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EDPS 674
Alison Lessard, Christina Majcher, Nicole Dickson
Introduction
Characteristics of stimulants
Controversies
Characteristics of Stimulants
Disrupt or modify the normal communication among brain neurons and circuitry
Overstimulates the receptors either by increasing the neurotransmitter called dopamine
or inhibiting its reuptake or breakdown
Result is increased levels of dopamine which increases the transmission of signals
between neurons
Affects the attention systems of the brain and activates the sympathetic nervous system,
producing increased heart rate and blood pressure
Higher the level of dopamine the greater the feelings of euphoria and satisfaction
Research:
Stimulant medications are effective in treating ADHD; in long-term they are equally as
effective as behavioural therapy
Long-term study of a group of adults treated with stimulant medication during childhood and
adolescence found stimulant medication is effective treatment for ADHD
focus better
ignore distraction
Negative Effects
Negative side effects include:
Decreased appetite
Mild insomnia
Stomach-aches
Headaches
Nausea and dizziness
Temporary growth suppression and weight loss
Irritability and or sadness
Motor and/or vocal tics
Increased blood pressure, heart rate, and body temperature
Allergic reactions (e.g., skin rashes)
Obsessive-compulsive ruminations
Stimulant induced psychosis
Psychological dependence, drug abuse, and addiction
Irreversible damage to blood vessels and sudden death
Overdosage
Negative Effects
According to the FDAs
Adverse Event
Reporting System
(MedWatch), there have
been 17,021 adverse
drug reactions reported
between 2004 and 2012
in connection with
stimulant use.
Negative Effects
Individuals with the following conditions should not take stimulants:
Significant anxiety, agitation, and/or nervousness
Motor tics or a family history of Tourette's disorder
Individuals who are currently experiencing or have a history of psychosis
Glaucoma (a disorder that causes increased pressure in the eyes)
Hyperthyroidism
Existing liver disorder or abnormal liver function test results
Individuals with known structural cardiac abnormalities, cardiomyopathy, heart
rhythm abnormalities, or other serious cardiac problems
History of drug abuse or addiction
Interaction Effects
Individuals who have taken an MAO inhibitor in the past 14
days should not be prescribed stimulant medication. MAO
inhibitors include isocarboxazid, linezolid, phenelzine,
rasagiline, selegiline, and tranylcypromine
There are no significant interaction effects between stimulants
and other antidepressants or drugs that are commonly
prescribed to youth
Stimulant medication can intensify the effects of alcohol, as
well as illicit drugs such as marijuana and cocaine
Concerns about the abuse potential of stimulants has been increasing given that:
o Children with ADHD are at increased risk for drug use and abuse during
adolescence
o Children and adolescents are being treated in increasing numbers with stimulants
o Stimulant use may serve as a gateway to other illicit drugs
Family members and other individuals may abuse a childs stimulant medication
Stimulant medications are classified as drugs of abuse by the Drug Enforcement
Administration
When stimulants are discontinued, the body must begin producing the neurotransmitters
that were previously used up by stimulant abuse. The time this takes is dependent on the
dosage and length of time that an individual used stimulants
Withdrawal effects, particularly on abrupt discontinuation of stimulant medication after
prolonged use, can last up to two weeks
Withdrawal Symptoms
Symptoms of withdrawal from stimulants can include:
Sleep disturbance (e.g., insomnia and hypersomnia)
Fatigue and lack of energy
Nervousness, anxiety, and irritability
Depression and suicidal thoughts
Intense hunger
Craving for the drug
Withdrawal of a stimulant drug after long-term use should be
gradual and closely monitored to avoid the risk of withdrawal
symptoms. Withdrawal symptoms are rarely life threatening.
Whether the use of stimulant medication to treat children with ADHD increases
the risk of substance abuse in adulthood
References
Greenhill, L.L., Pliszka, S., & Dulcan, M.K. (2002). Practice parameter for the use of stimulant
medications in the treatment of children, adolescents, and adults. Journal of American Academy of
Child and Adolescent Psychiatry, 41(2), 26-49. doi:10.1097/00004583-200202001-00003
Mash, E.J., & Barkley, R.A. (2006). Treatment of Childhood Disorders, 3 rd edition. The Guilford Press.
New York: London
Rasmussen, N. (2008). On speed: The many lives of amphetamine. New York: New York University
Press.
Santosh, P.J. & Taylor, E. (2000). Stimulant drugs. European Child & Adolescent Psychiatry, 9(1),
127-143. doi:10.1007/s007870070017
References
Spiller, H.A., Hays, H.L., and Aleguas, A. (2013). Overdoseof drugs
for attention-deficit hyperactivity disorder: Clinical presentation,mechanisms of toxicity, and managem
en
t. CNS Drugs, 27(7), 531-543. doi:10.1007/s40263-013-0084-8
Smith, M. E., & Farah, M. J. (2011). Are Prescription Stimulants Smart Pills?: The Epidemiology and
Cognitive Neuroscience of Prescription Stimulant Use by Normal Healthy Individuals. Psychological
Bulletin, 137(5), 717741. doi:10.1037/a0023825
Zheng, C., Lichenstein, P., Halldner, L., DOnofrio, B., Serlachius, E., Fazel, S., et al. (2014).
Stimulant ADHD medication and risk for substance abuse. Journal of Child Psychology and
Psychiatry, 55(8), 878-885. doi:10.1111/jcpp.12164