Non-medical use of methylphenidate by medical students: prevalence and motivations. Integrative review
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Published:
Jun 22, 2021
Keywords:
methylphenidate, medical students, non-prescription drug misuse
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Abstract
Objective: This study performed a literature review evaluating aspects of prevalence and motivations on the non-medical use of methylphenidate by medical students. Methods: We searched the Scopus, PubMed, SciELO, and Web of Science databases and the Google Scholar search tool using the keywords "Methylphenidate" and "Medical Student" and their correlates in Portuguese. A total of 472 articles were recovered, of which 24 were included for full reading and discussion after the application of the pre-established inclusion and exclusion criteria. Results: It was observed that the prevalence of non-prescribed use of methylphenidate ranged from 0.51% in Lithuania to 35% in Colombia. The main motivations reported for using the drug were academic outcomes improvement and increase in concentration during studies, although research shows no significant improvement in academic performance with the use of medication by healthy individuals. Conclusion: The non-prescribed use of methylphenidate presents a high and worrying frequency. Also, scientific studies questioning the use of psychostimulant medications for cognitive improvement by healthy students make the practice illegal and unfounded.
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1.
Batista da Costa L, Sousa JO de, Silva SVB de F, Almeida VD de, Fernandes TAA de M. Non-medical use of methylphenidate by medical students: prevalence and motivations. Integrative review. Health Sci J [Internet]. 2021Jun.22 [cited 2024Apr.25];11(2):24-. Available from: https://portalrcs.hcitajuba.org.br/index.php/rcsfmit_zero/article/view/1042
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ORIGINAL ARTICLE
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References
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5. Domitrovic N, Caliman LV. As controvérsias sócio-históricas das práticas farmacológicas com o metilfenidato. Psicol Soc. 2017;29: e163163. https://doi.org/10.1590/1807-0310/2017v29163163
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7. Arria AM, Wish ED. Nonmedical use of prescription stimulants among students. Psych Ann. 2005;35(3):565-71. https://doi.org/10.3928/00485713-20050301-06
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9. Mazzoglio y Nabar MJ, Algieri RD, Dogliotti CB, Gazzotti AM, Jiménez VHN, Rey LM. The use of psychoactive substances in anatomy students and its implication in learning. Educ Med. 2011;14(2):129-32. https://doi.org/10.4321/S1575-18132011000200009
10. Fallah G, Moudi S, Hamidia A, Bijani AA. Stimulant use in medical students and residents requires more careful attention. Casp J Intern Med. 2018;9(1):87-91. https://doi.org/10.22088/cjim.9.1.87
11. Ferraz L, Piato ALS, Anzolin V, Matter GR, Busato MA. Psychoactive substances: consumption among students of a university of southern Brazil. Momento. 2018; 27(1):371-86. https://doi.org/10.14295/momento.v27i1.6850
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13. Jain R, Chang CC, Koto M, Geldenhuys A, Nichol R, Joubert G. Non-medical use of methylphenidate among medical students of the University of the Free State. South African J Psychiatry. 2017; 23(1006):1-5. https://doi.org/10.4102/sajpsychiatry.v23.1006 PMid:30263181 PMCid:PMC6138185
14. Steyn F. Methylphenidate use and poly-substance use among undergraduate students attending a South African university. South African J Psychiatry. 2016; 22(1):a760. https://doi.org/10.4102/sajpsychiatry.v22i1.760 PMid:30263153 PMCid:PMC6138143
15. Habibzadeh A, Alizadeh M, Malek A, Maghbooli L, Shoja MM, Ghabili K. Illicit methylphenidate use among Iranian medical students: Prevalence and knowledge. Drug Des Devel Ther. 2011;5:71-6. https://doi.org/10.2147/DDDT.S13818 PMid:21340040 PMCid:PMC3038997
16. Brant LC, Carvalho TRF. Metilfenidato: Medicamento gadget da contemporaneidade. Interface (Botucatu). 2012;16(42):623-36. https://doi.org/10.1590/S1414-32832012000300004
17. Cohen GY, Segev RW, Shlafman N, Novack V, Ifergane G. Methylphenidate use among medical students at Ben-Gurion University of the Negev Yael. J Neurosci Rural Prat. 2015;6(3):320-5. https://doi.org/10.4103/0976-3147.158749 PMid:26167012 PMCid:PMC4481783
18. Coli ACM, de Sousa MP, Nakasu MVP. Uso não prescrito de metilfenidato entre estudantes de uma faculdade de medicina do Sul de Minas Gerais. Rev Cienc Saude. 2016;6(3):121-32. https://doi.org/10.21876/rcsfmit.v6i3.582
19. Silva Júnior DS, Costa KS, Silva DS, Teles FDD, Marcolino MMV, Schneid JL. Prevalência do uso de metilfenidato entre acadêmicos de medicina do Centro Universitário UNIRG - Tocantins. Rev Cereus. 2016;8(3):175-91. https://doi.org/10.18605/2175-7275/cereus.v8n3p175-191
20. Carneiro SG, Salviano AST, Moura HC, Strapassom JF, Rabelo NF, Ribeiro TT, et al. O uso não prescrito de metilfenidato entre acadêmicos de Medicina. Cad UniFOA [Internet]. 2013 [cited 2021 Apr 17];8(1):53-9. Avaiable from: https://bit.ly/3mXDIzd
21. Silveira RR, Lejderman B, Ferreira PEMS, Rocha GMP. Patterns of nonmedical use of methylphenidate among 5th and 6th year students in a medical school in southern Brazil. Trends Psychiatry Psychother. 2014;36(2):101-6. https://doi.org/10.1590/2237-6089-2013-0065 PMid:27000709
22. Emanuel RM, Frellsen SL, Kashima KJ, Sanguino SM, Sierles FS, Lazarus CJ. Cognitive enhancement drug use among future physicians: Findings from a multi-institutional census of medical students. J Gen Intern Med. 2013;28(8):1028-34. https://doi.org/10.1007/s11606-012-2249-4 PMid:23595918 PMCid:PMC3710394
23. Tuttle JP, Scheurich NE, Ranseen J. Prevalence of ADHD diagnosis and nonmedical prescription stimulant use in medical students. Acad Psychiatry. 2010;34:220-3. https://doi.org/10.1176/appi.ap.34.3.220 PMid:20431104
24. Ram SS, Hussainy S, Henning M, Jensen M, Russell B. Prevalence of cognitive enhancer use among New Zealand tertiary students. Drug Alcohol Rev. 2016;35(3):345-51. https://doi.org/10.1111/dar.12294 PMid:26121209
25. Hildt E, Lieb K, Franke AG. Life context of pharmacological academic performance enhancement among university students - a qualitative approach. BMC Med Ethics. 2014; 15:23. https://doi.org/10.1186/1472-6939-15-23 PMid:24606831 PMCid:PMC3973848
26. Cruz TC, Barreto Junior EPDS, Gama MLM, Maia LCDM, Melo Filho MJXD, Manganotti Neto O, et al. Uso não-prescrito de metilfenidato entre estudantes de medicina da Universidade Federal da Bahia. Gazeta Médica da Bahia [Internet]. 2011 [cited 2021 Apr 17];81:3-6. Avaiable from: https://bit.ly/3xdkCd9
27. Al-shagawi MA, Ahmad R, Naqvi AA. Determinants of academic stress and stress-related self-medication practice among undergraduate male pharmacy and medical students of a tertiary educational institution in Saudi Arabia. Trop J Pharm Res. 2017;16(2):2997-3003. https://doi.org/10.4314/tjpr.v16i12.26
28. Fond G, Gavaret M, Vidal C, Brunel L, Riveline J-P, Micoulaud-Franchi J-A, et al. Use of Prescribed stimulants in the medical student community: motives and behaviors. Medicine (Baltimore). 2016;95(16):e3366. https://doi.org/10.1097/MD.0000000000003366 PMid:27100420 PMCid:PMC4845824
29. Camargo JRW, Nicolato R. Características das prescrições no transtorno de déficit de atenção/hiperatividade. J Bras Psiquiatr. 2008;58(3):195-9. https://doi.org/10.1590/S0047-20852009000300009
30. Lengvenyte A, Strumila R, Grikiniene J. Use of cognitive enhancers among medical students in Lithuania. Nord Stud Alcohol Drug. 2016;33(2):173-88. https://doi.org/10.1515/nsad-2016-0014
31. Eslami AA, Jalilian F, Ataee M, Alavijeh MM, Mahboubi M, Afsar A, et al. Intention and willingness in understanding ritalin misuse among iranian medical college students: a cross-sectional study. Glob J Health Sci. 2014;6(6):43-53. https://doi.org/10.5539/gjhs.v6n6p43 PMid:25363098 PMCid:PMC4825534
32. Silva de Melo T, de Souza RSB. ''Pill of study'': use of methylphenidate for cognitive enhancement among psychology students of the Universidade do Estado de Minas Gerais (UEMG). Rev Cienc Saude. 2020;10(2):56-2. doi: https://doi.org/10.21876/rcshci.v10i2.887
33. Batistela S, Bueno OFA, Vaz LJ, Galduróz JCF. Methylphenidate as a cognitive enhancer in healthy young people. Dement Neuropsychol. 2016;10(2):134-42. https://doi.org/10.1590/S1980-5764-2016DN1002009 PMid:29213444 PMCid:PMC5642404
34. Bilitardo I de O, Orrutia VF de B, Jesus GM. Analysis of the use of methylphenidate by medical school admission candidates and undergraduates in a São Paulo state municipality. Rev Debates Psiquiatr [Internet]. 2017 [cited 2021 Apr 17];7:6-13. Avaiable from: https://bit.ly/3dpqpV0
35. Mineo L, Sarraf Y, Ingram C, Hanauer S, Infortuna C, Chusid E, et al. Affective temperaments and stimulant medications misuse for neuroenhancement in graduate students. J Subst Use. 2018;23(2):124-9. https://doi.org/10.1080/14659891.2017.1364307
36. Micoulaud-Franchi JA, Macgregor A, Fond G. A preliminary study on cognitive enhancer consumption behaviors and motives of French Medicine and Pharmacology students. Eur Rev Med Pharmacol Sci [Internet]. 2014 [cited 2021 Apr 17];18(13):1875-8. Avaiable from: https://www.europeanreview.org/article/7557 PMID: 25010616
37. Rahimi-Movaghar A, Khastoo G, Moinolghorabaei M, Yunesian M, Sadeghi AR. Use of stimulant substances among university students in tehran: a qualitative study. Iran J Psychiatry Behav Sci. 2011;5(2):32-42. PMID: 24644445; PMCID: PMC3939960
38. Majori S, Gazzani D, Pilati S, Paiano J, Sannino A, Ferrari S, Checchin E. Brain doping: stimulants use and misuse among a sample of Italian college students. J Prev Med Hyg. 2017;58(2):E130-E140. PMID: 28900353 PMCID: PMC5584082
39. Ram SS, Hussainy S, Henning M, Stewart K, Jensen M, Russell B. Attitudes toward cognitive enhancer use among New Zealand tertiary students. Subst Use Misuse. 2017;52(11):1387-92. https://doi.org/10.1080/10826084.2017.1281313 PMid:28429997
2. Pinto B. O transtorno de déficit de atenção e hiperatividade, com foco nos diagnósticos diferenciais descritos pelo DSM-V. Edu Unisalesiano. 2011;(14):1-6.
3. Barros D, Ortega F. Methylphenidate and pharmacological cognitive enhancement: social representations of university students. Saúde Soc. 2011;20(2):350-62. https://doi.org/10.1590/S0104-12902011000200008
4. Ortega F, Barros D, Caliman L, Itaborahy C, Junqueira L, Ferreira CP. A ritalina no Brasil: produções, discursos e práticas. Interface (Botucatu). 2010;14(34):499-512. https://doi.org/10.1590/S1414-32832010005000003
5. Domitrovic N, Caliman LV. As controvérsias sócio-históricas das práticas farmacológicas com o metilfenidato. Psicol Soc. 2017;29: e163163. https://doi.org/10.1590/1807-0310/2017v29163163
6. Lengvenyte A, Strumila R, Grikiniene J. Use of cognitive enhancers among medical students in Lithuania. Nordic Stud Alcohol Drugs. 2016;33(2):173-88. https://doi.org/10.1515/nsad-2016-0014
7. Arria AM, Wish ED. Nonmedical use of prescription stimulants among students. Psych Ann. 2005;35(3):565-71. https://doi.org/10.3928/00485713-20050301-06
8. Finger G, Silva ER, Falavigna A. Use of methylphenidate among medical students: a systematic review. Rev Assoc Med Bras. 2013;59(3):285-9. https://doi.org/10.1016/j.ramb.2012.10.007 PMid:23680277
9. Mazzoglio y Nabar MJ, Algieri RD, Dogliotti CB, Gazzotti AM, Jiménez VHN, Rey LM. The use of psychoactive substances in anatomy students and its implication in learning. Educ Med. 2011;14(2):129-32. https://doi.org/10.4321/S1575-18132011000200009
10. Fallah G, Moudi S, Hamidia A, Bijani AA. Stimulant use in medical students and residents requires more careful attention. Casp J Intern Med. 2018;9(1):87-91. https://doi.org/10.22088/cjim.9.1.87
11. Ferraz L, Piato ALS, Anzolin V, Matter GR, Busato MA. Psychoactive substances: consumption among students of a university of southern Brazil. Momento. 2018; 27(1):371-86. https://doi.org/10.14295/momento.v27i1.6850
12. Barón L, Botero-henao K, Castaño-Castrillón JJ, Castillo-Chang K, Díaz-Corrales J, Echeverri-Uribe JS, et al. Prevalencia y factores asociados al consumo de anfetaminas, en estudiantes del Programa de Medicina de la Universidad de Manizales (Colombia), 2010. Rev Fac Med [Internet]. 2011 [cited 2021 Apr 17];59:201-14. Avaiable from: https://bit.ly/3e9m8nP
13. Jain R, Chang CC, Koto M, Geldenhuys A, Nichol R, Joubert G. Non-medical use of methylphenidate among medical students of the University of the Free State. South African J Psychiatry. 2017; 23(1006):1-5. https://doi.org/10.4102/sajpsychiatry.v23.1006 PMid:30263181 PMCid:PMC6138185
14. Steyn F. Methylphenidate use and poly-substance use among undergraduate students attending a South African university. South African J Psychiatry. 2016; 22(1):a760. https://doi.org/10.4102/sajpsychiatry.v22i1.760 PMid:30263153 PMCid:PMC6138143
15. Habibzadeh A, Alizadeh M, Malek A, Maghbooli L, Shoja MM, Ghabili K. Illicit methylphenidate use among Iranian medical students: Prevalence and knowledge. Drug Des Devel Ther. 2011;5:71-6. https://doi.org/10.2147/DDDT.S13818 PMid:21340040 PMCid:PMC3038997
16. Brant LC, Carvalho TRF. Metilfenidato: Medicamento gadget da contemporaneidade. Interface (Botucatu). 2012;16(42):623-36. https://doi.org/10.1590/S1414-32832012000300004
17. Cohen GY, Segev RW, Shlafman N, Novack V, Ifergane G. Methylphenidate use among medical students at Ben-Gurion University of the Negev Yael. J Neurosci Rural Prat. 2015;6(3):320-5. https://doi.org/10.4103/0976-3147.158749 PMid:26167012 PMCid:PMC4481783
18. Coli ACM, de Sousa MP, Nakasu MVP. Uso não prescrito de metilfenidato entre estudantes de uma faculdade de medicina do Sul de Minas Gerais. Rev Cienc Saude. 2016;6(3):121-32. https://doi.org/10.21876/rcsfmit.v6i3.582
19. Silva Júnior DS, Costa KS, Silva DS, Teles FDD, Marcolino MMV, Schneid JL. Prevalência do uso de metilfenidato entre acadêmicos de medicina do Centro Universitário UNIRG - Tocantins. Rev Cereus. 2016;8(3):175-91. https://doi.org/10.18605/2175-7275/cereus.v8n3p175-191
20. Carneiro SG, Salviano AST, Moura HC, Strapassom JF, Rabelo NF, Ribeiro TT, et al. O uso não prescrito de metilfenidato entre acadêmicos de Medicina. Cad UniFOA [Internet]. 2013 [cited 2021 Apr 17];8(1):53-9. Avaiable from: https://bit.ly/3mXDIzd
21. Silveira RR, Lejderman B, Ferreira PEMS, Rocha GMP. Patterns of nonmedical use of methylphenidate among 5th and 6th year students in a medical school in southern Brazil. Trends Psychiatry Psychother. 2014;36(2):101-6. https://doi.org/10.1590/2237-6089-2013-0065 PMid:27000709
22. Emanuel RM, Frellsen SL, Kashima KJ, Sanguino SM, Sierles FS, Lazarus CJ. Cognitive enhancement drug use among future physicians: Findings from a multi-institutional census of medical students. J Gen Intern Med. 2013;28(8):1028-34. https://doi.org/10.1007/s11606-012-2249-4 PMid:23595918 PMCid:PMC3710394
23. Tuttle JP, Scheurich NE, Ranseen J. Prevalence of ADHD diagnosis and nonmedical prescription stimulant use in medical students. Acad Psychiatry. 2010;34:220-3. https://doi.org/10.1176/appi.ap.34.3.220 PMid:20431104
24. Ram SS, Hussainy S, Henning M, Jensen M, Russell B. Prevalence of cognitive enhancer use among New Zealand tertiary students. Drug Alcohol Rev. 2016;35(3):345-51. https://doi.org/10.1111/dar.12294 PMid:26121209
25. Hildt E, Lieb K, Franke AG. Life context of pharmacological academic performance enhancement among university students - a qualitative approach. BMC Med Ethics. 2014; 15:23. https://doi.org/10.1186/1472-6939-15-23 PMid:24606831 PMCid:PMC3973848
26. Cruz TC, Barreto Junior EPDS, Gama MLM, Maia LCDM, Melo Filho MJXD, Manganotti Neto O, et al. Uso não-prescrito de metilfenidato entre estudantes de medicina da Universidade Federal da Bahia. Gazeta Médica da Bahia [Internet]. 2011 [cited 2021 Apr 17];81:3-6. Avaiable from: https://bit.ly/3xdkCd9
27. Al-shagawi MA, Ahmad R, Naqvi AA. Determinants of academic stress and stress-related self-medication practice among undergraduate male pharmacy and medical students of a tertiary educational institution in Saudi Arabia. Trop J Pharm Res. 2017;16(2):2997-3003. https://doi.org/10.4314/tjpr.v16i12.26
28. Fond G, Gavaret M, Vidal C, Brunel L, Riveline J-P, Micoulaud-Franchi J-A, et al. Use of Prescribed stimulants in the medical student community: motives and behaviors. Medicine (Baltimore). 2016;95(16):e3366. https://doi.org/10.1097/MD.0000000000003366 PMid:27100420 PMCid:PMC4845824
29. Camargo JRW, Nicolato R. Características das prescrições no transtorno de déficit de atenção/hiperatividade. J Bras Psiquiatr. 2008;58(3):195-9. https://doi.org/10.1590/S0047-20852009000300009
30. Lengvenyte A, Strumila R, Grikiniene J. Use of cognitive enhancers among medical students in Lithuania. Nord Stud Alcohol Drug. 2016;33(2):173-88. https://doi.org/10.1515/nsad-2016-0014
31. Eslami AA, Jalilian F, Ataee M, Alavijeh MM, Mahboubi M, Afsar A, et al. Intention and willingness in understanding ritalin misuse among iranian medical college students: a cross-sectional study. Glob J Health Sci. 2014;6(6):43-53. https://doi.org/10.5539/gjhs.v6n6p43 PMid:25363098 PMCid:PMC4825534
32. Silva de Melo T, de Souza RSB. ''Pill of study'': use of methylphenidate for cognitive enhancement among psychology students of the Universidade do Estado de Minas Gerais (UEMG). Rev Cienc Saude. 2020;10(2):56-2. doi: https://doi.org/10.21876/rcshci.v10i2.887
33. Batistela S, Bueno OFA, Vaz LJ, Galduróz JCF. Methylphenidate as a cognitive enhancer in healthy young people. Dement Neuropsychol. 2016;10(2):134-42. https://doi.org/10.1590/S1980-5764-2016DN1002009 PMid:29213444 PMCid:PMC5642404
34. Bilitardo I de O, Orrutia VF de B, Jesus GM. Analysis of the use of methylphenidate by medical school admission candidates and undergraduates in a São Paulo state municipality. Rev Debates Psiquiatr [Internet]. 2017 [cited 2021 Apr 17];7:6-13. Avaiable from: https://bit.ly/3dpqpV0
35. Mineo L, Sarraf Y, Ingram C, Hanauer S, Infortuna C, Chusid E, et al. Affective temperaments and stimulant medications misuse for neuroenhancement in graduate students. J Subst Use. 2018;23(2):124-9. https://doi.org/10.1080/14659891.2017.1364307
36. Micoulaud-Franchi JA, Macgregor A, Fond G. A preliminary study on cognitive enhancer consumption behaviors and motives of French Medicine and Pharmacology students. Eur Rev Med Pharmacol Sci [Internet]. 2014 [cited 2021 Apr 17];18(13):1875-8. Avaiable from: https://www.europeanreview.org/article/7557 PMID: 25010616
37. Rahimi-Movaghar A, Khastoo G, Moinolghorabaei M, Yunesian M, Sadeghi AR. Use of stimulant substances among university students in tehran: a qualitative study. Iran J Psychiatry Behav Sci. 2011;5(2):32-42. PMID: 24644445; PMCID: PMC3939960
38. Majori S, Gazzani D, Pilati S, Paiano J, Sannino A, Ferrari S, Checchin E. Brain doping: stimulants use and misuse among a sample of Italian college students. J Prev Med Hyg. 2017;58(2):E130-E140. PMID: 28900353 PMCID: PMC5584082
39. Ram SS, Hussainy S, Henning M, Stewart K, Jensen M, Russell B. Attitudes toward cognitive enhancer use among New Zealand tertiary students. Subst Use Misuse. 2017;52(11):1387-92. https://doi.org/10.1080/10826084.2017.1281313 PMid:28429997