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Amphetamines, often referred to as uppers or speed, are in a classification of drugs known as stimulants. In , approximately 75, people aged 12 and older abused stimulants for the first time. Any person who abuses amphetamines is in danger of an amphetamine overdose , which can manifest as aggression, dangerously high blood pressure, rapid heartbeat, coma, or even death. Overdose can occur even in first-time users, depending on the amount of drug used in one sitting. Amphetamines have legitimate medical uses and are often prescribed for Attention Deficit Disorder ADD and narcolepsy; in certain severe cases of obesity, they may also be prescribed for appetite suppression. However, amphetamines are sometimes misused by people who want to stay awake for long periods of time—such as truck drivers, students, or even people attempting to lose weight. Other people abuse amphetamines simply to get high. Prescription amphetamines can be taken orally, crushed and snorted, or dissolved in water and then injected into the bloodstream. Amphetamine use and abuse may cause one or more of the following side effects : 2. Amphetamines are meant to produce short-term, immediate effects on the user. So using amphetamines in the long term can produce many negative side effects that may become chronic, including: 1. When people consistently take amphetamines for a long time, they typically develop a tolerance to the drug , which, in turn, results in the need for a higher amount of amphetamines to achieve the same effects. As the amount and frequency of drug use rises, the risk of developing a physiologic amphetamine dependence increases. Many users develop a dangerous pattern of abusing amphetamines: getting high and then crashing. These crashes often result in depression, anxiety, extreme fatigue, and a craving for more amphetamines—and so the cycle continues. In a significant numbers of users, aggressive behavior and hallucinations may occur over time. When someone overdoses on amphetamines, they may experience: 1. An amphetamine overdose is a serious medical emergency, and often indicates the presence of a serious underlying substance use disorder. When someone overdoses on amphetamines, the immediate need for intervention usually involves managing psychosis, agitation, and irregular heartbeat. A recent, comprehensive study for amphetamine overdose indicated that beta blockers were helpful in controlling heart issues and high blood pressure, and also identified that antipsychotic medications and benzodiazepines were the best course of action to control agitation and psychosis after an amphetamine overdose. For many people, detox may be necessary to deal with the symptoms of physical withdrawal. A detox program for amphetamine abuse can provide the necessary medical oversight, as well as crucial early emotional support for addicts. Ongoing treatment helps a person understand and work through the underlying emotional and mental issues that led to the addiction in the first place because a drug overdose is simply a red flag for a greater problem: substance abuse and addiction. The psychological dependence that develops in many cases of drug addiction is critically important to address as well. If the psychological dependence is not addressed and resolved, the addict may find it difficult to stay clean. There are a variety of treatment programs, whether inpatient or outpatient, that combine medical assessment, medical oversight, and group and individual counseling sessions. Ongoing counseling focuses on building coping skills as well as developing techniques to enable a person to remain drug-free. A person who abuses amphetamines in order to keep weight off, for example, will also need to address the emotional issues underlying his weight, and what issues must be resolved to prevent him from returning to using amphetamines to suppress his appetite. Majority of Young Adults Get Stimulant Medications from a Friend A lot of young people obtain prescription stimulant medications despite not have a prescription for them. This is a far-reaching problem that may have troubling results. But where do these young adults get access to the prescription drugs? Medical users are advised to keep track of their doctor-prescribed ADHD stimulants in order to protect susceptible college-age men and women from substance misuse and the consequences of it. Riverwalk Ranch. Ambrosia Treatment Center. Evolve Treatment Centers for Teens. Clearbrook Manor.
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Amphetamine \\\\\\\\\\[note 1\\\\\\\\\\] contracted from a lpha - m ethyl ph en et hyl amine is a central nervous system CNS stimulant that is used in the treatment of attention deficit hyperactivity disorder ADHD , narcolepsy , and obesity. Amphetamine was discovered in and exists as two enantiomers : \\\\\\\\\\[note 2\\\\\\\\\\] levoamphetamine and dextroamphetamine. Amphetamine properly refers to a specific chemical, the racemic free base , which is equal parts of the two enantiomers, levoamphetamine and dextroamphetamine, in their pure amine forms. The term is frequently used informally to refer to any combination of the enantiomers, or to either of them alone. Historically, it has been used to treat nasal congestion and depression. Amphetamine is also used as an athletic performance enhancer and cognitive enhancer , and recreationally as an aphrodisiac and euphoriant. It is a prescription drug in many countries, and unauthorized possession and distribution of amphetamine are often tightly controlled due to the significant health risks associated with recreational use. The first amphetamine pharmaceutical was Benzedrine , a brand which was used to treat a variety of conditions. Currently, pharmaceutical amphetamine is prescribed as racemic amphetamine, Adderall , \\\\\\\\\\[note 3\\\\\\\\\\] dextroamphetamine , or the inactive prodrug lisdexamfetamine. Amphetamine increases monoamine and excitatory neurotransmission in the brain, with its most pronounced effects targeting the norepinephrine and dopamine neurotransmitter systems. At therapeutic doses, amphetamine causes emotional and cognitive effects such as euphoria , change in desire for sex , increased wakefulness , and improved cognitive control. It induces physical effects such as improved reaction time, fatigue resistance, and increased muscle strength. Larger doses of amphetamine may impair cognitive function and induce rapid muscle breakdown. Addiction is a serious risk with heavy recreational amphetamine use, but is unlikely to occur from long-term medical use at therapeutic doses. Very high doses can result in psychosis e. Recreational doses are generally much larger than prescribed therapeutic doses and carry a far greater risk of serious side effects. Amphetamine belongs to the phenethylamine class. It is also the parent compound of its own structural class, the substituted amphetamines , \\\\\\\\\\[note 4\\\\\\\\\\] which includes prominent substances such as bupropion , cathinone , MDMA , and methamphetamine. As a member of the phenethylamine class, amphetamine is also chemically related to the naturally occurring trace amine neuromodulators, specifically phenethylamine and N -methylphenethylamine , both of which are produced within the human body. Phenethylamine is the parent compound of amphetamine, while N -methylphenethylamine is a positional isomer of amphetamine that differs only in the placement of the methyl group. Amphetamine is used to treat attention deficit hyperactivity disorder ADHD , narcolepsy a sleep disorder , and obesity , and is sometimes prescribed off-label for its past medical indications , particularly for depression and chronic pain. Reviews of clinical stimulant research have established the safety and effectiveness of long-term continuous amphetamine use for the treatment of ADHD. Amphetamine is used by some athletes for its psychological and athletic performance-enhancing effects , such as increased endurance and alertness; \\\\\\\\\\[27\\\\\\\\\\] \\\\\\\\\\[39\\\\\\\\\\] however, non-medical amphetamine use is prohibited at sporting events that are regulated by collegiate, national, and international anti-doping agencies. The adverse side effects of amphetamine are many and varied, and the amount of amphetamine used is the primary factor in determining the likelihood and severity of adverse effects. Amphetamine stimulates the medullary respiratory centers , producing faster and deeper breaths. USFDA-commissioned studies from indicate that in children, young adults, and adults there is no association between serious adverse cardiovascular events sudden death , heart attack , and stroke and the medical use of amphetamine or other ADHD stimulants. At normal therapeutic doses, the most common psychological side effects of amphetamine include increased alertness , apprehension, concentration , initiative, self-confidence and sociability, mood swings elated mood followed by mildly depressed mood , insomnia or wakefulness , and decreased sense of fatigue. Amphetamine has also been shown to produce a conditioned place preference in humans taking therapeutic doses, \\\\\\\\\\[63\\\\\\\\\\] \\\\\\\\\\[95\\\\\\\\\\] meaning that individuals acquire a preference for spending time in places where they have previously used amphetamine. Addiction is a serious risk with heavy recreational amphetamine use, but is unlikely to occur from long-term medical use at therapeutic doses; \\\\\\\\\\[43\\\\\\\\\\] \\\\\\\\\\[44\\\\\\\\\\] \\\\\\\\\\[45\\\\\\\\\\] in fact, lifetime stimulant therapy for ADHD that begins during childhood reduces the risk of developing substance use disorders as an adult. Chronic use of amphetamine at excessive doses causes alterations in gene expression in the mesocorticolimbic projection , which arise through transcriptional and epigenetic mechanisms. The effects of amphetamine on gene regulation are both dose- and route-dependent. As of December , \\\\\\\\\\[update\\\\\\\\\\] there is no effective pharmacotherapy for amphetamine addiction. A systematic review and meta-analysis from assessed the efficacy of 17 different pharmacotherapies used in RCTs for amphetamine and methamphetamine addiction; \\\\\\\\\\[\\\\\\\\\\] it found only low-strength evidence that methylphenidate might reduce amphetamine or methamphetamine self-administration. A systematic review and network meta-analysis of 50 trials involving 12 different psychosocial interventions for amphetamine, methamphetamine, or cocaine addiction found that combination therapy with both contingency management and community reinforcement approach had the highest efficacy i. Additionally, research on the neurobiological effects of physical exercise suggests that daily aerobic exercise, especially endurance exercise e. Drug tolerance develops rapidly in amphetamine abuse i. An amphetamine overdose can lead to many different symptoms, but is rarely fatal with appropriate care. In rodents and primates, sufficiently high doses of amphetamine cause dopaminergic neurotoxicity , or damage to dopamine neurons, which is characterized by dopamine terminal degeneration and reduced transporter and receptor function. An amphetamine overdose can result in a stimulant psychosis that may involve a variety of symptoms, such as delusions and paranoia. Many types of substances are known to interact with amphetamine, resulting in altered drug action or metabolism of amphetamine, the interacting substance, or both. In particular, amphetamine may decrease the effects of sedatives and depressants and increase the effects of stimulants and antidepressants. In general, there is no significant interaction when consuming amphetamine with food, but the pH of gastrointestinal content and urine affects the absorption and excretion of amphetamine, respectively. Amphetamine exerts its behavioral effects by altering the use of monoamines as neuronal signals in the brain, primarily in catecholamine neurons in the reward and executive function pathways of the brain. Amphetamine has been identified as a potent full agonist of trace amine-associated receptor 1 TAAR1 , a G s -coupled and G q -coupled G protein-coupled receptor GPCR discovered in , which is important for regulation of brain monoamines. Dextroamphetamine is a more potent agonist of TAAR1 than levoamphetamine. In certain brain regions, amphetamine increases the concentration of dopamine in the synaptic cleft. Amphetamine is also a substrate for the presynaptic vesicular monoamine transporter , VMAT2. Similar to dopamine, amphetamine dose-dependently increases the level of synaptic norepinephrine, the direct precursor of epinephrine. Amphetamine exerts analogous, yet less pronounced, effects on serotonin as on dopamine and norepinephrine. Acute amphetamine administration in humans increases endogenous opioid release in several brain structures in the reward system. In December , the first study assessing the interaction between amphetamine and human carbonic anhydrase enzymes was published; \\\\\\\\\\[\\\\\\\\\\] of the eleven carbonic anhydrase enzymes it examined, it found that amphetamine potently activates seven, four of which are highly expressed in the human brain , with low nanomolar through low micromolar activating effects. The half-lives of amphetamine enantiomers differ and vary with urine pH. The prodrug lisdexamfetamine is not as sensitive to pH as amphetamine when being absorbed in the gastrointestinal tract; \\\\\\\\\\[\\\\\\\\\\] following absorption into the blood stream, it is converted by red blood cell -associated enzymes to dextroamphetamine via hydrolysis. The human metagenome i. Similar to most biomolecules and other orally administered xenobiotics i. Amphetamine has a very similar structure and function to the endogenous trace amines, which are naturally occurring neuromodulator molecules produced in the human body and brain. Amphetamine is a methyl homolog of the mammalian neurotransmitter phenethylamine with the chemical formula C 9 H 13 N. The carbon atom adjacent to the primary amine is a stereogenic center , and amphetamine is composed of a racemic mixture of two enantiomers. The substituted derivatives of amphetamine, or 'substituted amphetamines', are a broad range of chemicals that contain amphetamine as a 'backbone'; \\\\\\\\\\[5\\\\\\\\\\] \\\\\\\\\\[48\\\\\\\\\\] \\\\\\\\\\[\\\\\\\\\\] specifically, this chemical class includes derivative compounds that are formed by replacing one or more hydrogen atoms in the amphetamine core structure with substituents. Since the first preparation was reported in , \\\\\\\\\\[\\\\\\\\\\] numerous synthetic routes to amphetamine have been developed. This intermediate is then hydrolyzed using hydrochloric acid, and subsequently basified, extracted with organic solvent, concentrated, and distilled to yield the free base. The free base is then dissolved in an organic solvent, sulfuric acid added, and amphetamine precipitates out as the sulfate salt. A number of chiral resolutions have been developed to separate the two enantiomers of amphetamine. In one example, optically pure R phenyl-ethanamine is condensed with phenylacetone to yield a chiral Schiff base. In the key step, this intermediate is reduced by catalytic hydrogenation with a transfer of chirality to the carbon atom alpha to the amino group. Cleavage of the benzylic amine bond by hydrogenation yields optically pure dextroamphetamine. A large number of alternative synthetic routes to amphetamine have been developed based on classic organic reactions. In this route, allylbenzene is reacted acetonitrile in sulfuric acid to yield an organosulfate which in turn is treated with sodium hydroxide to give amphetamine via an acetamide intermediate. A significant number of amphetamine syntheses feature a reduction of a nitro , imine , oxime , or other nitrogen-containing functional groups. Amphetamine is frequently measured in urine or blood as part of a drug test for sports, employment, poisoning diagnostics, and forensics. For the assays, a study noted that an enzyme multiplied immunoassay technique EMIT assay for amphetamine and methamphetamine may produce more false positives than liquid chromatography—tandem mass spectrometry. Amphetamine is still illegally synthesized today in clandestine labs and sold on the black market , primarily in European countries. From Wikipedia, the free encyclopedia. This article is about mixtures of levoamphetamine and dextroamphetamine. For other uses, see Amphetamine disambiguation. US : C Risk not ruled out \\\\\\\\\\[2\\\\\\\\\\]. IUPAC name. Interactive image. Signaling cascade in the nucleus accumbens that results in amphetamine addiction v t e. Note: colored text contains article links. Nuclear pore. Nuclear membrane. Plasma membrane. See also: Stimulant psychosis. Pharmacodynamics of amphetamine in a dopamine neuron v t e. Metabolic pathways of amphetamine in humans \\\\\\\\\\[sources 16\\\\\\\\\\]. Benzoic acid. Hippuric acid. Para- Hydroxylation. Beta- Hydroxylation. DBH \\\\\\\\\\[note 16\\\\\\\\\\]. Oxidative Deamination. Glycine Conjugation. Further information on related compounds: Trace amine. Racemic amphetamine. Amphetamine hydrochloride left bowl Phenylnitropropene right cups. For a more comprehensive list, see Substituted amphetamine. Main article: History and culture of substituted amphetamines. USFDA contraindications are not necessarily intended to limit medical practice but limit claims by pharmaceutical companies. Due to pharmacological differences between these medications e. Text color Transcription factors. Retrieved 5 August Retrieved 22 December Journal of Psychopharmacology. The intravenous use of d-amphetamine and other stimulants still pose major safety risks to the individuals indulging in this practice. Some of this intravenous abuse is derived from the diversion of ampoules of d-amphetamine, which are still occasionally prescribed in the UK for the control of severe narcolepsy and other disorders of excessive sedation. For these reasons, observations of dependence and abuse of prescription d-amphetamine are rare in clinical practice, and this stimulant can even be prescribed to people with a history of drug abuse provided certain controls, such as daily pick-ups of prescriptions, are put in place Jasinski and Krishnan, b. United States Food and Drug Administration. Shire US Inc. December Retrieved 30 December The simplest unsubstituted phenylisopropylamine, 1-phenylaminopropane, or amphetamine, serves as a common structural template for hallucinogens and psychostimulants. Amphetamine produces central stimulant, anorectic, and sympathomimetic actions, and it is the prototype member of this class The phase 1 metabolism of amphetamine analogs is catalyzed by two systems: cytochrome P and flavin monooxygenase. Amphetamine can also undergo aromatic hydroxylation to p -hydroxyamphetamine. Stereochemical course of the reaction' PDF. Journal of Biological Chemistry. Retrieved 6 November Journal of Pharmacology and Experimental Therapeutics. University of Alberta. Retrieved 5 November Journal of Pharmaceutical and Biomedical Analysis. Retrieved 21 January In Millichap JG ed. Table 9. Postgraduate Medicine. Hazardous Substances Data Bank. Archived from the original on 2 October Retrieved 2 October Duration of effect varies depending on agent and urine pH. Excretion is enhanced in more acidic urine. Amphetamines are distributed into most body tissues with high concentrations occurring in the brain and CSF. PubChem Compound Database. Retrieved 17 April In Klee H ed. Amsterdam, Netherlands: Harwood Academic Publishers. Retrieved 1 December Amphetamine, in the singular form, properly applies to the racemate of 2-aminophenylpropane. In its broadest context, however, the term \\\\\\\\\\[ amphetamines \\\\\\\\\\] can even embrace a large number of structurally and pharmacologically related substances. Retrieved 9 November Royal Society of Chemistry. Retrieved 13 October Emergency Medicine Australasia. International Union of Pure and Applied Chemistry. Archived from the original on 17 March Retrieved 14 March One of a pair of molecular entities which are mirror images of each other and non-superposable. Therapeutic relatively low doses of psychostimulants, such as methylphenidate and amphetamine, improve performance on working memory tasks both in normal subjects and those with ADHD. Thus, stimulants improve performance on effortful but tedious tasks Beyond these general permissive effects, dopamine acting via D1 receptors and norepinephrine acting at several receptors can, at optimal levels, enhance working memory and aspects of attention. Primary Care: Clinics in Office Practice. Amphetamines and caffeine are stimulants that increase alertness, improve focus, decrease reaction time, and delay fatigue, allowing for an increased intensity and duration of training Journal of the History of Medicine and Allied Sciences. United Nations Treaty Collection. United Nations. Archived from the original on 31 March Retrieved 11 November Stimulant misuse appears to occur both for performance enhancement and their euphorogenic effects, the latter being related to the intrinsic properties of the stimulants e. Although useful in the treatment of ADHD, stimulants are controlled II substances with a history of preclinical and human studies showing potential abuse liability. Medical Subject Headings. United States National Library of Medicine. Retrieved 16 December World Health Organization. In principle, INNs are selected only for the active part of the molecule which is usually the base, acid or alcohol. In some cases, however, the active molecules need to be expanded for various reasons, such as formulation purposes, bioavailability or absorption rate. In the experts designated for the selection of INN decided to adopt a new policy for naming such molecules. In future, names for different salts or esters of the same active substance should differ only with regard to the inactive moiety of the molecule. Arbor Pharmaceuticals, LLC. National Drug Code Directory. Archived from the original on 16 December Journal of Neurochemistry. Drug and Alcohol Dependence. When considered together with the rapidly growing literature in the field a compelling case emerges in support of developing TAAR1-selective agonists as medications for preventing relapse to psychostimulant abuse. Shoptaw SJ, Ali R ed. A minority of individuals who use amphetamines develop full-blown psychosis requiring care at emergency departments or psychiatric hospitals. In such cases, symptoms of amphetamine psychosis commonly include paranoid and persecutory delusions as well as auditory and visual hallucinations in the presence of extreme agitation. Findings from one trial indicate use of antipsychotic medications effectively resolves symptoms of acute amphetamine psychosis. BMC Psychiatry. In these studies, amphetamine was given in consecutively higher doses until psychosis was precipitated, often after — mg of amphetamine Archived from the original PDF on 3 November Retrieved 2 November CNS Drugs. Several other studies, \\\\\\\\\\[\\\\\\\\\\] including a meta-analytic review \\\\\\\\\\[98\\\\\\\\\\] and a retrospective study, \\\\\\\\\\[97\\\\\\\\\\] suggested that stimulant therapy in childhood is associated with a reduced risk of subsequent substance use, cigarette smoking and alcohol use disorders. Recent studies have demonstrated that stimulants, along with the non-stimulants atomoxetine and extended-release guanfacine, are continuously effective for more than 2-year treatment periods with few and tolerable adverse effects. The effectiveness of long-term therapy includes not only the core symptoms of ADHD, but also improved quality of life and academic achievements. The most concerning short-term adverse effects of stimulants, such as elevated blood pressure and heart rate, waned in long-term follow-up studies. The current data do not support the potential impact of stimulants on the worsening or development of tics or substance abuse into adulthood. Such agents also have important therapeutic uses; cocaine, for example, is used as a local anesthetic Chapter 2 , and amphetamines and methylphenidate are used in low doses to treat attention deficit hyperactivity disorder and in higher doses to treat narcolepsy Chapter Despite their clinical uses, these drugs are strongly reinforcing, and their long-term use at high doses is linked with potential addiction, especially when they are rapidly administered or when high-potency forms are given. Current Medical Research and Opinion. When oral formulations of psychostimulants are used at recommended doses and frequencies, they are unlikely to yield effects consistent with abuse potential in patients with ADHD. Retrieved 19 October Trends in Plant Science. Beyond 1 R ,2 S -ephedrine and 1 S ,2 S -pseudoephedrine, myriad other substituted amphetamines have important pharmaceutical applications. Postgraduate Medical Journal. Archives of Toxicology. Annals of the New York Academy of Sciences. JAMA Psychiatry. The Journal of Clinical Psychiatry. Acta Psychiatrica Scandinavica. Basal ganglia regions like the right globus pallidus, the right putamen, and the nucleus caudatus are structurally affected in children with ADHD. These changes and alterations in limbic regions like ACC and amygdala are more pronounced in non-treated populations and seem to diminish over time from child to adulthood. Treatment seems to have positive effects on brain structure. Among significantly improved outcomes, the largest effect sizes were found for combination treatment. The greatest improvements were associated with academic, self-esteem, or social function outcomes. Pharmacology Biochemistry and Behavior. Psychology Research and Behavior Management. Only one paper 53 examining outcomes beyond 36 months met the review criteria. Retrieved 12 November European Journal of Clinical Nutrition. Cochrane Database of Systematic Reviews. Biological Psychiatry. The procognitive actions of psychostimulants are only associated with low doses. Surprisingly, despite nearly 80 years of clinical use, the neurobiology of the procognitive actions of psychostimulants has only recently been systematically investigated. Collectively, this evidence indicates that at low, clinically relevant doses, psychostimulants are devoid of the behavioral and neurochemical actions that define this class of drugs and instead act largely as cognitive enhancers improving PFC-dependent function. In particular, in both animals and humans, lower doses maximally improve performance in tests of working memory and response inhibition, whereas maximal suppression of overt behavior and facilitation of attentional processes occurs at higher doses. Journal of Cognitive Neuroscience. Specifically, in a set of experiments limited to high-quality designs, we found significant enhancement of several cognitive abilities. The results of this meta-analysis Amphetamine has been shown to improve consolidation of information 0. Journal of Nuclear Medicine. Dopamine acts in the nucleus accumbens to attach motivational significance to stimuli associated with reward. Pharmacological Reviews. JS Online. Archived from the original on 15 August Retrieved 2 December NCAA Publications. National Collegiate Athletic Association. Retrieved 8 October British Journal of Pharmacology. Clinics in Sports Medicine. In , Chandler and Blair 47 showed significant increases in knee extension strength, acceleration, anaerobic capacity, time to exhaustion during exercise, pre-exercise and maximum heart rates, and time to exhaustion during maximal oxygen consumption VO2 max testing after administration of 15 mg of dextroamphetamine versus placebo. Most of the information to answer this question has been obtained in the past decade through studies of fatigue rather than an attempt to systematically investigate the effect of ADHD drugs on exercise. Sports Medicine. In high-ambient temperatures, dopaminergic manipulations clearly improve performance. The distribution of the power output reveals that after dopamine reuptake inhibition, subjects are able to maintain a higher power output compared with placebo. Frontiers in Integrative Neuroscience. Manipulations of dopaminergic signaling profoundly influence interval timing, leading to the hypothesis that dopamine influences internal pacemaker, or 'clock,' activity. For instance, amphetamine, which increases concentrations of dopamine at the synaptic cleft advances the start of responding during interval timing, whereas antagonists of D2 type dopamine receptors typically slow timing; Depletion of dopamine in healthy volunteers impairs timing, while amphetamine releases synaptic dopamine and speeds up timing. Frontiers in Physiology. Aside from accounting for the reduced performance of mentally fatigued participants, this model rationalizes the reduced RPE and hence improved cycling time trial performance of athletes using a glucose mouthwash Chambers et al. Dopamine stimulating drugs are known to enhance aspects of exercise performance Roelands et al. This indicates that subjects did not feel they were producing more power and consequently more heat. The authors concluded that the 'safety switch' or the mechanisms existing in the body to prevent harmful effects are overridden by the drug administration Roelands et al. Taken together, these data indicate strong ergogenic effects of an increased DA concentration in the brain, without any change in the perception of effort. Southern Medical Journal. Rather they are intended to limit claims by pharmaceutical companies. International Programme on Chemical Safety. Retrieved 24 June Journal of Affective Disorders. Tris Pharma, Inc. Retrieved 29 April Table 2. Archived from the original on 25 August Retrieved 24 December New England Journal of Medicine. Archived from the original on 14 December Merck Manual for Health Care Professionals. Retrieved 8 May This study demonstrates that humans, like nonhumans, prefer a place associated with amphetamine administration. These findings support the idea that subjective responses to a drug contribute to its ability to establish place conditioning. Dialogues in Clinical Neuroscience. Despite the importance of numerous psychosocial factors, at its core, drug addiction involves a biological process: the ability of repeated exposure to a drug of abuse to induce changes in a vulnerable brain that drive the compulsive seeking and taking of drugs, and loss of control over drug use, that define a state of addiction. Moreover, there is increasing evidence that, despite a range of genetic risks for addiction across the population, exposure to sufficiently high doses of a drug for long periods of time can transform someone who has relatively lower genetic loading into an addict. Mount Sinai School of Medicine. Department of Neuroscience. Retrieved 9 February Substance-use disorder: A diagnostic term in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders DSM-5 referring to recurrent use of alcohol or other drugs that causes clinically and functionally significant impairment, such as health problems, disability, and failure to meet major responsibilities at work, school, or home. Depending on the level of severity, this disorder is classified as mild, moderate, or severe. Addiction: A term used to indicate the most severe, chronic stage of substance-use disorder, in which there is a substantial loss of self-control, as indicated by compulsive drug taking despite the desire to stop taking the drug. In the DSM-5, the term addiction is synonymous with the classification of severe substance-use disorder. This is known to occur on many genes including fosB and c-fos in response to psychostimulant exposure. Chronic exposure to psychostimulants increases glutamatergic \\\\\\\\\\[signaling\\\\\\\\\\] from the prefrontal cortex to the NAc. The Journal of General Physiology. Coincident and convergent input often induces plasticity on a postsynaptic neuron. The NAc integrates processed information about the environment from basolateral amygdala, hippocampus, and prefrontal cortex PFC , as well as projections from midbrain dopamine neurons. Previous studies have demonstrated how dopamine modulates this integrative process. For example, high frequency stimulation potentiates hippocampal inputs to the NAc while simultaneously depressing PFC synapses Goto and Grace, KEGG Pathway. Retrieved 31 October Most addictive drugs increase extracellular concentrations of dopamine DA in nucleus accumbens NAc and medial prefrontal cortex mPFC , projection areas of mesocorticolimbic DA neurons and key components of the 'brain reward circuit'. Amphetamine achieves this elevation in extracellular levels of DA by promoting efflux from synaptic terminals. Chronic exposure to amphetamine induces a unique transcription factor delta FosB, which plays an essential role in long-term adaptive changes in the brain. Nature Reviews Neuroscience. The net result is gene activation and increased CDK5 expression. The net result is c-fos gene repression. Clinical Psychopharmacology and Neuroscience. Magnesium Research. Similar to environmental enrichment, studies have found that exercise reduces self-administration and relapse to drugs of abuse Cosgrove et al. There is also some evidence that these preclinical findings translate to human populations, as exercise reduces withdrawal symptoms and relapse in abstinent smokers Daniel et al. In humans, the role of dopamine signaling in incentive-sensitization processes has recently been highlighted by the observation of a dopamine dysregulation syndrome in some patients taking dopaminergic drugs. This syndrome is characterized by a medication-induced increase in or compulsive engagement in non-drug rewards such as gambling, shopping, or sex Evans et al. Exercise has been proposed as a treatment for drug addiction that may reduce drug craving and risk of relapse. Although few clinical studies have investigated the efficacy of exercise for preventing relapse, the few studies that have been conducted generally report a reduction in drug craving and better treatment outcomes Taken together, these data suggest that the potential benefits of exercise during relapse, particularly for relapse to psychostimulants, may be mediated via chromatin remodeling and possibly lead to greater treatment outcomes. Frontiers in Neuroendocrinology. The postulate that exercise serves as an ideal intervention for drug addiction has been widely recognized and used in human and animal rehabilitation. The limited research conducted suggests that exercise may be an effective adjunctive treatment for SUDs. In contrast to the scarce intervention trials to date, a relative abundance of literature on the theoretical and practical reasons supporting the investigation of this topic has been published. Annual Review of Neuroscience. Progress in Neurobiology. Proceedings of the National Academy of Sciences. Annals of Agricultural and Environmental Medicine. Nature Neuroscience. Nature Reviews. Journal of Psychoactive Drugs. It has been found that deltaFosB gene in the NAc is critical for reinforcing effects of sexual reward. Pitchers and colleagues reported that sexual experience was shown to cause DeltaFosB accumulation in several limbic brain regions including the NAc, medial pre-frontal cortex, VTA, caudate, and putamen, but not the medial preoptic nucleus. The Journal of Neuroscience. Pharmacologic treatment for psychostimulant addiction is generally unsatisfactory. As previously discussed, cessation of cocaine use and the use of other psychostimulants in dependent individuals does not produce a physical withdrawal syndrome but may produce dysphoria, anhedonia, and an intense desire to reinitiate drug use. Addiction Abingdon, England. Expert Review of Clinical Pharmacology. Despite concerted efforts to identify a pharmacotherapy for managing stimulant use disorders, no widely effective medications have been approved. European Journal of Pharmacology. Existing data provided robust preclinical evidence supporting the development of TAAR1 agonists as potential treatment for psychostimulant abuse and addiction. PLoS Medicine. Frontiers in Psychiatry. Physical Exercise There is accelerating evidence that physical exercise is a useful treatment for preventing and reducing drug addiction In some individuals, exercise has its own rewarding effects, and a behavioral economic interaction may occur, such that physical and social rewards of exercise can substitute for the rewarding effects of drug abuse. The value of this form of treatment for drug addiction in laboratory animals and humans is that exercise, if it can substitute for the rewarding effects of drugs, could be self-maintained over an extended period of time. Work to date in \\\\\\\\\\[laboratory animals and humans\\\\\\\\\\] regarding exercise as a treatment for drug addiction supports this hypothesis. Animal and human research on physical exercise as a treatment for stimulant addiction indicates that this is one of the most promising treatments on the horizon. Merck Manual Home Edition. February Archived from the original on 17 February Retrieved 28 February Shoptaw SJ ed. The prevalence of this withdrawal syndrome is extremely common Cantwell ; Gossop with The severity of withdrawal symptoms is greater in amphetamine dependent individuals who are older and who have more extensive amphetamine use disorders McGregor The first phase of this syndrome is the initial 'crash' that resolves within about a week Gossop ;McGregor Amphetamine, dextroamphetamine, and methylphenidate act as substrates for the cellular monoamine transporter, especially the dopamine transporter DAT and less so the norepinephrine NET and serotonin transporter. The mechanism of toxicity is primarily related to excessive extracellular dopamine, norepinephrine, and serotonin. The Lancet. Retrieved 3 March Amphetamine use disorders Journal of Attention Disorders. The hyperthermia and the hypertension produced by high doses amphetamines are a primary cause of transient breakdowns in the blood-brain barrier BBB resulting in concomitant regional neurodegeneration and neuroinflammation in laboratory animals. In animal models that evaluate the neurotoxicity of AMPH and METH, it is quite clear that hyperthermia is one of the essential components necessary for the production of histological signs of dopamine terminal damage and neurodegeneration in cortex, striatum, thalamus and hippocampus. Direct toxic damage to vessels seems unlikely because of the dilution that occurs before the drug reaches the cerebral circulation. Unlike cocaine and amphetamine, methamphetamine is directly toxic to midbrain dopamine neurons. Neurotoxicity Research. Acta Medica Okayama. Molecular Pharmacology. Although the monoamine transport cycle has been resolved in considerable detail, kinetic knowledge on the molecular actions of synthetic allosteric modulators is still scarce. This potentiates both the forward-transport mode i. Functional selectivity by conformational selection. Expert Review of Neurotherapeutics. Zinc binds at In this context, controlled double-blind studies in children are of interest, which showed positive effects of zinc \\\\\\\\\\[supplementation\\\\\\\\\\] on symptoms of ADHD \\\\\\\\\\[,\\\\\\\\\\]. It should be stated that at this time \\\\\\\\\\[supplementation\\\\\\\\\\] with zinc is not integrated in any ADHD treatment algorithm. Basal Ganglia. Despite the challenges in determining synaptic vesicle pH, the proton gradient across the vesicle membrane is of fundamental importance for its function. Exposure of isolated catecholamine vesicles to protonophores collapses the pH gradient and rapidly redistributes transmitter from inside to outside the vesicle. Amphetamine and its derivatives like methamphetamine are weak base compounds that are the only widely used class of drugs known to elicit transmitter release by a non-exocytic mechanism. As substrates for both DAT and VMAT, amphetamines can be taken up to the cytosol and then sequestered in vesicles, where they act to collapse the vesicular pH gradient. Frontiers in Systems Neuroscience. Three important new aspects of TAs action have recently emerged: a inhibition of firing due to increased release of dopamine; b reduction of D2 and GABAB receptor-mediated inhibitory responses excitatory effects due to disinhibition ; and c a direct TA1 receptor-mediated activation of GIRK channels which produce cell membrane hyperpolarization. University of Paris. Retrieved 29 May AMPH also increases intracellular calcium Gnegy et al. Trends in Pharmacological Sciences. AMPH and METH also stimulate DA efflux, which is thought to be a crucial element in their addictive properties \\\\\\\\\\[80\\\\\\\\\\], although the mechanisms do not appear to be identical for each drug \\\\\\\\\\[81\\\\\\\\\\]. International Union of Basic and Clinical Pharmacology. Retrieved 8 December Retrieved 13 November NCBI Gene. Amphetamine modulates excitatory neurotransmission through endocytosis of the glutamate transporter EAAT3 in dopamine neurons. The physiological importance of CART was further substantiated in numerous human studies demonstrating a role of CART in both feeding and psychostimulant addiction. Colocalization studies also support a role for CART in the actions of psychostimulants. Clinical and Experimental Pharmacology and Physiology. Several studies on CART cocaine- and amphetamine-regulated transcript -peptide-induced cell signalling have demonstrated that CART peptides activate at least three signalling mechanisms. Retrieved 4 May Retrieved 24 February More recently, Colasanti and colleagues reported that a pharmacologically induced elevation in endogenous opioid release reduced \\\\\\\\\\[ 11 C\\\\\\\\\\]carfentanil binding in several regions of the human brain, including the basal ganglia, frontal cortex, and thalamus Colasanti et al. Oral administration of d-amphetamine, 0. The results were confirmed in another group of subjects Mick et al. However, Guterstam and colleagues observed no change in \\\\\\\\\\[ 11 C\\\\\\\\\\]carfentanil binding when d-amphetamine, 0. It has been hypothesized that this discrepancy may be related to delayed increases in extracellular opioid peptide concentrations following amphetamine-evoked monoamine release Colasanti et al. Frontiers in Behavioral Neuroscience. Similar MOR activation patterns were reported during positive mood induced by an amusing video clip Koepp et al. Berlin, Germany; Heidelberg, Germany: Springer. Retrieved 4 December Journal of Enzyme Inhibition and Medicinal Chemistry. Here, we report the first such study, showing that amphetamine, methamphetamine, phentermine, mephentermine, and chlorphenteramine, potently activate several CA isoforms, some of which are highly abundant in the brain, where they play important functions connected to cognition and memory, among others26, We investigated psychotropic amines based on the phenethylamine scaffold, such as amphetamine 5, methamphetamine 6, phentermine 7, mephentermine 8, and the structurally diverse chlorphenteramine 9, for their activating effects on 11 CA isoforms of human origin This work may bring new lights on the intricate relationship between CA activation by this type of compounds and the multitude of pharmacologic actions that they can elicit. Recommendations for trace amine receptor nomenclature'. Retrieved 31 December Current Medicinal Chemistry. The emerging class of CAAs has recently gained attraction as the enhancement of the kinetic properties in hCAs expressed in the CNS were proved in animal models to be beneficial for the treatment of both cognitive and memory impairments. Thus, CAAs have enormous potentiality in medicinal chemistry to be developed for the treatment of symptoms associated to aging, trauma or deterioration of the CNS tissues. Retrieved 15 October Pubchem Compound Database. Retrieved 12 October British Journal of Pharmacology and Chemotherapy. Hydroxyamphetamine was administered orally to five human subjects The lack of effect of administration of neomycin to one patient indicates that the hydroxylation occurs in body tissues. Unfortunately, at the present time one cannot be completely certain that the hydroxylation of hydroxyamphetamine in vivo is accomplished by the same enzyme which converts dopamine to noradrenaline. Figure 1. Glycine conjugation of benzoic acid. The glycine conjugation pathway consists of two steps. In addition to the factors listed in the boxes, the levels of ATP, CoASH, and glycine may influence the overall rate of the glycine conjugation pathway. Relationship to hypertension and sympathetic activity'. Circulation Research. The percent of the drug hydroxylated to hydroxynorephedrine was comparable in all subjects 6. In species where aromatic hydroxylation of amphetamine is the major metabolic pathway, p -hydroxyamphetamine POH and p -hydroxynorephedrine PHN may contribute to the pharmacological profile of the parent drug. Following systemic administration of amphetamine to rats, POH has been found in urine and in plasma. The hundred trillion microbes and viruses residing in every human body, which outnumber human cells and contribute at least times more genes than those encoded on the human genome Ley et al. Meanwhile, a wealth of literature has long been available about the biotransformation of xenobiotics, notably by gut bacteria reviewed in Sousa et al. This valuable information is predominantly about drug metabolism by unknown human-associated microbes; however, only a few cases of inter-individual microbiome variations have been documented \\\\\\\\\\[e. Nature Reviews Genetics. The composition of the microbiome varies by anatomical site Figure 1. The primary determinant of community composition is anatomical location: interpersonal variation is substantial 23,24 and is higher than the temporal variability seen at most sites in a single individual How does the microbiome affect the pharmacology of medications? Can we manipulate the microbiome to improve pharmacokinetic stability? The description of this so-called human microbiome is of great interest and importance for several reasons. For one, it helps us redefine what a biological individual is. We suggest that a human individual is now best described as a super-individual in which a large number of different species including Homo sapiens coexist. Journal of Cellular Biochemistry. Particularly in the case of the human gut, which harbors a large diversity of bacterial species, the differences in microbial composition can significantly alter the metabolic activity in the gut lumen. The obtained results will be crucial in designing a surrogate molecule for amphetamine that can help either in improving the efficacy and bioavailability of the amphetamine drug via competitive inhibition or in redesigning the drug for better pharmacological effects. This study will also have useful clinical implications in reducing the gut microbiota caused variation in the drug response among different populations. Federal Register. Retrieved 3 January Retrieved 8 November Patent Application No. United States Patent Office. Tetrahedron Letters. Clinical Toxicology. Forensic Science International. Vermont Department of Health. Government of Vermont. Archived from the original on 5 October Retrieved 29 January Crime Scene. Northwest Association of Forensic Scientists. Retrieved 6 December United Nations Office on Drugs and Crime. Retrieved 14 October The Journal of Organic Chemistry. The Art of Drug Synthesis. Journal of the American Chemical Society. Organic Reactions. Rapid Communications in Mass Spectrometry. Journal of Chromatography B. Analytical and Bioanalytical Chemistry. Journal of Chromatography A. University of Colorado Denver. Technical Assistance Publication Series Archived PDF from the original on 14 May A single dose of amphetamine or methamphetamine can be detected in the urine for approximately 24 hours, depending upon urine pH and individual metabolic differences. People who use chronically and at high doses may continue to have positive urine specimens for 2—4 days after last use SAMHSA, b. Journal of Analytical Toxicology. Archived from the original on 25 December Topical nasal decongestants -- i For products containing levmetamfetamine identified in The product delivers in each milliliters of air 0. Retrieved 2 January Disposition of Toxic Drugs and Chemicals in Man 9th ed. Precursor compounds to amphetamine and methamphetamine'. Drug Metabolism Reviews. Journal of Occupational and Environmental Medicine. World Drug Report Retrieved 7 July London, England: Routledge. Journal of Interdisciplinary History. Bulletin of Anesthesia History. Archived from the original on 2 March Retrieved 4 November Retrieved 25 December Archived from the original on 14 February Retrieved 18 March Internet Journal of Criminology. Archived from the original PDF on 13 July Retrieved 25 May June Retrieved 18 August Retrieved 5 February May International Narcotics Control Board. August Archived from the original PDF on 5 December Retrieved 19 November The Korean Times. Retrieved 14 November Japanese Ministry of Health, Labour and Welfare. Retrieved 3 November Canadian Justice Laws Website. Government of Canada. Archived from the original on 22 November Government of the Netherlands. Retrieved 3 April Poisons Standard. Australian Government Department of Health. October Retrieved 15 December Thailand Food and Drug Administration. Archived from the original PDF on 8 March Home Office, Government of the United Kingdom. Archived from the original on 4 August Retrieved 23 July Neos Therapeutics, Inc. Retrieved 11 August Retrieved 19 August Mallinckrodt Pharmaceuticals. March Dexedrine ProCentra Zenzedi. ADHD pharmacotherapies. Amphetamine Mixed amphetamine salts , Levoamphetamine , Dextroamphetamine , Lisdexamfetamine Methamphetamine Methylphenidate Dexmethylphenidate. Atomoxetine Modafinil. Clonidine Guanfacine. Amantadine Carbamazepine. Human trace amine-associated receptor ligands. N , N -Dimethylethylamine Trimethylamine. Monoamine releasing agents. Oxazolines: 4-Methylaminorex Aminorex Clominorex Fluminorex. Others: Indeloxazine Viqualine. Recreational drug use. Calea zacatechichi Silene capensis. Coffee break Coffeehouse Latte art Tea house. Abuse Date rape drug Impaired driving Drug harmfulness Effects of cannabis Addiction Dependence Prevention Opioid replacement therapy Rehabilitation Responsible use Drug-related crime Fetal alcohol spectrum disorder Long-term effects of cannabis Neurotoxicity Overdose Passive smoking of tobacco or other substances. Alcohol legality Alcohol consumption Anabolic steroid legality Cannabis legality Annual use Lifetime use Cigarette consumption Cocaine legality Cocaine use Methamphetamine legality Opiates use Psilocybin mushrooms legality Salvia legality. Medicine portal Chemistry portal Biology portal. Namespaces Article Talk. Views Read View source View history. In other projects Wikimedia Commons. By using this site, you agree to the Terms of Use and Privacy Policy. Moderate \\\\\\\\\\[1\\\\\\\\\\]. Medical: oral , intravenous \\\\\\\\\\[3\\\\\\\\\\] Recreational: oral , insufflation , rectal , intravenous , intramuscular. CNS stimulant , anorectic. Racemic mixture \\\\\\\\\\[19\\\\\\\\\\]. Signaling cascade in the nucleus accumbens that results in amphetamine addiction v t e Note: colored text contains article links. Nuclear pore Nuclear membrane Plasma membrane Ca v 1. Following presynaptic dopamine and glutamate co-release by such psychostimulants, \\\\\\\\\\[\\\\\\\\\\] \\\\\\\\\\[\\\\\\\\\\] postsynaptic receptors for these neurotransmitters trigger internal signaling events through a cAMP-dependent pathway and a calcium-dependent pathway that ultimately result in increased CREB phosphorylation. Psychostimulant cross-sensitization. Psychostimulant self-administration. Psychostimulant conditioned place preference. Reinstatement of drug-seeking behavior. CREB phosphorylation in the nucleus accumbens. Sensitized dopamine response in the nucleus accumbens. Altered striatal dopamine signaling. Altered striatal opioid signaling. Changes in striatal opioid peptides. Number of dendrites in the nucleus accumbens. Dendritic spine density in the nucleus accumbens. Abnormal heartbeat High or low blood pressure. Cardiogenic shock heart not pumping enough blood Cerebral hemorrhage bleeding in the brain Circulatory collapse partial or complete failure of the circulatory system. Confusion Abnormally fast reflexes Severe agitation Tremor involuntary muscle twitching. Acute amphetamine psychosis e. Rhabdomyolysis rapid muscle breakdown. Pulmonary edema fluid accumulation in the lungs Pulmonary hypertension high blood pressure in the arteries of the lung Respiratory alkalosis reduced blood CO 2. Painful urination Urinary retention inability to urinate. No urine production Kidney failure. Elevated body temperature Mydriasis dilated pupils. Elevated or low blood potassium Hyperpyrexia extremely elevated core body temperature Metabolic acidosis excessively acidic bodily fluids. Pharmacodynamics of amphetamine in a dopamine neuron v t e via AADC Amphetamine enters the presynaptic neuron across the neuronal membrane or through DAT. Amphetamine- type stimulants.
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