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Chapter 11
Psychostimulants
• Cocaine
• Amphetamines – Amphetamine– Methamphetamine– Ephedrine– Cathinone – khat– MDMA – ecstasy
• Caffeine
• Nicotine
Amphetamine and related psychostimulants
11.16 Khat for sale in an Ethiopian marketplace
11.17 Mechanisms of amphetamine-stimulated DA release
Effects of amphetamine use
• Acute– Alertness/decreased fatigue– Self-confidence– Exhilaration– Activation of sympathetic nervous system– Improve performance for tasks that require
sustained attention– Impair performance for tasks that require
smooth, accurate muscle movements
Effects of amphetamine use• Chronic
– psychosis similar to paranoid schizophrenia– get suspicious & antisocial – stereotyped behavior (continuous chewing,
grinding teeth, rubbing tongue inside lips) – engage in repetitive thought or meaningless
act for hours– pre-occupied with own though processes or
engage in grand philosophies– brain damage
Methamphetamine
http://www.police.covington.va.us/images/Photographs/MethIce.gif http://dawsonfamilydentistry.com/Images/methmouth.jpg
11.19 Reduced serotonergic fiber density in the neocortex of squirrel monkeys treated with MDMA
Accepted medical uses for amphetamines:
• Narcolepsy
• ADHD– Ritalin (methylphenidate)– Dextroamphetamine– Cylert (pemoline)
– Strattera (atomoxetine)
Treatment of Psychostimulant Abuse• Similar to approaches for alcohol abuse - it’s the
person's environment, behavior, and exposure/access that's important - not the specific drug.
• Getting a cocaine addict to quit initially is not the problem - preventing a relapse is the big thing.
• But depression often precedes use and always follows it so antidepressants have been tried, only the SSRI's seem to be useful.
• A number of compounds have been tried - things that block the euphoric effect or decrease craving but only moderate success.