FROM: The London Observer ~ September 9, 2001
By Jean West
The children's drug Ritalin has a more potent effect on the brain than
cocaine, a study has found.
Using brain imaging, scientists have found that, in pill form, Ritalin -
taken by thousands of British children and four million in the United
States - occupies more of the neural transporters responsible for the "high"
experienced by addicts than smoked or injected cocaine. The research may
alarm parents whose children have been prescribed Ritalin as a solution to
Attention Deficit Hyperactive Disorder.
The study was commissioned to understand more about why Ritalin - which
has the same pharmacological profile as cocaine - is effective in calming
children and helping them concentrate, while cocaine produces an intense
'high' and is powerfully addictive.
In oral form, Ritalin did not induce this intense psychological "hit". But
Dr Nora Volkow, psychiatrist and imaging expert at Brookhaven National
Laboratory, in Upton, New York, who led the study, said that injected into
the veins as a liquid rather than taken as a pill, it produced a rush that
"addicts like very much". Interviewed in last week's Journal of the
American Medical Association newsletter, she said: "They say it's like cocaine."
Even in pill form, Ritalin blocked far more of the brain transporters that
affect mood change and had a greater potency in the brain than cocaine.
Researchers were shocked by this finding. A normal dose administered to
children blocked 70 per cent of the dopamine transporters. "The data
clearly show the notion that Ritalin is a weak stimulant is completely incorrect,"
said Volkow. Cocaine is known to block around 50 per cent of these
transporters, leaving a surfeit of dopamine in the system, which is
responsible for the hit addicts crave. But now it is known that Ritalin
blocks 20 per cent more of these auto-receptors.
"I've been almost obsessed about trying to understand [Ritalin] with
imaging," said Volkow. "As a psychiatrist I sometimes feel embarrassed
[about the lack of knowledge] because this is by far the drug we prescribe most
frequently to children."
However, it was still not clear why a drug that has been administered for
more than 40 years was not producing an army of addicted schoolchildren.
Volkow and her team concluded that this was due to the much slower process
of oral ingestion. It takes around an hour for Ritalin in pill form to raise
dopamine levels in the brain. Smoked or injected, cocaine does this in
seconds.
Dr Joanna Fowler, who worked with Volkow on the project, said: "All drugs
that are abused by humans release large quantities of dopamine. But
dopamine is also necessary for people to be able to pay attention and filter out
other distractions."
But opponents of Ritalin, labelled a 'wonder drug' and a 'chemical cosh',
believe it may be addictive and has dangerous side-effects. Moreover, many
believe ADHD is a fraudulent title for a non-existent condition once put
down to the exuberance of youth. Professor Steve Baldwin, a child psychologist
from Teesside University, who died this year in the Selby rail crash,
campaigned against Ritalin. He pointed out similarities between the drug
and amphetamines as well as cocaine.
Mandy Smith of Banff in Scotland has a son of eight who was prescribed
Ritalin for nine months. 'I am astonished the British Government have
allowed this drug to be prescribed,' she said. "It can destroy people's lives. My
son was a changed person when he took Ritalin. He was suicidal and depressed."
Janice Hill, of the Overload Support Network, a charity for parents of children with behavioural problems, said: "Now we have thousands of children in Scotland taking a drug that is more potent than cocaine. What does it take before the situation is thoroughly investigated?"
A spokeswoman for Novartis, which makes Ritalin, said: "Ritalin is available as tablets only. It should only be initially prescribed by a doctor who is a specialist in child behavioural disorders and should always be used and monitored under strict medical supervision."