Respond to at least two of your colleagues on 2 different days who were assigned your same medication but an opposite stance. For example, if you were assigned the con stance for amphetamine, you should respond to two students who were assigned the pro stance for amphetamine. Support or expand on your original argument to refute their claims. Work to share additional perspectives on the issue described by your colleague.
Mode of Action of Methylphenidate
Methylphenidate inhibits the reuptake of dopamine and norepinephrine, raising neurotransmitter levels at the synaptic cleft. The neurotransmitters primarily control impulses (Shellenberg et al., 2020). In the presented case, methylphenidate can effectively treat Malcolm’s inattention, impulsivity, and hyperactivity symptoms. Hence, he can improve his performance at home or school due to enhanced behavior control, attention span, and focus. Methylphenidate can improve Malcolm’s ability to complete assignments and increase his confidence and self-esteem.
Advantages and Disadvantages of Methylphenidate
Advantages
Methylphenidate has demonstrated effectiveness in enhancing cognitive function and reducing hyperactivity and impulsivity associated with ADHD. Therefore, it is likely to improve Malcolm’s behavior and his self-esteem. Various formulations are available to meet the individual needs of ADHD patients. Examples are extended-release, immediate-release, and chewable tablets. Methylphenidate can provide rapid symptom relief within 30 minutes, particularly in patients taking immediate-release tablets (Candido et al., 2021). The disadvantages of methylphenidate include its abuse potential, leading to dependence. Patients can experience adverse effects such as gastrointestinal disturbances, insomnia, anxiety, and tachycardia.
Benefits and Demerits of Alternative ADHD Medications
Alternative ADHD medications are non-stimulants and amphetamines. Non-stimulants include viloxazine and atomoxetine. Patients can benefit from non-stimulants due to their effectiveness in managing ADHD symptoms. They have a long duration of therapeutic effect since they are taken once daily. However, their onset of action is delayed; hence, patients take time to experience their full therapeutic benefits. Amphetamine exists in different formulations to meet the individual needs of patients. It is as effective as methylphenidate but has a prolonged duration of action than methylphenidate (Higgins et al., 2020). However, it can cause dependence and abuse and adverse effects such as sleeping difficulties, headache, irritability, and psychosis.
Adverse effects of methylphenidate
Patients can experience adverse effects such as gastrointestinal disturbances, insomnia, anxiety, headache, weight loss or reduced appetite, anxiety, and dizziness. They can experience serious adverse reactions such as severe aggression and suicidal ideations, hallucinations, seizures, breathing difficulties, and chest pain. Clinicians should assess the patient for risk of abuse due to methylphenidate’s propensity to cause dependence. They should also consider assessing the patient for cardiovascular disorder since the drug can cause tachycardia.
Legal, Ethical, and Social Considerations
Legal Considerations
Methylphenidate is a controlled drug classified under Schedule II. Clinicians should adhere to established regulations and government prescriptions for controlled drugs.
Ethical Considerations
The clinician must thoroughly explain the risks and benefits of methylphenidate to Malcolm’s parents for them to make an informed treatment decision. They should ensure the methylphenidate given confers maximum benefits by managing side effects and dependence.
Social Consideration
Healthcare providers must address stigma and discrimination issues associated with treating mental health disorders such as ADHD (Young & Calloway, 2021). Hence, they should engage Malcolm’s parents and teachers on strategies for mitigating negative perceptions to enhance recovery.
References
Candido, R. C. F., de Padua, C. A. M., Golder, S., & Junqueira, D. R. (2021). Immediate‐release methylphenidate for attention deficit hyperactivity disorder (ADHD) in adults. Cochrane Database of Systematic Reviews, (1). https://doi.org/10.1002/14651858.CD013011.pub2Links to an external site.
Higgins, G. A., Silenieks, L. B., MacMillan, C., Thevarkunnel, S., Parachikova, A. I., Mombereau, C., … & Bastlund, J. F. (2020). Characterization of amphetamine, methylphenidate, nicotine, and atomoxetine on measures of attention, impulsive action, and motivation in the rat: implications for translational research. Frontiers in pharmacology, 11, 427. https://doi.org/10.3389/fphar.2020.00427Links to an external site.
Shellenberg, T. P., Stoops, W. W., Lile, J. A., & Rush, C. R. (2020). An update on the clinical pharmacology of methylphenidate: therapeutic efficacy, abuse potential and future considerations. Expert Review of Clinical Pharmacology, 13(8), 825-833. https://doi.org/10.1080/17512433.2020.1796636Links to an external site.
Young, C. C., & Calloway, S. J. (2021). Assessing mental health stigma: Nurse practitioners’ attitudes regarding managing patients with mental health disorders. Journal of the American Association of Nurse Practitioners, 33(4), 278-282. https://doi.org/10.1097/JXX.0000000000000351Links to an external site.
