Ritalin - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

ITALIN A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES J AMES N. P A...

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ITALIN A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright 2004 by ICON Group International, Inc. Copyright 2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Ritalin: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-84068-7 1. Ritalin-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on Ritalin. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON RITALIN ..................................................................................................... 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Ritalin ........................................................................................... 4 The National Library of Medicine: PubMed ................................................................................ 14 CHAPTER 2. NUTRITION AND RITALIN ........................................................................................... 27 Overview...................................................................................................................................... 27 Finding Nutrition Studies on Ritalin .......................................................................................... 27 Federal Resources on Nutrition ................................................................................................... 28 Additional Web Resources ........................................................................................................... 29 CHAPTER 3. ALTERNATIVE MEDICINE AND RITALIN ..................................................................... 31 Overview...................................................................................................................................... 31 National Center for Complementary and Alternative Medicine.................................................. 31 Additional Web Resources ........................................................................................................... 37 General References ....................................................................................................................... 38 CHAPTER 4. DISSERTATIONS ON RITALIN....................................................................................... 39 Overview...................................................................................................................................... 39 Dissertations on Ritalin ............................................................................................................... 39 Keeping Current .......................................................................................................................... 40 CHAPTER 5. BOOKS ON RITALIN ..................................................................................................... 41 Overview...................................................................................................................................... 41 Book Summaries: Online Booksellers........................................................................................... 41 The National Library of Medicine Book Index ............................................................................. 43 Chapters on Ritalin ...................................................................................................................... 44 CHAPTER 6. MULTIMEDIA ON RITALIN .......................................................................................... 47 Overview...................................................................................................................................... 47 Audio Recordings......................................................................................................................... 47 Bibliography: Multimedia on Ritalin........................................................................................... 48 CHAPTER 7. PERIODICALS AND NEWS ON RITALIN ....................................................................... 49 Overview...................................................................................................................................... 49 News Services and Press Releases................................................................................................ 49 Academic Periodicals covering Ritalin ........................................................................................ 54 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 57 Overview...................................................................................................................................... 57 NIH Guidelines............................................................................................................................ 57 NIH Databases............................................................................................................................. 59 Other Commercial Databases....................................................................................................... 61 APPENDIX B. PATIENT RESOURCES ................................................................................................. 63 Overview...................................................................................................................................... 63 Patient Guideline Sources............................................................................................................ 63 Finding Associations.................................................................................................................... 65 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 67 Overview...................................................................................................................................... 67 Preparation................................................................................................................................... 67 Finding a Local Medical Library.................................................................................................. 67 Medical Libraries in the U.S. and Canada ................................................................................... 67 ONLINE GLOSSARIES.................................................................................................................. 73 Online Dictionary Directories ..................................................................................................... 73

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RITALIN DICTIONARY................................................................................................................ 75 INDEX .............................................................................................................................................. 101

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FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with Ritalin is indexed in search engines, such as www.google.com or others, a nonsystematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about Ritalin, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to Ritalin, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on Ritalin. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to Ritalin, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on Ritalin. The Editors

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From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON RITALIN Overview In this chapter, we will show you how to locate peer-reviewed references and studies on Ritalin.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and Ritalin, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “Ritalin” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Exploring the Link Between ADHD and CAPD Source: Advance for Speech-Language Pathologists [and] Audiologists. 7(26): 3, 4. June 30, 1997. Contact: Available from Merion Publications, Inc. 650 Park Avenue, Box 61556, King of Prussia, PA 19406-0956. (800) 355-1088 or (610) 265-7812. Summary: This article reports on clinicians and researchers who are exploring the connections between attention deficit hyperactivity disorders (ADHD) and central auditory processing disorders (CAPD). The first researcher notes that the underlying issue is that all children with attention deficit have problems with information processing. Topics include behavior changes from individual one-on-one conversations to noisy group settings, auditory processing tests and diagnosis, situational hyperactive

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behavior, symptoms common to both ADHD and CAPD, diagnosing ADHD, psychological evaluations, the role of the speech language pathologist, evaluating language functioning, Ritalin for children with ADHD who show signs of CAPD, evaluating language comprehension, and otitis media with effusion (OME) in these children. The article concludes with the contact information for the four researchers and clinicians interviewed in the text. (AA-M).

Federally Funded Research on Ritalin The U.S. Government supports a variety of research studies relating to Ritalin. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to Ritalin. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore Ritalin. The following is typical of the type of information found when searching the CRISP database for Ritalin: •

Project Title: ASSESSING ABUSE POTENTIAL IN HUMAN--CNS STIMULANTS Principal Investigator & Institution: Rush, Craig R.; Associate Professor of Psychiatry; Behavioral Science; University of Kentucky 109 Kinkead Hall Lexington, Ky 40506 Timing: Fiscal Year 2001; Project Start 01-FEB-2001; Project End 31-JAN-2005 Summary: Methylphenidate (RITALIN), a piperidine derivative, is commonly prescribed for the treatment of Attention Deficit Hyperactivity Disorder (ADHD). Alarmingly, recent data from the Drug Enforcement Agency (DEA) indicate that methylphenidate (METH) abuse is widespread and represents a significant publichealth concern. For example, between 1989 and 1993 emergency-room admissions involving METH increased by as much as 715%. There is accumulating evidence that the symptoms of childhood ADHD persist into adulthood in a significant number of cases, and adulthood ADHD is associated with high rates of psychiatric comorbidity, including cocaine (COC) abuse. Whether COC abusers with ADHD are at risk to abuse METH is unclear, and many clinicians are reluctant to prescribe stimulants to these patients because of their histories of COC abuse. The specific aim of this project is to rigorously characterize the abuse potential of METH, the most commonly prescribed medication for the treatment of childhood and adulthood ADHD. To accomplish this aim, 3 inpatient, laboratory experiments will be conducted with volunteers with histories of COC abuse. Exp. 1 will replicate and extend findings from a previous study conducted in our laboratory that showed the discriminative-stimulus and subjective effects of METH are indistinguishable from those of COC. Exp. 2 will determine the

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Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

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relative reinforcing effects of METH and COC. Exp. 3 will determine the influence of rate of onset on the reinforcing, subjective and physiological effects of drugs by examining the effects of sustained- and immediate- release METH. We have two primary hypotheses. First, METH and COC will produce positive subjective effects and function as reinforcers. METH and COC will differ in terms of potency, but not efficacy. Second, sustained- release METH will have less abuse potential than immediate-release METH. The experiments proposed in the present application have at least 3 basic science and clinical implications. First these experiments will determine the abuse potential of METH in individuals with histories of COC abuse. Second, these experiments will determine whether decreasing the rate of onset of METH's effect reduces its abuse potential. Rate of onset is thought to be an important determinant of a drug's abuse potential. Third, these experiments may identify compounds that have reduced abuse potential (e.g., sustained-release METH) and may guide the pharmacological treatment of COC abusers with ADHD. The proposed experiments will also allow us to assess the effects of participating in non-treatment, inpatient, drug-abuse studies and to conduct retrospective analysis to determine the influence of individual differences (e.g., amount of cocaine use, amount and kind of other drug use, gender, ethnicity, socioeconomic status, as well as scores on a structured mental status exam, the Wender-Utah Rating Scale, the Beck Depression Inventory and several measures of personality function) on the behavioral and physiological responses to stimulants. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: CONCENTRATION OF DOPAMINE TRANSPORTERS TO BMAX OR NOT TO BMAX ? Principal Investigator & Institution: Morris, Evan; Harvard University (Medical School) Medical School Campus Boston, Ma 02115 Timing: Fiscal Year 2001 Summary: The dopamine transporter is increasingly recognized as a window on the status of dopamine neurons Dopamine transporter levels decline in tandem with the loss of dopamine in Parkinson's disease and in experimentally produced parkinsonism The dopamine transporter is also a principal target of Ritalin , Zyban and cocaine in brain Although it is feasible to accurately measure the density of the transporter in postmortem tissue, measures of transporter density in living brain by PET or SPECT imaging are more challenging With PET imaging in non-human primate brain, we measured transporter levels using a technique of three injections of [11C]CFT (WIN 35,428) followed by non-linear least-squares (NLSQ) fitting of all the dynamic data simultaneously The resulting data yielded a value for B'max which does not correspond closely to B'max/Kd The advantages of the three-injection model is the feasibility of measuring B'max and Kd (Koff/Kon) separately It is inadvisabl e to use B'max/Kd or distribution volume ratio (DVR) in all circumstances as an indicator of B'max as the underlying assumption for generating binding potential is the constancy of Kd For receptor imaging, agonist drugs can convert receptors from high to low affinity, thereby reducing the apparent Kd for PET imaging agents that are either agonists or partial agonists Kd may also differ as a function of other factors, including age, pathological states, mutations in receptors, or modifications of the membrane matrix of protein targets If feasible, it seems imprudent to sacrifice the possibility of obtaining accurate data with measures of Kd and B'max Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: D4 RECEPTOR-MEDIATED EFFECTS OF METHYLPHENIDATE IN MICE Principal Investigator & Institution: Grandy, David K.; Associate Professor; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2003; Project Start 01-JAN-2003; Project End 31-DEC-2007 Summary: (provided by applicant): Attention Deficit Hyperactivity Disorder (ADHD) is a complex behavioral condition characterized, in part, by distractibility, impulsivity, hyperactivity, and abnormal novelty-seeking behavior. ADHD is currently estimated to affect 2.5 million children and adults nationwide. The molecular basis for ADHD is unknown but a wealth of clinical data supports the hypothesis that dysregulation of dopamine (DA) signaling in the central nervous system significantly contributes to its etiology. Although most individuals diagnosed with ADHD benefit from low doses of the psychostimulant Ritalin (r) (methylphenidate, MPD), its exact mode of action and long-term consequences of exposure are unclear. However, since MPD can elevate extracellular DA levels by interfering with DA transporter function, its cIinical benefit may involve an indirect stimulation of DA receptors (DARs). Of the five known DAR subtypes, recent family and twin studies have revealed an association between an allele of the human DA D4R gene (DRD4.7) and ADHD. Anatomically, D4Rs are expressed in brain regions thought to be relevant to ADHD. Furthermore, incipient congenic D4R-/mice display locomotor supersensitivity to the psychostimulants cocaine and methamphetamine in addition to elevated striatal dopamine content and diminished novelty-seeking behavior. Taken together these observations suggested to us the hypothesis: DA D4Rs mediate MPD's effects in mice and humans. Since the selective pharmacological antagonism of D4Rs in vivo has yet to be convincingly demonstrated, we chose to begin testing our hypothesis in D4R-deficient mice and have found that congenic (N10 on C57B1/6J) D4R-/- mice display a dose-dependent locomotor supersensitivity to MPD. Encouraged by these findings we propose the following course of experimentation: In specific aim 1 we describe studies designed to establish whether acute and/or chronic MPD exposure influences novelty-seeking and impulsivity behaviors in juvenile and adolescent mice lacking D4Rs. In aim 2 we address the question: What are the effects of acute and chronic MPD exposure on gene expression in ADHD-relevant brain regions of wild-type and D4R-deficient juvenile and adolescent mice? Finally, in aim 3, we propose to generate three novel strains of knock-in mice that express either the human allele associated with ADHD (DRD4.7), a "normal" human D4R allele (D4.4), or Green Fluorescent Protein-tagged (GFP) murine D4Rs to more reliably localize the receptor protein in mouse brain tissue. It is our expectation that upon the successful completion of these aims, a better understanding of the complex relationship between MPD exposure, D4R stimulation, gene expression, and rodent behaviors relevant to ADHD will emerge Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: DEVELOPMENTAL AFFECTS OF RITALIN ON BRAIN Principal Investigator & Institution: Milner, Teresa A.; Professor; Neurology and Neuroscience; Weill Medical College of Cornell Univ New York, Ny 10021 Timing: Fiscal Year 2002; Project Start 01-MAY-2002; Project End 30-APR-2005 Summary: (provided by applicant): Ritalin (methylphenidate; MPH) is one of the most commonly prescribed drugs for children with attention deficit hyperactivity disorder (ADHD). Over the past decade, ritalin usage has increased in the United States such that children diagnosed with ADHD often are maintained on the drug throughout late

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childhood and adolescence. Little is known however, regarding the long term consequences of therapeutic doses of MPH on brain development. Developmental MPH exposure may profoundly affect synaptogenesis, myelination and gliogenesis in several brain regions. Of particular note is the process of synaptogenesis, which occurs postnatally in several regions of the brain that are associated with learning and memory (e.g., hippocampus and cerebral cortex). Thus, the present proposal seeks to generate data to aid in evaluating the safety of therapeutic maintenance of MPH in children and adolescents. To achieve this goal, two aims are proposed: (1 ) to develop an animal model that reflects the clinical maintenance of MPH in children and (2) to assess the effects of long-term developmental exposure to therapeutic doses of MPH in this model on the adult brain. Initially, this model will utilize the maximum therapeutic dosage and duration of MPH that is used to treat ADHD in children. Long-term exposure to therapeutic doses of MPH then will be assessed in the forebrain of young adult rats at two time-points using sensitive, quantitative immunocytochemical methods. Focus will be on the: (a) dopaminergic system; (b) ascending noradrenergic system; and (c) ascending serotonergic system (especially their innervation of the cerebral cortex and hippocampus), since current experimental evidence indicates that these monoamines are either directly or indirectly affected following MPH administration. Additionally, the basal forebrain cholinergic and cortical glutamatergic systems will be analyzed since both are targeted by monoaminergic afferent systems, play a prominent role in attention and undergo synaptogenesis postnatally. Monoaminergic and cholinergic neurons and their efferent processes will be identified using antibodies to either their synthetic enzymes or transporters (i.e., to label subpopulations that are important in uptake and release), whereas cortical glutamatergic synapses will be identified by antibodies to NMDA receptors. If changes in any of the immunocytochemical markers are seen using these parameters in this model, future experiments would focus on: (1) dosage (e.g., to determine the maximum dose necessary to see these changes); (2) duration (e.g., to determine if the changes diminish with smaller periods of exposure or to identify developmental stages that may be uniquely sensitive to the drug effects); and (3) the age of assessment (e.g., to determine if the changes persist as the brain ages). Determining how therapeutic dosage regimens effect these transmitter systems is critical in understanding the safety of long-term therapeutic doses of MPH administered to children and adolescents with ADHD and other related disorders. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: DOPAMINERGIC & NONDOPAMINERGIC INTERACTIONS IN PARKINSON'S DISEASE Principal Investigator & Institution: Camicioli, Richard M.; Associate Professor; Oregon Health & Science University Portland, or 972393098 Timing: Fiscal Year 2001 Summary: One purpose of this study is to learn how Methylphenidate (Ritalin) affects and changes levodopa's effects on attention (ability to concentrate), mood and motor function (ability to move) in patients with Parkinson's Disease (PD). Another purpose of this study is to determine the effectiveness of Methylphenidate by itself. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: EVALUATION OF STIMULANT DRUGS Principal Investigator & Institution: Wigal, Sharon B.; Pediatrics; University of California Irvine Irvine, Ca 926977600

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Timing: Fiscal Year 2002; Project Start 11-JAN-2002; Project End 31-DEC-2006 Summary: The applicant is requesting five years of funding through the PatientOriented Research Career Award (K-23) program to enhance her independence as an investigator. The proposed training is in crucial basic methods for research in clinical and psychopharmacology of children with Attention Deficit Hyperactivity Disorder (ADHD). Methylphenidate (Ritalin(R)) is the most frequently prescribed psychostimulant by physicians to treat cases of ADHD. Few studies have been done to evaluate the efficacy of methylphenidate (MPH) in preschoolers with ADHD or to compare the time-response function of this age group with school-aged children. No study has addressed the comparative pharmacokinetics of MPH in these two age groups. The applicant will address these questions. The training will be based at the University of California, Irvine Child Development Canter, which has a well-established program for the treatment of ADHD and is a leading site for studying pharmacokinetics (PK) and pharmacodynamics (PD) of psychoactive stimulants. A unique component is the laboratory school paradigm (LSP) which was developed here. The research plan is designed to evaluate the variability of PD of MPH in preschoolers (3 to 5 year olds) versus school-aged (6 to 8 year olds) children with ADHD. Within-subject PK variability in time-course of serum concentration for each medication will be analyzed, and the time-response characteristics also will be estimated based on PD measures for methylphenidate. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: IMPROVING GUIDELINE ADHERENCE & MANAGEMENT OF ADHD CARE Principal Investigator & Institution: Bromberg, Jonas I.; Research Scientist; Inflexxion, Inc. Newton, Ma 02464 Timing: Fiscal Year 2002; Project Start 01-AUG-2002; Project End 31-JAN-2004 Summary: (provided by applicant): ADHD is a clinical problem for which multiple perspectives are needed in order to sufficiently make a diagnosis and provide optimal care. This process typically involves physicians, parents and teachers (or other school personnel). Traditional methods of gathering assessment and follow-up data are time consuming and happen inconsistently in clinical practice. Systems are critically needed that can facilitate a uniform and accurate procedure for gathering data from multiple sources. Virtually all professional guidelines, consensus statements, and recommendations from ADHD advocates, stress that the diagnosis and treatment of ADHD must involve the parents and teacher, and that the cornerstone of treatment should be the closely supervised use of psychostimulant medication. This proposal seeks to develop an Internet-based clinical tool that will permit faster, easier and more accurate collection of data from parents and teachers during the process of evaluation and will help physicians monitor medication effects as part of follow-up care. The system aims to reduce undesirable variations in care and improve the quality of care for children being evaluated and treated for ADHD. Phase I will develop a prototype system, which will be fully developed and tested in Phase II. PROPOSED COMMERCIAL APPLICATION: The commercial potential for the ADHD Online Coordination and Management System (OCMS) is outstanding. Inflexxion has been very successful in marketing our products through straytegic partnerships. We envision distributing the OCMS through a partnership with a large pharmaceutical company which sells medications used in the treatment of ADHD (e.g., Smith Kline Beecham Dexedrine, Ciba-Geigy - Ritalin, Richwood - Adderall). Most large pharmaceutical companies are eager to offer their customers "value-added" benefits such as the OCMS.

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A current marketing partner of Inflexxion is Health Practice Enhancement Network, a consulting company with deep roots in the pharmaceutical industry. Inflexxion would license the OCMS, rather than sell it outright, and continue to obtain revenues for management and support of the service. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: METHYLPHENIDATE & GENE EXPRESSION IN THE RAT BRAIN. Principal Investigator & Institution: Baizer, Joan S.; Physiology and Biophysics; State University of New York at Buffalo Suite 211 Ub Commons Amherst, Ny 14228 Timing: Fiscal Year 2003; Project Start 20-SEP-2003; Project End 31-JUL-2005 Summary: (provided by applicant): The long-term objectives of this research are to understand the changes in neuronal structure and function that may be caused by longterm use of ethylphenidate. ADHD/ADD is a common disorder affecting as many as 6% of schoolchildren. The ADHD/ADD population is at risk for school failure, difficulties with interpersonal relationships, and later substance abuse. ADHD/ADD is best treated by a combination of medication and behavior management. The most commonly prescribed drug used to treat ADHD/ADD is methylphenidate, Ritalin. Methylphenidate is a highly effective drug for treating impulsivity, hyperactivity, and inattention, the symptoms of ADHD, and seems to be safe. Abuse, tolerance and sensitivity are not major clinical concerns in its use. At present, we do not understand all of the mechanisms by which methylphenidate exerts its beneficial effects, nor do we know what neuronal changes may result from its use. There is concern about the potential effects on the brain and behavior of its long-term use, and especially over whether its use can affect the likelihood of later substance abuse. One reason for this concern is that Ritalin binds to the dopamine transporter and increases dopamine levels in the brain. Other psychostimulant drugs, amphetamine and cocaine, also increase dopamine levels, and these drugs are major drugs of abuse. A single dose of those drugs cause short-tem changes in expression of the Immediate Early Genes. Chronic use results in a complex pattern of changes in the expression of the IEG's and other genes. These changes in gene expression are thought to mediate the changes in behavior underlying addiction. We have found that a single dose of Ritalin results in expression of the Immediate Early Gene c-fos in the rat brain. We wish now to analyze the effects of chronic Ritalin use on gene expression, using the techniques of immunohistochemistry and DNA Microarray technology. Knowledge of the effects on gene expression will allow a more direct comparison of the effects of Ritalin on the brain with the effects of amphetamine and cocaine, provide more information about its mechanisms of action and allow more informed predictions about the long-term consequences of its use. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: MOLECULAR GENETICS OF NEUROTRANSMITTER TRANSPORT Principal Investigator & Institution: Blakely, Randy D.; Associate Professor; Vanderbilt University Med Ctr Nasville, Tn Timing: Fiscal Year 2001 Summary: Presynaptic dopamine (DA) transporters (DATs) constitute the primary mechanism for inactivation of DA in the brain. DAT proteins are high- affinity targets for important addictive and therapeutic drugs including cocaine, amphetamines and methylphenidate (Ritalin/TM). Little is known regarding how DAT proteins form a selective permeation pathway for DA and how different antagonist impact activity. Recent studies reveal DATs to be acutely regulated by coordinated mechanisms

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involving kinase activation, transporter phosphorylation and altered membrane trafficking/stabilization, though as yet genes responsible for this regulation remain to be identified. In rodents and man, DATs also constitute the portal through which exogenous neurotoxins (e.g. 6- OHDA, methamphetamine and MPP+) enter these neurons and affect lesions reminiscent of the selective pathology of Parkinson's disease. Controversy exits as to whether these toxic insults trigger cell death in vivo via necrotic or apoptotic pathways. We have cloned the product of the C. elegans gene T23G5.5 and demonstrated in its function as a DA transporter (CeDAT), opening the door to genetic strategies for the definition of critical DAT residues, the identification of CeDAT regulators and an understanding of molecular contributors to dopaminergic neuron sensitivity to environmental toxins. In our proposal, we seek to 1) validate the molecular and cellular specificity of CeDAT- targeted drugs and toxins, evaluate the properties of 6-OHDA-induced DA neuron degeneration in the work and determine whether CeDAT is both necessary and sufficient for toxin sensitivity, 2) to establish the cellular specificity, developmental expression and subcellular localization of CeDAT protein CeDAT mutants and CeDAT regulators using novel gain-of-function screens involving suppression of sensitivity to 6-OHDA. Together, these efforts provide important opportunities to identify and characterize regulators of transporter expression, localization and function and may provide clues to molecular determinants of dopamine- dependent psychiatric and neurodegenerative syndromes. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NEUROCHEMICAL CONSEQUENCES OF DRUGS IN ADOLESCENT RATS Principal Investigator & Institution: Izenwasser, Sari; Associate Professor; Psychiatry and Behavioral Scis; University of Miami-Medical Box 248293 Coral Gables, Fl 33124 Timing: Fiscal Year 2003; Project Start 01-AUG-2003; Project End 30-APR-2008 Summary: (provided by applicant): Most research to date using animal models of drug abuse has focused on the effects of psychostimulants on brain neurochemistry and behavior in adult, prenatal, or preweanling animals. There has been little research focusing on the effects of psychostimulants on adolescent rats. However, it is well known that a large number of people who use drugs started as teenagers. Because of this, it is of interest to examine the effects of psychostimulants in this adolescent population in order to determine whether there may be a difference in how this class of drugs effects this age cohort, and on how drug use at this age affects adult susceptibility to addiction. The specific hypothesis of this proposal is that psychostimulants have different effects on the behavior of periadolescent rats than of adult rats, and that exposure to drugs during this critical phase may alter the neurochemical underpinnings of stimulant abuse as an adult. A number of studies have examined the effects of preexposure to drugs on later response to cocaine. In all of these studies, both the pre- and post-exposure phases were conducted after the animal had reached adulthood. These studies have shown that pre-exposure to a number of different drugs can influence both the neurochemical and behavioral effects of subsequently administered psychostimulants. Repeated exposure to direct or indirect dopamine agonists in adult rats produces sensitization to the behavioral effects of psychostimulants. Our preliminary data show that, in adult rats, sensitization is evident both during a seven day treatment period, and 10 days after the treatment ends. In contrast, no sensitization is apparent in periadolescent rats treated under the same drug regimen. The aim of these experiments is to compare the effects of several drugs during the periadolescent phase to during the adult phase. Rats will be treated daily for one week with either

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cocaine, methylphenidate (ritalin), MDMA (ecstasy) or the appropriate vehicle during the periadolescent or adult phase. Locomotor activity will be tested for one hour daily during this period. Immediately subsequent to this period, or one month later, markers of dopamine and serotonin neurochemistry will be measured. In addition, one month later, the response to cocaine will be tested again on locomotor activity. An understanding of the differential effects of drugs during the periadolescent phase and of how this use impacts drug effects in adults may lead to different treatments for different age groups, as well as a better understanding of how drug use in adolescence may lead to psychostimulant abuse in adulthood. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: NON AMINES STRUCT ACTIVITY OF CARBATROPANES AT MONOAMINE TRANSPORTERS Principal Investigator & Institution: Madras, Bertha K.; Professor; Harvard University (Medical School) Medical School Campus Boston, Ma 02115 Timing: Fiscal Year 2001 Summary: Transporters for the monoamines dopamine, serotonin and norepinephrine are principal targets for the majority of antidepressant drugs such as fluoxetine/Prozac (serotonin transporter), methylphenidate/Ritalin (dopamine transporter), the most frequently prescribed drug for Attention Deficit Hyperactivity Disorder, and cocaine Without exception, the molecular structure of therapeutic and other drugs that modulate monoamine transporters contains an amine nitrogen We recently reported that the amine nitrogen can be exchanged for oxygen (aryloxatropanes, 8-oxa-bicyclo-3aryl-[3 2 1 ]octanes) and retain potent inhibition of the dopamine, serotonin and/or norepinephrine transporters in monkey brain Oxygen-induced hydrogen bonding to substitute for amine-induced ionic bond formation was proposed as a mechanism to account for high affinity of this class of non-amines To investigate whether even hydrogen bonding is necessary, we replaced the oxygen with a carbon atom We now repo rt that several carbon-based compounds displayed high affinity binding for the dopamine transporter, including O-1231 (IC50 7 1 q 1 7nM), O-1414 (IC50 9 6 q 1 8 nM), O-1442 (IC50 14 3 q 1 1 nM) O-1231, which contains a flattened 2,3-unsaturated bond in the ring structure, was > 700-fold selective for the dopamine (DAT) over the serotonin (SERT) transporter O-1414, a saturated analog of O1231 in the 3- form ("chair") was only 3-fold selective for the DAT over the SERT whereas its 3-` analog ("boat") was > 10-fold Five conclusions can be drawn from these data Conformation of a molecule plays a significant role in conferring DAT or SERT affinity Orientation of the 3-aryl ring and the orientation of the 2-carbomethoxy ring relative to the aromatic ring is critical for alignment with the transporter Development of transporter-selective drug therapies for neuropsychiatric diseases can be guided by appropriate orientation of the 3-aryl group 8-Carbatropanes display high affinity for monoamine transporters, indicating that a functionality corresponding to an amine nitrogen is not necessary for anchoring the molecule to its target protein and blockade of monoamine transporters Within this series, transporter affinity appears to be largely sustained by the aromatic ring The DAT may have multiple binding sites for tropanes, while the SERT may be less flexible Ongoing research with mutant forms of the DAT will explore this premise This research has several implications First, it will clarify the feasibility of developing cocaine antagonists targeted to the dopamine transporter Second, it will help to clarify the molecular mechanisms by which drugs block monoamine transport Finally, these compounds have created a new generation of transporter drugs Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: SENSITIZATION PSYCHOSTIMULANTS

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CROSS-SENSITIZATION

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Principal Investigator & Institution: Yang, Pamela B.; Neurobiology and Anatomy; University of Texas Hlth Sci Ctr Houston Box 20036 Houston, Tx 77225 Timing: Fiscal Year 2002; Project Start 01-JUL-2002 Summary: (Provided by Applicant): Repeated treatment with methylphenidate (MPD; Ritalin) and other psychomotor stimulants, such as amphetamine and cocaine, has been shown to cause behavioral sensitization in rats and humans. Behavioral sensitization is characterized by an increase in locomotor and/or stereotypic behavior. It is not known, however, whether the behavioral sensitization produced by MPD involves the same neuronal mechanisms as amphetamine and cocaine. More importantly, chronic administration of MPD may also result in cross-sensitization with other psychostimulants. Methylphenidate is widely used to treat attention deficit/hyperactivity disorder (ADHD). The objectives of this study are to determine whether early exposure to MPD in juvenile rats increases their sensitivity to the drug when they are adult rats and whether treatment with MPD in juvenile and adult rats produces cross-sensitization to amphetamine. The study will consist of (1) monitoring the locomotor activity of two strains of rats (a model of ADHD and its control) before and after acute and repeated MPD administration when the rats are young and as adults followed by an amphetamine treatment and (2) evaluating sensory evoked potentials before and after drug treatment in freely moving rats with electrodes implanted in brain regions believed to be involved with ADHD, behavioral sensitization, and crosssensitization. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: THE NEURAL BASIS OF HYPERACTIVE WHEEL RUNNING IN MICE Principal Investigator & Institution: Rhodes, Justin S.; Zoology; University of Wisconsin Madison 750 University Ave Madison, Wi 53706 Timing: Fiscal Year 2001; Project Start 01-JUN-2001 Summary: The major goal of the proposed project is to investigate the neural basis of hyperactivity in a novel mouse model. Through artificial selection we have produced lines of mice that are internally motivated to run faster on running wheels than randombred controls, resulting in a 26-fold increase in wheel revolutions in a 24 hour period. Wheel-running in the hyperactive animals is composed of short bursts of activity separated by frequent short rests. High wheel-running mice are also more active in their home cages when deprived of wheels. The high-running mice may, therefore, be a good animal model for attention deficit hyperactivity disorder (ADHD). An association between deficiencies in dopamine transmission and ADHD has been suggested, and preliminary neuropharmacological results are consistent with the hypothesis that the hyperactive wheel running is caused by diminished dopaminergic function. To further explore the neural basis of genetic hyperactivity, I propose to examine whether: 1) apomorphine, and Ritalin(TM) attenuate wheel-running behavior in the high-running mice, 2) dopamine metabolism is slower in the high-running mice compared to controls at a given speed of running, and 3) the high-running mice contain fewer or smaller dopamine neurons in the ventral tegmental area. Together the proposed studies will help clarify the underlying neurochemistry and neuroanatomy of genetic hyperactivity. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

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Project Title: TRAFFICKING TRANSPORTERS

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REGULATION

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MONOAMINE

Principal Investigator & Institution: Melikian, Haley E.; Assistant Professor; Psychiatry; Univ of Massachusetts Med Sch Worcester Office of Research Funding Worcester, Ma 01655 Timing: Fiscal Year 2002; Project Start 01-MAY-2002; Project End 30-APR-2007 Summary: (provided by applicant): Monoamine reuptake is a major mechanism for regulating extraneuronal monoamine levels and terminating synaptic transmission. Reuptake is mediated by plasma membrane transporters that are the primary targets for psychostimulants such as cocaine, methamphetamine and MDMA ("Ecstasy"), as well as for therapeutic drugs such as fluoxetine (Prozac), sibutramine (Meridia), bupropion (Wellbutrin) and methylphenidate (Ritalin). These agents block reuptake, resulting in elevated extraneuronal monoamine levels and enhanced postsynaptic responses. Recent evidence demonstrates that transporters are subject to acute regulation by cellular signaling pathways. Transporter regulation is coupled to dynamic changes in transporter cell-surface presentation, suggesting that membrane trafficking is fundamental to transporter homeostasis and regulation. However, the cellular and molecular mechanisms governing transporter regulation and trafficking are not yet defined. Given the pronounced effect pharmacological transporter blockade exerts on synaptic transmission, it is highly likely that transporter sequestration also has significant downstream effects on neuronal signaling. Moreover, modulation of transporter availability is certain to have significant impact on the efficacy of psychoactive drugs. The major goals of this project are to elucidate the cellular and molecular mechanisms mediating acute transporter regulation and trafficking. This investigative line will be pursued by testing the following hypotheses: (1) Transporters undergo constitutive internalization and recycling, and (2) transporter regulation is achieved by altering transporter trafficking kinetics. These hypotheses are based on strong preliminary data that the dopamine transporter (DAT) undergoes constitutive endosomal trafficking and that protein kinase C (PKC) activation directly alters DAT trafficking. The proposed hypotheses will be tested by directly analyzing basal and regulated transporter trafficking kinetics in cell lines. Intrinsic domains mediating basal and PKC-regulated DAT trafficking will be identified using molecular truncation and mutagenesis approaches. It is expected that these approaches will provide a clear and comprehensive picture of the mechanisms underlying acute transporter modulation. Such results are expected to have a significant impact on future therapeutic strategies aimed at monoamine-related drug abuse and mental illnesses. Moreover, the outcomes will greatly improve our understanding of the factors contributing to monoamine availability and signaling in the brain. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: TREATMENT OF ADHD IN CHILDREN WITH TOURETTE'S SYNDROME Principal Investigator & Institution: Como, Peter; University of Rochester Orpa - Rc Box 270140 Rochester, Ny 14627 Timing: Fiscal Year 2001 Summary: This is a multicenter double-blind,. study of methylphenidate (Ritalin), clonidine (Catapres), and combined methylphenidate and clonidine (2x2 factorial design) for children with both ADHA and chronic tics. The study will address the following aims: to determine the efficacy of the 2 drugs used alone or in combination for

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the symptoms of ADHD and to determine the influence of the 2 drugs alone or in combination on the severity of tics in children with chronictics. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen •

Project Title: BEHAVIOR

VULNERABILITY

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RITALIN:

ELECTOPHYSIOLOGY

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Principal Investigator & Institution: Brandon, Cindy L.; Cellular & Molecular Pharm; Finch Univ of Hlth Sci/Chicago Med Sch North Chicago, Il 60064 Timing: Fiscal Year 2001; Project Start 01-OCT-2000 Summary: Drug addiction is a serious health issue. The reported relationship between ADHD diagnosis and increased substance abuse is obscured by lacking uniformity in diagnosis of ADHD, and long-term exposure to stimulants in those who are treated. Some individuals receiving medication may not have a distinct clinical disorder and may be more reactive to methylphenidate (MP) (the most widely prescribed treatment). In animal models, enhanced reactivity (sensitization) to stimulants can be measured as increased motor activity or propensity to self-administer abused drugs. Individuals at greater risk for acquiring self- administration (SA) can be predicted based on drugindependent criteria; their locomotor response to a novel setting. These individuals, high responders (HR), are more readily sensitized following drug exposure and are known to show basal and drug-induced differences in DA neurotransmission. The general aim of this study is to determine whether MP is a psychostimulant that causes behavioral sensitization following repeated exposure. Measuring MPs locomotor stimulant effect and ability to increase acquisition of cocaine SA will test this. We will determine whether there are subgroups of animals (HR) that are more susceptible to these effects. Using extracellular single-unit recording and microiontophoretic techniques we will measure post-synaptic (receptor function in the nucleus accumbens (Nac)) effects in a circuit known to mediate both the rewarding and motor stimulant effects of other indirect DA agonists. We will test before and after repeated MP in order to determine basal from drug-induced changes and compare them to neuronal adaptations that are known to occur following repeated exposure to amphetamine and cocaine. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.3 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals.

3 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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To generate your own bibliography of studies dealing with Ritalin, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “Ritalin” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for Ritalin (hyperlinks lead to article summaries): •

A comparison of ritalin and adderall: efficacy and time-course in children with attention-deficit/hyperactivity disorder. Author(s): Pelham WE, Aronoff HR, Midlam JK, Shapiro CJ, Gnagy EM, Chronis AM, Onyango AN, Forehand G, Nguyen A, Waxmonsky J. Source: Pediatrics. 1999 April; 103(4): E43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10103335&dopt=Abstract

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A fatality due to the intranasal abuse of methylphenidate (Ritalin). Author(s): Massello W 3rd, Carpenter DA. Source: J Forensic Sci. 1999 January; 44(1): 220-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9987890&dopt=Abstract

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A safer methylation procedure with boron trifluoride-methanol reagent for gas chromatographic analysis of ritalinic acid in urine. Author(s): Vu-Duc T, Vernay A. Source: Journal of Pharmaceutical and Biomedical Analysis. 1992 February-March; 10(23): 187-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1391098&dopt=Abstract

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ADHD, Ritalin, and big brother. Author(s): Miller AL. Source: Alternative Medicine Review : a Journal of Clinical Therapeutic. 2000 October; 5(5): 401. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11056410&dopt=Abstract

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Adolescents and ritalin. Author(s): Huessy HR. Source: Pediatrics. 1985 March; 75(3): 614. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3975134&dopt=Abstract

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An analysis of the legal issue surrounding the forced use of Ritalin: protecting a child's right to “just say no. Author(s): O'Leary JC. Source: New Engl Law Rev. 1993 Summer; 27(4): 1173-209. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11659842&dopt=Abstract

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An outline of hazardous side effects of Ritalin (methylphenidate). Author(s): Scarnati R. Source: Int J Addict. 1986 July; 21(7): 837-41. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3536764&dopt=Abstract

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An unlikely vice: Ritalin. Author(s): Vishio J. Source: Adv Nurse Pract. 2001 February; 9(2): 60. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12416056&dopt=Abstract

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Behavior disorders and the Ritalin controversy. Author(s): Huessy HR. Source: Jama : the Journal of the American Medical Association. 1988 October 21; 260(15): 2219. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3172401&dopt=Abstract

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Boom in Ritalin sales raises ethical issues. Author(s): Kolata G. Source: Ny Times (Print). 1996 May 15; : C8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11647121&dopt=Abstract

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Caveat lector: be wary of media reports about excessive Ritalin use in BC. Author(s): Dormuth C, Anderson JF, Warren L. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 2000 February 8; 162(3): 313. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10693576&dopt=Abstract

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Childhood is not what it used to be: the rise of Ritalin has more to do with shifting social values than advances in neuropharmacology. Author(s): Concar D. Source: New Scientist (1971). 2002 August 24; 175(2357): 25. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12731536&dopt=Abstract

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Clinical trials. Planned Ritalin trial for tots heads into uncharted waters. Author(s): Marshall E. Source: Science. 2000 November 17; 290(5495): 1280-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11185396&dopt=Abstract

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Concerns about Ritalin. Author(s): Carey WB, Diller LH. Source: The Journal of Pediatrics. 2001 August; 139(2): 338-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11487772&dopt=Abstract

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Deep neck abscesses secondary to methylphenidate (Ritalin) abuse. Author(s): Zemplenyi J, Colman MF. Source: Head Neck Surg. 1984 March-April; 6(4): 858-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6706625&dopt=Abstract

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Detection of ritalinic acid in urine by thin-layer chromatography and gas chromatography. Author(s): Allen HW, Sedgwick B. Source: Journal of Analytical Toxicology. 1984 March-April; 8(2): 61-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6716975&dopt=Abstract

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Developmental changes in the mother-child interactions of hyperactive boys: effects of two dose levels of Ritalin. Author(s): Barkley RA, Karlsson J, Pollard S, Murphy JV. Source: Journal of Child Psychology and Psychiatry, and Allied Disciplines. 1985 September; 26(5): 705-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3900116&dopt=Abstract

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Dispensing errors: Ritalin v. ritodrine. Author(s): Hall P. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 1986 September 1; 135(5): 432. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3742381&dopt=Abstract

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Does my child need Ritalin? Stimulants are still the most effective treatment for ADHD. The challenge is to use them wisely. Author(s): Adesman A. Source: Newsweek. 2000 April 24; 135(17): 81. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10848381&dopt=Abstract

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Doing Ritalin right. Sure, it works--but there are big flaws in the way it's being given. Author(s): Brink S. Source: U.S. News & World Report. 1998 November 23; 125(20): 76-7, 80-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10187350&dopt=Abstract

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Effects of age and Ritalin dosage on the mother-child interactions of hyperactive children. Author(s): Barkley RA, Karlsson J, Strzelecki E, Murphy JV. Source: Journal of Consulting and Clinical Psychology. 1984 October; 52(5): 750-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6501660&dopt=Abstract

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Effects of methylphenidate (Ritalin) on auditory performance in children with attention and auditory processing disorders. Author(s): Tillery KL, Katz J, Keller WD. Source: Journal of Speech, Language, and Hearing Research : Jslhr. 2000 August; 43(4): 893-901. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11386476&dopt=Abstract

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Effects of methylphenidate (Ritalin) on information processing in hyperactive children. Author(s): Reid MK, Borkowski JG. Source: Journal of Abnormal Child Psychology. 1984 March; 12(1): 169-85. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6715692&dopt=Abstract

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Enantioselective gas chromatographic assay with electron-capture detection for dlritalinic acid in plasma. Author(s): Srinivas NR, Hubbard JW, Midha KK. Source: Journal of Chromatography. 1990 September 14; 530(2): 327-36. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2079507&dopt=Abstract

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Extended-release methylphenidate (Ritalin LA). Author(s): Lyseng-Williamson KA, Keating GM. Source: Drugs. 2002; 62(15): 2251-9; Discussion 2260-1. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12381228&dopt=Abstract

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Federal regulation of Ritalin in the treatment of hyperactive children. Author(s): Padway L. Source: Ecol Law Q. 1978; 7(2): 457-95. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11664992&dopt=Abstract

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Is ritalin the answer? Author(s): Dunn M. Source: The American Journal of Nursing. 2002 December; 102(12): 22. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12473925&dopt=Abstract

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Liquid chromatography/atmospheric pressure chemical ionization tandem mass spectrometry enantiomeric separation of dl-threo-methylphenidate, (Ritalin) using a macrocyclic antibiotic as the chiral selector. Author(s): Ramos L, Bakhtiar R, Majumdar T, Hayes M, Tse F. Source: Rapid Communications in Mass Spectrometry : Rcm. 1999; 13(20): 2054-62. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10510420&dopt=Abstract

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Liquid-liquid extraction using 96-well plate format in conjunction with liquid chromatography/tandem mass spectrometry for quantitative determination of methylphenidate (Ritalin) in human plasma. Author(s): Ramos L, Bakhtiar R, Tse FL. Source: Rapid Communications in Mass Spectrometry : Rcm. 2000; 14(9): 740-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10825011&dopt=Abstract

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Maternal death associated with intravenous methylphenidate (Ritalin) and pentazocine (Talwin) abuse. Author(s): Lundquest DE, Young WK, Edland JF. Source: J Forensic Sci. 1987 May; 32(3): 798-801. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3598527&dopt=Abstract

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Medicating children: the case of Ritalin. Author(s): Perring C. Source: Bioethics. 1997 July-October; 11(3-4): 228-40. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11654776&dopt=Abstract

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Megadose intranasal methylphenidate (ritalin) abuse in adult attention deficit hyperactivity disorder. Author(s): Coetzee M, Kaminer Y, Morales A. Source: Substance Abuse : Official Publication of the Association for Medical Education and Research in Substance Abuse. 2002 September; 23(3): 165-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12444349&dopt=Abstract

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Methylphenidate (Ritalin) treatment of cocaine dependence--a preliminary report. Author(s): Khantzian EJ, Gawin F, Kleber HD, Riordan CE. Source: Journal of Substance Abuse Treatment. 1984; 1(2): 107-12. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6536756&dopt=Abstract

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Methylphenidate (Ritalin) use and abuse. Author(s): Crutchley A, Temlett JA. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1999 October; 89(10): 1076-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10582063&dopt=Abstract

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Methylphenidate hydrochloride given with or before breakfast: II. Effects on plasma concentration of methylphenidate and ritalinic acid. Author(s): Chan YP, Swanson JM, Soldin SS, Thiessen JJ, Macleod SM, Logan W. Source: Pediatrics. 1983 July; 72(1): 56-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6866592&dopt=Abstract

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Narcotics plus methylphenidate (Ritalin) for advanced cancer pain. Author(s): Bruera E, Brenneis C, Paterson AH, MacDonald RN. Source: The American Journal of Nursing. 1988 November; 88(11): 1555-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3177508&dopt=Abstract

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Need for bedtime dose of ritalin. Author(s): Rogers WB. Source: Pediatrics. 1996 August; 98(2 Pt 1): 314. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8692642&dopt=Abstract

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New Ritalin ad blitz makes parents jumpy. Author(s): Novak V. Source: Time. 2001 September 10; 158(10): 62-3. Erratum In: Time 2001 October 8; 158(16): Preceding 19. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11558351&dopt=Abstract

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NICE issues new guidelines on Ritalin. Author(s): Dobson R. Source: Bmj (Clinical Research Ed.). 2000 November 4; 321(7269): 1100. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11203218&dopt=Abstract

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No more 'afternoon nasties'. A new rival of Ritalin keeps kids out of the nurse's office. Author(s): Wingert P. Source: Newsweek. 2000 December 4; 136(23): 59. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11126066&dopt=Abstract

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One pill makes you smarter: an ethical appraisal of the rise of Ritalin. Author(s): Mills C. Source: Rep Inst Philos Public Policy. 1998 Fall; 18(4): 13-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11657726&dopt=Abstract

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Panlobular emphysema in young intravenous Ritalin abusers. Author(s): Schmidt RA, Glenny RW, Godwin JD, Hampson NB, Cantino ME, Reichenbach DD. Source: Am Rev Respir Dis. 1991 March; 143(3): 649-56. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2001078&dopt=Abstract

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Panlobular pulmonary emphysema caused by i.v. injection of methylphenidate (Ritalin): findings on chest radiographs and CT scans. Author(s): Stern EJ, Frank MS, Schmutz JF, Glenny RW, Schmidt RA, Godwin JD. Source: Ajr. American Journal of Roentgenology. 1994 March; 162(3): 555-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8109495&dopt=Abstract

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Pay attention: ritalin acts much like cocaine. Author(s): Vastag B. Source: Jama : the Journal of the American Medical Association. 2001 August 22-29; 286(8): 905-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11509035&dopt=Abstract

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Paying attention. The controversy over ADHD and the drug Ritalin is obscuring a real look at the disorder and its underpinnings. Author(s): Leutwyler K. Source: Scientific American. 1996 August; 275(2): 12; 14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8693319&dopt=Abstract

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Pharmaceuticals: conspiracy to increase ritalin profits alleged. Author(s): Lan I. Source: The Journal of Law, Medicine & Ethics : a Journal of the American Society of Law, Medicine & Ethics. 2001 Spring; 29(1): 100-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11521256&dopt=Abstract

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Placebo-controlled evaluation of Ritalin side effects. Author(s): Ahmann PA, Waltonen SJ, Olson KA, Theye FW, Van Erem AJ, LaPlant RJ. Source: Pediatrics. 1993 June; 91(6): 1101-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8502509&dopt=Abstract

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Prediction of methylphenidate (Ritalin) responsiveness through sensory integrative testing. Author(s): Kimball JG. Source: Am J Occup Ther. 1986 April; 40(4): 241-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3963134&dopt=Abstract

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Psychophysiological effects of methylphenidate (Ritalin). Author(s): Murray JB. Source: Psychological Reports. 1987 August; 61(1): 315-36. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3313484&dopt=Abstract

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Pulmonary talc granulomatosis due to intravenous ritalin. Author(s): Williams J, Wilhoite S, Manos P, Zollars P, Youngberg G, Dralle W. Source: J Tenn Med Assoc. 1988 September; 81(9): 560-1. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3184943&dopt=Abstract

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Pushing pills on kids? Lawyers claim a conspiracy to oversell Ritalin. Author(s): Shute N. Source: U.S. News & World Report. 2000 October 2; 129(13): 60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11183332&dopt=Abstract

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Relative efficacy of ritalin and biofeedback treatments in the management of hyperactivity. Author(s): Potashkin BD, Beckles N. Source: Biofeedback Self Regul. 1990 December; 15(4): 305-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2275943&dopt=Abstract

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Ritalin for nicotine withdrawal: Nesbitt's paradox revisited. Author(s): Robinson MD, Anastasio GD, Little JM, Sigmon JL Jr, Menscer D, Pettice YJ, Norton HJ. Source: Addictive Behaviors. 1995 July-August; 20(4): 481-90. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7484329&dopt=Abstract

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Ritalin is okay for kids with both ADHD and Tourette's syndrome, study says. Author(s): Levenson D. Source: Rep Med Guidel Outcomes Res. 2002 March 22; 13(6): 5-7. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12449103&dopt=Abstract

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Ritalin revisited: does it really help in neurological injury? Author(s): Kajs-Wyllie M. Source: The Journal of Neuroscience Nursing : Journal of the American Association of Neuroscience Nurses. 2002 December; 34(6): 303-13. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12506813&dopt=Abstract

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Ritalin tests for preschoolers. Author(s): Greenhill LL. Source: Science. 2000 December 8; 290(5498): 1897. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11187044&dopt=Abstract

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Ritalin use in BC. Author(s): Rees A. Source: Cmaj : Canadian Medical Association Journal = Journal De L'association Medicale Canadienne. 2000 March 21; 162(6): 753-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10750449&dopt=Abstract

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Ritalin: drug of abuse. Two case reports of intra-arterial injection. Author(s): Still A, Gordon M, Mercer J, Roake J. Source: N Z Med J. 2001 November 23; 114(1144): 521-2. No Abstract Available. Erratum In: N Z Med J 2002 January 25; 115(1146): 28. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11795565&dopt=Abstract

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Ritalin: mom's little helper. A disorder long linked to sons migrates up the family tree. Author(s): Ripley A. Source: Time. 2001 February 12; 157(6): 73. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11216227&dopt=Abstract

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Role of Ritalin in preschoolers. Author(s): Koplewicz HS. Source: Journal of Child and Adolescent Psychopharmacology. 2000 Summer; 10(2): 534. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10933114&dopt=Abstract

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Serotonin and the therapeutic effects of ritalin. Author(s): Volkow ND, Gatley SJ, Fowler JS, Wang GJ, Swanson J. Source: Science. 2000 April 7; 288(5463): 11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10766624&dopt=Abstract

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Severe precocious emphysema in intravenous methylphenidate (Ritalin) abusers. Author(s): Sherman CB, Hudson LD, Pierson DJ. Source: Chest. 1987 December; 92(6): 1085-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3677815&dopt=Abstract

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Simultaneous detection of methylphenidate and its main metabolite, ritalinic acid, in doping control. Author(s): Solans A, Carnicero M, De La Torre R, Segura J. Source: Journal of Chromatography. B, Biomedical Applications. 1994 August 19; 658(2): 380-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7820267&dopt=Abstract

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The age of Ritalin. Author(s): Gibbs N. Source: Time. 1998 November 30; 152(22): 86-90, 92-4, 96. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10339008&dopt=Abstract

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The coerced use of Ritalin for behavior control in public schools: legal challenges. Author(s): Jackson JE. Source: Clgh Rev. 1976 July; 10(3): 181-93. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11664661&dopt=Abstract

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The Ritalin controversy: what's made this drug's opponents hyperactive? Author(s): Cowart VS. Source: Jama : the Journal of the American Medical Association. 1988 May 6; 259(17): 2521-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3357218&dopt=Abstract

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The ritalin wars continue. Author(s): Diller LH. Source: The Western Journal of Medicine. 2000 December; 173(6): 366-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11112735&dopt=Abstract

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The run on Ritalin. Attention deficit disorder and stimulant treatment in the 1990s. Author(s): Diller LH. Source: The Hastings Center Report. 1996 March-April; 26(2): 12-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8722521&dopt=Abstract

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Unexpected interaction of methylphenidate (Ritalin) with anaesthetic agents. Author(s): Ririe DG, Ririe KL, Sethna NF, Fox L. Source: Paediatric Anaesthesia. 1997; 7(1): 69-72. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9041578&dopt=Abstract

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US panel calls for research into effects of Ritalin. Author(s): Charatan F. Source: Bmj (Clinical Research Ed.). 1998 December 5; 317(7172): 1545. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9890761&dopt=Abstract

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US parents sue psychiatrists for promoting ritalin. Author(s): Charatan F. Source: Bmj (Clinical Research Ed.). 2000 September 23; 321(7263): 723. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10999893&dopt=Abstract

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What's all the fuss about Ritalin? Author(s): Accardo P, Blondis TA. Source: The Journal of Pediatrics. 2001 January; 138(1): 6-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11148505&dopt=Abstract

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Why we really do need Ritalin. Author(s): Roesch TA. Source: Pediatrics. 1998 January; 101(1 Pt 1): 161. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11345985&dopt=Abstract

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CHAPTER 2. NUTRITION AND RITALIN Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and Ritalin.

Finding Nutrition Studies on Ritalin The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.4 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “Ritalin” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

4

Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

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The following information is typical of that found when using the “Full IBIDS Database” to search for “Ritalin” (or a synonym): •

Separation of ritalin racemate and its by-product racemates by capillary electrophoresis. Author(s): Novartis Pharmaceuticals Corp., Chemical & Analytical R & D Department, East Hanover, NJ 07936, USA. [email protected] Source: Huang, W X Gao, Q Harris, M Fazio, S D Vivilecchia, R V Electrophoresis. 2001 September; 22(15): 3226-31 0173-0835

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Valproate modulates the expression of methylphenidate (ritalin) sensitization. Author(s): Department of Psychiatry and Behavioral Sciences, The University of Texas Medical School at Houston, P.O. Box 20708, Houston, TX 77225, USA. Source: Yang, P Beasley, A Swann, A Dafny, N Brain-Res. 2000 August 25; 874(2): 216-20 0006-8993

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Valproate prevents the induction of sensitization to methylphenidate (ritalin) in rats. Author(s): Department of Psychiatry and Behavioral Sciences, The University of Texas Medical School at Houston, PO Box 20708, Houston, TX 77225, USA. Source: Yang, P Beasley, A Eckermann, K Swann, A Dafny, N Brain-Res. 2000 December 29; 887(2): 276-84 0006-8993

Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

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The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

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The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

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The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

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The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

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Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

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Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

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Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

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Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

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Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

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Google: http://directory.google.com/Top/Health/Nutrition/

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Healthnotes: http://www.healthnotes.com/

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Open Directory Project: http://dmoz.org/Health/Nutrition/

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Yahoo.com: http://dir.yahoo.com/Health/Nutrition/

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WebMDHealth: http://my.webmd.com/nutrition

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

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CHAPTER 3. ALTERNATIVE MEDICINE AND RITALIN Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to Ritalin. At the conclusion of this chapter, we will provide additional sources.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to Ritalin and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “Ritalin” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to Ritalin: •

A 55-year-old man with attention-deficit/hyperactivity disorder, 1 year later. Author(s): Parker RA, Hartman EE. Source: Jama : the Journal of the American Medical Association. 1999 May 26; 281(20): 1945. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10349899&dopt=Abstract

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A longitudinal study of short- and long-term activity levels in male and female spontaneously hypertensive, Wistar-Kyoto, and Sprague-Dawley rats. Author(s): Ferguson SA, Cada AM. Source: Behavioral Neuroscience. 2003 April; 117(2): 271-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12708524&dopt=Abstract

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A pilot study of antihypertensive therapy in cerebrovascular disease. Author(s): Meyer JS, Eadie GA, Ericsson AD, Hoobler SW, MacMahon HR.

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Source: Journal of the American Geriatrics Society. 1967 April; 15(4): 313-21. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5335634&dopt=Abstract •

A positron emission tomography study of methylphenidate in adults with ADHD: alterations in resting blood flow and predicting treatment response. Author(s): Schweitzer JB, Lee DO, Hanford RB, Tagamets MA, Hoffman JM, Grafton ST, Kilts CD. Source: Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology. 2003 May; 28(5): 967-73. Epub 2003 March 26. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12700698&dopt=Abstract

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A review of psychophysiological research with hyperkinetic children. Author(s): Hastings JE, Barkley RA. Source: Journal of Abnormal Child Psychology. 1978 December; 6(4): 413-47. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=215613&dopt=Abstract

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A slow start to the new millennium. Zyvox, Concerta and Mifeprex headline the year. Author(s): Cornell S. Source: Adv Nurse Pract. 2000 December; 8(12): 62-4. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12397912&dopt=Abstract

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A treatment trial of delayed sleep phase syndrome with triazolam. Author(s): Ozaki N, Iwata T, Itoh A, Ohta T, Okada T, Kasahara Y. Source: Jpn J Psychiatry Neurol. 1989 March; 43(1): 51-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2739169&dopt=Abstract

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Acute challenge ERP as a prognostic of stimulant therapy outcome in attention-deficit hyperactivity disorder. Author(s): Young ES, Perros P, Price GW, Sadler T. Source: Biological Psychiatry. 1995 January 1; 37(1): 25-33. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7893855&dopt=Abstract

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ADHD, Ritalin, and big brother. Author(s): Miller AL. Source: Alternative Medicine Review : a Journal of Clinical Therapeutic. 2000 October; 5(5): 401. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11056410&dopt=Abstract

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An experimental comparison of Pycnogenol and methylphenidate in adults with Attention-Deficit/Hyperactivity Disorder (ADHD). Author(s): Tenenbaum S, Paull JC, Sparrow EP, Dodd DK, Green L.

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Source: J Atten Disord. 2002 September; 6(2): 49-60. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12142861&dopt=Abstract •

Attention deficit hyperactivity disorder: binding of [99mTc]TRODAT-1 to the dopamine transporter before and after methylphenidate treatment. Author(s): Dresel S, Krause J, Krause KH, LaFougere C, Brinkbaumer K, Kung HF, Hahn K, Tatsch K. Source: European Journal of Nuclear Medicine. 2000 October; 27(10): 1518-24. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11083541&dopt=Abstract

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Attention deficit/hyperactivity disorder (ADHD) in children: rationale for its integrative management. Author(s): Kidd PM. Source: Alternative Medicine Review : a Journal of Clinical Therapeutic. 2000 October; 5(5): 402-28. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11056411&dopt=Abstract

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Auditory attention in hyperactive children: effects of stimulant medication on dichotic listening performance. Author(s): Hiscock M, Kinsbourne M, Caplan B, Swanson JM. Source: Journal of Abnormal Psychology. 1979 February; 88(1): 27-32. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=422801&dopt=Abstract

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Blockade of striatal dopamine transporters by intravenous methylphenidate is not sufficient to induce self-reports of “high”. Author(s): Volkow ND, Wang GJ, Fowler JS, Gatley SJ, Logan J, Ding YS, Dewey SL, Hitzemann R, Gifford AN, Pappas NR. Source: The Journal of Pharmacology and Experimental Therapeutics. 1999 January; 288(1): 14-20. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9862747&dopt=Abstract

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Cerebral glucose metabolism in adults with attention deficit hyperactivity disorder after chronic stimulant treatment. Author(s): Matochik JA, Liebenauer LL, King AC, Szymanski HV, Cohen RM, Zametkin AJ. Source: The American Journal of Psychiatry. 1994 May; 151(5): 658-64. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8166305&dopt=Abstract

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Clinical studies with propericiazine (R.P. 8909). Author(s): St Jean A, Sterlin C, Noe W, Ban TA. Source: Dis Nerv Syst. 1967 August; 28(8): 526-31. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4383004&dopt=Abstract

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Cocaine abuse and its treatment. Author(s): Resnick RB, Resnick EB. Source: The Psychiatric Clinics of North America. 1984 December; 7(4): 713-28. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6522310&dopt=Abstract

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Controversies in ADHD. Fundamental questions being answered slowly, but scientifically. Author(s): Flick GL. Source: Adv Nurse Pract. 2002 February; 10(2): 34-6, 39-43. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12400297&dopt=Abstract

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Daily activity and persistent sleep-wake schedule disorders. Author(s): Ohta T, Iwata T, Kayukawa Y, Okada T. Source: Progress in Neuro-Psychopharmacology & Biological Psychiatry. 1992 July; 16(4): 529-37. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1641496&dopt=Abstract

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Differential effects of methylphenidate on reticular formation and thalamic neuronal activity. Author(s): Shih TM, Khachaturian ZS, Barry H 3rd, Reisler KL. Source: Psychopharmacologia. 1975 October 14; 44(1): 11-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1197575&dopt=Abstract

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Dopamine transporter gene, response to methylphenidate and cerebral blood flow in attention-deficit/hyperactivity disorder: a pilot study. Author(s): Rohde LA, Roman T, Szobot C, Cunha RD, Hutz MH, Biederman J. Source: Synapse (New York, N.Y.). 2003 May; 48(2): 87-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12619042&dopt=Abstract

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Dopamine transporter occupancies in the human brain induced by therapeutic doses of oral methylphenidate. Author(s): Volkow ND, Wang GJ, Fowler JS, Gatley SJ, Logan J, Ding YS, Hitzemann R, Pappas N. Source: The American Journal of Psychiatry. 1998 October; 155(10): 1325-31. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9766762&dopt=Abstract

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EEG aspects in the diagnosis and treatment of minimal brain dysfunction. Author(s): Satterfield JH, Lesser LI, Saul RE, Cantwell DP. Source: Annals of the New York Academy of Sciences. 1973 February 28; 205: 274-82. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4511281&dopt=Abstract

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EEG issues in children with minimal brain dysfunction. Author(s): Satterfield JH. Source: Semin Psychiatry. 1973 February; 5(1): 35-46. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4803377&dopt=Abstract

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Effects of acute stimulant medication on cerebral metabolism in adults with hyperactivity. Author(s): Matochik JA, Nordahl TE, Gross M, Semple WE, King AC, Cohen RM, Zametkin AJ. Source: Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology. 1993 June; 8(4): 377-86. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8512624&dopt=Abstract

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Effects of methylphenidate discontinuation on cerebral blood flow in prepubescent boys with attention deficit hyperactivity disorder. Author(s): Langleben DD, Acton PD, Austin G, Elman I, Krikorian G, Monterosso JR, Portnoy O, Ridlehuber HW, Strauss HW. Source: Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine. 2002 December; 43(12): 1624-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12468511&dopt=Abstract

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Effects of TENS and methylphenidate in tuberculous meningo-encephalitis. Author(s): Scherder EJ, Van Deursen S, Van Manen SR, Ferenschild K, Simis R, Vuyk PJ. Source: Brain Injury : [bi]. 2001 June; 15(6): 545-58. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11394974&dopt=Abstract

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Efficacy or effectiveness: which comes first, the cure or the treatment? Author(s): Oster MI. Source: Am J Clin Hypn. 2003 July; 46(1): 3-10. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12894927&dopt=Abstract

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Electrodermal correlates of hyperactivity in children. Author(s): Satterfield JH, Dawson ME. Source: Psychophysiology. 1971 March; 8(2): 191-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=5089415&dopt=Abstract

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Elevated striatal dopamine transporter in a drug naive patient with Tourette syndrome and attention deficit/ hyperactivity disorder: positive effect of methylphenidate. Author(s): Krause KH, Dresel S, Krause J, Kung HF, Tatsch K, Lochmuller H. Source: Journal of Neurology. 2002 August; 249(8): 1116-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12420715&dopt=Abstract

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Emerging drugs of abuse in Connecticut. Author(s): Weiner AL. Source: Conn Med. 2000 January; 64(1): 19-23. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10697361&dopt=Abstract

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EMG and EEG biofeedback training in the treatment of a 10-year-old hyperactive boy with a developmental reading disorder. Author(s): Tansey MA, Bruner RL. Source: Biofeedback Self Regul. 1983 March; 8(1): 25-37. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6882815&dopt=Abstract

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Ephedrine and other stimulants as ergogenic aids. Author(s): Bohn AM, Khodaee M, Schwenk TL. Source: Curr Sports Med Rep. 2003 August; 2(4): 220-5. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12834578&dopt=Abstract

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Evoked potentials in hyperkinetic and normal children under certainty and uncertainty: a placebo and methylphenidate study. Author(s): Prichep LS, Sutton S, Hakerem G. Source: Psychophysiology. 1976 September; 13(5): 419-28. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=972965&dopt=Abstract

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Fatigue in multiple sclerosis. Author(s): Krupp LB, Christodoulou C. Source: Curr Neurol Neurosci Rep. 2001 May; 1(3): 294-8. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11898532&dopt=Abstract

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Methylphenidate (ritalin) abuse and methadone maintenance. Author(s): Raskind M, Bradford T. Source: Dis Nerv Syst. 1975 January; 36(1): 9-12. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1109888&dopt=Abstract

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Operant conditioning of EEG rhythms and ritalin in the treatment of hyperkinesis. Author(s): Shouse MN, Lubar JF. Source: Biofeedback Self Regul. 1979 December; 4(4): 299-312. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=526475&dopt=Abstract

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Outcome-based comparison of Ritalin versus food-supplement treated children with AD/HD. Author(s): Harding KL, Judah RD, Gant C.

Alternative Medicine 37

Source: Alternative Medicine Review : a Journal of Clinical Therapeutic. 2003 August; 8(3): 319-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12946241&dopt=Abstract •

Pay attention: ritalin acts much like cocaine. Author(s): Vastag B. Source: Jama : the Journal of the American Medical Association. 2001 August 22-29; 286(8): 905-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11509035&dopt=Abstract

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Paying attention. The controversy over ADHD and the drug Ritalin is obscuring a real look at the disorder and its underpinnings. Author(s): Leutwyler K. Source: Scientific American. 1996 August; 275(2): 12; 14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8693319&dopt=Abstract

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Relative efficacy of ritalin and biofeedback treatments in the management of hyperactivity. Author(s): Potashkin BD, Beckles N. Source: Biofeedback Self Regul. 1990 December; 15(4): 305-15. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2275943&dopt=Abstract

Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •

Alternative Medicine Foundation, Inc.: http://www.herbmed.org/

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AOL: http://search.aol.com/cat.adp?id=169&layer=&from=subcats

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Chinese Medicine: http://www.newcenturynutrition.com/

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drkoop.com: http://www.drkoop.com/InteractiveMedicine/IndexC.html

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Family Village: http://www.familyvillage.wisc.edu/med_altn.htm

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Google: http://directory.google.com/Top/Health/Alternative/

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Healthnotes: http://www.healthnotes.com/

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MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine

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Open Directory Project: http://dmoz.org/Health/Alternative/

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HealthGate: http://www.tnp.com/

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WebMDHealth: http://my.webmd.com/drugs_and_herbs

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WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

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Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/

The following is a specific Web list relating to Ritalin; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

General Overview Attention Deficit Disorder Source: Prima Communications, Inc.www.personalhealthzone.com Attention Deficit Hyperactivity Disorder Source: Integrative Medicine Communications; www.drkoop.com Attention Deficit Hyperactivity Disorder Source: Healthnotes, Inc.; www.healthnotes.com Depression Source: Integrative Medicine Communications; www.drkoop.com

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Herbs and Supplements Astragalus MEM Alternative names: Huang-Qi; Astragalus membranaceus Source: Alternative Medicine Foundation, Inc.; www.amfoundation.org Ginseng (Panax) Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10029,00.html Methylphenidate Source: Healthnotes, Inc.; www.healthnotes.com

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

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CHAPTER 4. DISSERTATIONS ON RITALIN Overview In this chapter, we will give you a bibliography on recent dissertations relating to Ritalin. We will also provide you with information on how to use the Internet to stay current on dissertations. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical dissertations that use the generic term “Ritalin” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on Ritalin, we have not necessarily excluded non-medical dissertations in this bibliography.

Dissertations on Ritalin ProQuest Digital Dissertations, the largest archive of academic dissertations available, is located at the following Web address: http://wwwlib.umi.com/dissertations. From this archive, we have compiled the following list covering dissertations devoted to Ritalin. You will see that the information provided includes the dissertation’s title, its author, and the institution with which the author is associated. The following covers recent dissertations found when using this search procedure: •

A Contrast of the Knowledge and Attitudes of Special Education Teachers and Elementary Teachers about Ritalin in Its Use with Hyperkinetic Children. by Treegoob, Mark Richard, PhD from Indiana State University, 1976, 160 pages http://wwwlib.umi.com/dissertations/fullcit/7628300

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A Double-blind Study of the Central Auditory Processing and Auditory Continuous Test Performances of Children with Attention Deficit Hyperactivity Disorder and Central Auditory Processing Disorder under Ritalin and Placebo Conditions by Tillery, Kim Laurel, PhD from State University of New York at Buffalo, 1997, 104 pages http://wwwlib.umi.com/dissertations/fullcit/9801350

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A Study of the Effects of Ritalin (r) Intervention upon the Perceptual Competencies of Children Diagnosed As Giving Evidence of Psychoneurological Learning Disabilities. by Skorina, Jane Koepel, PhD from Wayne State University, 1973, 176 pages http://wwwlib.umi.com/dissertations/fullcit/7411157

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An Academic and Social Follow-up of Children Placed on Dexedrine or Ritalin for Severe Hyperactive or Hyperkinetic Disorders by Disenhouse, Harvey Alan, PhD from The University of Iowa, 1972, 148 pages http://wwwlib.umi.com/dissertations/fullcit/7226670

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Analysis and Pharmacokinetics of Methylphenidate (Ritalin) Studies in Hyperactive Children by Chan, Ying-pui Mick; PhD from University of Toronto (Canada), 1980 http://wwwlib.umi.com/dissertations/fullcit/NK47027

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Effects of Ritalin on Hyperkinetic Children Attending the Glendale Elementary Schools by Conley, Daniel Peter, EDD from Arizona State University, 1973, 162 pages http://wwwlib.umi.com/dissertations/fullcit/7320427

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The Effects of Ritalin and Dexedrine upon Certain Behavioral Characteristics of Overactive Youngsters As Perceived by Parents and Teachers by Murray, Joseph Norman, PhD from The Ohio State University, 1971, 122 pages http://wwwlib.umi.com/dissertations/fullcit/7204592

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The Effects of Ritalin on Levels of Processing and Laterality in Children with Attention Deficit Disorder by Malone, Molly; PhD from University of Toronto (Canada), 1986 http://wwwlib.umi.com/dissertations/fullcit/NL34167

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The Effects of Ritalin on the Postrotatory Nystagmus Response of Hyperactive Children with Attention Deficit Disorders by Jackson, Shelia Lucyle, PhD from Texas Woman's University, 1988, 148 pages http://wwwlib.umi.com/dissertations/fullcit/8821413

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Vulnerability to Cocaine Following Exposure to Ritalin Rtm: a Behavioral and Electrophysiological Study in Rats Treated Wit Ritalinrtm As Adolescents by Brandon, Cindy Lorrance; PhD from The Herman M. Finch U. of Health Sciences - the Chicago Medical Sch., 2002, 189 pages http://wwwlib.umi.com/dissertations/fullcit/3061525

Keeping Current Ask the medical librarian at your library if it has full and unlimited access to the ProQuest Digital Dissertations database. From the library, you should be able to do more complete searches via http://wwwlib.umi.com/dissertations.

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CHAPTER 5. BOOKS ON RITALIN Overview This chapter provides bibliographic book references relating to Ritalin. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on Ritalin include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “Ritalin” at online booksellers’ Web sites, you may discover nonmedical books that use the generic term “Ritalin” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “Ritalin” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Attention Deficits, Learning Disabilities, and Ritalin (1991); ISBN: 0316469874; http://www.amazon.com/exec/obidos/ASIN/0316469874/icongroupinterna

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Attention Deficits, Learning Disabilities, and Ritalin: A Practical Guide by Robert B. Johnston; ISBN: 1879105128; http://www.amazon.com/exec/obidos/ASIN/1879105128/icongroupinterna

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Beyond Ritalin : Facts About Medication and Other Strategies for Helping Children, Adolescents, and Adults with Attention Deficit Disorders by Stephen W. Garber (Author) (1997); ISBN: 0060977256; http://www.amazon.com/exec/obidos/ASIN/0060977256/icongroupinterna

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Do We Really Need Ritalin?: A Family Guide to Attention Deficit Hyperactivity Disorder (ADHD) by Josephine, Md. Wright; ISBN: 0380793563; http://www.amazon.com/exec/obidos/ASIN/0380793563/icongroupinterna

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Getting Rid of Ritalin: How Neurofeedback Can Successfully Treat Attention Deficit Disorder Without Drugs by Robert W. Hill, Eduardo Castro; ISBN: 1571742549; http://www.amazon.com/exec/obidos/ASIN/1571742549/icongroupinterna

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Is Ritalin Necessary?: The Ritalin Report by Billie Jay Sahley (1996); ISBN: 0962591491; http://www.amazon.com/exec/obidos/ASIN/0962591491/icongroupinterna

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Is Ritalin Wrong for Our Hyperactive Kids/Cassette; ISBN: 9990990999; http://www.amazon.com/exec/obidos/ASIN/9990990999/icongroupinterna

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Nature's Ritalin for the Marathon Mind: Nurturing Your ADHD Child With Exercise by Stephen C. Putnam, et al; ISBN: 0942679261; http://www.amazon.com/exec/obidos/ASIN/0942679261/icongroupinterna

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No Apologies For Ritalin by Vidya Bhushan Gupta MD, Vidya Bhushan Gupta; ISBN: 0930958098; http://www.amazon.com/exec/obidos/ASIN/0930958098/icongroupinterna

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No More Ritalin: Treating Adhd Without Drugs by Mary Ann Block (Preface) (1996); ISBN: 1575661268; http://www.amazon.com/exec/obidos/ASIN/1575661268/icongroupinterna

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Ritalin by Eileen J. Beal; ISBN: 1568382480; http://www.amazon.com/exec/obidos/ASIN/1568382480/icongroupinterna

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Ritalin by David J., Ph.d Triggle (Editor), Carmen Ferreiro; ISBN: 0791076377; http://www.amazon.com/exec/obidos/ASIN/0791076377/icongroupinterna

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Ritalin is Not the Answer Action Guide: An Interactive Companion to the Bestselling Drug-Free ADD/ADHD Parenting Program by David B. Stein (Author); ISBN: 0787960446; http://www.amazon.com/exec/obidos/ASIN/0787960446/icongroupinterna

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Ritalin Nation: Rapid-Fire Culture and the Transformation of Human Consciousness by Richard J. DeGrandpre (2000); ISBN: 0393320251; http://www.amazon.com/exec/obidos/ASIN/0393320251/icongroupinterna

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Ritalin use among youth : examining the issues and concerns : hearing before the Subcommittee on Early Childhood, Youth, and Families of the Committee on Education and the Workforce, House of Representatives, One Hundred Sixth Congress, second session, hearing held in Washington, DC, May 16, 2000 (SuDoc Y 4.ED 8/1:106-109); ISBN: B000113HOY; http://www.amazon.com/exec/obidos/ASIN/B000113HOY/icongroupinterna

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Ritalin: Its Use and Abuse (Drug Abuse Prevention) by Eileen J. Beal (1998); ISBN: 082392775X; http://www.amazon.com/exec/obidos/ASIN/082392775X/icongroupinterna

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Ritalin: Theory and Practice by Laurence L. Greenhill (Editor), Betty B. Osman (Editor); ISBN: 0913113824; http://www.amazon.com/exec/obidos/ASIN/0913113824/icongroupinterna

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Ritalin-Free Kids: Safe and Effective Homeopathic Medicine for ADHD and Other Behavioral and Learning Problems by M.S.W. N.D. Judyth Reichenberg-Ullman (Author), N.D. Robert Ullman (Author) (2000); ISBN: 0761527699; http://www.amazon.com/exec/obidos/ASIN/0761527699/icongroupinterna

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Running on Ritalin : A Physician Reflects on Children, Society, and Performance in a Pill by Lawrence H. Diller (Author) (1999); ISBN: 0553379062; http://www.amazon.com/exec/obidos/ASIN/0553379062/icongroupinterna

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•

Talking Back to Ritalin: What Doctors Aren't Telling You About Stimulants and ADHD by Peter R. Breggin, Dick Scruggs (2001); ISBN: 0738205443; http://www.amazon.com/exec/obidos/ASIN/0738205443/icongroupinterna

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Teaching the Restless : One School's Remarkable no-Ritalin Approach to Helping Children Learn and Succeed by Chris Mercogliano (Author) (2004); ISBN: 0807032468; http://www.amazon.com/exec/obidos/ASIN/0807032468/icongroupinterna

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The Myth of ADHD and Other Learning Disabilities. Parenting Without Ritalin. by Jan, Dr. Strydom, Susan Du Plessis; ISBN: 1563841800; http://www.amazon.com/exec/obidos/ASIN/1563841800/icongroupinterna

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The Ritalin Fact Book: What Your Doctor Won't Tell You by Peter R., MD Breggin (2002); ISBN: 0738204501; http://www.amazon.com/exec/obidos/ASIN/0738204501/icongroupinterna

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The Ritalin Handbook by John S. Markowitz, C. Lindsay DeVane; ISBN: 0970311508; http://www.amazon.com/exec/obidos/ASIN/0970311508/icongroupinterna

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The Ritalin-Free Child: Managing Hyperactivity & Attention Deficits Without Drugs by Diana Hunter, Joseph Pappas (Editor) (1995); ISBN: 0962833681; http://www.amazon.com/exec/obidos/ASIN/0962833681/icongroupinterna

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Unglued & Tattooed: How to Save Your Teen from Raves, Ritalin, Goth, Body Carving, Ghb, Sex, and 12 Other Emerging Threats; ISBN: 0895261693; http://www.amazon.com/exec/obidos/ASIN/0895261693/icongroupinterna

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What You Need to Know About Ritalin by James Windell (Author), et al; ISBN: 055357552X; http://www.amazon.com/exec/obidos/ASIN/055357552X/icongroupinterna

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Without Ritalin [DOWNLOAD: MICROSOFT READER] by Samuel A. Berne (2001); ISBN: B000096B49; http://www.amazon.com/exec/obidos/ASIN/B000096B49/icongroupinterna

The National Library of Medicine Book Index The National Library of Medicine at the National Institutes of Health has a massive database of books published on healthcare and biomedicine. Go to the following Internet site, http://locatorplus.gov/, and then select “Search LOCATORplus.” Once you are in the search area, simply type “Ritalin” (or synonyms) into the search box, and select “books only.” From there, results can be sorted by publication date, author, or relevance. The following was recently catalogued by the National Library of Medicine:5 •

5

Beyond ritalin: facts about medication and other strategies for helping children, adolescents, and adults with attention deficit disorders Author: Garber, Stephen W.,; Year: 1996; New York: Villard, c1996; ISBN: 0679450181

In addition to LOCATORPlus, in collaboration with authors and publishers, the National Center for Biotechnology Information (NCBI) is currently adapting biomedical books for the Web. The books may be accessed in two ways: (1) by searching directly using any search term or phrase (in the same way as the bibliographic database PubMed), or (2) by following the links to PubMed abstracts. Each PubMed abstract has a "Books" button that displays a facsimile of the abstract in which some phrases are hypertext links. These phrases are also found in the books available at NCBI. Click on hyperlinked results in the list of books in which the phrase is found. Currently, the majority of the links are between the books and PubMed. In the future, more links will be created between the books and other types of information, such as gene and protein sequences and macromolecular structures. See http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Books.

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http://www.amazon.com/exec/obidos/ASIN/0679450181/icongroupinterna •

Guidance on the use of methylphenidate (Ritalin, Equasym) for attention deficit Author: National Institute for Clinical Excellence (Great Britain); Year: 2000; London: National Institute for Clinical Excellence, 2000; ISBN: 1842570471

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Lysergic acid (LSD 25) & Ritalin in the treatment of neurosis [by] Thomas M. Ling [and] John Buckman. Author: Ling, Thomas Mortimer; Year: 1963

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Lysergic acid (LSD 25) & Ritalin in the treatment of neurosis [by] Thomas M. Ling [and] John Buckman. Author: Ling, Thomas Mortimer.; Year: 9999; [London] Lambarde Press [1963]

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Ritalin: therory and patient management Author: Greenhill, Laurence L.; Year: 1991; New York, NY: M.A. Liebert Publishers, c1991; ISBN: 0913113530 http://www.amazon.com/exec/obidos/ASIN/0913113530/icongroupinterna

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Ritalin is not the answer: a drug-free, practical program for children diagnosed with ADD or ADHD Author: Stein, David B.; Year: 1999; San Francisco: Jossey-Bass, c1999; ISBN: 0787945145 http://www.amazon.com/exec/obidos/ASIN/0787945145/icongroupinterna

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Ritalin nation: rapid-fire culture and the transformation of human consciousness Author: DeGrandpre, Richard J.; Year: 1999; New York: W.W. Norton, c1999; ISBN: 0393046850 http://www.amazon.com/exec/obidos/ASIN/0393046850/icongroupinterna

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Talking back to Ritalin: what doctors aren't telling you about stimulants and ADHD Author: Breggin, Peter Roger,; Year: 2001; Cambridge, Mass.: Perseus Pub., c2001; ISBN: 1567511295 http://www.amazon.com/exec/obidos/ASIN/1567511295/icongroupinterna

Chapters on Ritalin In order to find chapters that specifically relate to Ritalin, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and Ritalin using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “Ritalin” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on Ritalin: •

Stimulants Source: in Barkley, R.A. Taking Charge of ADHD: The Complete, Authoritative Guide for Parents. New York, NY: Guilford Press. 2000. p. 269-287. Contact: Available from Guilford Publications. 72 Spring Street, New York, NY 10012. (800) 365-7006. Fax (212) 966-6708. E-mail: [email protected]. Website: www.guilford.com. PRICE: $18.95 plus shipping and handling. ISBN: 1572305606. Summary: Children whose problems with attention, overactivity, and lack of inhibition reach a certain level have a developmental disability known as attention deficit hyperactivity disorder (ADHD). This chapter on medications (drug therapy) is from a book intended to help parents who are raising a child with ADHD and for others who wish to know more about the disorder and its management. The author's main goal is to

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empower parents to take charge of the care of these often demanding children in a way that ensures the health of the entire family, collectively and individually. In this chapter, the author focuses on stimulants, the drugs most commonly used, noting that stimulants have been shown to be effective in improving behavior, academic work, and social adjustment in 50 to 95 percent of children with ADHD. The author offers up to date information on the stimulant medications. The brand names of these medications include Ritalin (methylphenidate), Dexedrine (d amphetamine), Adderall (d and l amphetamine combination), and Cylert (pemoline). The author begins by refuting myths about these drugs, and encouraging readers to gather information from their physicians and from reference tools. The author then describes how the stimulants work, what the drugs do for behavior and emotions, how the drugs change learning and academic performance, the effect of these medications on social behavior, how long the effects of the drugs last, possible side effects (decreased appetite, increased heart rate and blood pressure, increased brain electrical activity, insomnia, nervous tics, temporary psychosis, long term effects), deciding about stimulant use in an individual child, how stimulants are prescribed, and when the medicines should be stopped. 1 figure.

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CHAPTER 6. MULTIMEDIA ON RITALIN Overview In this chapter, we show you how to keep current on multimedia sources of information on Ritalin. We start with sources that have been summarized by federal agencies, and then show you how to find bibliographic information catalogued by the National Library of Medicine.

Audio Recordings The Combined Health Information Database contains abstracts on audio productions. To search CHID, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find audio productions, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Sound Recordings.” Type “Ritalin” (or synonyms) into the “For these words:” box. The following is a typical result when searching for sound recordings on Ritalin: •

Plenary Presentation Sessions on AIDS Update. The Second International Lesbian and Gay Health Conference and AIDS Forum, Boston, MA, July 20-26, 1988 Contact: Audio Video Transcripts, 250 W 49th St, New York, NY, 10019, (212) 586-1972. Summary: This sound recording of the Second International Lesbian and Gay Health Conference and AIDS Forum, on July 20-26, 1988, in Boston, MA, presents a session on the neuropsychiatric aspects of Acquired immunodeficiency syndrome (AIDS) and Human immunodeficiency virus (HIV) infection. Dr. Marshall Forstein, co-director of an outpatient psychiatric hospital in Cambridge, examines the broad spectrum of concerns, clinical issues, and treatment modalities for the mental illnesses associated with AIDS. The organic basis for behavioral changes, primary infection of HIV in brain tissue, and primary dementing illness are explained in reference to differential diagnosis from delirium, toxoplasmosis and other infections, and drug effects. Compliance; management of pain syndromes; suicide; psychopharmacology, particularly with ritalin; and psychotherapy are also discussed. Dr. David Ostrow, associate professor of psychiatry at the University of Michigan, discusses the natural history of HIV-related brain disease and related ethical problems as evident from a general opinion survey regarding AIDS policies: Employment-based policies, social programs, and mandatory public health policies.

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Bibliography: Multimedia on Ritalin The National Library of Medicine is a rich source of information on healthcare-related multimedia productions including slides, computer software, and databases. To access the multimedia database, go to the following Web site: http://locatorplus.gov/. Select “Search LOCATORplus.” Once in the search area, simply type in Ritalin (or synonyms). Then, in the option box provided below the search box, select “Audiovisuals and Computer Files.” From there, you can choose to sort results by publication date, author, or relevance. The following multimedia has been indexed on Ritalin: •

Oatbrand & oatmeal claims [videorecording]; Ritalin Source: RTV; Year: 1996; Format: Videorecording; [New York?]: CMR, [1996?]

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Ritalin [videorecording]: drug treatment for attention deficit disorder Source: a presentation of Films for the Humanities & Sciences; Year: 1996; Format: Videorecording; Princeton, N.J.: Films for the Humanities & Sciences, c1996

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Ritilin [i.e. Ritalin] [videorecording]. Year: 1996; Format: I.e. Ritalin; [Atlanta, Ga.: CNN, 1996?]

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CHAPTER 7. PERIODICALS AND NEWS ON RITALIN Overview In this chapter, we suggest a number of news sources and present various periodicals that cover Ritalin.

News Services and Press Releases One of the simplest ways of tracking press releases on Ritalin is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “Ritalin” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to Ritalin. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “Ritalin” (or synonyms). The following was recently listed in this archive for Ritalin: •

Kids' use of Ritalin, other drugs varies across US Source: Reuters Health eLine Date: February 03, 2003

•

German insurer warns of steep rise in Ritalin use Source: Reuters Health eLine Date: January 27, 2003

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•

German health insurance chief warns of "alarming increase" in Ritalin use Source: Reuters Industry Breifing Date: January 27, 2003

•

Foes clash in Washington over Ritalin use in kids Source: Reuters Health eLine Date: September 26, 2002

•

Ritalin use by Canadian children grew in mid-1990s Source: Reuters Health eLine Date: September 02, 2002

•

Once-daily version of Ritalin approved by US FDA Source: Reuters Medical News Date: June 06, 2002

•

Once-daily version of Novartis' Ritalin wins FDA approval Source: Reuters Industry Breifing Date: June 06, 2002

•

Once-a-day Ritalin formulation wins FDA OK Source: Reuters Health eLine Date: June 06, 2002

•

Alpharma wins FDA okay for new generic Ritalin dosages Source: Reuters Industry Breifing Date: February 06, 2002

•

Alpharma gets FDA approval to sell generic Ritalin; issues convertible notes Source: Reuters Industry Breifing Date: December 24, 2001

•

Single-isomer Ritalin to help Celgene maintain profitability, analysts say Source: Reuters Industry Breifing Date: November 15, 2001

•

Single-isomer version of Novartis' Ritalin approved by FDA Source: Reuters Industry Breifing Date: November 14, 2001

•

Some kids on Ritalin sell the drug to classmates Source: Reuters Health eLine Date: November 13, 2001

•

Ritalin may change brain long-term, study shows Source: Reuters Health eLine Date: November 12, 2001

•

Once-daily Ritalin product receives FDA approvable letter Source: Reuters Medical News Date: October 02, 2001

•

Once-daily Ritalin close to FDA approval Source: Reuters Health eLine Date: October 02, 2001

•

Novartis, Celgene once-daily Ritalin product receives FDA approvable letter Source: Reuters Industry Breifing Date: October 02, 2001

Periodicals and News

•

Govt. report downplays Ritalin abuse in schools Source: Reuters Health eLine Date: September 19, 2001

•

FDA grants approvable letter for new Ritalin formulation Source: Reuters Industry Breifing Date: August 22, 2001

•

Ritalin lawsuit withdrawn by class-action plaintiffs in Puerto Rico Source: Reuters Industry Breifing Date: August 17, 2001

•

Connecticut Ritalin law targets schools, not docs Source: Reuters Health eLine Date: July 25, 2001

•

Connecticut Ritalin law targets schools, not doctors Source: Reuters Industry Breifing Date: July 24, 2001

•

Biovail, Celgene file Ritalin formulation for Canadian approval Source: Reuters Industry Breifing Date: July 10, 2001

•

Judge dismisses Ritalin lawsuit against Novartis Source: Reuters Industry Breifing Date: May 21, 2001

•

Ritalin helps teens with ADHD, study shows Source: Reuters Health eLine Date: May 15, 2001

•

Judge in US rejects Ritalin complaints Source: Reuters Industry Breifing Date: March 14, 2001

•

Watson wins FDA approval for Daypro, Ritalin-SR generics Source: Reuters Industry Breifing Date: February 13, 2001

•

Study unlocks brain mystery of Ritalin Source: Reuters Health eLine Date: January 19, 2001

•

Study suggests Ritalin abuse occurs on campus Source: Reuters Health eLine Date: December 29, 2000

•

Celgene files Ritalin formulation with FDA, earns $5 million milestone Source: Reuters Industry Breifing Date: December 27, 2000

•

Children can overdose on Ritalin Source: Reuters Health eLine Date: December 15, 2000

•

UK drug watchdog OKs use of Ritalin Source: Reuters Health eLine Date: October 31, 2000

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•

UK drug watchdog approves Ritalin use Source: Reuters Industry Breifing Date: October 31, 2000

•

Ritalin treats chronic fatigue in cirrhosis patients Source: Reuters Health eLine Date: October 19, 2000

•

Lawsuits allege conspiracy in Ritalin use; Congressman urges probe of abuses Source: Reuters Industry Breifing Date: September 15, 2000

•

Lawsuits allege Ritalin conspiracy; Congressman orders probe Source: Reuters Health eLine Date: September 14, 2000

•

UK mulls restricting Ritalin use Source: Reuters Industry Breifing Date: September 12, 2000

•

UK reexamines Ritalin use in children Source: Reuters Health eLine Date: September 11, 2000

•

Novartis says will fight Ritalin suit Source: Reuters Health eLine Date: May 16, 2000

•

Ritalin and Prozac combination used by more children Source: Reuters Health eLine Date: May 15, 2000

•

Survey finds potential for Ritalin abuse Source: Reuters Health eLine Date: June 16, 1998

•

Ritalin could be made more effective Source: Reuters Health eLine Date: May 26, 1998

•

Ethicists Assert Electroshock Misused, Ritalin Overused In Children Source: Reuters Medical News Date: November 26, 1996

•

White House announces plan to curb children's use of Ritalin, psychotropic drugs Source: Reuters Medical News Date: March 21, 2000

•

White House plan aims to curb Ritalin use Source: Reuters Health eLine Date: March 20, 2000

•

Adderall at least as effective as Ritalin in children with ADHD Source: Reuters Medical News Date: April 08, 1999

•

New Ritalin allows lower dose Source: Reuters Health eLine Date: March 25, 1999

Periodicals and News

•

53

Slow brain uptake prevents Ritalin addiction Source: Reuters Health eLine Date: September 29, 1998 The NIH

Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “Ritalin” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “Ritalin” (or synonyms). If you know the name of a company that is relevant to Ritalin, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “Ritalin” (or synonyms).

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Academic Periodicals covering Ritalin Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to Ritalin. In addition to these sources, you can search for articles covering Ritalin that have been published by any of the periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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APPENDICES

57

APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute6: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

•

National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

•

National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

•

National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

•

National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

•

National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

•

National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

•

National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

6

These publications are typically written by one or more of the various NIH Institutes.

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•

National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

•

National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

•

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

•

National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

•

National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

•

National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

•

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

•

National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

•

National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

•

National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

•

National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

•

National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

•

National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

•

Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

•

National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

•

National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

•

Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

•

Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.7 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:8 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

•

NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

•

Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

•

Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

•

Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

•

Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

•

Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

•

Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

•

MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

7

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 8 See http://www.nlm.nih.gov/databases/databases.html.

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•

Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

•

Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html

The NLM Gateway9 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.10 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd. Type “Ritalin” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 3041 61 968 4 0 4074

HSTAT11 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.12 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.13 Simply search by “Ritalin” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

9

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

10

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH). 11 Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html. 12 13

The HSTAT URL is http://hstat.nlm.nih.gov/.

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations.

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Coffee Break: Tutorials for Biologists14 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.15 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.16 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/.

Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

14 Adapted 15

from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html.

The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 16 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on Ritalin can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to Ritalin. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to Ritalin. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “Ritalin”:

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•

Other guides Attention Deficit Disorder with Hyperactivity http://www.nlm.nih.gov/medlineplus/attentiondeficitdisorderwithhyperactivity.t ml Prescription Drug Abuse http://www.nlm.nih.gov/medlineplus/prescriptiondrugabuse.html Sleep Disorders http://www.nlm.nih.gov/medlineplus/sleepdisorders.html Tourette Syndrome http://www.nlm.nih.gov/medlineplus/tourettesyndrome.html

You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. Healthfinder™ Healthfinder™ is sponsored by the U.S. Department of Health and Human Services and offers links to hundreds of other sites that contain healthcare information. This Web site is located at http://www.healthfinder.gov. Again, keyword searches can be used to find guidelines. The following was recently found in this database: •

Ritalin Summary: This consumer information fact sheet addresses the problems associated with Ritalin abuse by people for whom it is not a medication. Source: National Institute on Drug Abuse, National Institutes of Health http://www.healthfinder.gov/scripts/recordpass.asp?RecordType=0&RecordID=3807 The NIH Search Utility

The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to Ritalin. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html.

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65

Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=168&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/specific.htm

•

Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

•

Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

•

Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

•

WebMDHealth: http://my.webmd.com/health_topics

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to Ritalin. By consulting all of associations listed in this chapter, you will have nearly exhausted all sources for patient associations concerned with Ritalin. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about Ritalin. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “Ritalin” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received

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your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “Ritalin”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “Ritalin” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “Ritalin” (or a synonym) into the search box, and click “Submit Query.”

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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.17

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

17

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)18: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

•

California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

•

California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

•

California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

•

Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

18

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

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•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

•

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

•

Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

•

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

•

Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

•

Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

•

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

•

Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

•

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

•

Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

•

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

•

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

•

Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

•

Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

•

Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

•

Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

•

Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

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Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

•

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

•

Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

•

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

•

Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

•

Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

•

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

•

Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

•

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

•

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

•

Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

•

Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

•

Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

•

Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

•

Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

Finding Medical Libraries

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Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

•

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

•

New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

•

New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

•

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

•

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

•

New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

•

Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

•

Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

•

Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

•

Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

•

Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

•

Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

•

Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

•

Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

•

Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

•

Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

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South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

•

Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

•

Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

•

Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

73

ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

•

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

•

Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

•

Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

•

Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a).

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

•

MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

•

Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

•

Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

75

RITALIN DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Adaptability: Ability to develop some form of tolerance to conditions extremely different from those under which a living organism evolved. [NIH] Adjustment: The dynamic process wherein the thoughts, feelings, behavior, and biophysiological mechanisms of the individual continually change to adjust to the environment. [NIH] Adolescence: The period of life beginning with the appearance of secondary sex characteristics and terminating with the cessation of somatic growth. The years usually referred to as adolescence lie between 13 and 18 years of age. [NIH] Adrenal Medulla: The inner part of the adrenal gland; it synthesizes, stores and releases catecholamines. [NIH] Adrenergic: Activated by, characteristic of, or secreting epinephrine or substances with similar activity; the term is applied to those nerve fibres that liberate norepinephrine at a synapse when a nerve impulse passes, i.e., the sympathetic fibres. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Afferent: Concerned with the transmission of neural impulse toward the central part of the nervous system. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Age Groups: Persons classified by age from birth (infant, newborn) to octogenarians and older (aged, 80 and over). [NIH] Aged, 80 and Over: A person 80 years of age and older. [NIH] Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Allergen: An antigenic substance capable of producing immediate-type hypersensitivity (allergy). [EU] Allylamine: Possesses an unusual and selective cytotoxicity for vascular smooth muscle

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cells in dogs and rats. Useful for experiments dealing with arterial injury, myocardial fibrosis or cardiac decompensation. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Alveoli: Tiny air sacs at the end of the bronchioles in the lungs. [NIH] Amine: An organic compound containing nitrogen; any member of a group of chemical compounds formed from ammonia by replacement of one or more of the hydrogen atoms by organic (hydrocarbon) radicals. The amines are distinguished as primary, secondary, and tertiary, according to whether one, two, or three hydrogen atoms are replaced. The amines include allylamine, amylamine, ethylamine, methylamine, phenylamine, propylamine, and many other compounds. [EU] Amino Acid Sequence: The order of amino acids as they occur in a polypeptide chain. This is referred to as the primary structure of proteins. It is of fundamental importance in determining protein conformation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Amphetamine: A powerful central nervous system stimulant and sympathomimetic. Amphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulation of release of monamines, and inhibiting monoamine oxidase. Amphetamine is also a drug of abuse and a psychotomimetic. The l- and the d,l-forms are included here. The l-form has less central nervous system activity but stronger cardiovascular effects. The d-form is dextroamphetamine. [NIH] Amygdala: Almond-shaped group of basal nuclei anterior to the inferior horn of the lateral ventricle of the brain, within the temporal lobe. The amygdala is part of the limbic system. [NIH]

Anaesthesia: Loss of feeling or sensation. Although the term is used for loss of tactile sensibility, or of any of the other senses, it is applied especially to loss of the sensation of pain, as it is induced to permit performance of surgery or other painful procedures. [EU] Anaesthetic: 1. Pertaining to, characterized by, or producing anaesthesia. 2. A drug or agent that is used to abolish the sensation of pain. [EU] Anal: Having to do with the anus, which is the posterior opening of the large bowel. [NIH] Analog: In chemistry, a substance that is similar, but not identical, to another. [NIH] Animal model: An animal with a disease either the same as or like a disease in humans. Animal models are used to study the development and progression of diseases and to test new treatments before they are given to humans. Animals with transplanted human cancers or other tissues are called xenograft models. [NIH] Antagonism: Interference with, or inhibition of, the growth of a living organism by another living organism, due either to creation of unfavorable conditions (e. g. exhaustion of food

Dictionary 77

supplies) or to production of a specific antibiotic substance (e. g. penicillin). [NIH] Anti-Anxiety Agents: Agents that alleviate anxiety, tension, and neurotic symptoms, promote sedation, and have a calming effect without affecting clarity of consciousness or neurologic conditions. Some are also effective as anticonvulsants, muscle relaxants, or anesthesia adjuvants. Adrenergic beta-antagonists are commonly used in the symptomatic treatment of anxiety but are not included here. [NIH] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibodies: Immunoglobulin molecules having a specific amino acid sequence by virtue of which they interact only with the antigen that induced their synthesis in cells of the lymphoid series (especially plasma cells), or with an antigen closely related to it. [NIH] Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antidepressant: A drug used to treat depression. [NIH] Antidepressive Agents: Mood-stimulating drugs used primarily in the treatment of affective disorders and related conditions. Several monoamine oxidase inhibitors are useful as antidepressants apparently as a long-term consequence of their modulation of catecholamine levels. The tricyclic compounds useful as antidepressive agents also appear to act through brain catecholamine systems. A third group (antidepressive agents, secondgeneration) is a diverse group of drugs including some that act specifically on serotonergic systems. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU] Antihypertensive: An agent that reduces high blood pressure. [EU] Apomorphine: A derivative of morphine that is a dopamine D2 agonist. It is a powerful emetic and has been used for that effect in acute poisoning. It has also been used in the diagnosis and treatment of parkinsonism, but its adverse effects limit its use. [NIH] Aromatic: Having a spicy odour. [EU] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Arterioles: The smallest divisions of the arteries located between the muscular arteries and the capillaries. [NIH] Assay: Determination of the amount of a particular constituent of a mixture, or of the biological or pharmacological potency of a drug. [EU] Astrocytes: The largest and most numerous neuroglial cells in the brain and spinal cord. Astrocytes (from "star" cells) are irregularly shaped with many long processes, including those with "end feet" which form the glial (limiting) membrane and directly and indirectly

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contribute to the blood brain barrier. They regulate the extracellular ionic and chemical environment, and "reactive astrocytes" (along with microglia) respond to injury. Astrocytes have high- affinity transmitter uptake systems, voltage-dependent and transmitter-gated ion channels, and can release transmitter, but their role in signaling (as in many other functions) is not well understood. [NIH] Atmospheric Pressure: The pressure at any point in an atmosphere due solely to the weight of the atmospheric gases above the point concerned. [NIH] Auditory: Pertaining to the sense of hearing. [EU] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Autonomic: Self-controlling; functionally independent. [EU] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Basal Ganglia: Large subcortical nuclear masses derived from the telencephalon and located in the basal regions of the cerebral hemispheres. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU] Binding Sites: The reactive parts of a macromolecule that directly participate in its specific combination with another molecule. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Biotransformation: The chemical alteration of an exogenous substance by or in a biological system. The alteration may inactivate the compound or it may result in the production of an active metabolite of an inactive parent compound. The alteration may be either nonsynthetic (oxidation-reduction, hydrolysis) or synthetic (glucuronide formation, sulfate conjugation, acetylation, methylation). This also includes metabolic detoxication and clearance. [NIH] Bladder: The organ that stores urine. [NIH] Blood Platelets: Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Blood vessel: A tube in the body through which blood circulates. Blood vessels include a network of arteries, arterioles, capillaries, venules, and veins. [NIH] Blood-Brain Barrier: Specialized non-fenestrated tightly-joined endothelial cells (tight

Dictionary 79

junctions) that form a transport barrier for certain substances between the cerebral capillaries and the brain tissue. [NIH] Bone scan: A technique to create images of bones on a computer screen or on film. A small amount of radioactive material is injected into a blood vessel and travels through the bloodstream; it collects in the bones and is detected by a scanner. [NIH] Boron: A trace element with the atomic symbol B, atomic number 5, and atomic weight 10.81. Boron-10, an isotope of boron, is used as a neutron absorber in boron neutron capture therapy. [NIH] Boron Neutron Capture Therapy: A technique for the treatment of neoplasms, especially gliomas and melanomas in which boron-10, an isotope, is introduced into the target cells followed by irradiation with thermal neutrons. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breakdown: A physical, metal, or nervous collapse. [NIH] Bronchioles: The tiny branches of air tubes in the lungs. [NIH] Bupropion: A unicyclic, aminoketone antidepressant. The mechanism of its therapeutic actions is not well understood, but it does appear to block dopamine uptake. The hydrochloride is available as an aid to smoking cessation treatment. [NIH] Capillary: Any one of the minute vessels that connect the arterioles and venules, forming a network in nearly all parts of the body. Their walls act as semipermeable membranes for the interchange of various substances, including fluids, between the blood and tissue fluid; called also vas capillare. [EU] Cardiovascular: Having to do with the heart and blood vessels. [NIH] Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Catecholamine: A group of chemical substances manufactured by the adrenal medulla and secreted during physiological stress. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Caudate Nucleus: Elongated gray mass of the neostriatum located adjacent to the lateral ventricle of the brain. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Death: The termination of the cell's ability to carry out vital functions such as metabolism, growth, reproduction, responsiveness, and adaptability. [NIH] Central Nervous System: The main information-processing organs of the nervous system, consisting of the brain, spinal cord, and meninges. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebrovascular: Pertaining to the blood vessels of the cerebrum, or brain. [EU] Cerebrum: The largest part of the brain. It is divided into two hemispheres, or halves, called the cerebral hemispheres. The cerebrum controls muscle functions of the body and also controls speech, emotions, reading, writing, and learning. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU]

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Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening, prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Coca: Any of several South American shrubs of the Erythroxylon genus (and family) that yield cocaine; the leaves are chewed with alum for CNS stimulation. [NIH] Cocaine: An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Colloidal: Of the nature of a colloid. [EU] Comorbidity: The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival. [NIH] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy,

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spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH] Computed tomography: CT scan. A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called computerized tomography and computerized axial tomography (CAT) scan. [NIH] Computerized axial tomography: A series of detailed pictures of areas inside the body, taken from different angles; the pictures are created by a computer linked to an x-ray machine. Also called CAT scan, computed tomography (CT scan), or computerized tomography. [NIH] Consciousness: Sense of awareness of self and of the environment. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Coordination: Muscular or motor regulation or the harmonious cooperation of muscles or groups of muscles, in a complex action or series of actions. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Cortex: The outer layer of an organ or other body structure, as distinguished from the internal substance. [EU] Cortical: Pertaining to or of the nature of a cortex or bark. [EU] Curative: Tending to overcome disease and promote recovery. [EU] Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Delirium: (DSM III-R) an acute, reversible organic mental disorder characterized by reduced ability to maintain attention to external stimuli and disorganized thinking as manifested by rambling, irrelevant, or incoherent speech; there are also a reduced level of consciousness, sensory misperceptions, disturbance of the sleep-wakefulness cycle and level of psychomotor activity, disorientation to time, place, or person, and memory impairment. Delirium may be caused by a large number of conditions resulting in derangement of cerebral metabolism, including systemic infection, poisoning, drug intoxication or withdrawal, seizures or head trauma, and metabolic disturbances such as hypoxia,

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hypoglycaemia, fluid, electrolyte, or acid-base imbalances, or hepatic or renal failure. Called also acute confusional state and acute brain syndrome. [EU] Delusions: A false belief regarding the self or persons or objects outside the self that persists despite the facts, and is not considered tenable by one's associates. [NIH] Dendrites: Extensions of the nerve cell body. They are short and branched and receive stimuli from other neurons. [NIH] Density: The logarithm to the base 10 of the opacity of an exposed and processed film. [NIH] Dentate Gyrus: Gray matter situated above the gyrus hippocampi. It is composed of three layers. The molecular layer is continuous with the hippocampus in the hippocampal fissure. The granular layer consists of closely arranged spherical or oval neurons, called granule cells, whose axons pass through the polymorphic layer ending on the dendrites of pyramidal cells in the hippocampus. [NIH] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Dextroamphetamine: The d-form of amphetamine. It is a central nervous system stimulant and a sympathomimetic. It has also been used in the treatment of narcolepsy and of attention deficit disorders and hyperactivity in children. Dextroamphetamine has multiple mechanisms of action including blocking uptake of adrenergics and dopamine, stimulating release of monamines, and inhibiting monoamine oxidase. It is also a drug of abuse and a psychotomimetic. [NIH] Diagnostic procedure: A method used to identify a disease. [NIH] Dilatation: The act of dilating. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Disorientation: The loss of proper bearings, or a state of mental confusion as to time, place, or identity. [EU] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Distal: Remote; farther from any point of reference; opposed to proximal. In dentistry, used to designate a position on the dental arch farther from the median line of the jaw. [EU] Dopa: The racemic or DL form of DOPA, an amino acid found in various legumes. The dextro form has little physiologic activity but the levo form (levodopa) is a very important physiologic mediator and precursor and pharmacological agent. [NIH] Dopamine: An endogenous catecholamine and prominent neurotransmitter in several systems of the brain. In the synthesis of catecholamines from tyrosine, it is the immediate precursor to norepinephrine and epinephrine. Dopamine is a major transmitter in the extrapyramidal system of the brain, and important in regulating movement. A family of dopaminergic receptor subtypes mediate its action. Dopamine is used pharmacologically for its direct (beta adrenergic agonist) and indirect (adrenergic releasing) sympathomimetic effects including its actions as an inotropic agent and as a renal vasodilator. [NIH]

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Dopamine Agonists: Drugs that bind to and activate dopamine receptors. [NIH] Doping: The action of administering a drug to someone before a sports event (originally to a horse before a race); the substance thus administered. [EU] Dose-dependent: Refers to the effects of treatment with a drug. If the effects change when the dose of the drug is changed, the effects are said to be dose dependent. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Drug Tolerance: Progressive diminution of the susceptibility of a human or animal to the effects of a drug, resulting from its continued administration. It should be differentiated from drug resistance wherein an organism, disease, or tissue fails to respond to the intended effectiveness of a chemical or drug. It should also be differentiated from maximum tolerated dose and no-observed-adverse-effect level. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is based on the results of a randomized control trial. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Electrophoresis: An electrochemical process in which macromolecules or colloidal particles with a net electric charge migrate in a solution under the influence of an electric current. [NIH]

Embryo: The prenatal stage of mammalian development characterized by rapid morphological changes and the differentiation of basic structures. [NIH] Emetic: An agent that causes vomiting. [EU] Emphysema: A pathological accumulation of air in tissues or organs. [NIH] Empirical: A treatment based on an assumed diagnosis, prior to receiving confirmatory laboratory test results. [NIH] Encephalitis: Inflammation of the brain due to infection, autoimmune processes, toxins, and other conditions. Viral infections (see encephalitis, viral) are a relatively frequent cause of this condition. [NIH] Encephalitis, Viral: Inflammation of brain parenchymal tissue as a result of viral infection. Encephalitis may occur as primary or secondary manifestation of Togaviridae infections; Herpesviridae infections; Adenoviridae infections; Flaviviridae infections; Bunyaviridae infections; Picornaviridae infections; Paramyxoviridae infections; Orthomyxoviridae infections; Retroviridae infections; and Arenaviridae infections. [NIH] Entorhinal Cortex: Cortex where the signals are combined with those from other sensory systems. [NIH] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymes: Biological molecules that possess catalytic activity. They may occur naturally or be synthetically created. Enzymes are usually proteins, however catalytic RNA and catalytic DNA molecules have also been identified. [NIH]

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Epinephrine: The active sympathomimetic hormone from the adrenal medulla in most species. It stimulates both the alpha- and beta- adrenergic systems, causes systemic vasoconstriction and gastrointestinal relaxation, stimulates the heart, and dilates bronchi and cerebral vessels. It is used in asthma and cardiac failure and to delay absorption of local anesthetics. [NIH] Erythrocytes: Red blood cells. Mature erythrocytes are non-nucleated, biconcave disks containing hemoglobin whose function is to transport oxygen. [NIH] Evoke: The electric response recorded from the cerebral cortex after stimulation of a peripheral sense organ. [NIH] Evoked Potentials: The electric response evoked in the central nervous system by stimulation of sensory receptors or some point on the sensory pathway leading from the receptor to the cortex. The evoked stimulus can be auditory, somatosensory, or visual, although other modalities have been reported. Event-related potentials is sometimes used synonymously with evoked potentials but is often associated with the execution of a motor, cognitive, or psychophysiological task, as well as with the response to a stimulus. [NIH] Exhaustion: The feeling of weariness of mind and body. [NIH] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extracellular: Outside a cell or cells. [EU] Extraction: The process or act of pulling or drawing out. [EU] Extrapyramidal: Outside of the pyramidal tracts. [EU] Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

Fetus: The developing offspring from 7 to 8 weeks after conception until birth. [NIH] Fixation: 1. The act or operation of holding, suturing, or fastening in a fixed position. 2. The condition of being held in a fixed position. 3. In psychiatry, a term with two related but distinct meanings : (1) arrest of development at a particular stage, which like regression (return to an earlier stage), if temporary is a normal reaction to setbacks and difficulties but if protracted or frequent is a cause of developmental failures and emotional problems, and (2) a close and suffocating attachment to another person, especially a childhood figure, such as one's mother or father. Both meanings are derived from psychoanalytic theory and refer to 'fixation' of libidinal energy either in a specific erogenous zone, hence fixation at the oral, anal, or phallic stage, or in a specific object, hence mother or father fixation. 4. The use of a fixative (q.v.) to preserve histological or cytological specimens. 5. In chemistry, the process whereby a substance is removed from the gaseous or solution phase and localized, as in carbon dioxide fixation or nitrogen fixation. 6. In ophthalmology, direction of the gaze so that the visual image of the object falls on the fovea centralis. 7. In film processing, the chemical removal of all undeveloped salts of the film emulsion, leaving only the developed silver to form a permanent image. [EU] Flatus: Gas passed through the rectum. [NIH] Fluoxetine: The first highly specific serotonin uptake inhibitor. It is used as an antidepressant and often has a more acceptable side-effects profile than traditional antidepressants. [NIH] Fold: A plication or doubling of various parts of the body. [NIH]

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Forearm: The part between the elbow and the wrist. [NIH] Gap Junctions: Connections between cells which allow passage of small molecules and electric current. Gap junctions were first described anatomically as regions of close apposition between cells with a narrow (1-2 nm) gap between cell membranes. The variety in the properties of gap junctions is reflected in the number of connexins, the family of proteins which form the junctions. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

Gene Expression: The phenotypic manifestation of a gene or genes by the processes of gene action. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Hallucinogens: Drugs capable of inducing illusions, hallucinations, delusions, paranoid ideations, and other alterations of mood and thinking. Despite the name, the feature that distinguishes these agents from other classes of drugs is their capacity to induce states of altered perception, thought, and feeling that are not experienced otherwise. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Headache: Pain in the cranial region that may occur as an isolated and benign symptom or as a manifestation of a wide variety of conditions including subarachnoid hemorrhage; craniocerebral trauma; central nervous system infections; intracranial hypertension; and other disorders. In general, recurrent headaches that are not associated with a primary disease process are referred to as headache disorders (e.g., migraine). [NIH] Hemostasis: The process which spontaneously arrests the flow of blood from vessels carrying blood under pressure. It is accomplished by contraction of the vessels, adhesion and aggregation of formed blood elements, and the process of blood or plasma coagulation. [NIH]

Hepatic: Refers to the liver. [NIH] Heredity: 1. The genetic transmission of a particular quality or trait from parent to offspring. 2. The genetic constitution of an individual. [EU] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]

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Hippocampus: A curved elevation of gray matter extending the entire length of the floor of the temporal horn of the lateral ventricle (Dorland, 28th ed). The hippocampus, subiculum, and dentate gyrus constitute the hippocampal formation. Sometimes authors include the entorhinal cortex in the hippocampal formation. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Homologous: Corresponding in structure, position, origin, etc., as (a) the feathers of a bird and the scales of a fish, (b) antigen and its specific antibody, (c) allelic chromosomes. [EU] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrogen Bonding: A low-energy attractive force between hydrogen and another element. It plays a major role in determining the properties of water, proteins, and other compounds. [NIH]

Hyperkinesis: Excessive movement of muscles of the body as a whole, which may be associated with organic or psychological disorders. [NIH] Hypersensitivity: Altered reactivity to an antigen, which can result in pathologic reactions upon subsequent exposure to that particular antigen. [NIH] Hypoglycaemia: An abnormally diminished concentration of glucose in the blood, which may lead to tremulousness, cold sweat, piloerection, hypothermia, and headache, accompanied by irritability, confusion, hallucinations, bizarre behaviour, and ultimately, convulsions and coma. [EU] Hypokinesia: Slow or diminished movement of body musculature. It may be associated with basal ganglia diseases; mental disorders; prolonged inactivity due to illness; experimental protocols used to evaluate the physiologic effects of immobility; and other conditions. [NIH] Hypoxia: Reduction of oxygen supply to tissue below physiological levels despite adequate perfusion of the tissue by blood. [EU] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immune system: The organs, cells, and molecules responsible for the recognition and disposal of foreign ("non-self") material which enters the body. [NIH] Immunization: Deliberate stimulation of the host's immune response. Active immunization involves administration of antigens or immunologic adjuvants. Passive immunization involves administration of immune sera or lymphocytes or their extracts (e.g., transfer factor, immune RNA) or transplantation of immunocompetent cell producing tissue (thymus or bone marrow). [NIH] Immunodeficiency: The decreased ability of the body to fight infection and disease. [NIH] Immunodeficiency syndrome: The inability of the body to produce an immune response. [NIH]

Immunohistochemistry: Histochemical localization of immunoreactive substances using labeled antibodies as reagents. [NIH] Immunology: The study of the body's immune system. [NIH]

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Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Induction: The act or process of inducing or causing to occur, especially the production of a specific morphogenetic effect in the developing embryo through the influence of evocators or organizers, or the production of anaesthesia or unconsciousness by use of appropriate agents. [EU] Infant, Newborn: An infant during the first month after birth. [NIH] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease. [EU]

Innervation: 1. The distribution or supply of nerves to a part. 2. The supply of nervous energy or of nerve stimulus sent to a part. [EU] Inotropic: Affecting the force or energy of muscular contractions. [EU] Insomnia: Difficulty in going to sleep or getting enough sleep. [NIH] Insulator: Material covering the metal conductor of the lead. It is usually polyurethane or silicone. [NIH] Interpersonal Relations: The reciprocal interaction of two or more persons. [NIH] Intoxication: Poisoning, the state of being poisoned. [EU] Intracellular: Inside a cell. [NIH] Intravenous: IV. Into a vein. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Ion Channels: Gated, ion-selective glycoproteins that traverse membranes. The stimulus for channel gating can be a membrane potential, drug, transmitter, cytoplasmic messenger, or a mechanical deformation. Ion channels which are integral parts of ionotropic neurotransmitter receptors are not included. [NIH] Ionization: 1. Any process by which a neutral atom gains or loses electrons, thus acquiring a net charge, as the dissociation of a substance in solution into ions or ion production by the passage of radioactive particles. 2. Iontophoresis. [EU] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Kinetic: Pertaining to or producing motion. [EU]

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Lesion: An area of abnormal tissue change. [NIH] Levodopa: The naturally occurring form of dopa and the immediate precursor of dopamine. Unlike dopamine itself, it can be taken orally and crosses the blood-brain barrier. It is rapidly taken up by dopaminergic neurons and converted to dopamine. It is used for the treatment of parkinsonism and is usually given with agents that inhibit its conversion to dopamine outside of the central nervous system. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Lipid: Fat. [NIH] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Liver scan: An image of the liver created on a computer screen or on film. A radioactive substance is injected into a blood vessel and travels through the bloodstream. It collects in the liver, especially in abnormal areas, and can be detected by the scanner. [NIH] Localization: The process of determining or marking the location or site of a lesion or disease. May also refer to the process of keeping a lesion or disease in a specific location or site. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Locomotion: Movement or the ability to move from one place or another. It can refer to humans, vertebrate or invertebrate animals, and microorganisms. [NIH] Locomotor: Of or pertaining to locomotion; pertaining to or affecting the locomotive apparatus of the body. [EU] Longitudinal study: Also referred to as a "cohort study" or "prospective study"; the analytic method of epidemiologic study in which subsets of a defined population can be identified who are, have been, or in the future may be exposed or not exposed, or exposed in different degrees, to a factor or factors hypothesized to influence the probability of occurrence of a given disease or other outcome. The main feature of this type of study is to observe large numbers of subjects over an extended time, with comparisons of incidence rates in groups that differ in exposure levels. [NIH] Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphoid: Referring to lymphocytes, a type of white blood cell. Also refers to tissue in which lymphocytes develop. [NIH] Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. [NIH] Manic: Affected with mania. [EU] Manic-depressive psychosis: One of a group of psychotic reactions, fundamentally marked by severe mood swings and a tendency to remission and recurrence. [NIH] Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Mediator: An object or substance by which something is mediated, such as (1) a structure of the nervous system that transmits impulses eliciting a specific response; (2) a chemical substance (transmitter substance) that induces activity in an excitable tissue, such as nerve or muscle; or (3) a substance released from cells as the result of the interaction of antigen with antibody or by the action of antigen with a sensitized lymphocyte. [EU]

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MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Meiosis: A special method of cell division, occurring in maturation of the germ cells, by means of which each daughter nucleus receives half the number of chromosomes characteristic of the somatic cells of the species. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Meninges: The three membranes that cover and protect the brain and spinal cord. [NIH] Mental Disorders: Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH] Mesolimbic: Inner brain region governing emotion and drives. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Methamphetamine: A central nervous system stimulant and sympathomimetic with actions and uses similar to dextroamphetamine. The smokable form is a drug of abuse and is referred to as crank, crystal, crystal meth, ice, and speed. [NIH] Methanol: A colorless, flammable liquid used in the manufacture of formaldehyde and acetic acid, in chemical synthesis, antifreeze, and as a solvent. Ingestion of methanol is toxic and may cause blindness. [NIH] Methylphenidate: A central nervous system stimulant used most commonly in the treatment of attention-deficit disorders in children and for narcolepsy. Its mechanisms appear to be similar to those of dextroamphetamine. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecular Structure: The location of the atoms, groups or ions relative to one another in a molecule, as well as the number, type and location of covalent bonds. [NIH] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH] Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Monoamine: Enzyme that breaks down dopamine in the astrocytes and microglia. [NIH] Morphine: The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. [NIH] Motility: The ability to move spontaneously. [EU] Motor Activity: The physical activity of an organism as a behavioral phenomenon. [NIH] Multiple sclerosis: A disorder of the central nervous system marked by weakness, numbness, a loss of muscle coordination, and problems with vision, speech, and bladder

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control. Multiple sclerosis is thought to be an autoimmune disease in which the body's immune system destroys myelin. Myelin is a substance that contains both protein and fat (lipid) and serves as a nerve insulator and helps in the transmission of nerve signals. [NIH] Mutagenesis: Process of generating genetic mutations. It may occur spontaneously or be induced by mutagens. [NIH] Mutagens: Chemical agents that increase the rate of genetic mutation by interfering with the function of nucleic acids. A clastogen is a specific mutagen that causes breaks in chromosomes. [NIH] Myelin: The fatty substance that covers and protects nerves. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Naive: Used to describe an individual who has never taken a certain drug or class of drugs (e. g., AZT-naive, antiretroviral-naive), or to refer to an undifferentiated immune system cell. [NIH] Narcolepsy: A condition of unknown cause characterized by a periodic uncontrollable tendency to fall asleep. [NIH] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Nervous System: The entire nerve apparatus composed of the brain, spinal cord, nerves and ganglia. [NIH] Neural: 1. Pertaining to a nerve or to the nerves. 2. Situated in the region of the spinal axis, as the neutral arch. [EU] Neuroanatomy: Study of the anatomy of the nervous system as a specialty or discipline. [NIH]

Neuronal: Pertaining to a neuron or neurons (= conducting cells of the nervous system). [EU] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neuropharmacology: The branch of pharmacology dealing especially with the action of drugs upon various parts of the nervous system. [NIH] Neurosis: Functional derangement due to disorders of the nervous system which does not affect the psychic personality of the patient. [NIH] Neurotoxic: Poisonous or destructive to nerve tissue. [EU] Neurotoxins: Toxic substances from microorganisms, plants or animals that interfere with the functions of the nervous system. Most venoms contain neurotoxic substances. Myotoxins are included in this concept. [NIH] Neurotransmitters: Endogenous signaling molecules that alter the behavior of neurons or effector cells. Neurotransmitter is used here in its most general sense, including not only messengers that act directly to regulate ion channels, but also those that act through second messenger systems, and those that act at a distance from their site of release. Included are neuromodulators, neuroregulators, neuromediators, and neurohumors, whether or not

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acting at synapses. [NIH] Nicotine: Nicotine is highly toxic alkaloid. It is the prototypical agonist at nicotinic cholinergic receptors where it dramatically stimulates neurons and ultimately blocks synaptic transmission. Nicotine is also important medically because of its presence in tobacco smoke. [NIH] Nitrogen: An element with the atomic symbol N, atomic number 7, and atomic weight 14. Nitrogen exists as a diatomic gas and makes up about 78% of the earth's atmosphere by volume. It is a constituent of proteins and nucleic acids and found in all living cells. [NIH] Nonverbal Communication: Transmission of emotions, ideas, and attitudes between individuals in ways other than the spoken language. [NIH] Norepinephrine: Precursor of epinephrine that is secreted by the adrenal medulla and is a widespread central and autonomic neurotransmitter. Norepinephrine is the principal transmitter of most postganglionic sympathetic fibers and of the diffuse projection system in the brain arising from the locus ceruleus. It is also found in plants and is used pharmacologically as a sympathomimetic. [NIH] Nucleic acid: Either of two types of macromolecule (DNA or RNA) formed by polymerization of nucleotides. Nucleic acids are found in all living cells and contain the information (genetic code) for the transfer of genetic information from one generation to the next. [NIH] Nucleus: A body of specialized protoplasm found in nearly all cells and containing the chromosomes. [NIH] Nucleus Accumbens: Collection of pleomorphic cells in the caudal part of the anterior horn of the lateral ventricle, in the region of the olfactory tubercle, lying between the head of the caudate nucleus and the anterior perforated substance. It is part of the so-called ventral striatum, a composite structure considered part of the basal ganglia. [NIH] Octanes: Eight-carbon saturated hydrocarbon group of the methane series. Include isomers and derivatives. [NIH] Odour: A volatile emanation that is perceived by the sense of smell. [EU] Opacity: Degree of density (area most dense taken for reading). [NIH] Otitis: Inflammation of the ear, which may be marked by pain, fever, abnormalities of hearing, hearing loss, tinnitus, and vertigo. [EU] Otitis Media: Inflammation of the middle ear. [NIH] Otitis Media with Effusion: Inflammation of the middle ear with a clear pale yellowcolored transudate. [NIH] Outpatient: A patient who is not an inmate of a hospital but receives diagnosis or treatment in a clinic or dispensary connected with the hospital. [NIH] Overdose: An accidental or deliberate dose of a medication or street drug that is in excess of what is normally used. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Parkinsonism: A group of neurological disorders characterized by hypokinesia, tremor, and muscular rigidity. [EU] Pemoline: A central nervous system stimulant used in fatigue and depressive states and to treat hyperkinetic disorders in children. [NIH] Penicillin: An antibiotic drug used to treat infection. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of

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proteins. Peptides are combined to make proteins. [NIH] Pharmacodynamics: The study of the biochemical and physiological effects of drugs and the mechanisms of their actions, including the correlation of actions and effects of drugs with their chemical structure; also, such effects on the actions of a particular drug or drugs. [EU] Pharmacokinetic: The mathematical analysis of the time courses of absorption, distribution, and elimination of drugs. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Phosphorylation: The introduction of a phosphoryl group into a compound through the formation of an ester bond between the compound and a phosphorus moiety. [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Pilot study: The initial study examining a new method or treatment. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Plasma cells: A type of white blood cell that produces antibodies. [NIH] Pleomorphic: Occurring in various distinct forms. In terms of cells, having variation in the size and shape of cells or their nuclei. [NIH] Poisoning: A condition or physical state produced by the ingestion, injection or inhalation of, or exposure to a deleterious agent. [NIH] Pons: The part of the central nervous system lying between the medulla oblongata and the mesencephalon, ventral to the cerebellum, and consisting of a pars dorsalis and a pars ventralis. [NIH] Postsynaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Post-synaptic: Nerve potential generated by an inhibitory hyperpolarizing stimulation. [NIH] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Prenatal: Existing or occurring before birth, with reference to the fetus. [EU] Presynaptic: Situated proximal to a synapse, or occurring before the synapse is crossed. [EU] Probe: An instrument used in exploring cavities, or in the detection and dilatation of

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strictures, or in demonstrating the potency of channels; an elongated instrument for exploring or sounding body cavities. [NIH] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Projection: A defense mechanism, operating unconsciously, whereby that which is emotionally unacceptable in the self is rejected and attributed (projected) to others. [NIH] Prophase: The first phase of cell division, in which the chromosomes become visible, the nucleus starts to lose its identity, the spindle appears, and the centrioles migrate toward opposite poles. [NIH] Prospective study: An epidemiologic study in which a group of individuals (a cohort), all free of a particular disease and varying in their exposure to a possible risk factor, is followed over a specific amount of time to determine the incidence rates of the disease in the exposed and unexposed groups. [NIH] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychomotor: Pertaining to motor effects of cerebral or psychic activity. [EU] Psychosis: A mental disorder characterized by gross impairment in reality testing as evidenced by delusions, hallucinations, markedly incoherent speech, or disorganized and agitated behaviour without apparent awareness on the part of the patient of the incomprehensibility of his behaviour; the term is also used in a more general sense to refer to mental disorders in which mental functioning is sufficiently impaired as to interfere grossly with the patient's capacity to meet the ordinary demands of life. Historically, the term has been applied to many conditions, e.g. manic-depressive psychosis, that were first described in psychotic patients, although many patients with the disorder are not judged psychotic. [EU] Psychotherapy: A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication. [NIH] Psychotomimetic: Psychosis miming. [NIH] Psychotropic: Exerting an effect upon the mind; capable of modifying mental activity; usually applied to drugs that effect the mental state. [EU] Psychotropic Drugs: A loosely defined grouping of drugs that have effects on psychological function. Here the psychotropic agents include the antidepressive agents, hallucinogens, and tranquilizing agents (including the antipsychotics and anti-anxiety agents). [NIH] Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level. [NIH] Public Policy: A course or method of action selected, usually by a government, from among

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alternatives to guide and determine present and future decisions. [NIH] Pulmonary: Relating to the lungs. [NIH] Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. [NIH] Pulmonary Emphysema: Condition of the lungs characterized by increase beyond normal in the size of air spaces distal to the terminal bronchioles, either from dilatation of the alveoli or from destruction of their walls. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

Race: A population within a species which exhibits general similarities within itself, but is both discontinuous and distinct from other populations of that species, though not sufficiently so as to achieve the status of a taxon. [NIH] Radiation: Emission or propagation of electromagnetic energy (waves/rays), or the waves/rays themselves; a stream of electromagnetic particles (electrons, neutrons, protons, alpha particles) or a mixture of these. The most common source is the sun. [NIH] Radioactive: Giving off radiation. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Reagent: A substance employed to produce a chemical reaction so as to detect, measure, produce, etc., other substances. [EU] Reality Testing: The individual's objective evaluation of the external world and the ability to differentiate adequately between it and the internal world; considered to be a primary ego function. [NIH] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Receptors, Serotonin: Cell-surface proteins that bind serotonin and trigger intracellular changes which influence the behavior of cells. Several types of serotonin receptors have been recognized which differ in their pharmacology, molecular biology, and mode of action. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Red Nucleus: A pinkish-yellow portion of the midbrain situated in the rostral mesencephalic tegmentum. It receives a large projection from the contralateral half of the cerebellum via the superior cerebellar peduncle and a projection from the ipsilateral motor cortex. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Refraction: A test to determine the best eyeglasses or contact lenses to correct a refractive error (myopia, hyperopia, or astigmatism). [NIH] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Renal failure: Progressive renal insufficiency and uremia, due to irreversible and progressive renal glomerular tubular or interstitial disease. [NIH] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH]

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Reticular: Coarse-fibered, netlike dermis layer. [NIH] Reticular Formation: A region extending from the pons & medulla oblongata through the mesencephalon, characterized by a diversity of neurons of various sizes and shapes, arranged in different aggregations and enmeshed in a complicated fiber network. [NIH] Retrospective: Looking back at events that have already taken place. [NIH] Rigidity: Stiffness or inflexibility, chiefly that which is abnormal or morbid; rigor. [EU] Ritalin: Drug used to treat hyperactive children. [NIH] Ritodrine: Adrenergic beta-agonist used to control premature labor. [NIH] Scans: Pictures of structures inside the body. Scans often used in diagnosing, staging, and monitoring disease include liver scans, bone scans, and computed tomography (CT) or computerized axial tomography (CAT) scans and magnetic resonance imaging (MRI) scans. In liver scanning and bone scanning, radioactive substances that are injected into the bloodstream collect in these organs. A scanner that detects the radiation is used to create pictures. In CT scanning, an x-ray machine linked to a computer is used to produce detailed pictures of organs inside the body. MRI scans use a large magnet connected to a computer to create pictures of areas inside the body. [NIH] Schizoid: Having qualities resembling those found in greater degree in schizophrenics; a person of schizoid personality. [NIH] Schizophrenia: A mental disorder characterized by a special type of disintegration of the personality. [NIH] Schizotypal Personality Disorder: A personality disorder in which there are oddities of thought (magical thinking, paranoid ideation, suspiciousness), perception (illusions, depersonalization), speech (digressive, vague, overelaborate), and behavior (inappropriate affect in social interactions, frequently social isolation) that are not severe enough to characterize schizophrenia. [NIH] Sclerosis: A pathological process consisting of hardening or fibrosis of an anatomical structure, often a vessel or a nerve. [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Secretory: Secreting; relating to or influencing secretion or the secretions. [NIH] Seizures: Clinical or subclinical disturbances of cortical function due to a sudden, abnormal, excessive, and disorganized discharge of brain cells. Clinical manifestations include abnormal motor, sensory and psychic phenomena. Recurrent seizures are usually referred to as epilepsy or "seizure disorder." [NIH] Sensitization: 1. Administration of antigen to induce a primary immune response; priming; immunization. 2. Exposure to allergen that results in the development of hypersensitivity. 3. The coating of erythrocytes with antibody so that they are subject to lysis by complement in the presence of homologous antigen, the first stage of a complement fixation test. [EU] Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-tryptophan. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (receptors, serotonin) explain the broad physiological actions and distribution of this biochemical mediator. [NIH] Serum: The clear liquid part of the blood that remains after blood cells and clotting proteins have been removed. [NIH] Sex Characteristics: Those characteristics that distinguish one sex from the other. The

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primary sex characteristics are the ovaries and testes and their related hormones. Secondary sex characteristics are those which are masculine or feminine but not directly related to reproduction. [NIH] Sibutramine: A drug used for the management of obesity that helps reduce food intake and is indicated for weight loss and maintenance of weight loss when used in conjunction with a reduced-calorie diet. It works to suppress the appetite primarily by inhibiting the reuptake of the neurotransmitters norepinephrine and serotonin. Side effects include dry mouth, headache, constipation, insomnia, and a slight increase in average blood pressure. In some patients it causes a higher blood pressure increase. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Social Behavior: Any behavior caused by or affecting another individual, usually of the same species. [NIH] Social Values: Abstract standards or empirical variables in social life which are believed to be important and/or desirable. [NIH] Solvent: 1. Dissolving; effecting a solution. 2. A liquid that dissolves or that is capable of dissolving; the component of a solution that is present in greater amount. [EU] Somatic: 1. Pertaining to or characteristic of the soma or body. 2. Pertaining to the body wall in contrast to the viscera. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Spectrum: A charted band of wavelengths of electromagnetic vibrations obtained by refraction and diffraction. By extension, a measurable range of activity, such as the range of bacteria affected by an antibiotic (antibacterial s.) or the complete range of manifestations of a disease. [EU] Spinal cord: The main trunk or bundle of nerves running down the spine through holes in the spinal bone (the vertebrae) from the brain to the level of the lower back. [NIH] Stabilization: The creation of a stable state. [EU] Staging: Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from the original site to other parts of the body. [NIH]

Stimulant: 1. Producing stimulation; especially producing stimulation by causing tension on muscle fibre through the nervous tissue. 2. An agent or remedy that produces stimulation. [EU]

Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Striatum: A higher brain's domain thus called because of its stripes. [NIH]

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Subacute: Somewhat acute; between acute and chronic. [EU] Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subiculum: A region of the hippocampus that projects to other areas of the brain. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Suppression: A conscious exclusion of disapproved desire contrary with repression, in which the process of exclusion is not conscious. [NIH] Sympathomimetic: 1. Mimicking the effects of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. 2. An agent that produces effects similar to those of impulses conveyed by adrenergic postganglionic fibres of the sympathetic nervous system. Called also adrenergic. [EU] Synapses: Specialized junctions at which a neuron communicates with a target cell. At classical synapses, a neuron's presynaptic terminal releases a chemical transmitter stored in synaptic vesicles which diffuses across a narrow synaptic cleft and activates receptors on the postsynaptic membrane of the target cell. The target may be a dendrite, cell body, or axon of another neuron, or a specialized region of a muscle or secretory cell. Neurons may also communicate through direct electrical connections which are sometimes called electrical synapses; these are not included here but rather in gap junctions. [NIH] Synapsis: The pairing between homologous chromosomes of maternal and paternal origin during the prophase of meiosis, leading to the formation of gametes. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synaptic Transmission: The communication from a neuron to a target (neuron, muscle, or secretory cell) across a synapse. In chemical synaptic transmission, the presynaptic neuron releases a neurotransmitter that diffuses across the synaptic cleft and binds to specific synaptic receptors. These activated receptors modulate ion channels and/or secondmessenger systems to influence the postsynaptic cell. Electrical transmission is less common in the nervous system, and, as in other tissues, is mediated by gap junctions. [NIH] Synaptic Vesicles: Membrane-bound compartments which contain transmitter molecules. Synaptic vesicles are concentrated at presynaptic terminals. They actively sequester transmitter molecules from the cytoplasm. In at least some synapses, transmitter release occurs by fusion of these vesicles with the presynaptic membrane, followed by exocytosis of their contents. [NIH] Systemic: Affecting the entire body. [NIH] Talc: A native magnesium silicate. [NIH] Temporal: One of the two irregular bones forming part of the lateral surfaces and base of the skull, and containing the organs of hearing. [NIH] Thalamic: Cell that reaches the lateral nucleus of amygdala. [NIH] Therapeutics: The branch of medicine which is concerned with the treatment of diseases,

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palliative or curative. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Tinnitus: Sounds that are perceived in the absence of any external noise source which may take the form of buzzing, ringing, clicking, pulsations, and other noises. Objective tinnitus refers to noises generated from within the ear or adjacent structures that can be heard by other individuals. The term subjective tinnitus is used when the sound is audible only to the affected individual. Tinnitus may occur as a manifestation of cochlear diseases; vestibulocochlear nerve diseases; intracranial hypertension; craniocerebral trauma; and other conditions. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tolerance: 1. The ability to endure unusually large doses of a drug or toxin. 2. Acquired drug tolerance; a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response. [EU] Tomography: Imaging methods that result in sharp images of objects located on a chosen plane and blurred images located above or below the plane. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicokinetics: Study of the absorption, distribution, metabolism, and excretion of test substances. [NIH] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Toxoplasmosis: The acquired form of infection by Toxoplasma gondii in animals and man. [NIH]

Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Tranquilizing Agents: A traditional grouping of drugs said to have a soothing or calming effect on mood, thought, or behavior. Included here are the anti-anxiety agents (minor tranquilizers), antimanic agents, and the antipsychotic agents (major tranquilizers). These drugs act by different mechanisms and are used for different therapeutic purposes. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transmitter: A chemical substance which effects the passage of nerve impulses from one cell to the other at the synapse. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Tremor: Cyclical movement of a body part that can represent either a physiologic process or a manifestation of disease. Intention or action tremor, a common manifestation of cerebellar diseases, is aggravated by movement. In contrast, resting tremor is maximal when there is no attempt at voluntary movement, and occurs as a relatively frequent manifestation of

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Parkinson disease. [NIH] Triazolam: A short-acting benzodiazepine used in the treatment of insomnia. Some countries temporarily withdrew triazolam from the market because of concerns about adverse reactions, mostly psychological, associated with higher dose ranges. Its use at lower doses with appropriate care and labeling has been reaffirmed by the FDA and most other countries. [NIH] Tryptophan: An essential amino acid that is necessary for normal growth in infants and for nitrogen balance in adults. It is a precursor serotonin and niacin. [NIH] Tubercle: A rounded elevation on a bone or other structure. [NIH] Tyrosine: A non-essential amino acid. In animals it is synthesized from phenylalanine. It is also the precursor of epinephrine, thyroid hormones, and melanin. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Urethra: The tube through which urine leaves the body. It empties urine from the bladder. [NIH]

Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Vaccines: Suspensions of killed or attenuated microorganisms (bacteria, viruses, fungi, protozoa, or rickettsiae), antigenic proteins derived from them, or synthetic constructs, administered for the prevention, amelioration, or treatment of infectious and other diseases. [NIH]

Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasodilator: An agent that widens blood vessels. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venoms: Poisonous animal secretions forming fluid mixtures of many different enzymes, toxins, and other substances. These substances are produced in specialized glands and secreted through specialized delivery systems (nematocysts, spines, fangs, etc.) for disabling prey or predator. [NIH] Venous: Of or pertaining to the veins. [EU] Ventral: 1. Pertaining to the belly or to any venter. 2. Denoting a position more toward the belly surface than some other object of reference; same as anterior in human anatomy. [EU] Ventral Tegmental Area: A region in the mesencephalon which is dorsomedial to the substantia nigra and ventral to the red nucleus. The mesocortical and mesolimbic dopaminergic systems originate here, including an important projection to the nucleus accumbens. Overactivity of the cells in this area has been suspected to contribute to the positive symptoms of schizophrenia. [NIH] Ventricle: One of the two pumping chambers of the heart. The right ventricle receives oxygen-poor blood from the right atrium and pumps it to the lungs through the pulmonary artery. The left ventricle receives oxygen-rich blood from the left atrium and pumps it to the body through the aorta. [NIH] Venules: The minute vessels that collect blood from the capillary plexuses and join together to form veins. [NIH] Vertigo: An illusion of movement; a sensation as if the external world were revolving around the patient (objective vertigo) or as if he himself were revolving in space (subjective vertigo). The term is sometimes erroneously used to mean any form of dizziness. [EU] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and

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treatment of diseases in animals. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Vivo: Outside of or removed from the body of a living organism. [NIH] Wakefulness: A state in which there is an enhanced potential for sensitivity and an efficient responsiveness to external stimuli. [NIH] Withdrawal: 1. A pathological retreat from interpersonal contact and social involvement, as may occur in schizophrenia, depression, or schizoid avoidant and schizotypal personality disorders. 2. (DSM III-R) A substance-specific organic brain syndrome that follows the cessation of use or reduction in intake of a psychoactive substance that had been regularly used to induce a state of intoxication. [EU] Xenograft: The cells of one species transplanted to another species. [NIH] X-ray: High-energy radiation used in low doses to diagnose diseases and in high doses to treat cancer. [NIH]

101

INDEX A Adaptability, 75, 79 Adjustment, 45, 75 Adolescence, 7, 11, 75 Adrenal Medulla, 75, 79, 84, 91 Adrenergic, 75, 77, 82, 84, 95, 97 Adverse Effect, 75, 77, 96 Afferent, 7, 75 Affinity, 5, 9, 11, 75, 78 Age Groups, 8, 11, 75 Aged, 80 and Over, 75 Agonist, 5, 75, 77, 82, 91, 95 Algorithms, 75, 78 Alkaloid, 75, 80, 89, 91 Allergen, 75, 95 Allylamine, 75, 76 Alternative medicine, 53, 76 Alveoli, 76, 94 Amine, 11, 76 Amino Acid Sequence, 76, 77 Amino Acids, 76, 91, 93 Ammonia, 76 Amphetamine, 9, 12, 14, 45, 76, 82 Amygdala, 76, 97 Anaesthesia, 24, 76, 87 Anaesthetic, 24, 76 Anal, 76, 84, 88 Analog, 11, 76 Animal model, 7, 10, 12, 14, 76 Antagonism, 6, 76 Anti-Anxiety Agents, 77, 93, 98 Antibacterial, 77, 96 Antibiotic, 18, 77, 91, 96 Antibodies, 7, 77, 85, 86, 92 Antibody, 75, 77, 80, 85, 86, 87, 88, 95, 96 Antidepressant, 11, 77, 79, 84 Antidepressive Agents, 77, 93 Antigen, 75, 77, 80, 86, 87, 88, 95 Antihypertensive, 31, 77 Apomorphine, 12, 77 Aromatic, 11, 77 Arterial, 23, 76, 77, 93 Arteries, 77, 78, 81, 89 Arterioles, 77, 78, 79 Assay, 18, 77 Astrocytes, 77, 89 Atmospheric Pressure, 18, 78 Auditory, 3, 18, 33, 39, 78, 84

Autoimmune disease, 78, 90 Autonomic, 78, 91 B Bacteria, 77, 78, 96, 99 Basal Ganglia, 78, 86, 91 Base, 78, 82, 87, 97 Binding Sites, 11, 78 Biochemical, 78, 92, 95 Biotechnology, 14, 43, 53, 59, 78 Biotransformation, 78 Bladder, 78, 89, 99 Blood Platelets, 78, 95 Blood pressure, 45, 77, 78, 89, 96 Blood vessel, 78, 79, 88, 98, 99 Blood-Brain Barrier, 78, 88 Bone scan, 79, 95 Boron, 15, 79 Boron Neutron Capture Therapy, 79 Branch, 71, 79, 90, 93, 96, 97 Breakdown, 79, 85 Bronchioles, 76, 79, 94 Bupropion, 13, 79 C Capillary, 28, 79, 99 Cardiovascular, 76, 79, 95 Case report, 23, 79 Catecholamine, 77, 79, 82 Caudal, 79, 91 Caudate Nucleus, 79, 91 Cell, 10, 13, 75, 78, 79, 80, 82, 84, 85, 86, 87, 88, 89, 90, 92, 93, 94, 97, 98 Cell Death, 10, 79, 90 Central Nervous System, 6, 76, 79, 80, 82, 84, 85, 88, 89, 91, 92, 95 Cerebral, 7, 33, 34, 35, 78, 79, 81, 84, 93 Cerebrovascular, 31, 79 Cerebrum, 79 Cholinergic, 7, 79, 91 Chronic, 6, 9, 12, 13, 33, 52, 80, 87, 97 Clinical trial, 4, 16, 59, 80, 94 Cloning, 78, 80 Coca, 80 Cocaine, 4, 5, 6, 9, 10, 11, 12, 13, 14, 19, 21, 34, 37, 40, 80 Cofactor, 80, 93 Colloidal, 80, 83 Comorbidity, 4, 80 Complement, 80, 81, 95

102 Ritalin

Complementary and alternative medicine, 31, 38, 80 Complementary medicine, 31, 81 Computational Biology, 59, 81 Computed tomography, 81, 95 Computerized axial tomography, 81, 95 Consciousness, 42, 44, 77, 81, 82 Constipation, 81, 96 Contraindications, ii, 81 Coordination, 8, 81, 89 Coronary, 81, 89 Coronary Thrombosis, 81, 89 Cortex, 7, 81, 83, 84, 94 Cortical, 7, 81, 95 Curative, 81, 98 D Databases, Bibliographic, 59, 81 Delirium, 47, 81 Delusions, 82, 85, 93 Dendrites, 82, 90 Density, 5, 82, 91 Dentate Gyrus, 82, 86 Deuterium, 82, 86 Dextroamphetamine, 76, 82, 89 Diagnostic procedure, 53, 82 Dilatation, 82, 92, 94 Direct, iii, 9, 10, 82, 94, 97 Disorientation, 81, 82 Dissociation, 75, 82, 87 Distal, 82, 94 Dopa, 82, 88 Dopamine, 5, 6, 9, 10, 11, 12, 13, 33, 34, 35, 76, 77, 79, 80, 82, 83, 88, 89 Dopamine Agonists, 10, 83 Doping, 23, 83 Dose-dependent, 6, 83 Drug Interactions, 83 Drug Tolerance, 83, 98 E Efficacy, 5, 8, 13, 15, 22, 35, 37, 83 Electrolyte, 82, 83 Electrons, 78, 83, 87, 94 Electrophoresis, 28, 83 Embryo, 83, 87 Emetic, 77, 83 Emphysema, 20, 23, 83 Empirical, 83, 96 Encephalitis, 35, 83 Encephalitis, Viral, 83 Entorhinal Cortex, 83, 86 Environmental Health, 58, 60, 83 Enzymes, 7, 83, 90, 99

Epinephrine, 75, 82, 84, 91, 99 Erythrocytes, 84, 95 Evoke, 84, 96 Evoked Potentials, 12, 84 Exhaustion, 76, 84 Exogenous, 10, 78, 84 Extracellular, 6, 14, 78, 84 Extraction, 19, 84 Extrapyramidal, 82, 84 F Family Planning, 59, 84 Fat, 84, 88, 90 Fatigue, 36, 52, 84, 91 Fetus, 84, 92 Fixation, 84, 95 Flatus, 84, 85 Fluoxetine, 11, 13, 84 Fold, 11, 12, 84 Forearm, 78, 85 G Gap Junctions, 85, 97 Gas, 15, 17, 18, 76, 84, 85, 86, 91 Gastrointestinal, 84, 85, 95, 97 Gastrointestinal tract, 85, 95 Gene, 6, 9, 10, 34, 43, 78, 85 Gene Expression, 6, 9, 85 Gland, 75, 85, 96 Glucose, 33, 85, 86 Governing Board, 85, 92 Growth, 75, 76, 77, 79, 85, 92, 99 H Hallucinogens, 85, 93 Haptens, 75, 85 Headache, 85, 86, 96 Hemostasis, 85, 95 Hepatic, 82, 85 Heredity, 85 Heterogeneity, 75, 85 Hippocampus, 7, 82, 86, 97 Homeostasis, 13, 86 Homologous, 86, 95, 97 Hydrogen, 11, 76, 78, 82, 86, 89, 93 Hydrogen Bonding, 11, 86 Hyperkinesis, 36, 86 Hypersensitivity, 75, 86, 95 Hypoglycaemia, 82, 86 Hypokinesia, 86, 91 Hypoxia, 81, 86 I Id, 29, 37, 65, 70, 72, 86 Immune response, 77, 78, 85, 86, 95, 97, 100

Index 103

Immune system, 86, 90 Immunization, 86, 95 Immunodeficiency, 47, 86 Immunodeficiency syndrome, 47, 86 Immunohistochemistry, 9, 86 Immunology, 75, 86 Impairment, 81, 87, 89, 93 In vitro, 87 In vivo, 6, 10, 87 Indicative, 41, 87, 99 Induction, 28, 87 Infant, Newborn, 75, 87 Infarction, 81, 87, 89 Infection, 47, 81, 83, 86, 87, 88, 91, 97, 98 Innervation, 7, 87 Inotropic, 82, 87 Insomnia, 45, 87, 96, 99 Insulator, 87, 90 Interpersonal Relations, 9, 87 Intoxication, 81, 87, 100 Intracellular, 87, 94 Intravenous, 19, 20, 22, 23, 33, 87 Intrinsic, 13, 75, 87 Ion Channels, 78, 87, 90, 97 Ionization, 18, 87 Ions, 78, 82, 83, 86, 87, 89 K Kb, 58, 87 Kinetic, 87 L Lesion, 88 Levodopa, 7, 82, 88 Library Services, 70, 88 Lipid, 88, 90 Liver, 85, 88, 95 Liver scan, 88, 95 Localization, 10, 86, 88 Localized, 84, 87, 88, 92 Locomotion, 88, 92 Locomotor, 6, 11, 12, 14, 88 Longitudinal study, 31, 88 Lymphatic, 87, 88 Lymphoid, 77, 88 M Magnetic Resonance Imaging, 88, 95 Manic, 88, 93 Manic-depressive psychosis, 88, 93 Mediate, 6, 9, 14, 82, 88 Mediator, 82, 88, 95 MEDLINE, 59, 89 Meiosis, 89, 97 Membrane, 5, 10, 13, 77, 80, 87, 89, 97

Memory, 7, 81, 89 Meninges, 79, 89 Mental Disorders, 86, 89, 93 Mental Health, iv, 4, 58, 60, 89, 93 Mesolimbic, 89, 99 Metabolite, 23, 78, 89 Methamphetamine, 6, 10, 13, 89 Methanol, 15, 89 Methylphenidate, 4, 6, 7, 8, 9, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 23, 24, 28, 32, 33, 34, 35, 36, 38, 40, 44, 45, 89 MI, 35, 73, 89 Molecular, 6, 10, 11, 13, 14, 59, 61, 78, 81, 82, 89, 94 Molecular Structure, 11, 89 Molecule, 11, 77, 78, 80, 82, 89, 94 Monitor, 8, 89 Monoamine, 11, 13, 76, 77, 82, 89 Morphine, 77, 89 Motility, 89, 95 Motor Activity, 14, 89 Multiple sclerosis, 36, 89 Mutagenesis, 13, 90 Mutagens, 90 Myelin, 90 Myocardium, 89, 90 N Naive, 35, 90 Narcolepsy, 82, 89, 90 Necrosis, 87, 89, 90 Need, 3, 17, 20, 25, 41, 43, 44, 66, 90, 98 Nerve, 75, 82, 87, 88, 90, 92, 95, 96, 98 Nervous System, 75, 76, 79, 88, 90, 97 Neural, 12, 75, 90 Neuroanatomy, 12, 90 Neuronal, 9, 12, 13, 14, 34, 90 Neurons, 5, 7, 10, 12, 80, 82, 88, 90, 91, 95, 97 Neuropharmacology, 16, 90 Neurosis, 44, 90 Neurotoxic, 90 Neurotoxins, 10, 90 Neurotransmitters, 90, 96 Nicotine, 22, 91 Nitrogen, 11, 75, 76, 84, 91, 99 Nonverbal Communication, 91, 93 Norepinephrine, 11, 75, 82, 91, 96 Nucleic acid, 90, 91 Nucleus, 14, 82, 89, 91, 93, 97, 99 Nucleus Accumbens, 14, 91, 99 O Octanes, 11, 91

104 Ritalin

Odour, 77, 91 Opacity, 82, 91 Otitis, 4, 91 Otitis Media, 4, 91 Otitis Media with Effusion, 4, 91 Outpatient, 47, 91 Overdose, 51, 91 P Palliative, 91, 98 Parkinsonism, 5, 77, 88, 91 Pemoline, 45, 91 Penicillin, 77, 91 Peptide, 91, 93 Pharmacodynamics, 8, 92 Pharmacokinetic, 92 Pharmacologic, 92, 98 Phosphorus, 92 Phosphorylation, 10, 92 Physiologic, 75, 82, 86, 92, 94, 98 Pilot study, 31, 34, 92 Plants, 75, 80, 85, 90, 91, 92, 98 Plasma, 13, 18, 19, 77, 85, 92 Plasma cells, 77, 92 Pleomorphic, 91, 92 Poisoning, 77, 81, 87, 92 Pons, 92, 95 Postsynaptic, 13, 92, 97 Post-synaptic, 14, 92 Practice Guidelines, 60, 92 Precursor, 82, 88, 91, 92, 99 Prenatal, 10, 83, 92 Presynaptic, 9, 92, 97 Probe, 52, 92 Progression, 76, 93 Projection, 91, 93, 94, 99 Prophase, 93, 97 Prospective study, 88, 93 Protein S, 43, 78, 93 Proteins, 9, 76, 77, 80, 83, 85, 86, 89, 91, 92, 93, 94, 95, 98, 99 Protons, 86, 93, 94 Psychiatric, 4, 10, 34, 47, 89, 93 Psychiatry, 4, 10, 13, 17, 28, 32, 33, 34, 35, 47, 84, 93 Psychic, 90, 93, 95 Psychomotor, 12, 81, 93 Psychosis, 45, 93 Psychotherapy, 47, 93 Psychotomimetic, 76, 82, 93 Psychotropic, 52, 93 Psychotropic Drugs, 52, 93 Public Health, 47, 60, 93

Public Policy, 20, 59, 93 Pulmonary, 21, 22, 78, 94, 99 Pulmonary Artery, 78, 94, 99 Pulmonary Emphysema, 21, 94 Pulse, 89, 94 R Race, 82, 83, 94 Radiation, 94, 95, 100 Radioactive, 79, 86, 87, 88, 94, 95 Randomized, 83, 94 Reagent, 15, 94 Reality Testing, 93, 94 Receptor, 5, 6, 14, 77, 82, 84, 94, 95 Receptors, Serotonin, 94, 95 Rectum, 84, 85, 94 Red Nucleus, 94, 99 Refer, 1, 80, 84, 88, 90, 93, 94 Refraction, 94, 96 Regimen, 10, 83, 94 Renal failure, 82, 94 Respiration, 89, 94 Reticular, 34, 95 Reticular Formation, 34, 95 Retrospective, 5, 95 Rigidity, 91, 92, 95 Ritodrine, 17, 95 S Scans, 21, 95 Schizoid, 95, 100 Schizophrenia, 95, 99, 100 Schizotypal Personality Disorder, 95, 100 Sclerosis, 90, 95 Screening, 80, 95 Secretory, 95, 97 Seizures, 81, 95 Sensitization, 10, 12, 14, 28, 95 Serotonin, 11, 23, 84, 94, 95, 96, 99 Serum, 8, 80, 95 Sex Characteristics, 75, 95 Sibutramine, 13, 96 Side effect, 16, 21, 45, 75, 96, 98 Social Behavior, 45, 96 Social Values, 16, 96 Solvent, 89, 96 Somatic, 75, 89, 96 Specialist, 65, 96 Species, 84, 89, 94, 96, 100 Specificity, 10, 75, 96 Spectrum, 47, 96 Spinal cord, 77, 79, 89, 90, 96 Stabilization, 10, 96 Staging, 95, 96

Index 105

Stimulant, 10, 14, 24, 32, 33, 35, 45, 76, 82, 89, 91, 96 Stimulus, 4, 84, 87, 96 Stress, 8, 79, 96 Striatum, 91, 96 Subacute, 87, 97 Subclinical, 87, 95, 97 Subiculum, 86, 97 Substance P, 89, 97 Suppression, 10, 97 Sympathomimetic, 76, 82, 84, 89, 91, 97 Synapses, 7, 91, 97 Synapsis, 97 Synaptic, 13, 91, 97 Synaptic Transmission, 13, 91, 97 Synaptic Vesicles, 97 Systemic, 78, 81, 84, 87, 97 T Talc, 22, 97 Temporal, 76, 86, 97 Thalamic, 34, 97 Therapeutics, 33, 97 Thrombosis, 93, 98 Tinnitus, 91, 98 Tissue, 5, 6, 47, 77, 79, 83, 86, 88, 89, 90, 94, 96, 98 Tolerance, 9, 75, 98 Tomography, 32, 81, 98 Toxic, iv, 10, 89, 90, 91, 98 Toxicity, 83, 98 Toxicokinetics, 98 Toxicology, 17, 60, 98 Toxins, 10, 77, 83, 87, 98, 99 Toxoplasmosis, 47, 98 Trace element, 79, 98

Tranquilizing Agents, 93, 98 Transfection, 78, 98 Transmitter, 7, 78, 82, 87, 88, 91, 97, 98 Trauma, 81, 85, 90, 98 Tremor, 91, 98 Triazolam, 32, 99 Tryptophan, 95, 99 Tubercle, 91, 99 Tyrosine, 82, 99 U Unconscious, 86, 99 Urethra, 99 Urine, 15, 17, 78, 99 V Vaccines, 99, 100 Vascular, 75, 87, 99 Vasodilator, 82, 99 Vein, 87, 99 Venoms, 90, 99 Venous, 93, 99 Ventral, 12, 91, 92, 99 Ventral Tegmental Area, 12, 99 Ventricle, 76, 79, 86, 91, 94, 99 Venules, 78, 79, 99 Vertigo, 91, 99 Veterinary Medicine, 59, 99 Virus, 47, 100 Vivo, 100 W Wakefulness, 81, 100 Withdrawal, 22, 81, 100 X Xenograft, 76, 100 X-ray, 81, 95, 100

106 Ritalin

Index 107

108 Ritalin

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Peanut Allergy: A Medical Dictionary, Bibliography, And Annotated Research Guide To Internet References

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