PROVIDE A RESPONSE TO POST WITH REFERENCES. DISCUSSION RESPONSE.
Methylphenidate Con
Malcolm
has been diagnosed with Attention-Deficit Hyperactivity Disorder (ADHD)
combined type. First-line drugs for ADHD are typically stimulants such as
amphetamines and methylphenidate (Fu et al., 2022). Second-line medications are
nonstimulants, such as atomoxetine and alpha-2 agonists. The purpose of this
discussion board post is to discuss the cons of methylphenidate.
Methylphenidate
blocks the reuptake of norepinephrine and dopamine therefore, it increases
their actions (Stahl, 2024). An increase in these levels in the brain may
improve attention, hyperactivity, concentration, fatigue, and sleepiness
(Stahl, 2024). Malcolm has problems with hyperactivity, attention, and
focusing, which makes methylphenidate an option for him. Methylphenidate comes
in two forms, immediate release, or extended release. This can be both an
advantage and a disadvantage. This could be a disadvantage because it may take
a while to figure out which form works best for Malcolm. It will also take a
while to determine what dosage works best for him. A disadvantage of immediate
release is that he may need a second dose in the afternoon, which could be a
problem while he is in school and there is also a higher likelihood of
forgetting that dose when he is out of school. Another disadvantage of
methylphenidate for Malcolm is that it increase the risk of insomnia if taken later
in the day (Stahl, 2024). Methylphenidate taken with food may also delay the
mechanism of action by two to three hours (Stahl, 2024).
Advantages
of other medications such as atomoxetine (Strattera) is that it is not a
controlled stimulant. This means there is less of a potential for abuse or
addiction. Additionally, atomoxetine has much less milder side effects than
stimulants. Although atomoxetine can cause weight loss, studies show the growth
rate seems to be reversible in the long run (Fu et al., 2022).
Side
effects associated with methylphenidate include insomnia, nervousness,
headaches, anorexia, and weight loss (Stahl, 2024). One main side effect that
is significant for Malcolm’s case is growth retardation when taken long-term
(Verghese and Abdijadid, 2023). His height and weight would need to be
monitored monthly, especially if used long-term. If he is already underweight,
he does not need to be prescribed methylphenidate. Another consideration to
keep in mind is the potential for abuse due to methylphenidate being a
controlled medication.
One
legal consideration is that methylphenidate is a controlled substance and can
cause legal issues if misused. This is also an ethical issue because Malcolm
has the potential to become addicted and misuse the medication (U.S. National
Library of Medicine, 2021). Socially, Malcolm may feel like he is being judged
by his peers for having to take medication at his age.
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