Methylphenidate: long-term consequences of performance-enhancing abuse

The consumption of methylphenidate (Ritalin) in Switzerland has increased more than tenfold since 1996 (www.swissmedic.ch) and it is assumed that this increased is not only due to a change in the prescribing behavior of doctors, but also due to an increased use of methylphenidate for cognitive preformace enhancement (neuroenhancement). The use of methylphenidate and other stimulants as neuroenhancers is of significant social interest and has been controversially discussed in the media and among bioethicists for years. Possible benefits are often set against possible risks. The possible risks or long-term effects of repeated use of methylphenidate for neuro-enhancement in healthy individuals have not yet been sufficiently researched. However, the misuse of prescription stimulants (especially amphetamines, but also methylphenidate) for intoxication purposes is probably associated with neuropsychological deficits. verschreibungspflichtiger Stimulanzien (v.a. Amphetamine, aber auch Methylphenidat) zu Rauschzwecken dürfte jedoch mit neuropsychologischen Defiziten verbunden sein.

It is still unclear whether regular misuse of methylphenidate for acute performance enhancement in healthy people has long-term cognitive, psychopathological and neurobiological consequences. Based on previous data on cognitive disorders in cocaine and stimulant users, we assume that such abuse is associated with a decrease in cognitive performance, an increase in psychopathological stress and corresponding structural and functional changes in the brain.

To answer the research question, cognitive and psychopathological measurements already used in the testing of cocaine users will be carried out in a cross-sectional design in 60 persons with regular methylphenidate abuse to improve performance and in 60 healthy and stimulant-inexperienced control persons (matched for gender, age and education).

If possible long-term negative effects of methylphendiate misuse for performance enhancement are uncovered, this result would be important for educating the population and directing future prevention of non-medically indicated use of prescription stimulants.