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Methylphenidate (Ritalin) With Alcohol Appears to Raise Blood Pressure in Adults: Presented at ACCP

By Crystal Phend

WASHINGTON, DC -- September 13, 2005 -- Methylphenidate (Ritalin) appears to have a larger effect on females and both genders experience an increase in blood pressure when the drug is combined with even one dose of alcohol, according to results of a small randomized study.

"We need to be concerned about adults taking methylphenidate and then drinking," said presenter Robin R. Minhinnett, PharmD candidate, Medical University of South Carolina, Charleston, South Carolina, United States.

The study was led by Kennerly S. Patrick, Professor of Pharmaceutical Sciences, Medical University of South Carolina.

Fatal overdoses of methylphenidate (MPH) have occurred in at least two college students who took it with alcohol, Minhinnett said at the annual meeting of the American College of Clinical Pharmacology (ACCP) here on September 11^th. These cases led to the discovery of an isomer that when combined with alcohol is similar to those found in cocaine, she said.

For the study, researchers enrolled healthy adults, 10 male and 10 female, who were given 0.3 mg/kg MPH in a randomized crossover design, with subject participating in each of the three phases of treatment -- MPH was administered 30 minutes before receiving 0.6 g/kg of ethanol; MPH 30 minutes after 0.6 g/kg of ethanol; and MPH alone.

Blood samples and vital signs were obtained as well as self and observer scoring on items such as anxiety, feeling of intoxication and "feeling high."

Results show that alcohol significantly increased the rate of absorption and the maximum plasma values of MPH. Blood pressure was elevated significantly when ethanol was taken after MPH; systolic blood pressure increased by about 5 mm Hg and diastolic by about 3 mm Hg compared to control measurements with MPH alone. This effect by itself probably would not be considered dangerous but additional drinks could raise the cardiovascular risk, Minhinnett said.

Women reported significantly more feelings of intoxication and depression than did men with or without alcohol.

"This drug sensitivity could constitute a gender-based differential vulnerability to MPH abuse," the researchers concluded.

[Presentation title: Influence of Ethanol and Gender on Methylphenidate Bioavailability, Metabolism and Response. Abstract 67]

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