‘The dose makes the poison’, says an old adage. When it comes to medicines, the truth is not too far from popular wisdom. A study carried out by Pietro Domenico Gramuglia, a UniCamillus 5th-year student on the MSc in Medicine and Surgery, under the supervision of Professor Chiappini, lecturer in Psychiatry at UniCamillus, sheds light on the side effects caused by the misuse of a particular active ingredient: methylphenidate. This is a substance used to treat Attention Deficit Hyperactivity Disorder (ADHD), which in many cases can even lead to addiction.
Seven other students and researchers from different universities and international research institutes contributed to the research. The work was published in the journal Frontiers in Psychiatry. Pietro Gramuglia explains how this research project came about: “It all started in May 2024 with the study of psychiatric disorders associated with drug use. Methylphenidate is a drug that regulates the serotonin and dopamine neurotransmitters, not unlike opioids or cocaine. These are known to be addictive, and several previous studies have already shown that methylphenidate has similar effects. In fact, increasing rates of misuse and abuse have been reported, particularly in patients with a dual diagnosis of co-occurring psychiatric and substance use disorders. We wanted to understand whether the high risk of addiction and adverse effects in these vulnerable groups might warrant a systematic review of the use of this medication”.
How did you proceed?
“We started by selecting over 1,300 articles from different sources (PubMed, Scopus and WebofScience) and then carried out a systematic review using keywords related to the topic of methylphenidate abuse. It was a job that took months, from the selection of articles in the various databases to the final drafting of the results and discussion”.
What did your research reveal?
“We have seen that there were several side effects—even serious ones. There have been two suicides as a result of the misuse of methylphenidate. There are also various intestinal and cardiac effects. Much also depends on the formulation of the medication itself and how it is taken (orally or intravenously). Long-release formulations tend to have less severe side effects than immediate-release formulations. However, it seems clear at this stage that there is a need for greater control over the way medicines are prescribed. We have therefore analysed several possible strategies to intervene in the administration of this medication, always under medical supervision, and in the dosage. It is also very important to educate patients about the use of the substance and the side effects they may experience”.
Are you happy with the result?
“Yes, very. Our paper was published in Frontiers in Psychiatry and received over 1,600 views and 500 downloads in a month and a half, and was quoted and republished by several other authoritative medical-scientific and academic sources and institutions. The European Network Adult ADHD also featured the article. Together with Professor Chiappini, we are now looking forward to presenting this study at a major world conference to be held in Prague in May. It will be the tenth on this topic and will present all the major scientific innovations in the field”.