Black Market Doses of ADHD Drugs Deemed Unsafe in Adolescents

A meta-analysis of the effects of current attention-deficit/hyperactivity disorder (ADHD) drugs has led researchers to conclude black market doses are unsafe for adolescent consumers.

For their study published in Frontiers in Systems Neuroscience, a collaborative research team from the University of Delaware and Drexel University College of Medicine reviewed medical literature focused on current ADHD medications and their effects on developing brains. Specifically, the team examined wakefulness-promoting drugs like Provigil (modafinil), glutamate activators like ampakines, and psychostimulants like Adderall (amphetamine) and Ritalin [methylphenidate (MPH)] — which is not only the most prescribed ADHD treatment, but also the drug most likely to be abused and sold on the black market across college campuses and high schools.

According to the authors, “a large proportion of literature on the safety and efficacy of MPH comes from studies performed on normal, healthy adult animals, as there is currently no sufficiently reliable animal model for ADHD.” In addition, recent studies have demonstrated the drugs’ efficacy in animal models, but only in small doses. When the dose was too large, the drugs produced adverse effects similar to those that appear in human patients, the researchers noted. The study pointed out that the drugs damage the development of the prefrontal cortex in adolescents, which does not fully develop until roughly 20 years of age.

The researchers also looked at modafinil, which produces effects similar to MPH, though its active mechanism is still debated. The drug is commonly used to boost alertness among people in the military, as well as those who suffer from jet lag, narcolepsy, depression, and chronic fatigue. In both human and animal models, modafinil increased target sensitivity in a rapid visual information-processing (RVIP) task, though it may cause deficits in healthy higher performers.

Lastly, the investigators examined the Alzheimer’s disease (AD) drugs known as ampakines and their cognitive-enhancing effects. The medications operate by binding to the glutamatergic AMPA receptor and enhancing its activity. Although ampakines have not yet been approved by the US Food and Drug Administration (FDA), they are being explored as treatments for AD, Parkinson’s disease (PD), ADHD, Rhett syndrome, schizophrenia, depression, autism, and Angelman syndrome. In the meantime, the researchers commented that the excess doses of ampakines that might reach the black market would damage the brains of consumers.

“It is, therefore, the responsibility of scientists and the medical community to stringently evaluate and research each new candidate substance, furthering our understanding of the brain in the process,” the authors concluded. “Perhaps, most importantly, the role of age and developmental stage in individual responses to cognitive-enhancing substances needs to be thoroughly examined.”