Submitted Successfully!
Thank you for your contribution! You can also upload a video entry related to this topic through the link below: https://encyclopedia.pub/user/video_add?id=25629
Check Note
2000/2000
Ver. Summary Created by Modification Content Size Created at Operation
1 -- 2582 2022-07-28 19:13:51 |
2 format correction -26 word(s) 2556 2022-07-29 02:38:24 |
Prescription Stimulants in College and Medical Students
Edit
Upload a video

Stimulants are effective in treating attention-deficit/hyperactivity disorder (ADHD). Psychiatrist Charles Bradley first made this discovery in 1937 when he found that children treated with amphetamines showed improvements in school performance and behavior. Between 1995 and 2008, stimulants to treat ADHD increased six-fold among American adults and adolescents at an annual rate of 6.5%. Stimulants without a prescription, known as nonmedical use or misuse, have also increased.

stimulant misuse college students ADHD
Information
Subjects: Neurosciences
Contributors : , , , , , , , , ,
View Times: 83
Revisions: 2 times (View History)
Update Date: 29 Jul 2022
Table of Contents

    1. Introduction

    Stimulants are effective in treating attention-deficit/hyperactivity disorder (ADHD). Psychiatrist Charles Bradley first made this discovery in 1937 when he found that children treated with amphetamines showed improvements in school performance and behavior [1]. However, an increase in the use of stimulants for the treatment of ADHD did not occur until almost 20 years later, when the American Psychiatric Association began focusing on hyperactivity symptoms in children [2]. Since then, the prevalence of stimulant use for ADHD has increased. Between 1995 and 2008, stimulants to treat ADHD increased six-fold among American adults and adolescents at an annual rate of 6.5% [3][4]. Stimulants without a prescription, known as nonmedical use, have also increased [5].
    The primary motive for the nonmedical use of stimulants is enhancing concentration while studying, especially when preparing for multiple exams [6]. However, about a quarter of nonmedical users reported recreational reasons, such as “getting high” [7][8]. Many students without a prescription for stimulants obtained them from peers. Still, in one study, over one-third reported stealing it, and 20% exaggerated their symptoms to obtain a prescription from a physician [9][10][11][12]. Although most nonmedical users believed that stimulant use had an overall positive impact on their academic success, this is inconsistent with a documented link between nonmedical use and lower GPAs (grade point averages) [11][13][14].
    Misuse of prescribed medication can be differentiated from nonmedical use. Misusers have a prescription for ADHD medication but may take the medication at a higher dose or more frequently than originally intended. Misuse has been reported by between 27% and 36% of students across numerous studies. The primary motivation behind this kind of use is similar to nonmedical users, improving academic performance [15][16][17]. Students may also divert their medications to peers by giving them away or selling them, which has been reported by 62% of students in their lifetime [9].

    2. Misuse in College and Medical Students

    2.1. Prevalence

    The highest rates of nonmedical prescription drug misuse in the United States are seen most notably in young adults between 18 and 25 years, according to the Substance Abuse and Mental Health Services Administration (SAMHSA) in 2020 [18]. Generally, stimulant misuse occurs more frequently in college students than young adults not attending college [18]. The estimated lifetime prevalence rate of prescription stimulant misuse in college students is 5.3% to 35% [19]. Using data collected from the National Survey on Drug Use and Health (NSDUH) to analyze the effects of educational status on stimulant misuse, outcomes demonstrated the highest past-year misuse rates in college students and highest lifetime misuse rates in college graduates [20]. A long-term study conducted by the University of Michigan in 2015 reported amphetamine, dextroamphetamine mixed salts (brand name Adderall®) misuse in 14.8% of U.S. college males compared to 7.4% in non-college males of the same age [21]. In 2017, 23% of students reported using stimulants without a prescription in a survey of 988 undergraduate students [22].
    Furthermore, compared to opioid misuse, college students have higher rates of nonmedical stimulant misuse [20][21][23][24]. Aside from undergraduate students, nonmedical prescription stimulant use is prevalent among medical students worldwide. A review reported the utilization of stimulants without a prescription in 970 out of 11,029 medical students. The percentages of medical students across the country misusing stimulants varied from 5.2% to 47.4% [25].

    2.2. High-Risk Factors

    The likelihood of prescription stimulant misuse correlates with certain student demographic criteria. Several studies observed a greater risk of stimulant misuse in male U.S. college students than female students [11][14][19][26][27][28][29][30][31][32]. Among 984 college students, 80.5% of stimulant misusers were Caucasian, another frequent finding [33]. Additionally, higher yearly family income has been noted in students misusing stimulants compared to non-users (USD76,000 vs. USD71,000, respectively) [33]. College students in sororities and fraternities report prescription stimulant misuse more often than non-Greek students [11][14][26][27][34][35][36]. Low-GPAs and other factors implicating poor academic performance correspond with a higher risk of stimulant misuse [11][33][37].
    Risk factors for nonmedical stimulant use, including male gender and Caucasian race, also apply to medical students. The risk of stimulant misuse is elevated in medical students with a past medical history significant for psychiatric disorders [38]. Additionally, in a study, osteopathic medical students were more likely to engage in stimulant misuse when a close friend or roommate also used stimulants nonmedically [39]

    2.3. Stimulant Sources

    College students frequently disclose easy accessibility to prescription stimulants [27][36][40]. In this population, the use of peers as a source of obtaining prescription stimulants remains a common finding [27][36][37][40]. Moreover, misused stimulants are more likely to be obtained for free through peers or relatives in current full-time undergraduate students or recent college graduates compared to non-college individuals [20].

    2.4. Motivation for Misuse

    Academic enhancement, reported in 50% to 89% of college students with stimulant misuse, is the most common reason for nonmedical stimulant use [27]. Examples include receiving higher exam scores, increasing concentration, and achieving greater productivity [19][34][37]. Although less common, additional motivations regarding the misuse of stimulants in college students include recreational purposes (2% to 31% of misusers), self-treating undiagnosed ADHD (4% to 12% of misusers), and weight loss (3.5% to 11.7% of misusers) [27].
    Similar to college students, improving school performance motivates stimulant misuse in medical students. The high-stress environment and pressure to score well on exams can motivate increased use of stimulants in medical students [41]. In one study, most French medical students using stimulants reported drug initiation during their first year to promote wakefulness while studying [42]. On the other hand, over half of the Saudi Arabian medical students who reported stimulant misuse were in their final two years of medical school. Researchers suggested that senior-level medical students showed a greater risk of stimulant use because of elevated stress of board exams, choosing a medical specialty, and competing for residency positions [41]. These studies suggest a worldwide phenomenon of stimulant misuse.

    2.5. Placebo Effect and Perceived Cognitive Enhancement

    Some studies question the contribution of the placebo effect on subjective outcomes of stimulant use in students without ADHD. One randomized trial revealed a subjective increase in arousal in students at high risk for stimulant misuse who believed they were receiving methylphenidate [43]. Another trial in college students without ADHD associated stimulant expectation with better cognitive performance, regardless of receiving the active stimulant or placebo. Cognitive performance declined when participants believed the placebo was given [44]. A small placebo-controlled trial, which consisted of 13 college students without ADHD, found significant results regarding perceived effects of Adderall 30 mg. Minor neurocognitive effects were found for healthy college students. Still, substantial outcomes were noted for perceived drug effects, self-reported stimulant experience, and mood positivity [45].

    3. Adverse Effects of Stimulant Misuse by People with ADHD

    Stimulant use has been increasing among college students, with rates as high as one-third of students who generally use them for enhanced academic performance and recreational use [6]. Unfortunately, little data exist that describe differences in how side effects are experienced for prescribed and non-prescribed users [46].
    Studies show that prescribed users report side effects more frequently, which might be explained by some users feeling they have less control over their use of stimulants, leading them to perceive the effects as undesirable [46]. However, prescribed users may have more experience with the drug and its side effects than non-prescribed users, leading them to remember the most prominent effects over the time they have used stimulants [47].

    3.1. General Adverse Effects among Nonmedical Use and Misuse

    Other studies have shown that stimulant misusers appeared to experience more side effects than those that use stimulants under medical supervision. In one study, both those who misuse and those who have non-medical use were more likely to experience exaggerated well-being (euphoria) and restlessness than those who have it prescribed and use it as directed. They were also more likely to report changes in sex drive [48]. Specifically, in athletes with ADHD, stimulants may lead to an increased risk of cardiac injury, possibly due to stimulant-induced hyperthermia. This is exacerbated by long durations of exercise athletes regularly experience, so caution should be used when prescribing stimulants to athletes [49].
    Of note, those with medical misuse were more likely than those with non-medical use to endorse the use of cigarettes, amphetamines, marijuana, and anxiety medication concurrently with stimulants. They have also reported alcohol use at a relatively high rate compared to those who have non-medical use. This is concerning due to the potential interaction between stimulants and alcohol. Stimulants may counteract the perceived effect of alcohol intoxication on an individual, leading them to consume more alcohol to have a greater perceived effect, leading to poor decision-making [48].

    3.2. Potential Neuropsychiatric Effects

    Since stimulants are psychoactive, there is always a theoretical risk of developing a neuropsychiatric disorder due to their use; the risk is augmented with prolonged exposure and increased doses. Studying these possible psychiatric effects is complicated by comorbidities and the overlap between ADHD symptoms and symptoms of other psychiatric disorders, such as anxiety, mood disorders, sleep disorders, and psychotic disorders [50][51][52].
    There is widespread concern regarding the induction of depression, both suicidal behavior, and ideation, and substance use disorders as possible adverse effects of long-term methylphenidate (MPH) use [53][54][55][56][57][58]. However, the preponderance of data collected to date indicates that while these are potential adverse effects, MPH is relatively safe [59]. However, caution should be used in individuals with suicidal ideation who may potentially overdose on stimulants. Some studies have reported anxiety and irritability as a potential result of long-term MPH use. Still, many studies also indicate that MPH is also generally safe regarding these outcomes [59][60][61][62]. A consensus opinion on the long-term safety of prescription stimulant use, especially when initiated during adolescence, has not yet been achieved. Studies have also reported the induction of tics and repetitive muscle contractions resulting in sudden and difficult-to-control body jolts or sounds resulting from long-term effects of MPH use [61][63][64]. These studies suggest that MPH be used with caution in those with tic disorders or prone to develop a tic disorder [59]. Psychosis has also been cited in several studies as a possible effect of long-term MPH use. However, these studies have also provided evidence that MPH reduces psychotic symptoms and psychosis-related hospitalization [53][65][66], and ADHD itself may also be a risk factor for psychosis [67]. Although more studies are needed to investigate this relationship, those with psychosis or prone to it should be more cautious with stimulants [59].

    4. Adverse Effects of Stimulant Misuse by People without ADHD

    4.1. Medical Adverse Effects

    Commonly self-reported adverse effects of stimulant misuse include headache, dizziness, stomach upset, negative mood, diminished appetite, and difficulty sleeping [27]. Stimulants can increase autonomic activity, such as blood pressure and heart rate, which is especially dangerous in nonmedical use without appropriate medical observation [37]. Stimulant-related emergency department (ED) visits from 2005 to 2010 increased from 13,376 to 31,244. Specifically, ED presentations involving nonmedical stimulant use increased from 5212 to 15,585 [68]. Compared to prescribed stimulant users, cases of amphetamine exposures reported to poison control centers from 2012 to 2016 occurred more frequently in those with misuse. Non-prescription use of amphetamines is associated with a greater risk of intensive care unit or inpatient psychiatric facility admission [69]. Adverse effects of misused stimulants often vary by route of administration. Although oral intake of nonprescription stimulants is the most common route of administration, adverse effects among stimulant misusers are seen across all administration methods [27]. Intravenous (IV) stimulant misuse is associated with more side effects than nasal or oral intake, with critical care admission being the most frequent consequence [69]. Prevalence of hospital admission from 2012 to 2016 was elevated for all young adults with stimulant misuse (64.7% oral, 49% nasal, and 68% IV) compared to those who did not misuse amphetamines (22% control) [69].
    Additionally, a higher odds of death is associated with IV and intranasal administration among stimulant misusers (nasal: 0.5%; IV: 1.2%; non-users: 0.3%) [69]. Intranasal stimulant misuse has increased the risk of cardiovascular events compared to oral use [37]. Prevalence of admission to a psychiatric inpatient facility and risk of suicide attempts are greater with oral misuse than IV or intranasal misuse [69].

    4.2. Psychiatric Disorders

    Recent data suggest a link between stimulant misuse and psychiatric disorders such as depression, conduct disorder, and substance use disorder [37]. Misuse of ADHD medications in students without a prescription is associated with a higher risk of ADHD symptoms. For instance, among 184 college students in Northern Virginia, 71% of those misusing stimulants received positive results when screened for ADHD symptoms [32]. Similar findings were reported in another study highlighting greater features of ADHD in college students with chronic stimulant misuse relative to non-users and chronic cannabis users. Whether untreated ADHD or illicit stimulant use contributed to worsening impulsivity and hyperactivity remains unclear [29].
    Associations between stimulant misuse and psychocutaneous disorders are another topic of interest. A retrospective study of 317 patients presenting with psychocutaneous diseases revealed that 60.2% of patients reported stimulant use before dermatologic presentation, with over half of them utilizing nonprescription stimulants [70]. The association between stimulant use and the development of trichotillomania, delusional infestation, or tactile hallucinations was questioned in another recent study. Although most findings were related to authorized prescription stimulant use, adult patients presenting with delusional infestation, belief that parasites inhabit one’s skin or body, were more likely to be misusing stimulants [71].

    4.3. Substance Use Disorders

    Associations have been made between stimulant misuse and illicit use of other drugs. Among 31,244 stimulant-related ED presentations in 2010, 26% were associated with anxiolytics and sleep aids, 16% were associated with narcotics, 14% with cannabis, and 19% with alcohol [68]. One longitudinal study of 948 college students from 2013 suggested a link between marijuana or alcohol use in students with prescription stimulant misuse. During their freshman year of college, 40% of those with stimulant misuse met the Diagnostic and Statistical Manual of Mental Disorders (DSM) IV criteria for alcohol use disorder (vs. 18.5% in those with nonuse), and 25% met DSM-IV criteria for cannabis use disorder (vs. 7% in those with nonuse) [33]. Additionally, researchers reported that 89–92% of those with prescription stimulant misuse also used cannabis [33]. This association was further indicated in a study of 1016 college students in 2014, with 25% reporting prescription stimulant misuse and 11% reporting simultaneous alcohol and stimulant use. A greater number of standard alcoholic beverages and engagement in past-month binge drinking was associated with a higher likelihood of co-ingesting nonmedical prescription stimulants with alcohol [72].
    Similarly, another study using data from the NSDUH from 2009 to 2014 indicated that a substance use disorder within the past year was more commonly reported in young adults with past-month prescription stimulant, opioid, or sedative/sedative/tranquilizer misuse history. Interestingly, compared to young adult misusers who obtained prescriptions for free from peers, researchers found the highest prevalence of substance dependence in misusers who purchased prescriptions, utilized fake prescriptions, or acquired prescriptions from multiple sources [20]. College students with a history of 14-day prescription stimulant and/or opioid misuse in 2016–2017 experienced a greater likelihood of 14-day alcohol use, increased alcohol intake, and alcohol-related adverse events than non-using students. Alcohol-related adverse events included a hangover, blackout, vehicle operation after a binge, car ride with an impaired driver, sexual assault, and injury to another person [73].

    4.4. Academic Adverse Effects

    The academic benefit of stimulants in students without an ADHD diagnosis is a topic of interest, as cognitive enhancement is a commonly reported motivation of students. Although a low GPA is associated with a greater risk of nonmedical stimulant use, one study of 898 undergraduate students in 2017 suggested that GPA improvement was significantly greater in students who did not utilize stimulants. There was no associated GPA change in college students who misused stimulants [74]. When observing changes in cognitive effects, college students with stimulant misuse displayed greater deficits in executive function than students without misuse. Additionally, increased frequency of buying or trading stimulants was associated with greater executive dysfunction [75].

    References

    1. Bradley, C. The behavior of children receiving benzedrine. Am. J. Psychiatry 1937, 94, 577–585.
    2. Weyandt, L.L.; Oster, D.R.; Marraccini, M.E.; Gudmundsdottir, B.G.; Munro, B.A.; Rathkey, E.S.; McCallum, A. Prescription stimulant medication misuse: Where are we and where do we go from here? Exp. Clin. Psychopharmacol. 2016, 24, 400–414.
    3. Sclar, D.A.; Robison, L.M.; Castillo, L.V.; Bowen, K.A.; Schmidt, J.M.; Oganov, A.M. Attention Deficit/Hyperactivity Disorder among Adults in the United States. Pharm. Med. 2012, 26, 97–101.
    4. Zuvekas, S.H.; Vitiello, B. Stimulant Medication Use in Children: A 12-Year Perspective. Am. J. Psychiatry 2012, 169, 160–166.
    5. Rabiner, D.L. Stimulant Prescription Cautions: Addressing Misuse, Diversion and Malingering. Curr. Psychiatry Rep. 2013, 15, 375.
    6. DeSantis, A.D.; Webb, E.M.; Noar, S.M. Illicit Use of Prescription ADHD Medications on a College Campus: A Multimethodological Approach. J. Am. Coll. Health 2008, 57, 315–324.
    7. Teter, C.J.; McCabe, S.; Lagrange, K.; Cranford, J.; Boyd, C. Illicit Use of Specific Prescription Stimulants Among College Students: Prevalence, Motives, and Routes of Administration. Pharmacother. J. Hum. Pharmacol. Drug Ther. 2006, 26, 1501–1510.
    8. Teter, C.J.; McCabe, S.; Cranford, J.; Boyd, C.; Guthrie, S.K. Prevalence and Motives for Illicit Use of Prescription Stimulants in an Undergraduate Student Sample. J. Am. Coll. Health 2005, 53, 253–262.
    9. Garnier-Dykstra, L.M.; Caldeira, K.M.; Vincent, K.B.; O’Grady, K.E.; Arria, A.M. Nonmedical use of prescription stimulants during college: Four-year trends in exposure opportunity, use, motives, and sources. J. Am. Coll. Health 2012, 60, 226–234.
    10. McCabe, S.E.; Teter, C.J.; Boyd, C. Sources of prescription drugs for illicit use. Addict Behav. 2005, 30, 1342–1350.
    11. Rabiner, D.L.; Anastopoulos, A.D.; Costello, E.J.; Hoyle, R.H.; McCabe, S.E.; Swartzwelder, H.S. Motives and perceived consequences of nonmedical ADHD medication use by college students: Are students treating themselves for attention problems? J. Atten. Disord. 2009, 13, 259–270.
    12. Novak, S.P.; Kroutil, L.A.; Williams, R.L.; Van Brunt, D.L. The nonmedical use of prescription ADHD medications: Results from a national Internet panel. Subst. Abus. Treat. Prev. Policy 2007, 2, 32.
    13. Teter, C.J.; McCabe, S.E.; Boyd, C.J.; Guthrie, S.K. Illicit methylphenidate use in an undergraduate student sample: Prevalence and risk factors. Pharmacotherapy 2003, 23, 609–617.
    14. McCabe, S.E.; Teter, C.J.; Boyd, C. Medical Use, Illicit Use and Diversion of Prescription Stimulant Medication. J. Psychoact. Drugs 2006, 38, 43–56.
    15. Foley, R.; Mrvos, R.; Krenzelok, E.P. A Profile of Methylphenidate Exposures. J. Toxicol. Clin. Toxicol. 2000, 38, 625–630.
    16. Sepúlveda, D.R.; Thomas, L.M.; McCabe, S.E.; Cranford, J.A.; Boyd, C.J.; Teter, C.J. Misuse of Prescribed Stimulant Medication for ADHD and Associated Patterns of Substance Use: Preliminary Analysis Among College Students. J. Pharm. Pract. 2011, 24, 551–560.
    17. Rabiner, D.L.; Anastopoulos, A.D.; Costello, E.J.; Hoyle, R.H.; McCabe, S.; Swartzwelder, H.S. The Misuse and Diversion of Prescribed ADHD Medications by College Students. J. Atten. Disord. 2009, 13, 144–153.
    18. SAMHSA. Key Substance Use and Mental Health Indicators in the United States: Results from the 2020 National Survey on Drug Use and Health; SAMHSA: Rockville, MD, USA, 2020; 156p.
    19. Weyandt, L.L.; Marraccini, M.E.; Gudmundsdottir, B.G.; Zavras, B.M.; Turcotte, K.D.; Munro, B.A.; Amoroso, A.J. Misuse of prescription stimulants among college students: A review of the literature and implications for morphological and cognitive effects on brain functioning. Exp. Clin. Psychopharmacol. 2013, 21, 385–407.
    20. McCabe, S.E.; Teter, C.J.; Boyd, C.J.; Wilens, T.E.; Schepis, T.S. Sources of Prescription Medication Misuse among Young Adults in the United States: The Role of Educational Status. J. Clin. Psychiatry 2018, 79, 17m11958.
    21. Johnston, L.D.; O’Malley, P.M.; Miech, R.A.; Bachman, J.G.; Schulenberg, J.E. Monitoring the Future National Survey Results on Drug Use, 1975–2015: Overview, Key Findings on Adolescent Drug Use. Institute for Social Research. 2016. Available online: https://eric.ed.gov/?id=ED578539 (accessed on 14 March 2022).
    22. Kinman, B.A.; Armstrong, K.J.; Hood, K.B. Perceptions of Risks and Benefits Among Nonprescription Stimulant Consumers, Diverters, and Non-Users. Subst. Use Misuse 2017, 52, 1256–1265.
    23. Martini, C.; Proto, P.; Olofsen, E.; Velzen, M.; Aarts, L.; Dahan, A.; Niesters, M. A randomized controlled trial and novel mathematical analysis of the analgesic effect of oxycodone versus paracetamol orodispersible tablets. Eur. J. Pain 2015, 19, 295–304.
    24. Schepis, T.S.; Teter, C.J.; McCabe, S.E. Prescription drug use, misuse and related substance use disorder symptoms vary by educational status and attainment in U.S. adolescents and young adults. Drug Alcohol Depend. 2018, 189, 172–177.
    25. Plumber, N.; Majeed, M.; Ziff, S.; Thomas, S.E.; Bolla, S.R.; Gorantla, V.R. Stimulant Usage by Medical Students for Cognitive Enhancement: A Systematic Review. Cureus 2021, 13, e15163.
    26. Faraone, S.V.; Rostain, A.L.; Montano, C.B.; Mason, O.; Antshel, K.; Newcorn, J.H. Systematic Review: Nonmedical Use of Prescription Stimulants: Risk Factors, Outcomes, and Risk Reduction Strategies. J. Am. Acad. Child Adolesc. Psychiatry 2020, 59, 100–112.
    27. Benson, K.; Woodlief, D.T.; Flory, K.; Siceloff, E.R.; Coleman, K.; Lamont, A. Is ADHD, independent of ODD, associated with whether and why college students misuse stimulant medication? Exp. Clin. Psychopharmacol. 2018, 26, 476–487.
    28. Advokat, C.D.; Guidry, D.; Martino, L. Licit and Illicit Use of Medications for Attention-Deficit Hyperactivity Disorder in Undergraduate College Students. J. Am. Coll. Health 2008, 56, 601–606.
    29. Arria, A.M.; Garnier-Dykstra, L.M.; Caldeira, K.M.; Vincent, K.B.; O’Grady, K.E.; Wish, E.D. Persistent Nonmedical Use of Prescription Stimulants Among College Students: Possible Association with ADHD Symptoms. J. Atten. Disord. 2010, 15, 347–356.
    30. Dupont, R.L.; Coleman, J.J.; Bucher, R.H.; Ms, B.B.W. Characteristics and Motives of College Students Who Engage in Nonmedical Use of Methylphenidate. Am. J. Addict. 2008, 17, 167–171.
    31. Hall, K.M.; Irwin, M.M.; Bowman, K.A.; Frankenberger, W.; Jewett, D.C. Illicit Use of Prescribed Stimulant Medication Among College Students. J. Am. Coll. Health 2005, 53, 167–174.
    32. Peterkin, A.L.; Crone, C.C.; Sheridan, M.J.; Wise, T.N. Cognitive Performance Enhancement: Misuse or Self-Treatment? J. Atten. Disord. 2011, 15, 263–268.
    33. Arria, A.M.; Wilcox, H.C.; Caldeira, K.M.; Vincent, K.B.; Garnier-Dykstra, L.M.; O’Grady, K.E. Dispelling the myth of “smart drugs”: Cannabis and alcohol use problems predict nonmedical use of prescription stimulants for studying. Addict. Behav. 2013, 38, 1643–1650.
    34. Dussault, C.L.; Weyandt, L.L. An Examination of Prescription Stimulant Misuse and Psychological Variables Among Sorority and Fraternity College Populations. J. Atten. Disord. 2011, 17, 87–97.
    35. Rabiner, D.L.; Anastopoulos, A.D.; Costello, E.J.; Hoyle, R.H.; Swartzwelder, H.S. Predictors of Nonmedical ADHD Medication Use by College Students. J. Atten. Disord. 2009, 13, 640–648.
    36. Weyandt, L.L.; Janusis, G.; Wilson, K.G.; Verdi, G.; Paquin, G.; Lopes, J.; Varejao, M.; Dussault, C. Nonmedical Prescription Stimulant Use Among a Sample of College Students: Relationship with psychological variables. J. Atten. Disord. 2009, 13, 284–296.
    37. Wilens, T.E.; Kaminski, T.A. Prescription Stimulants: From Cognitive Enhancement to Misuse. Pediatr. Clin. N. Am. 2019, 66, 1109–1120.
    38. Fallah, G.; Moudi, S.; Hamidia, A.; Bijani, A. Stimulant use in medical students and residents requires more careful attention. Casp. J. Intern. Med. 2018, 9, 87–91.
    39. Wasserman, J.A.; Fitzgerald, J.E.; Sunny, M.A.; Cole, M.; Suminski, R.R.; Dougherty, J.J. Nonmedical Use of Stimulants Among Medical Students. J. Osteopat. Med. 2014, 114, 643–653.
    40. Verdi, G.; Weyandt, L.L.; Zavras, B.M. Non-Medical Prescription Stimulant Use in Graduate Students: Relationship with Academic Self-Efficacy and Psychological Variables. J. Atten. Disord. 2016, 20, 741–753.
    41. Alrakaf, F.A.; BinYousef, F.H.; Altammami, A.F.; Alharbi, A.A.; Shadid, A.; Alrahili, N. Illicit Stimulant Use among Medical Students in Riyadh, Saudi Arabia. Cureus 2020, 12, e6688.
    42. Fond, G.; Gavaret, M.; Vidal, C.; Brunel, L.; Riveline, J.-P.; Micoulaud-Franchi, J.-A.; Domenech, P. (Mis)use of Prescribed Stimulants in the Medical Student Community: Motives and Behaviors. Medicine 2016, 95, e3366.
    43. Looby, A.; Earleywine, M. Expectation to receive methylphenidate enhances subjective arousal but not cognitive performance. Exp. Clin. Psychopharmacol. 2011, 19, 433–444.
    44. Cropsey, K.L.; Schiavon, S.; Hendricks, P.S.; Froelich, M.; Lentowicz, I.; Fargason, R. Mixed-amphetamine salts expectancies among college students: Is stimulant induced cognitive enhancement a placebo effect? Drug Alcohol Depend. 2017, 178, 302–309.
    45. Weyandt, L.L.; White, T.L.; Gudmundsdottir, B.G.; Nitenson, A.Z.; Rathkey, E.S.; De Leon, K.A.; Bjorn, S.A. Neurocognitive, Autonomic, and Mood Effects of Adderall: A Pilot Study of Healthy College Students. Pharmacy 2018, 6, 58.
    46. Smith, T.E.; Martel, M.M.; DeSantis, A.D. Subjective Report of Side Effects of Prescribed and Nonprescribed Psychostimulant Use in Young Adults. Subst. Use Misuse 2016, 52, 548–552.
    47. Friedman, M.C.; McGillivray, S.; Murayama, K.; Castel, A.D. Memory for medication side effects in younger and older adults: The role of subjective and objective importance. Mem. Cogn. 2014, 43, 206–215.
    48. Hartung, C.M.; Canu, W.H.; Cleveland, C.S.; Lefler, E.K.; Mignogna, M.J.; Fedele, D.A.; Correia, C.J.; Leffingwell, T.R.; Clapp, J.D. Stimulant medication use in college students: Comparison of appropriate users, misusers, and nonusers. Psychol. Addict. Behav. 2013, 27, 832–840.
    49. Piper, B.J.; Fraiman, J.B.; Meyer, J.S. Repeated MDMA (“Ecstasy”) exposure in adolescent male rats alters temperature regulation, spontaneous motor activity, attention, and serotonin transporter binding. Dev. Psychobiol. 2005, 47, 145–157.
    50. Kessler, R.C.; Adler, L.; Barkley, R.; Biederman, J.; Conners, C.K.; Demler, O.; Faraone, S.V.; Greenhill, L.L.; Howes, M.J.; Secnik, K.; et al. The Prevalence and Correlates of Adult ADHD in the United States: Results from the National Comorbidity Survey Replication. Am. J. Psychiatry 2006, 163, 716–723.
    51. Silvestri, R.; Gagliano, A.; Aricò, I.; Calarese, T.; Cedro, C.; Bruni, O.; Condurso, R.; Germanò, E.; Gervasi, G.; Siracusano, R.; et al. Sleep disorders in children with Attention-Deficit/Hyperactivity Disorder (ADHD) recorded overnight by video-polysomnography. Sleep Med. 2009, 10, 1132–1138.
    52. Hennig, T.; Jaya, E.; Koglin, U.; Lincoln, T. Associations of attention-deficit/hyperactivity and other childhood disorders with psychotic experiences and disorders in adolescence. Eur. Child Adolesc. Psychiatry 2016, 26, 421–431.
    53. Cortese, S.; Panei, P.; Arcieri, R.; Germinario, E.A.P.; Capuano, A.; Margari, L.; Chiarotti, F.; Curatolo, P. Safety of Methylphenidate and Atomoxetine in Children with Attention-Deficit/Hyperactivity Disorder (ADHD): Data from the Italian National ADHD Registry. CNS Drugs 2015, 29, 865–877.
    54. Lee, M.-J.; Yang, K.-C.; Shyu, Y.-C.; Yuan, S.-S.; Yang, C.-J.; Lee, S.-Y.; Lee, T.-L.; Wang, L.-J. Attention-deficit hyperactivity disorder, its treatment with medication and the probability of developing a depressive disorder: A nationwide population-based study in Taiwan. J. Affect. Disord. 2016, 189, 110–117.
    55. Garland, E.J. Intranasal abuse of prescribed methylphenidate. J. Am. Acad. Child Adolesc. Psychiatry 1998, 37, 1242–1243.
    56. Erkuran, H.; Cakaloz, B.; Onen, O.; Kutlu, A. Suicide attempt with high dose long acting methylphenidate ingestion: A case presentation. Klin. Psikofarmakol. Bülteni-Bull Clin. Psychopharmacol. 2016, 26, 316–318.
    57. Eryılmaz, G.; Gul, I.; Yorbik, O.; Işiten, N. Long-acting methylphenidate toxicity: A case report. Klin. Psikofarmakol. Bülteni-Bull Clin. Psychopharmacol. 2014, 24, 384–386.
    58. Torgersen, T.; Gjervan, B.; Nordahl, H.M.; Rasmussen, K. Predictive factors for more than 3 years’ duration of central stimulant treatment in adult attention-deficit/hyperactivity disorder: A retrospective, naturalistic study. J. Clin. Psychopharmacol. 2012, 32, 645–652.
    59. Krinzinger, H.; Hall, C.L.; Groom, M.J.; Ansari, M.T.; Banaschewski, T.; Buitelaar, J.K.; Carucci, S.; Coghill, D.; Danckaerts, M.; Dittmann, R.W.; et al. Neurological and psychiatric adverse effects of long-term methylphenidate treatment in ADHD: A map of the current evidence. Neurosci. Biobehav. Rev. 2019, 107, 945–968.
    60. Edvinsson, D.; Ekselius, L. Long-Term Tolerability and Safety of Pharmacological Treatment of Adult Attention-Deficit/Hyperactivity Disorder: A 6-Year Prospective Naturalistic Study. J. Clin. Psychopharmacol. 2018, 38, 370–375.
    61. Gadow, K.D.; Sverd, J.; Sprafkin, J.; Nolan, E.E.; Grossman, S. Long-term Methylphenidate Therapy in Children with Comorbid Attention-Deficit Hyperactivity Disorder and Chronic Multiple Tic Disorder. Arch. Gen. Psychiatry 1999, 56, 330–336.
    62. Kutlu, A.; Akyol Ardic, U.; Ercan, E.S. Effect of Methylphenidate on Emotional Dysregulation in Children with Attention-Deficit/Hyperactivity Disorder + Oppositional Defiant Disorder/Conduct Disorder. J. Clin. Psychopharmacol. 2017, 37, 220–225.
    63. Riddle, M.A.; Lynch, K.A.; Scahill, L.; Devries, A.; Cohen, D.J.; Leckman, J.F. Methylphenidate Discontinuation and Reinitiation during Long-Term Treatment of Children with Tourette’s Disorder and Attention-Deficit Hyperactivity Disorder: A Pilot Study. J. Child Adolesc. Psychopharmacol. 1995, 5, 205–214.
    64. Varley, C.K.; Vincent, J.; Varley, P.; Calderon, R. Emergence of tics in children with attention deficit hyperactivity disorder treated with stimulant medications. Compr. Psychiatry 2001, 42, 228–233.
    65. Paternite, C.E.; Loney, J.; Salisbury, H.; Whaley, M.A. Childhood Inattention-Overactivity, Aggression, and Stimulant Medication History as Predictors of Young Adult Outcomes. J. Child Adolesc. Psychopharmacol. 1999, 9, 169–184.
    66. Hechtman, L.; Abikoff, H.; Klein, R.G.; Weiss, G.; Respitz, C.; Kouri, J.; Blum, C.; Greenfield, B.; Etcovitch, J.; Fleiss, K.; et al. Academic Achievement and Emotional Status of Children with ADHD Treated with Long-Term Methylphenidate and Multimodal Psychosocial Treatment. J. Am. Acad. Child Adolesc. Psychiatry 2004, 43, 812–819.
    67. Shyu, Y.-C.; Yuan, S.-S.; Lee, S.-Y.; Yang, C.-J.; Yang, K.-C.; Lee, T.-L.; Wang, L.-J. Attention-deficit/hyperactivity disorder, methylphenidate use and the risk of developing schizophrenia spectrum disorders: A nationwide population-based study in Taiwan. Schizophr. Res. 2015, 168, 161–167.
    68. Mattson, M.E. Emergency Department Visits Involving Attention Deficit/Hyperactivity Disorder Stimulant Medications. In The CBHSQ Report; Substance Abuse and Mental Health Services Administration (US): Rockville, MD, USA, 2013. Available online: http://www.ncbi.nlm.nih.gov/books/NBK384678/ (accessed on 15 March 2022).
    69. Faraone, S.V.; Hess, J.; Wilens, T. Prevalence and Consequences of the Nonmedical Use of Amphetamine Among Persons Calling Poison Control Centers. J. Atten. Disord. 2017, 23, 1219–1228.
    70. Richey, P.M.; Laageide, L.; Swick, B.L. Stimulant use in patients presenting with psychocutaneous disorders. J. Am. Acad. Dermatol. 2021, 86, 1002–1009.
    71. Moattari, C.R.; França, K. Adverse psychocutaneous effects of prescription stimulant use and abuse: A systematic review. JDDG J. Dtsch. Dermatol. Ges. 2022, 20, 7–15.
    72. Messina, B.G.; Silvestri, M.M.; Diulio, A.R.; Murphy, J.G.; Garza, K.B.; Correia, C.J. Alcohol use, impulsivity, and the non-medical use of prescription stimulants among college students. Addict. Behav. 2014, 39, 1798–1803.
    73. Schepis, T.S.; Acheson, S.; Zapp, D.; Swartzwelder, H.S. Alcohol use and consequences in matriculating US college students by prescription stimulant/opioid nonmedical misuse status. Addict. Behav. 2019, 98, 106026.
    74. Arria, A.M.; Caldeira, K.M.; Vincent, K.B.; O’Grady, K.E.; Cimini, M.D.; Geisner, I.M.; Fossos-Wong, N.; Kilmer, J.R.; Larimer, M.E. Do college students improve their grades by using prescription stimulants nonmedically? Addict. Behav. 2016, 65, 245–249.
    75. Wilens, T.E.; Carrellas, N.W.; Martelon, M.; Yule, A.M.; Fried, R.; Anselmo, R.; McCabe, S.E. Neuropsychological functioning in college students who misuse prescription stimulants. Am. J. Addict. 2017, 26, 379–387.
    More
    Information
    Subjects: Neurosciences
    Contributors MDPI registered users' name will be linked to their SciProfiles pages. To register with us, please refer to https://encyclopedia.pub/register : , , , , , , , , ,
    View Times: 83
    Revisions: 2 times (View History)
    Update Date: 29 Jul 2022
    Table of Contents
      1000/1000

      Confirm

      Are you sure you want to delete?

      Video Upload Options

      Do you have a full video?
      Cite
      If you have any further questions, please contact Encyclopedia Editorial Office.
      Edinoff, A.N.; Nix, C.A.; Mcneil, S.E.; Wagner, S.E.; Johnson, C.A.; Williams, B.C.; Cornett, E.M.; Murnane, K.S.; Kaye, A.M.; Kaye, A.D. Prescription Stimulants in College and Medical Students. Encyclopedia. Available online: https://encyclopedia.pub/entry/25629 (accessed on 07 February 2023).
      Edinoff AN, Nix CA, Mcneil SE, Wagner SE, Johnson CA, Williams BC, et al. Prescription Stimulants in College and Medical Students. Encyclopedia. Available at: https://encyclopedia.pub/entry/25629. Accessed February 07, 2023.
      Edinoff, Amber N., Catherine A. Nix, Shawn E. Mcneil, Sarah E. Wagner, Catherine A. Johnson, Brooke C. Williams, Elyse M. Cornett, Kevin S. Murnane, Adam M. Kaye, Alan D. Kaye. "Prescription Stimulants in College and Medical Students," Encyclopedia, https://encyclopedia.pub/entry/25629 (accessed February 07, 2023).
      Edinoff, A.N., Nix, C.A., Mcneil, S.E., Wagner, S.E., Johnson, C.A., Williams, B.C., Cornett, E.M., Murnane, K.S., Kaye, A.M., & Kaye, A.D. (2022, July 28). Prescription Stimulants in College and Medical Students. In Encyclopedia. https://encyclopedia.pub/entry/25629
      Edinoff, Amber N., et al. ''Prescription Stimulants in College and Medical Students.'' Encyclopedia. Web. 28 July, 2022.
      Top
      Feedback