Ritalin: What You Don’t Know About Its Metabolism and Inter-Individual Variability
John S. Markowitz, PharmD, University of Florida College of Pharmacy
Methylphenidate is the most commonly prescribed psychostimulant for ADHD in the world. Although it has been in continuous clinical use since the 1950s, there remains some unpredictability in patient response and optimal dosing strategies. Factors contributing to these uncertainties will be discussed in the lecture.
– Describe the pertinent parameters of methylphenidate metabolism and the interindividual variability associated with long-acting formulations.
– Understand how methylphenidate and structurally related compounds can interact uniquely with alcohol.
– Describe the role of the hepatic enzyme carboxylesterase 1 (CES1) in the metabolism of methylphenidate, and how genetic variants of the CES1 gene can influence the concentrations of methylphenidate in carriers vs non-carriers.