Chapter 65 - Methylphenidate Abuse: An Overview

Abstract

Methylphenidate (MPH) belongs to the group of (psycho) stimulants and enhances the activity of the central and peripheral nervous system, resulting in, for example, enhanced alertness, improved vigilance and working memory, as well as reduced need for food and sleep, and increased arousal, heart rate, and blood pressure. MPH is the first-line agent in the pharmacologic treatment of attention deficit hyperactivity disorder. Its hypothesized mechanism of action is reuptake inhibition at the dopamine and noradrenaline transporters, resulting in increased extracellular availability of these neurotransmitters. Regarding the abuse liability of MPH, it is important to consider that the localization of MPH binding to dopaminergic pathways as well as its potency to inhibit dopamine uptake is similar to that of cocaine; moreover, results from neuroimaging studies demonstrate that MPH directly affects the limbic reward circuit. Within the context of MPH abuse, oral application is typically performed for the purpose of cognitive neuroenhancement and sports doping; parenteral application is usually performed to induce subjective feelings of “high.”