Medliorate

Improving medical students

Cognitive Enhancement in Medical School

Posted by medliorator on July 7, 2008

by Alison Hayward, M.D., Sarah M. Lawrence, and Bill Johnson, D.D.S.

The first drug used to treat ADHD was methylphenidate (Ritalin), patented in the 1950s for depression, narcolepsy and fatigue. It then began to be used as a treatment for ‘minimal brain dysfunction,’ as ADHD was known at the time. Ritalin’s popularity exploded with the acceptance of ADHD as a clinical entity, and it is now the most commonly prescribed drug for ADHD in the USA. Methylphenidate is available in numerous preparations, including a transdermal patch and extended release formulations such as Concerta. Ritalin is a CNS stimulant, thought to activate the frontal lobes of the brain by binding to dopamine and norepinephrine receptors.

Other, similar drugs used to treat ADHD include mixed amphetamine salts (Adderall) and dextroamphetamine (Dexedrine), which is one of the components of Adderall. Like Ritalin, these medications all have typical amphetamine side effects like decreased appetite, insomnia, and dry mouth. Dexedrine, the oldest patented amphetamine drug, has been used for its weight loss properties in extreme cases of resistant obesity. All are Schedule II, the most restricted classification for a drug considered to have a legitimate medical use, due to the potential for abuse and addiction. They are close relatives of methamphetamine, an illegal substance that has spawned an epidemic of ‘meth labs’ across the country in recent years.

Widespread abuse of drugs like Adderall and Ritalin on college campuses, however, is well-documented in the literature. One annual government study on the use of Ritalin by college students in 2003 concluded that 5% had used Ritalin without a prescription in the previous year, and broader studies have shown up to 35% prevalence of stimulant abuse, misuse, or illicit sales on undergraduate campuses. Anecdotally, the use of stimulants as “academic steroids” amongst health professions students appears to be similarly frequent.

Stimulant Use Among Professional Students [Medscape]

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