chapter 11. psychostimulants cocaine amphetamines –amphetamine –methamphetamine –ephedrine...

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.