294 Methylphenidate
disease. In one experiment mice developed liver tumors after receiving many
times the therapeutic dose, but the strain of mice used is prone to such tumors,
so scientists are uncertain about what the experiment means.
Pregnancy.An experiment using mice found the drug to have no effect on
reproduction. Studies of pregnant women abusing methylphenidate find no
birth defects associated with the drug, but babies tend to be small and pre-
mature. A one-year follow-up found the infants to be in the normal range of
development, although some were at the low end of normal. In one study all
the pregnant women abusing methylphenidate were cigarette smokers; some
were alcoholics; some had sexually transmitted disease; few received much
prenatal care. In another study the methylphenidate-abusing mothers’ situa-
tions were so grim that over half the infants were put into immediate foster
care after delivery and did not go home with their mothers. Such confounding
factors cloud any conclusions about the drug’s effect on fetal development.
Whether levels in breast milk are safe for infants is unconfirmed.
Additional scientific information may be found in:Cox, D.J., et al. “Effect of Stimulant Medication on Driving Performance of Young
Adults with Attention-Deficit Hyperactivity Disorder: A Preliminary Double-
Blind Placebo Controlled Trial.”Journal of Nervous and Mental Disease188 (2000):
230–34.
Crutchley, A., and J.A. Temlett. “Methylphenidate (Ritalin) Use and Abuse.”South
African Medical Journal89 (1999): 1076–79.
Debooy, V.D., et al. “Intravenous Pentazocine and Methylphenidate Abuse during
Pregnancy. Maternal Lifestyle and Infant Outcome.”American Journal of Diseases
of Children147 (1993): 1062–65.
Efron, D., F.C. Jarman, and M.J. Barker. “Child and Parent Perceptions of Stimulant
Medication Treatment in Attention Deficit Hyperactivity Disorder.”Journal of
Paediatrics and Child Health34 (1998): 288–92.
Jadad, A.R., et al. “Treatment of Attention-Deficit/Hyperactivity Disorder.”Evidence
Report/Technology Assessment, no. 11 (1999): 1–341. Issue no. 11 is available online
at: http://hstat.nlm.nih.gov/ftrs/dbaccess/adhd
Llana, M.E., and M.L. Crismon. “Methylphenidate: Increased Abuse or Appropriate
Use?”Journal of the American Pharmaceutical Association39 (1999): 526–30.
Parran, T.V., Jr., and D.R. Jasinski. “Intravenous Methylphenidate Abuse. Prototype
for Prescription Drug Abuse.”Archives of Internal Medicine151 (1991): 781–83.
Scarnati, R. “An Outline of Hazardous Side Effects of Ritalin (Methylphenidate).”In-
ternational Journal of the Addictions21 (1986): 837–41.