Psychostimulants: Regulation of Behavior

A second variety of psychotropic medication prescribed to the common population are the psychostimulants, such as Ritalin, which have been the preferred treatment for hyperactivity since the late 1950s. Ritalin, the compound methylphenidate, and its relatives are stimulant drugs belonging to a class known as the amphetamine congeners that are structurally related to the amphetamines and have similar, but milder, effects. As is also true for the SSRIs, several competing psychostimulant drugs are produced by the various drug manufacturers, including Ritalin, Adderall, Metadate, and Cylert.

Ritalin and it cousins

Indications and effects

Psychostimulants are most commonly prescribed for the treatment of attention deficeit/hyperactivity disorder. This disorder, diagnosed especially commonly among male children and adolescents, is characterized by difficulty maintaining attention, inappropriate social behavior, excessive activity, and impulsivity; although, in females, it often takes the form of social withdrawal. Stimulants are often effective at correcting attention problems in children and adults, although no specific affectiveness rates can be established due to the slippery nature both of positively defining ADD and measuring such phenomena as attention. Psychostimulants have an excitatory effect on the body, increasing heart and respiratory rate while decreasing appetite. Because of this stimulating effect, they have also been successful in the treatment of narcolepsy, a disorder marked by chronic lapses into sleep. The most common side effects reported for psychostimulants are characteristic of stimulants in general: insomnia, nervousness, and loss of appetite.

methylphenidate

Pharmacology

Like the SSRIs, psychostimulant drugs act on the brain by increasing the amount of neurotransmitter carrying signals between neurons. Whereas SSRIs elevate the neurotransmitter serotonin, psychostimulants increase the level of a different neurotransmitter known as dopamine. Rather than blocking the reuptake of neurotransmitter as do SSRIs, psychostimulants actively add neurotransmitter between neurons by signaling dopamine release. Because dopamine serves as an activator of both the peripheral and central nervous systems, increases in dopamine levels give a general stimulant effect, characterized by increases in alertness, heart rate, and respiration.

Who's on Ritalin?

There are currently over 4 million prescriptions for psychostimulants in the US alone, a large fraction of which are used by children to control behavior. While the number of Ritalin prescriptions ordered is already growing as public acceptance of ADHD widens, it is likely to increase at an even faster rate in the immediate future given a recent trend in vigorous direct-to-consumer advertising of psychostimulant medication. The rate of psychostimulant treatment is three times as high in boys as in girls, an observation that has prompted many to claim that these drugs are being used as form of behavioral control against the often unruly natural tendencies of young boys.

Chris Liverman [liverman@grinnell.edu]