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Stimulants
Source: National Institute on Drug Addiction
What are stimulants?
As the name suggests,
stimulants are a class of drugs that enhance brain
activity - they cause an increase in alertness, attention,
and energy that is accompanied by elevated blood
pressure and increased heart rate and respiration.
Stimulants were used historically to treat asthma
and other respiratory problems, obesity, neurological
disorders, and a variety of other ailments. But as
their potential for abuse and addiction became apparent,
the medical use of stimulants began to wane. Now,
stimulants are prescribed for the treatment of only
a few health conditions, including narcolepsy, attention-deficit
hyperactivity disorder, and depression that has not
responded to other treatments. Stimulants may be
used as appetite suppressants for short-term treatment
of obesity, and they also may be used for patients
with asthma.
How do stimulants affect the brain and body?
Stimulants, such
as dextroamphetamine (Dexedrine) and methylphenidate
(Ritalin), have chemical structures that are similar
to a family of key brain neurotransmitters called
monoamines, which include norepinephrine and dopamine.
Stimulants increase the amount of these chemicals
in the brain. This, in turn, increases blood pressure
and heart rate, constricts blood vessels, increases
blood glucose, and opens up the pathways of the respiratory
system. In addition, the increase in dopamine is
associated with a sense of euphoria that can accompany
the use of these drugs.
What are the possible consequences of stimulant use and abuse?
The consequences
of stimulant abuse can be dangerous. Although their
use may not lead to physical dependence and risk
of withdrawal, stimulants can be addictive in that
individuals begin to use them compulsively. Taking
high doses of some stimulants repeatedly over a short
time can lead to feelings of hostility or paranoia.
Additionally, taking high doses of a stimulant may
result in dangerously high body temperatures and
an irregular heartbeat. There is also the potential
for cardiovascular failure or lethal seizures.
Is it safe to use stimulants with other medications?
Stimulants should
be used with other medications only when the patient
is under a physician's supervision. For example,
a stimulant may be prescribed to a patient taking
an antidepressant. However, health care providers
and patients should be mindful that antidepressants
enhance the effects of a stimulant. Patients also
should be aware that stimulants should not be mixed
with over-the-counter cold medicines that contain
decongestants, as this combination may cause blood
pressure to become dangerously high or lead to irregular
heart rhythms.
Treating addiction to prescription stimulants
Treatment of addiction to prescription stimulants,
such as Ritalin, is often based on behavioral therapies proven effective for
treating cocaine or methamphetamine addiction. At this time, there are no proven
medications for the treatment of stimulant addiction. However, antidepressants
may help manage the symptoms of depression that can accompany the early days
of abstinence from stimulants.
Depending on the patient's situation, the first steps in treating prescription
stimulant addiction may be tapering off the drug's dose and attempting to treat
withdrawal symptoms. The detoxification process could then be followed by one
of many behavioral therapies. Contingency management, for example, uses a system
that enables patients to earn vouchers for drug-free urine tests. The vouchers
can be exchanged for items that promote healthy living.
Another behavioral approach is cognitive-behavioral intervention, which focuses
on modifying the patient's thinking, expectations, and behaviors while at the
same time increasing skills for coping with various life stressors. Recovery
support groups may also be effective in conjunction with behavioral therapy.
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