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Stimulants
Stimulants are a class of drugs that enhance
brain activity - they cause an increase in alertness, attention, and energy
that is accompanied by increases in blood pressure, heart rate, and
respiration.
Historically, stimulants were used to treat
asthma and other respiratory problems, obesity, neurological disorders, and a
variety of other ailments. As their potential for abuse and addiction became
apparent, the use of stimulants began to wane. Now, stimulants are prescribed
for treating only a few health conditions, including narcolepsy,
attention-deficit hyperactivity disorder (ADHD), and depression that has not
responded to other treatments. Stimulants may also be used for short-term
treatment of obesity, and for patients with asthma.
Stimulants such as dextroamphetamine (Dexedrine)
and methylphenidate (Ritalin) have chemical structures that are similar to key
brain neurotransmitters called monoamines, which include norepinephrine and
dopamine. Stimulants increase the levels of these chemicals in the brain and
body. 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.
Research indicates that people with ADHD do not
become addicted to stimulant medications, such as Ritalin, when taken in the
form prescribed and at treatment dosages. However, when misused, stimulants can
be addictive.
The consequences of stimulant abuse can be
extremely dangerous. Taking high doses of a stimulant can result in an
irregular heartbeat, dangerously high body temperatures, and/or the potential
for cardiovascular failure or lethal seizures. Taking high doses of some
stimulants repeatedly over a short period of time can lead to hostility or
feelings of paranoia in some individuals.
Stimulants should not be mixed with
antidepressants or over-the-counter cold medicines containing decongestants.
Anti-depressants may enhance the effects of a stimulant, and stimulants in
combination with decongestants may cause blood pressure to become dangerously
high or lead to irregular heart rhythms.
Treatment of addiction to prescription
stimulants, such as methylphenidate and amphetamines, is 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. Antidepressants, however, may be used to manage the symptoms of
depression that can accompany early abstinence from stimulants.
Depending on the patient's situation, the first
step in treating prescription stimulant addiction may be to slowly decrease the
drug's dose and attempting to treat withdrawal symptoms. This process of
detoxification could then be followed with 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. Cognitive-behavioral therapies are proving
beneficial, and recovery support groups may also be effective in conjunction
with a behavioral therapy. |