Distinguishing Patient Interests between Non-therapeutic vs. Therapeutic Use of Methylphenidate as a Study Aid: A Topic Modelling of Attention-Deficit/Hyperactivity Disorder Social Media Community (Preprint)

Abstract

Methylphenidate (MPH) is commonly used off-label as a study aid, raising concerns about its non-therapeutic use and associated risks. While use of MPH as a study aid is discouraged, students with academic difficulties would therapeutically need MPH for enhancing their executive function. Understanding user topic patterns related to therapeutic and non-therapeutic use of MPH can provide insights into factors influencing usage patterns and guide interventions.

This study aimed to investigate user topic patterns associated with therapeutic and non-therapeutic use of MPH as study aids, utilizing social media posts.

We utilized Latent Dirichlet Allocation (LDA) topic modeling to identify underlying themes from user-generated posts on an Attention-Deficit/Hyperactivity Disorder (ADHD) social media platform. The posts pertaining to MPH use for academic purposes (N=1,447) were classified into therapeutic and non-therapeutic use and the distribution of posting season and topic prevalence were assessed between two usage patterns. Logistic regression and interaction analyses were conducted to examine associations between topics and MPH usage, accounting for seasonal variations.

The result of LDA topic modeling revealed six key topics: effect alteration, atomoxetine therapy, ADHD challenges, diagnosis and consultation, brain stimulation, and academic performance. While effect alteration (OR=6.31, P=.017) and brain stimulation (OR=6.63, P=.042), were significantly associated with non-therapeutic use, atomoxetine therapy (OR=0.04, P<.001) and ADHD challenges (OR=0.16, P=.013) were linked to therapeutic use. Interaction analyses revealed synergistic and antagonistic effects between topic pairs, modulating their impacts on usage patterns. Pro-therapeutic topics such as atomoxetine therapy and ADHD challenges exhibited a shift towards non-therapeutic use during non-winter seasons.

Our findings provide insights into the complex interplay of user topics associated with therapeutic and non-therapeutic use of MPH for academic purposes. Understanding these patterns can inform targeted interventions aimed at promoting safe and appropriate MPH use among students, particularly during seasons when misuse risks may increase among those experiencing ADHD challenges.