• Willem Andries Nienaber Louw and Ryan Alroy Davids.
• Anaesthesiology and Critical care, University of Stellenbosch, Parow, South Africa wanlouw@gmail.com.
• Postgrad Med J. 2022 Dec 1; 98 (1166): 925929925-929.

BackgroundMethylphenidate is mainly used for the treatment of attention-deficit/hyperactive-disorder (ADHD). Its effect of increased attentiveness leads to the potential of off-label use by students for academic enhancement-previously demonstrated in undergraduate students. No publication exists on postgraduate student use of methylphenidate.ObjectivesTo provide a summary of the self-reported prevalence and correlates of methylphenidate use in Masters of Medicine (MMed) students registered at the Faculty of Medical and Health Sciences of a South African university.MethodsA cross-sectional study was conducted. Data were collected via a self-administered anonymous online questionnaire distributed by email to 505 registered MMed students.ResultsOf the 253 responses (response rate 50.1%) received 71 (28.1%) have used methylphenidate. Only 2.4% have been diagnosed with ADHD. The majority (73.2%) obtained it without a formal medical consultation. Self-prescription (26.8%) and prescription by a colleague without consultation (23.9%) contributed significantly. Academic performance enhancement was the primary motivation for use in 71.8% and 42.3% of users started using methylphenidate while registered as an MMed student. There was no statistically significant difference in terms of gender (p=0.151), age (p=0.288) or year of study (p=0.149).ConclusionsOff-label use of methylphenidate is prevalent in MMed students registered at this South African university. The prevalence is significantly higher than in undergraduate medical students. The non-conventional means of access is of great concern. Efforts should be made to discourage self-prescription, educate students on the dangers of methylphenidate use, promote better access regulation and enhance psychological support.© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.

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