC of .01 or higher who were involved in fatal crashes had BAC levels at or above .08, and 51 percent (7,084) had BAC levels at or above .16. The most frequently recorded BAC level among drinking drivers involved in fatal crashes was .18.
The problem of alcohol and other drugs is one of abuse and not merely of use. Various drugs have various affects, and the effects depend on the method of administration, the amount taken and the social situation as well as the chemical composition of the drug. Alcohol is the most widely used drug, and its effects can be extremely deleterious. Many experts consider alcohol abuse much more serious than abuse of other drugs.

Around 1980, drug use of all kinds began to decline for the first time in two decades. In the 1990s, patterns of use fluctuated. Although less than in the peak years, use and abuse are still quite high. More than one-half all Americans drink and more than a third say that drinking has been a source of trouble in their families. Millions of Americans indicate that they are current users of marijuana. Many users tend toward multiple drug use. Most alcohol abusers are young and male but not poor, whereas other drug addicts tend to be young, male, poor, and a minority.
The meaning of the drug problem for the quality of life is seen in the consequences for physical health, psychological health, interpersonal relationships, and economic costs. Abusers suffer various undesirable effects in all areas, and they inflict suffering on others. The nation as a whole also suffers great economic cost because billions of dollars per year are involved in lost services and in efforts to combat the deleterious effects of abuse.

Major hazards associated with tobacco use:
Nicotine is a toxic, dependency-producing drug that is responsible for about one in every five deaths it the United States. People who smoke have a greater likelihood of developing cardiovascular disease, lung cancer, and/or cancer of the larynx, mouth, and esophagus. Even those who do not smoke may be subjected to the hazard of environmental tobacco smoke—the smoke in the air as a result of other people’s tobacco smoking. Infants born to women who smoke typically have lower than average birth weights and sometimes have slower rates of physical and mental growth.

Problems associated with the use of prescription and over-the-counter drugs:
Some prescription drugs have the potential for short-term abuse and long-term psychological and physical dependence. This form of dependency is known as iatrogenic addiction-drug dependency that results from physician-supervised treatment for a recognized medical disorder. Over-the-counter drugs, which are widely advertised and readily available, may be dangerous when combined with alcohol or other drugs.

Categories of people which are most likely to use marijuana:
Most marijuana users are between the ages of eighteen and twenty-five; however, use by twelve-to-seventeen-year-olds more than doubled in the 1990s. More men than women smoke marijuana, but teenage girls are slightly more likely than boys to have used marijuana at least once.

Major stimulant drugs in the United States:
Cocaine and amphetamines are the major stimulant drugs abused in the United States. Cocaine is an extremely potent and dependency-producing stimulant drug. Amphetamines can be obtained legally in the form of diet pills and pep formulas when they are prescribed by a physician.

Depressants and their health-related risk:
Depressants depress the central nervous system; they also may have some painkilling properties. The most common depressants are barbiturates and anti-anxiety drugs or tranquilizers. Users may develop both physical addiction and psychological dependency on these drugs. There is also the risk of potentiation-the drug interaction that takes place when two drugs are mixed together and the combination produces a far greater effect than that of either drug administrated separately.

Other drugs widely abused in the United States:
Narcotics or opiates, including natural substances (e.g. opium, morphine, and codeine), opiate derivatives (e.g. heroin and Percodan), and synthetic drugs with opiate like effects (e.g. Darvon and Demerol) are frequently abused. Hallucinogens or psychedelics such as mescaline (peyote), lysergic acid diethylamide (LSD), phencyclidine (PCP), and MDMA (Ecstasy) are also widely abused.

Drug addiction viewed by biological and psychological perspectives:
Biological explanations of alcohol and drug addiction focus on inherited biological factors and on the effects of drugs on the human brain. Psychological explanations of drug abuse focus on personality disorders and the effects of social learning and reinforcement on people’s drug-taking behavior.

Among social psychological factors is the alienation of users from the larger society. Many people believe drug use produces desirable psychic effects. These positive attitudes toward drug use combine with group norms and various ideologies that develop in groups. The ideologies explain and validate drug use.

Alcohol and drug addition view by sociological perspectives:
Interactionists believe that drug use and abuse are learned behaviors that are strongly influenced by families, peers, and others who serve as role modes. People are more prone to accept attitudes and behaviors that are favorable to drug use if they spend time with members of a drug subculture.

Symbolic interactions emphasize social meanings of drugs. Prohibition, for example, has been analyzed as a symbolic crusade: As the old order lost political control, it attempted to dominate society morally by wrapping itself in abstinence (morality) and associating drunkenness (immorality) with the newcomers.

Applying the symbolic interaction perspective pharmaceutical companies, with the cooperation of the medical profession, play a central role in getting Americans’ to define drugs as a first choice to relieve the stresses of everyday life. Defining problems of living as medical matters, known as the medicalization of human problems, includes defining unruly children as sick and in need of medication.
Various structural factors contribute to the problem. An important one is group norms. Integration into a group that approves drug use is one of the most reliable predictors of use. Role problems, including role conflict and undesirable role change, create stress in the individual and that stress can lead to abuse. Abusers are more likely to come from homes in which family members are abusers, from broken homes, or from hoes with problematic relationships.

Functionalists believe that drug-related problems have increased as social institutions such as the family, education, and religion have become fragmented and somewhat disorganized. However, use of alcohol and other drugs serves important functions even though some aspects of their use are dysfunctional for society.

Applying functionalism: Legal drugs are functional for the medical profession, their patents, and those whom manufacture and sell these drugs. Illegal drugs are also functional for their users, manufacturers (or growers), and distributors. The dysfunctions of drugs include miss-prescribing, arrest for breaking the law, and abuse that harms people physically and socially. A major latent function of illegal drugs is to support agents of social control.

According to conflict theorists, people in positions of economic and political power are responsible for making the sale, use, and possession of some drugs illegal. Conflict theorists also point out that powerful corporate interests perpetuate the use and abuse of alcohol, tobacco, and other legal drugs.

Applying conflict perspective: Drugs have been criminalized to maintain interests of people with access to power. Opium, for example, was made illegal in an attempt to overcome the economic threat that cheap Chinese labor posed to white workers. Similarly, marijuana legislation was a tool directed against Mexican working class in the United States. Some see the heroine trade as a means of defusing revolutionary potential.

The purpose of prevention and treatment programs:
Primary prevention programs seek to prevent drug problems before they begin. Secondary prevention programs seek to limit the extent of drug abuse, prevent the spread of drug abuse to other substances beyond the drugs already experienced, and teach strategies for the responsible use of licit drugs such as alcohol. Tertiary prevention programs seek to limit relapses by individuals recovering from alcoholism or drug addiction.
They may be based either on a medical model or the therapeutic community. The best-known therapeutic community is Alcoholic Anonymous (AA).

Other factors to be taken into account in efforts to reduce the drug problem:
Alcoholism and drug abuse are intertwined with other social problems such as dramatic changes in the economic and technological bases of the society, the growing gap between the rich and poor, and inequalities based on race/ethnicity and gender.

In treating the problem, efforts to help the individual abuser or reduce the supply available to users have far exceeded efforts to get at the social roots of the problem. If it is to be dealt with effectively, both approaches are needed-attacks on the social factors as well as the treatment of individual abusers.

Conclusion:
What constitutes drug abuse is a matter of definition. What is considered drug abuse at one time or in one society may be considered drug use at another time or in another society. From the historical record, we know that drug use and abuse are ancient.

Americans have a strong pro-drug orientation, although they consider some drugs to be disreputable, and those who use them to be part of a social problem. People generally consider the particular drugs that they use to be outside the realm of a social problem.

A major problem in drug abuse is addiction—becoming dependent on a drug so that in its absence one feels the stress of withdrawal. One of the most highly addiction drugs is nicotine. Heroin appears to be less addicting than previously thought. The narcotics are addicting but in and of themselves do not cause crime or destroy people’s work incentive or health. Street addicts deal with a black market that demands exorbitant prices and motivates them to commit predatory crimes. Street addicts buy drugs whose purity are far from guaranteed—and suffer the consequences. Physician narcotic addicts, in contrast, maintain normal lives because they need not deal with a black market and are able to obtain pure drugs.

Developing an adequate social policy is difficult because drugs arouse strong emotions and biases. At a minimum, an adequate social policy would involve drug education that presents scientific findings honestly, whether they are favorable or unfavorable to any particular drug. It would also break the addicts’ dependence on a black market and provide help for their multiple problems. Alcoholics Anonymous appears to be a model recovery program.

It can be anticipated that the future will bring more use of drugs in the workplace, more effective products from pharmaceutical companies (which will further increase the demand for drugs), and social policies similar to those we now have: illegal status for drugs that are out of favor, stigmas for their users, and overflowing coffers for members of organized crime.

Source: www.dmacc.cc.ia.us/Instructors/elglick/Lec-3a%20(Drugs).doc

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What is IDARS?
“IDARS” is an acronym for the International Drug Abuse Research Society. The purposes of IDARS are scientific, educational and charitable. The Society seeks to promote excellence in: 1) advancing the understanding of drug abuse, substance abuse, and addiction, 2) bringing together scientists of varying backgrounds and disciplines within the field of drug abuse research, 3) integrating drug abuse research directed at all levels of biological organization to improve prevention and treatment efforts, 4) promoting education in the addiction sciences, 5) informing the general public about the results and implications of current research in the addiction sciences.

Who are the members of IDARS?
Members of IDARS are research scientists and clinicians from around the world. The current president of IDARS is Dr. Michael J. Kuhar, Professor of Pharmacology, at the Yerkes National Primate Center of Emory University, in Atlanta, GA. The Executive Officer is Dr. Syed F. Ali, Head, Neurochemistry Laboratory, Division of Neurotoxicology, at the National Toxicological Research Center, Food and Drug Administration, in Jefferson, AR.

IDARS has 3 categories of membership.
Regular Members: Any credentialed research scientist or health professional working in the field of substance abuse may be considered for Regular Membership. Annual dues are $50.
Student and Post-Doctoral Fellow Members: Any post-baccalaureate student matriculated in an advanced degree program, or anyone participating in a post-doctoral training program, in a field related to drug abuse research, may be considered for this category of membership. Annual dues are $20.
Emeritus Members: Upon retirement, any member of IDARS may apply for Emeritus status. In some cases, distinguished scientists will be nominated for Emeritus membership. There are no annual dues for Emeritus members.

The current IDARS Board of Directors:
Peter Dodd, Brisbane, Australia
Francesco Fornai, Pisa, Italy
Carlos Jimenez-Rivera, San Juan, Puerto Rico
Timothy Maher, Boston, MA, USA
Deborah Mash, Miami, FL, USA
Jerrold Meyer, Amherst, MA, USA
Sakire Pogun, Izmir, Turkey
Marcus Rattray, London, UK
Susan Schenk, Wellington, NZ
George Uhl, Baltimore, MD, USA

When does IDARS meet?
IDARS will have annual meetings, where members and non-members alike can share their most recent research data. IDARS plans to hold its first meeting in Spring 2006 in Washington, DC. This year, many members of IDARS will attend a scientific conference entitled, “Cellular and Molecular Mechanisms of Drugs of Abuse and Neurotoxicity: Cocaine, GHB and Substituted Amphetamines”, which will take place from August 16-19, in Venice, Italy. The Venice conference is an official Pre-Satellite meeting of the 20th Biennial meeting of the International Society for Neurochemistry (ISN), held jointly with the European Society for Neurochemistry (ESN).

Worldwide Stimulant Abuse – An Emerging Health Crisis
“Stimulant” drugs produce a spectrum of effects that includes increased energy, cardiovascular stimulation, heightened mood and decreased need for sleep. After high doses or long periods of use, stimulants can produce a range of medical complications including heart attacks, strokes, psychotic episodes and seizures. From a molecular perspective, most stimulants interact with monoamine transporter proteins found on nerve cells. Stimulant drugs can be divided into two classes based on their transporter-mediated mechanisms of action: monoamine transporter blockers (i.e., cocaine) and substrate-type monoamine releasers (i.e., amphetamines) [reviewed in Baumann and Rothman, 2003]. It is noteworthy that many stimulants are useful medications with long histories of safety and efficacy, whereas others are highly addictive substances associated with considerable morbidity and mortality. Illicit stimulants are some of most commonly abused drugs worldwide – during the year 2000, it is estimated that 34.3 million people used amphetamines, 14.1 million used cocaine, and 7.7 million used the amphetamine analog, 3,4,-methylenedioxymethamphetamine (MDMA) [UNODC, 2003]. Such evidence supports the emergence of stimulant abuse as global health crisis.

“Super Coke” In Colombia – It’s the Real Thing!
The abuse of cocaine continues to be a problem in the US and other nations around the world. Colombia remains the number one producer of marketable cocaine hydrochloride and provides more than 80% of global supply. Figure 1 shows the explosive growth in Colombian cocaine production in the past few years. Cocaine alkaloid is extracted from the coca plant, Erythroxylaceae coca, which is cultivated throughout the Andean region (see Figure 2). Recently, anti-drug operatives in Colombia have identified genetically-modified (GM) coca plants that produce yields of cocaine much greater than normal. The “super coke” plants grow to heights of 7-9 ft whereas typical coca plants grow to heights of 3-4 ft. Furthermore, the GM plants are resistant to herbicides and produce up to 5-times more cocaine alkaloid than normal plants. The discovery of transgenic coca plants adds a troubling new dimension to the spread of cocaine abuse.

Few treatments options are available for cocaine-dependent patients, and the development of medications to combat cocaine addiction is a major challenge for biomedical research. IDARS scientists have discovered novel approaches for treating cocaine dependence. Christian Heidbreder and colleagues at Glaxo-Smith-Kline have identified and tested the selective dopamine D3 receptor antagonist, SB277011A as a potential treatment for cocaine dependence [reviewed in Heidbreder and Hagan, 2005]. In animal models, SB277011A blocks the ability of cocaine and stress to induce reinstatement of cocaine-seeking behavior [Xi et al., 2004]. Moreover, SB277011A appears to reduce drug-seeking behavior in general, suggesting that D3 antagonists could have anti-addictive efficacy in the treatment of nicotine, opioid and stimulant dependence.

“Ya-Ba” Da-Ba Doom in Thailand
Similar to the cocaine crisis, the abuse of methamphetamine is increasing in the US and abroad. One of worst epidemics of methamphetamine abuse is occurring in Thailand, where 70% of drug addicts, or 2.5 million people, are dependent upon methamphetamine. Most users ingest a tablet formulation of methamphetamine known as “Ya-Ba”, meaning “crazy medicine”. Figure 3 depicts the typical appearance of Ya-Ba tablets. Nearly all Ya-Ba confiscated in Thailand is produced in the neighboring country of Burma, by the drug-trafficking insurgent group, the United Wa State Army (USWA). USWA and other such groups pose a significant threat to the national security of countries in South East Asia and elsewhere. It is estimated that Burmese methamphetamine production exceeds 800 million tablets per year. Figure 4 shows Thai police prepared to destroy large quantities of confiscated Ya-Ba tablets.

The long-term effects of methamphetamine abuse in humans are not well studied, but in rodents, methamphetamine causes depletions of dopamine and serotonin in the brain. Methamphetamine-induced loss of monoamines could underlie depression and suicidal ideation that often accompany drug withdrawal. Members of IDARS have shown that methamphetamine can cause neurotoxic effects. Francesco Fornai and colleagues at the University of Pisa, in Italy, demonstrated that mice treated with methamphetamine display abnormal dopamine cells in the brain [Fornai et al., 2004a]. The affected cells have intracellular inclusions which resemble those found in Parkinson’s disease and other neurodegenerative disorders. Methamphetamine produces similar inclusions in cultured PC12 cells. While the clinical relevance of these data is uncertain, they suggest that methamphetamine abuse could predispose individuals to neurodegenerative disorders [Fornai et al., 2004b].

Ecstasy in the UK and Beyond: It’s Nothing to Rave About!
The “rave” scene continues to be major source of drug abuse in the UK, throughout Europe, and in the US. In particular, the substituted amphetamine MDMA (Ecstasy, or E) is commonly abused at all night dance parties, or raves. Users often take multiple doses of MDMA at once (i.e., “stacking”) or take supplemental doses of the drug repeatedly during the party (i.e., “bumping”). Figure 5 shows some examples of MDMA tablets. US statistics show that medical complications associated with MDMA use have risen exponentially – MDMA-related emergency room visits increased from 253 in 1994 to 4026 in 2002. Young people continue to experiment with MDMA despite the risk of adverse effects including depression, cognitive disturbances and memory problems. Figure 6 depicts a popular DVD program, “Generation E”, that describes the rave culture and criticizes attempts by the US government to criminalize rave-related activities.

The long-term consequences of MDMA abuse in humans are not well understood, and there is disagreement concerning the reinforcing properties of MDMA in animals and humans. IDARS scientists are exploring the potential addictive properties of MDMA. Susan Schenk and colleagues at University of Wellington, in New Zealand, have developed a novel paradigm where rats learn to self-administer MDMA [Schenk et al., 2003]. Their work shows that MDMA is a positive reinforcer in rats, and prior experience with cocaine engenders more rapid acquisition of MDMA intake. Dopamine appears to be involved in the addictive properties of MDMA, since D1 dopamine receptor antagonists reduce self-administration of the drug [Daniela et al., 2004]. These findings may have implications for the development of treatments for MDMA addiction.

New “Legal Highs” in New Zealand
A number of non-amphetamine designer drugs have appeared on internet websites where they are marketed as “legal Ecstasy”. In particular, the substituted piperazine analogs 1-benzylpiperazine (BZP, or ‘A2’) and 1-(m-trifluoromethylphenyl)piperazine (TFMPP, or ‘Molly’) are increasingly trafficked in the US, Europe, and elsewhere. BZP produces amphetamine-like stimulant effects in humans, suggesting the potential for abuse. Figure 7 shows BZP tablets confiscated by US authorities. The US DEA has moved swiftly to place BZP in Schedule 1 of the Controlled Substances Act, making possession of this substance a criminal offense. In other places, however, BZP is legally available. A significant level of BZP abuse is occurring in New Zealand, where BZP is widely sold over the internet and at “party pill” shops. Figure 8 depicts the Rave.Net.NZ website, a popular site for sharing information about the rave scene in New Zealand.

The pharmacology of BZP, and other substituted piperazines, is not well characterized, but available data suggest that BZP has stimulant properties. Members of IDARS are examining the neurobiological effects of BZP in animal models. Michael Baumann and colleagues at the NIDA IRP have shown BZP interacts with monoamine transporters to release dopamine and serotonin from brain tissue in vitro [Baumann et al., 2005]. Microdialysis studies in rats show that BZP causes elevations in extracellular monoamines that are similar to the effects of methamphetamine. Likewise, self-administration studies in monkeys demonstrate that BZP is a powerful reinforcer with significant abuse liability [Fantegrossi et al., 2005]. The long-term effects of BZP are unexplored and warrant further investigation.

Michael H. Baumann, Ph.D., Staff Scientist, IRP, NIDA, NIH, Baltimore, MD, USA
Chairman, Membership Committee, International Drug Abuse Research Society (IDARS)

References
Baumann MH, Clark RD, Budzynski AG, et al. (2005) Neuropsychopharmacology 30: 550-560.
Daniela E, Brennan K, Gittings D, et al. (2004) Pharmacol Biochem Behav 77: 745-750.
Fantegrossi WE, Winger G, Woods JH, et al. (2005) Drug Alcohol Depend 77: 161-168.
Fornai F, Lenzi P, Gesi M (2004a) J Neurochem 88: 114-123.
Fornai F, Lenzi P, Gesi M (2004b) Ann N Y Acad Sci 1025: 162-170.
Heidbreder CA, Hagan JJ (2005) Curr Opin Pharmacol 5:107-118.
Rothman RB, Baumann MH (2003) Eur J Pharmacol 479: 23-40.
Schenk S, Gittings D, Johnstone M, et al. (2003) Psychopharmacology 169: 21-27.
UNODC (2003) Global Illicit Drug Trends, New York, NY, United Nations Office on Drugs and Crime.
Xi Z, Gilbert J, Campos AC, et al. Psychopharmacology 176: 57-65.

The IDARS reception held at the NIDA International Forum is generously supported by the following sponsors:

Bio-Rad Laboratories
C.A.R.E., Inc., Addiction Treatment Center
G & G Holistic Addiction Treatment, Inc.
Geller and Geller, P.A., Attorneys at Law
Luis and Stavroula Mendez
Novoneuron, Inc., Miami, FL.
Ocean Drive Magazine
Tango Technology

Source: www.idars.org/docs/IDARS-Final.doc

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Below are some common drug slang terms or drug street names:

STREET NAMES AND SLANG FOR HALLUCINOGENS
Marijuana
Pot, Reefer, Grass, Weed, Dope, Ganja, Mary Jane, or Sinsemilla, Urb,
Hashish
Hash
Mescaline and Peyote
Mesc, Buttons, and Cactus
Psilocybin (Shrooms)
Magic Mushrooms, ‘shrooms
Lysergic acid diethylamide
Acid, Microdot, White lightning, Blue heaven, and Sugar Cubes
Analog of Amphetamines or Methamphetamines
MDMA (Ecstasy, XTC, Adam, Essence), MDM, STP, PMA, 2, 5-DMA, TMA, DOM, DOB, EVE
Phencyclidine
PCP, Hog, Angel Dust, Loveboat, Lovely
Analog of Phencyclidine (PCP)
PCPy, PCE

STREET NAMES AND SLANG FOR DEPRESSANTS
Nitrous Oxide
Laughing gas or Whippets
Amyl Nitrite
Poppers or Snappers
Butyl Nitrite
Rush, Bolt, Bullet, Locker Room, and Climax
Chloro-hydrocarbons
Aerosol sprays or cleaning fluids
Hydrocarbons
Solvents
Barbiturates
Downers, Barbs, Blue Devils, Red Devils, Yellow Jackets,
Yellows, Nembutal, Tuinals, Seconal, and Amytal
Methaqualone
Quaaludes, Ludes, Sopors
Tranquilizers
Valium, Librium, Serax, Equanil, Miltown, and Tranxene

STREET NAMES AND SLANG FOR STIMULANTS
Cocaine
Coke, Snow, Nose Candy, Flake, Blow, Big C, Lady, White, and Snowbirds, Powder,
Crack Cocaine
Crack, rock, freebase, Cookie,
Amphetamines
Speed, Uppers, Ups, Black beauties, Pep pills, Co-pilots, Bumblebees, Hearts, Benzedrine, Dexedrine, Footballs, and Biphetamine
Methamphetamines
Crank, Crystal meth, Crystal methadrine, and Speed
Additional Stimulants
Ritalin, Cylert, Preludin, Didrex, Pre-State, Voranil, Sandrex, and Plegine

STREET NAMES AND SLANG FOR NARCOTICS
Heroin
Smack, Horse, Mud, Brown sugar, Junk, Black tar, and Big H
Morphine
Pectoral syrup
Opium
Paregoric, Dover’s Powder, Parepectolin
Codeine
Empirin compound with codeine, Tylenol with codeine,
Codeine in cough medicine
Meperidine
Pethidine, Demerol, Mepergan
Analog of Fentanyl (Narcotic)
Synthetic heroin, China white
Analog of Meperidine (Narcotic)
MPTP (New heroin), MPPP, synthetic heroin

Source: http://www.njlawman.com/Feature%20Pieces/Drug%20Slang.htm

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How does Ritalin work? What will it do for me?

Methylphenidate belongs to the family of medications known as stimulants. It is used to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy (uncontrollable need to sleep) in children over 6 years old and adults. It helps to increase attention and decrease restlessness in children and adults who have been diagnosed with ADHD. Other measures (e.g., psychological, educational, and social therapies) are used along with methylphenidate as part of an overall treatment program for ADHD. This medication also helps to stimulate people with narcolepsy so that they do not fall asleep at inappropriate times.

Your doctor may have suggested this medication for conditions other than the ones listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.
How should I use Ritalin?

The dose of methylphenidate needs to be individualized according to the needs of the person taking the medication. The dose is usually started low and increased gradually to the dose that works best for the person. The usual starting dose for this medication is 5 mg to 10 mg two or three times daily. Doses above 60 mg daily are not recommended. If symptoms worsen or if side effects occur, contact your doctor for further instruction. In many cases for children, the medication does not need to be continued after puberty.

Take methylphenidate with or shortly after a meal or snack.

If you are taking the SR tablets, swallow the medication whole and do not crush or split the tablets.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones above, do not change the way that you are taking the medication without consulting your doctor.

It is important that this medication be taken exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue on with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue on with your regular dosing schedule. Do not take a double dose to make up for a missed one.

This medication is available under multiple brand names and in several different forms. Any specific brand name of this medication may not be available in all of the forms listed here. The forms available for the specific brand you have searched are listed under “What form(s) does this medication come in?”

What form(s) does Ritalin come in?

10 mg
Each pale blue, round, flat-faced, beveled-edged tablet, scored and imprinted “AB” on one side with “CIBA” on the other, contains methylphenidate HCl 10 mg. Nonmedicinal ingredients: cornstarch, FD&C Green No. 3, lactose, magnesium stearate, polyethylene glycol, sugar and talc.

20 mg
Each pale yellow, round, flat-faced, beveled-edged tablet, scored and imprinted “PN” on one side with “CIBA” on the other, contains methylphenidate HCl 20 mg. Nonmedicinal ingredients: D&C Yellow No. 10, lactose, magnesium stearate, polyethylene glycol, sugar, tragacanth and talc.
Some medications may have other generic brands available. Always ask your doctor or pharmacist about the safety of switching between brands of the same medication.
Who should NOT take Ritalin?

Methylphenidate should not be taken by anyone who:
is allergic to methylphenidate or to any of the ingredients of the medication
is taking an monoamine oxidase (MAO) inhibitor (e.g., phenelzine, tranylcypromine) or has taken one in the last 14 days
has advanced hardening of the arteries
has an overactive thyroid gland
has anxiety, tension, or agitation
has glaucoma (increased pressure in the eye)
has heart disease
has moderate-to-severe high blood pressure
has motor tics, Tourette’s syndrome, or a family history of Tourette’s syndrome
has pheochromocytoma (a condition that causes excess production of epinephrine and norepinephrine hormones)

What side effects are possible with Ritalin?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
agitation, nervousness, or anxiety
diarrhea
dizziness or drowsiness
dry mouth
headache
heartburn
joint pain
loss of appetite
nausea or vomiting
skin rash or itching (mild)
stomach pain
trouble sleeping

Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:
chest pain
confusion
hallucinations (hearing, seeing, or feeling things that are not actually there) or abnormal thoughts or behaviour
increased blood pressure
muscle twitching or tics
palpitations (feeling your heart beat quickly or irregularly)
pinpoint-sized red spots on skin or unusual bruising
prickling or tingling sensations in the hands, arms, feet, or legs
sore throat and fever
sudden high fever
sweating
symptoms of depression (e.g., losing interest in your usual activities, feeling sad, having thoughts of suicide – see below)
symptoms of liver damage (e.g., yellow skin or eyes, abdominal pain, loss of appetite, pale stools, dark urine)
symptoms of Tourette’s syndrome (involuntary, sudden body movements or uncontrolled vocal outbursts)
vision changes

Stop taking the medication and seek immediate medical attention if any of the following occur:
convulsions (seizures)
peeling or blistering of the skin
signs of a serious allergic reaction (difficulty breathing; hives; swelling of the face, lips, eyes, mouth, or throat)
thoughts of suicide or hurting yourself

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for Ritalin?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Behaviour or mood changes: There have been reports of agitation, hallucinations, symptoms of depression, and thoughts of self-harm in people taking this medication. If you experience these types of symptoms while taking methylphenidate, contact your doctor immediately

Blood pressure: This medication may increase blood pressure. People with high blood pressure or heart problems talk to their doctor before taking this medication.

Drowsiness/reduced alertness: Methylphenidate may affect the mental or physical abilities needed to drive or operate machinery. People taking this medication are cautioned against undertaking these and other potentially hazardous activities until they determine if the medication affects them in this way.

Drug dependence: Abuse of methylphenidate is possible by certain individuals. This can lead to high levels of tolerance and psychological dependence, and a wide range of abnormal behaviours. People with a history of drug or alcohol dependence should be carefully monitored by their doctors while using this medication.

Epilepsy: There is some evidence that methylphenidate may increase the risk of seizures for people who have had seizures before.

Exercise: People participating in strenuous exercise or activities should consult their doctor before taking methylphenidate.

Heart problems: This medication can increase heart rate and blood pressure. It may also increase the risk of sudden death for people with heart problems. This medication should generally not be used by people with known heart problems, including an irregular heartbeat, known structural heart abnormalities (such as abnormal size, missing or poorly functioning heart valves, or problems with blood vessels connected to the heart), or a family history of sudden death related to heart disease.

Heart or brain circulation problems: People who have, or have a history of, heart or brain circulation problems should be closely monitored by their doctor while using this medication.

Long-term use: If you will be using this medication for a long period of time, you will need regular heart check-ups and lab tests to check your white blood cell counts.

Stopping the medication: Check with your doctor before stopping this medication.

Suppression of growth: Growth suppression (i.e., less increase in height or weight than usual) has been reported for children using stimulants such as methylphenidate for long periods of time. It is not known if the medication causes the growth suppression. However, children who need long-term therapy should be carefully monitored for growth. Their doctor may also recommend a “drug holiday,” where the medication is not given on weekends or during school holidays.

Vision: Rarely, people taking methylphenidate have experienced vision changes. If you notice any changes in your vision, contact your doctor.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if this medication passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of this medication have not been established for children under 6 years old. Methylphenidate should not be used by children of this age group.
What other drugs could interact with Ritalin?

There may be an interaction between methylphenidate and any of the following:
alcohol
amphetamines (e.g., dextroamphetamine)
antidepressants (e.g., amitriptyline, imipramine, fluoxetine)
appetite suppressants (e.g., phentermine)
carbamazepine
clonidine
guanethidine
monoamine oxidase (MAO) inhibitors (e.g., phenelzine, tranylcypromine)
methyldopa
other medications for ADHD
phenobarbital
phenytoin
primidone
sympathomimetic medications (e.g., epinephrine)
warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
stop taking one of the medications,
change one of the medications to another,
change how you are taking one or both of the medications, or
leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Source: http://bodyandhealth.canada.com/drug_info_details.asp?channel_id=0&relation_id=0&brand_name_id=971&page_no=1

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