Prescription Stimulants at College

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Stimulants

Stimulant medications can be very helpful and effective in treating learning problems. This is important for you to know because, although it is thought that attention deficit problems usually begin in childhood, the condition is often not diagnosed until later in life. It is not uncommon for learning disabilities to show themselves during the college years when the academic requirements are tougher. There is also evidence that these problems can persist into adulthood.

Stimulants such as Ritalin (methylphenidate) and amphetamines (such as Dexedrine) are popular and effective for this use. There are a variety of newer, longer-acting preparations of these medications, and newer drugs are in the research pipeline.

A new drug, Strattera (atemoxetine), which has recently been re­ leased, is not a stimulant but has been proven to be effective in the treatment of attentional problems. It has the advantage of not being addictive nor having the abuse potential of many of the drugs in this class. There is anecdotal evidence that some of the antidepressants can also be effective with attention problems, but they are not "first line" drugs.

There is a push to find alternative medications for learning disabilities due to the potential for abuse and serious side effects of the most commonly prescribed stimulant, Ritalin (methylphenidate). Some families are passionately against the use of this drug, and they picket outside of psychiatric conventions at every opportunity. The controversy has now spread to the college campus, where Ritalin (or "vitamin R," "R ball," and "cramming drug" as it is sometimes called) is fast becoming a major substance abuse problem.

Some students have found that this stimulant improves their academic capabilities by allowing them to stay awake for many hours in a row while they study, and it helps them maintain abnormally high levels of concentration. Other students use Ritalin so they can consume more alcohol or mix it with other drugs to party longer without falling asleep. In fact, of 2,250 undergraduates who completed an Internet survey, 3 percent reported illicit methylphenidate use in the past year associated with weekend partying.⁴

To achieve these results, some students take Ritalin tablets whole, but others gain stronger stimulation by crushing tablets and snorting them. Still others grind the tablets, mix them with water, "cook" them, and inject the mix intravenously.

In addition to this misuse of a potent and potentially addictive drug, there are serious side effects that also need to be considered. Nervousness, insomnia, irritability, hypertension, rapid heart rate, and GI problems are occasional side effects, particularly if the dosage of medication is not monitored closely. When the medication is abused in high doses or concentrations there are risks of paranoia and psychosis. And some people have significant depression upon withdrawal of medication.

These are legitimate concerns over the use of stimulants. However, the scientific evidence is that the medications are relatively safe if used thoughtfully and monitored closely.

Key Points About Stimulants

• Although attention problems are usually present from an early age, sometimes they don't surface until college.
• Stimulants are often prescribed to treat learning ­ disabilities.
• Stimulants have the potential for abuse, addiction, and serious side effects.
• Stimulant medications are safe if used with close ­ supervision.