Wednesday, October 19, 2011

In the South Park episode Timmy 2000, the boys, thinking they can get out doing homework, are diagnosed with ADHD and immediately prescribed Ritalin (Methylphenidate). Here we see Cartman smacking Kenny with a frying pan in an attempt to defeat a little pink Christina-Aguilera-monster which he begins to hallucinate soon after beginning the drug.

Pink monsters (and an unnatural affinity for Phil Collins) aside, it's time to investigate how Ritalin is believed to affect the brain and why it is prescribed as a method of treating ADHD.

Initially approved over 40 years ago, Ritalin has been used for decades to treat "distractability, short attention, hyperactivity, impulsivity and emotional lability," behaviors which are viewed as symptoms of Attention Deficit Hyperactivity Disorder. However, it was only in the 1990s when this particular drug rose to fame due to the explosion of ADD and ADHD diagnoses.

Methlyphenidate proved to be reliable drug for decreasing the severity and intensity of behaviors associated with the disorder, but why? As a stimulant, it seems almost paradoxical.

According to a study conducted by the Brookhaven National Laboratory in 2001, dopamine (as explained earlier) floods the brain about an hour after the ingestion of methlyphenidate. According to researcher Nora Volkow "[...]by increasing the levels of extracellular dopamine, you can activate these motivational circuits and make the tasks that children are performing seem much more exciting." (Emphasis mine)

The results of the PET scans used in the research also seem to indicate that this flood of dopamine suppresses the firing of neurons not associated with dopamine and task and reward pathways. Because the "random activation of other cells" can be distracting, the shut-down of other activity restricts cognition to the task at hand, whatever that may be.

"Look at all the coffee. One, two... nah that's pointless. Why's that one darker?"
"I'm supposed to find something here, and the face in the beans at the bottom stands out."
Concerning the matter of the "Highs"and physiological dependency associated with methylphenidate use, Volkow et al. hypothesized the one hour delay time between ingestion of the drug and the achievement of peak levels of dopamine was too slow to create an actual "high"-high.
"We've found that for drugs of abuse to be effective, they must get into the brain very quickly, and for that reason, when injected, Ritalin can become addictive [...] So, it is the speed at which you increase dopamine that appears to be a key element in the addiction process."
One last thing, about Cartman's hallucination, there's actually something to that. In fact, in 2006 the United States Food and drug administration was officially advised to add warnings to ADHD drugs about the risks of the hallucinations experiences by up to 5% of users.



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