Expectation to receive methylphenidate enhances subjective arousal but not cognitive performance.

Abstract

Nonmedical use of prescription stimulant medication such as methylphenidate (MPH) has increased among college students over the past several years. Common motivations for use include enhancements in cognition and subjective arousal. As it is unclear whether stimulant medication exerts the same effect on healthy individuals as for those with ADHD, it is possible that many reported effects of prescription stimulants by healthy individuals may stem from placebo effects, which may be an important mechanism underlying initiation and maintenance of nonmedical use. This study examined whether placebo effects influence reports of subjective mood and cognitive performance among college students who endorsed several risk factors for prescription stimulant misuse (i.e., low GPA, fraternity/sorority involvement, binge drinking, cannabis use). Ninety-six subjects (60% male) completed a battery of cognitive tests and questionnaires assessing present mood state on two occasions. Forty-seven participants were randomized to an experimental condition and orally ingested what they believed to be MPH, though actually placebo, on one visit and received no medication on the other visit. The control group received no medication on either visit. During the administration visit, experimental participants reported feeling significantly more high and stimulated compared to the non-administration visit and to the control subjects. However, cognitive enhancement differences were not generally seen between visits or groups. This research demonstrates that placebo effects for prescription stimulants do influence subjective mood and may be implicated in nonmedical stimulant use. This knowledge may be useful in challenging prescription stimulant-related expectancies to decrease the prevalence of use among college students.

An N-of-1 Trial as an Individualized Withdrawal Treatment Approach to Psychological Methylphenidate Dependence

“…Indeed, there is evidence that the belief that one receives active treatment sometimes predicts subjective responses better than the actual treatment [6]. Interestingly, the subjectively perceived improved concentration was not substantiated in better d2-R performance, which is in agreement with findings in healthy prescription stimulant-naive college students, who reported enhanced subjective arousal when assuming methylphenidate intake, while cognitive performance was in fact unchanged [7]. …”

Do college students improve their grades by using prescription stimulants nonmedically?

“…Ilieva, et al, (2013) observed that individuals believed that their cognitive performance was enhanced when they received a stimulant, relative to placebo, even though the effects on their performance were small. Similarly, Looby and Earleywine (2011) found that individuals felt subjectively more stimulated when administered a stimulant, relative to when receiving a placebo, but did not perform differently on cognitive tests. Further research is needed to examine how expectancies might play a role in improving academic performance.…”

“…Interestingly, some research supports that there might be a “placebo effect” associated with NPS (Ilieva et al, 2013; Looby & Earleywine, 2011). Ilieva, et al, (2013) observed that individuals believed that their cognitive performance was enhanced when they received a stimulant, relative to placebo, even though the effects on their performance were small.…”

The Role of Dopamine D₁ and D₂ Receptors in Adolescent Methylphenidate Conditioned Place Preference: Sex Differences and Brain-Derived Neurotrophic Factor

“…The potential for abuse and dependence of MPH is alarming considering the rise in the amount of children misdiagnosed and subsequently prescribed a stimulant medication for treatment [5,6]. Evidence suggests that MPH abuse has noticeably increased over the past several years [7,8]. In fact, of those persons aged 12 years and older, 4.2 million have used Ritalin or MPH recreationally at least once in their lifetime [9].…”