Psychostimulants

Abuse of psychostimulants

See cocaine, amphetamines, amphetamine substituted substances and synthetic cathinones

ADHD and other disorders, where we use psychostimulants

ADHD

• Drugs used : Methylphenidate, dextroamphetamine, methamphetamine, lisdexamfetamin
• Other nonstimulant alternatives with less proven efficacy include clonidine, guanfacine, bupropion, and/or nortriptyline.
• Indication
  • ADHD: first-line therapy for patients ≥ 6 years of age
• Mechanism of action: indirect and central sympathomimetic activity → increased release and blocked reuptake of norepinephrine and dopamine (minor effect on serotonin) → increased concentration in the synaptic cleft

Other disorders and their indications

• Caffeine (group of methylxanthines): In coffee. Proposed to block adenosine receptors, making oneself less tired

• Depression with suicidality and only a few weeks left to live (e.g. palliative patients)
• Binge-eating disorder (obesity)
• Narcolepsy (Modafinil- nonamphetamine CNS stimulant)
• Hypersomnolence disorder: modafinil or methylphenidate or atomoxetine

Side-effects of stimulants (in general)

• Insomnia, anorexia, tachycardia, hypertension, dry mouth, irritability, anxiety...psychoses