Previous research identified lower educational attainment, more extensive treatment exposure and greater baseline methamphetamine use as characteristics portending negative outcomes [76–78]. Using data from a randomised controlled trial of bupropion, Dean [79] assessed the relative value of neurocognitive function, psychiatric function, demographics, and pre-treatment substance use variables in predicting abstinence and retention. Using a statistical methodology that inductively prioritises variables on the basis of their predictive validity – classification and regression trees – a multivariate model was determined. Although the predictors of poor outcomes included impaired neurocognition and nicotine dependence, level of baseline use of methamphetamine overwhelmed the predictive power of these other variables. These findings encourage careful accounting of baseline drug-use patterns in planning clinical trials.
Varenicline, a partial agonist at alpha-4, beta-2 nicotinic acetylcholine receptors [101], is being examined as a pharmacotherapy following promising pilot data and encouraging results with both cocaine [102] and alcohol [103]. As the role of glutamatergic mechanisms become more prominent in models of addiction [107], attention has also been directed to compounds that restore glutamate homeostasis. N-acetylcysteine, an amino acid cystine precursor, restores glutamate levels reduced by chronic cocaine exposure and this effect endures long after the cessation of active treatment [108].
Enhancing Healthcare Team Outcomes
Amphetamine is a central nervous (CNS) system stimulant that functions by increasing the amounts of dopamine, norepinephrine, and serotonin (to a lesser extent) in the synaptic cleft through a variety of mechanisms. Amphetamine enters the presynaptic axon terminal through diffusion or uptake by the monoamine transporters DAT, NET, and SERT. Amphetamine is FDA-approved for the treatment of attention-deficit/hyperactivity disorder (ADHD) and narcolepsy. It has indications as a first-line agent for ADHD in adults and children six years of age and older. Amphetamine is also a second-line agent for the treatment of narcolepsy.
Further and substantial investment to determine effective pharmacotherapies is required. Finally, because of the similarities in chemical structure and behavioural, psychological and physical effects of AMPH and MA [84], we have included studies of AMPH and MA, and studies that did not distinguish between AMPH and MA. MA and AMPH may be knowingly or unknowingly consumed or co-consumed in uncertain concentrations, with variability over time and place. However, there is little data on which to assess whether there are distinct differences in use disorders due to these two substances; further assessment is required. The titles and abstracts of the studies identified by the search strategy were evaluated by two reviewers (KS and LA) independently. Divergent selection of publications was discussed among the investigators until a consensus was obtained, and if required a third reviewer (NE) resolved disputes.
Serotonergic medications
CNS stimulation may vary from slight degrees of agitation to intense hyperactivity or seizures. This kind of behavior may be accompanied by gross psychosis with hallucinations and paranoid delusions. Patients generally exhibit paranoia, hostility, combativeness, and sometimes presents with suicidal and homicidal ideations. The sympathomimetic impacts of amphetamine toxicity include diaphoresis, hypertension, tachycardia, tachypnea, flushing, headache, mydriasis, nausea, vomiting, and abdominal pain in some severe cases with dryness of mucous membranes. Amphetamine toxicity is a clinical diagnosis and some of the key features to look for are agitation, hyperthermia, tachycardia, hypertension, and diaphoresis.
The use of amphetamine with other serotonergic agents and/or CYP2D6 inhibitors (including fluoxetine, paroxetine, and bupropion) can increase the risk of serotonin syndrome. Amphetamine should be started cautiously in patients taking these medications, with close monitoring for signs and symptoms of serotonin syndrome. When used illegally, pure amphetamines may be mixed with other substances—such as sugar, glucose, or bi-carb soda—that can be poisonous. This may cause collapsed veins, tetanus, abscesses, and damage to the heart, lungs, liver, and brain. Amphetamine users may also use other drugs inappropriately to manage the side effects of amphetamines. Benzodiazepines, for example, are anti-anxiety agents that may be used to help an individual sleep, but that can also be addictive.
Can amphetamines treat ADHD in children?
Some preclinical evidence suggested modest efficacy for cocaine dependence of the selective GABAB agonist baclofen, and a clinical trial found some support as a treatment for cocaine dependence [70]. Gabapentin was originally developed as an anticonvulsant but its utility in treating neuropathic pain has been well documented. It does not appear to block GABA uptake or metabolism [71] but has global effects on GABA in the brain [72]. Misuse of prescription drugs, including amphetamines, can lead to addiction. The proper name for addiction to a substance is substance use disorder (SUD). Due to insufficient data needed for conducting a meta-analysis and lack of consistency in reporting the findings, only a systematic review was conducted.
- Amphetamines are drugs that make people feel awake and alert and can create euphoria.
- An initial search for randomised placebo-controlled clinical trials treating amphetamine or methamphetamine use disorders published from 1980 through July 2012 produced 468 results.
- Of the 38 reporting on study completion rates, the total number of participants randomised was 3733 (92% of the total) and of these, 2298 participants completed the study (61.6%).
- Furthermore, overall reduced criminality [20, 21], improved motivation to change and self-efficacy [21, 23] as well as improved physical and mental health [20, 21] were found among both the treatment and control groups in some studies.
- Amphetamines create a calming effect for children diagnosed with ADHD by targeting the chemicals in their brain that transmit signals between nerves in the central nervous system.
These changes to the brain mean that a person may always be at risk of using a substance again, even if they have not used it for a long time. An individual’s brain chemistry changes during regular misuse of a substance or activity. The brain’s reward circuit changes, reducing a person’s ability to exercise self-control and leading to strong urges to continue. When someone https://ecosoberhouse.com/article/drug-use-in-sports-risks-you-have-to-know/ misuses a substance consistently over time, they may find that they need more and more of the substance to feel the same degree of euphoria. A person can find it hard to stop taking a substance, which usually implies that they are physically dependent on the substance. This is not the same as substance dependency — the physical symptoms of tolerance and withdrawal.
In addition, the data collected by both reviewers can be located in its entirety in the Supplementary Data (see ESM). We approached this report as a systematic review of the peer-reviewed literature, and present the methods and results in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement [22]. You should take FDA-approved amphetamines orally (by mouth) as directed by your healthcare provider.
The broad selection of outcomes and measures render it difficult to meta-analyse or otherwise collectively synthesise the study results as reported. Future endeavours to standardise outcome measures across clinical trials in addiction medicine would make it easier to interpret study results collectively and better translate research results to clinical practice. Importantly, only three studies reviewed here (7%) provided information on adverse events/serious adverse events, despite the standard reporting format adopted by most publishers (CONSORT [83]) including a minimum standard of harm reporting. This limits the capacity to appropriately assess the risk versus benefit of the pharmacotherapies reviewed here. We elected to include studies in this review irrespective of safety reporting, to provide a comprehensive review of the current status of research. In men who have sex with men, the antidepressant mirtazapine reduced MA use and high-risk sexual behaviours, despite low medication adherence rates [30].
BetterHelp can connect you to an addiction and mental health counselor. NL had the idea for this systematic review; KJS, LSA, NL, and NE designed the study; KJS and LSA performed the literature search and data analyses; Amphetamine Addiction KJS drafted the first manuscript; LSA, NL and NE critically revised the manuscript. A summary of the reviewed studies is presented in Table 4, and an extended version is available in Supplementary Table 1 (see ESM).
Nevertheless, the drug does make people feel like they can focus more and do better even if the opposite is true. More significantly, this level of abuse can lead to more severe, illicit use of the drug to get high. You may become dependent if you use these drugs without a prescription. It’s even possible to develop a use disorder if you take amphetamines according to your doctor’s directions. Amphetamine dependence, a type of stimulant use disorder, occurs when you need the drug to function on a daily basis. You’ll experience symptoms of withdrawal if you’re dependent and you abruptly stop using the drug.
