Pleasure and discipline in the uses of Ritalin

Background: The stimulant drug methylphenidate, otherwise known as Ritalin, is the mainstay of treatment for Attention Deficit Hyperactivity Disorder and is the most common psychotropic medication prescribed to children. Whilst psychiatric discourse presents it as a safe and effective treatment, critics point out its similarity to drugs like cocaine and describe it as "legalised speed". This article examines the ambivalent identity of Ritalin as both benign medicine and dangerous drug. Methods: This paper draws on and analyses existing medical and critical literature on Ritalin, as well psychopharmacological literature on pleasure and drug use. Results: Anxiety about the nature and use of Ritalin reflects tensions within medical and drug science about the therapeutic use of psychoactive drugs. Pleasure is central to this anxiety, as medically authorised use of drugs must not be contaminated by the uncontrolled bodily pleasures of illicit drug use. This is particularly the case for a drug like Ritalin which is used specifically to improve self-discipline and self-regulation. But the association of Ritalin with discipline rather than pleasure is complicated by pharmacological and behavioural evidence of its effects on neural reward systems and its capacities as a positive reinforcer. Conclusion: Ritalin is likely to maintain its ambivalent identity in medical, legal and Popular discourses, despite lack of evidence of widespread abuse and addiction. The question of the correct use of Ritalin remains ultimately uncertain because of the heterogeneous and ambiguous nature of the scientific and medical discourses on psychoactive drugs. (C) 2007 Elsevier B.V. All rights reserved.