Lecture 12: CNS Stimulants

ADHD Treatment

Stimulants: Methylphenidate and Methamphetamine salt compounds

Central Alpha 2 agonists

Atypical antidepressants

NE reuptake inhibitors

TCA

CNS Stimulants

Act through catecholamines and dopamine

Inhibit reuptake or increase release

Elevate mood, cause euphoria

Increase alertness, wakefulness

Increase energy, reduce fatigue

Decrease appetite

Amphetamines

Sympathomimetic, with profound central effect

Increase non-vesicular release of catecholamines, esp dopamine, reverse transporter/prevent vesicular storage

Dopamine release from neurons in brain

Stimulate dopamine receptors in mesolimbic system

Peripheral effects: increased sympathetic activity due to stimulation of NE release

Increased blood pressure

Reflex bradycardia → arrhythmias

Alertness, insomnia

Euphoria, excitement

Appetite suppression- severe weight loss

Increased motor activity and speech

Stereotypic behavior

Paranoia, delusions, hallucinations, Psychosis

Amphetamine Withdrawal

Withdrawal unpleasant but rarely life-threatening

Depression and suicide possible

Sleep

Increased appetite

Lack of energy

Paranoia

Narcolepsy

Methylphenidate, amphetamines

Stimulants Side Effects

Appetite/sleep changes

Headaches

Mood/anxiety symptoms

Tics

Psychotic symptoms

Risk of abuse/dependence- higher rates of abuse with older adolescents and adult

DEATH-Cardiovascular risks