Methylphenidate: Chaos in the cortex

7. July 2014
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Methylphenidate in actuality is supposed to help people with ADHD to manage their daily lives. Yet more and more young people swallow the medication with the aim of improving their performance in school and university. This can have fatal consequences, as a recent study shows.

The number of annual sick days accounted for by brain doping over the past ten years increased from 8,000 to 30,000, according to AOK’s (one of the largest German health insurance firm’s) Absenteeism Report 2013. Five percent of all persons in employment stated during the AOK survey that they had used performance-enhancing medications in the last twelve months without having medical need for them. Among the under 30-year-olds, the “doped-up” even reached a figure of eight percent.

Brain doping not an isolated case

Sociologist Sebastian Sattler from the University of Bielefeld arrived at similar results in a survey of 3,486 randomly selected students at four major universities in Germany: nearly five percent stated that they had already at least once increased their performance using medication. 40 percent of them had resorted at least once in the previous six months to using performance enhancing agents, every fourth person more than three times.

“It is very likely that a large proportion of the population consumes cognitive stimulants”, the authors of a recent U.S. study write. Especially among students the pressure to perform is continually increasing. Often they resort to taking the medical agent methylphenidate, which is prescribed under the trade name Ritalin® for the treatment of Attention Deficit Disorder (ADHD). In the U.S. black market methylphenidate is the most traded drug among students. In order to be able to stay awake longer and to increase their performance, young people reach for the drug especially before exams.

Consistent behavioural changes

“This is not something without consequences”, the scientists warn, because specifically with adolescents and young adults up to about age 30 the brain’s prefrontal cortex is not yet fully developed. Up until full maturation this brain region is particularly sensitive to fluctuations in certain metabolites such as dopamine or norepinephrine. “Altered levels of these important neurotransmitters may interfere with the maturation of the prefrontal cortex and effect lasting behavioural changes”, say the scientists.
In tests on young rats, the researchers see their suspicions confirmed: when they administered low doses of the Ritalin agent to the animals, the excitability of neurons was decreased in the prefrontal cortex. Metabolites that shape feelings and behaviour were thus secreted in different amounts to those in the absence of methylphenidate.

Flexibility and ability to learn impaired

In contrast to other regions of the brain, the prefrontal cortex demonstrates a high proportion of a particular receptor type. “The resulting high plasticity is the basis for working memory and active decision making”, the scientists explain. Brain doping agents such as methylphenidate, or the narcolepsy medication modafinil, can damage the plasticity of this region in the long term. An impressive animal study exists with respect to this as well: if young rats receive small amounts of methylphenidate or modafinil, the specific type of receptor in the prefrontal cortex decreases. As a result, in the short term the animals’ awareness does indeed increase, in the long term however their flexibility and their ability to learn suffer from this event, the researchers explain.

Methylphenidate only alongside a confirmed diagnosis

These findings lead the researchers to assume that methylphenidate wrongly administered to children not actually suffering from ADHD could also have fatal consequences. To begin with, an improvement in the condition will most likely come about, the scientists predict. The children involved might be able to follow the teacher better, their hyperactivity would be slowed down and their learning success improved. In the long term they say it significantly affects the central working memory and the flexibility of the behaviour of these children and probably carries lifelong consequences, because these skills in themselves are indispensable as part of everyday activities such as driving a car and social interaction with others. The scientists are therefore calling for the effect of methylphenidate on the brain of adolescents to be examined in further studies in order to better prevent risks posed by the abuse of this substance.

How do young people come to acquire the prescription drugs?

Methylphenidate and other agents which improve performance and concentration ability exist only as prescription-based medication. The students who had participated in Sebastian Sattler’s survey commented in this regard as follows: Most respondents stated that they had acquired the drugs from friends, acquaintances or family members who suffer from the respective conditions and have been prescribed the medication by their doctors. Also, the young people according to their own statements came to acquire these prescription medications by deceiving their doctor, via ordering on the internet, through the black market or a physician passing it ‘under the table’.

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Medicine, Neurology, Psychiatry

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