Methylphenidate was first synthesized in 1944 by Ciba (now a part of the global pharma major Novartis) chemist Leandro Panizzon; he named the drug after his wife Rita. It was first approved for use in adults during the mid-1950s and marketed by Ciba as Ritalin; it was originally promoted for indications very different from what we now understand as ADD / ADHD (the diagnoses did not exist then; the medical term was “hyperkinetic syndrome”).
By the late 1950s, escalating concern about the educational abilities of American children during the height of the Cold War encouraged Ciba to consider a new application for their drug: underachieving schoolchildren. They received approval from the US Food and Drug Administration (FDA) to promote Ritalin for use in children in 1962 and, almost immediately, it became a best-selling drug.
There are many reasons for Ritalin’s success as a drug for children. Some critics argue that Ciba marketed the notion of ADHD as much as Ritalin. Others contended that Ritalin was used as a tool to control children, molding them to meet the expectations of adults. The real reasons are, as always, less simplistic and more nuanced - Ritalin emerged as a drug for children at the same time as other psychiatric medicines, which helps explain why it was seen as an acceptable treatment. But Ritalin also did what it was supposed to: although it did not work for every child, it was effective in helping children focus and enabled them gain control over their activity levels. Ritalin, originally a drug in search of an indication, eventually became the drug of choice for ADHD – for children, adolescents and adults. Over more than half-a-century of use for ADHD – in millions of patients spanning three generations – it has established itself as the gold-standard against which every ADHD medication is evaluated.
How does methylphenidate work?
Neuroscience research indicates that the brains of children and adults with ADHD have too little dopamine, a brain chemical needed for several vital brain functions. Why? It's because their brains have too many molecules that suck up dopamine before it does its thing. Methylphenidate gums up these molecules, so they leave the dopamine alone.
Dopamine is not only involved with attention and activity levels but with reward and motivation - it modulates brain signals that say, “This is important! Pay attention!” Methylphenidate seems to highlight the task the child is doing. If you are bored, I cannot get your attention. But if you are interested, I can. The drug is, in this way, improving the performance of the child. The same scientific principle holds true in adolescents and adults as well.
When a person concentrates on a task, the part of the brain that is working becomes highly active. But other parts of the brain are active, too. This "white noise" helps a normal person make new, creative associations. But for someone with ADHD, the white noise drowns out the main signal. Research findings show that by increasing dopamine to more normal levels, methylphenidate amplifies the main program.
Methylphenidate vs. the amphetamines
There is not much difference between methylphenidate and the amphetamine salts as treatment alternatives for ADHD, either in safety or in efficacy. However, the discussion is moot in the Indian context, as amphetamines are classified as controlled substances and their manufacture / import / sale / possession are illegal and invite punishment – including imprisonment - under the provisions of the Narcotic Drugs and Psychotropic Substances (NDPS) Act, 1985.
Methylphenidate also comes under the purview of the NDPS Act; however, over the last two decades, the government has allowed the manufacture of the drug, realizing the pressing need for effective medical options in the management of ADD / ADHD. At the same time, the relevant authorities have stepped in to regulate every aspect of the process, from manufacture to distribution, retailing and prescribing.