Stimulant 66391 225396927 2008-07-13T13:40:34Z 86.162.35.228 {{Unreferenced|date=December 2007}} [[Image:Dexedrine Spansules.jpg|250px|thumb|right|Sustained-Release 15mg [[Dexedrine]] Spansules.]] '''Stimulant drugs''' are [[drugs]] that temporarily increase alertness and awareness. They usually have increased side-effects with increased effectiveness, and the more powerful variants are therefore often [[prescription medicines]] or illegal drugs. == Function == [[Image:Ritalin-SR-20mg-full.jpg|thumb|right|200px|[[Ritalin]] SR 20mg.]] Stimulants increase the activity of either the [[sympathetic nervous system]], the [[central nervous system]] ([[central nervous system|CNS]]) or both. Some stimulants produce a sense of [[Euphoria (emotion)|euphoria]], in particular the stimulants which exert influence on the [[central nervous system|CNS]]. Stimulants are used therapeutically to increase or maintain alertness, to counteract fatigue in situations where sleep is not practical (''e.g.'' while operating vehicles), to counteract abnormal states that diminish alertness consciousness (such as in [[narcolepsy]]), to promote weight loss ([[phentermine]]) as well as to enhance the ability to concentrate in people diagnosed with attentional disruptions (especially [[ADHD]]). Occasionally, they are also used to treat depression. Stimulants are sometimes used to boost endurance and productivity as well as to [[anorectic|suppress appetite]], therefore also known to promote eating disorders such as [[anorexia]] if abused. The euphoria produced by some stimulants leads to their recreational use, although this is illegal in the majority of jurisdictions.<ref> AJ Giannini. Biological Foundations of Clinical Psychiatry. NY,Medical Examination Publishing Co,1981986,pp.282-286</ref> [[Caffeine]], found in beverages such as [[coffee]] and [[soft drinks]], as well as [[nicotine]], which is found in [[tobacco]], are among some of the world's most commonly used stimulants. Examples of other well known stimulants include [[ephedrine]], [[amphetamine]]s, [[cocaine]], [[methylphenidate]], [[MDMA]], and [[modafinil]]. Stimulants are commonly referred in slang as "uppers". Stimulants with significant abuse potential are very carefully controlled substances in America and most other jurisdictions. Some may be legally available only by prescription (e.g. [[methamphetamine]], brand name [[Desoxyn]], mixed [[amphetamine]] salts, brand name [[Adderall]], [[dexamphetamine]], brand name [[Dexedrine]]) or not at all (e.g. [[methcathinone]]). == Amphetamine == {{main|Amphetamine}} Amphetamines (prescribed as either racemic [[amphetamine]] or [[dextroamphetamine]]) increase the heart and respiration rates, increase blood pressure and in some users, dilate the pupils of the eyes and decrease appetite. Like [[NDRI]]s, amphetamine increases the levels of norepinephrine and dopamine in the brain via reuptake inhibition; however, the more important mechanism by which amphetamines cause stimulation is through the direct release of these [[catecholamine]]s from storage [[vesicles]] in cells. Amphetamines are known to cause elevated mood and euphoria as well as rebound depression and anxiety. Other possible effects include blurred vision, insomnia, and dizziness.<ref>P Knapp. Amphetamine and addiction. Journal of Nervous and Mental Disorders. 115:406-409, 1952</ref> Amphetamines are sometimes prescribed therapeutically by physicians and their availability makes them prime candidates for misuse [http://www.drugabuse.gov/Testimony/7-26-06Testimony.html]. Used properly, amphetamines increase alertness, concentration and physical endurance. They are often prescribed to counter the effects of [[narcolepsy]], a disorder marked by episodes of uncontrollable sleep, and to help patients with learning disabilities such as [[ADHD| ADD and ADHD]]. Dextrorotary [[methamphetamine]] is occasionally used in the treatment of AD(H)D that does not respond sufficiently to traditional [[amphetamine]]s. On occasion, [[major depression]] is treated with [[amphetamine]]s as well. [[Amphetamine]]s can be used as an add-on to antidepressant therapy as well, with some success in certain populations. == Methylenedioxymethamphetamine == {{main|Methylenedioxymethamphetamine}} Methylenedioxymethamphetamine (MDMA) is a drug that comes either in tablet or capsule form (known as [[ecstasy (drug)|ecstasy, zoom, scrap]]), as a powder or crystal. Stimulant effects of MDMA include increased blood pressure and heart rate, loss of appetite, rapid sweating, and a dry mouth and throat. Ecstasy pills often contain amounts of other drugs which may include any of a wide range of substances such as [[3,4-Methylenedioxyamphetamine|MDA]], [[MDEA]], [[MBDB]], [[Phencyclidine|PCP]], [[DXM]], [[Ketamine]], [[Caffeine]], [[Amphetamine]], [[Methamphetamine]], [[Ephedrine]], cinnamedryl <ref> KW Fellows, AJ Giannini. Cinnamedryl: Potential for abuse. Clinical Toxicology. 20:93-95,1983. </ref>[[Pseudoephedrine]], [[Aspirin]], [[Paracetamol]], and, in a small number of cases, [[PMA]] [http://ecstasy.org/testing/pma.html], [[Cocaine]] [http://www.ecstasydata.org/results.php?A=SearchAll&Start=0&S=cocaine&OldSort=DTD&NewSort=&SField=Substance], [[Fentanyl]] [http://erowid.org/chemicals/mdma/mdma_info11.shtml], [[1-(3-Chlorophenyl)piperazine|mCPP]], [[benzylpiperazine|BZP]]+[[TFMPP]], [[2,5-Dimethoxy-4-bromoamphetamine|DOB]] [http://www.ecstasydata.org/results.php?A=SearchAll&Start=0&S=dob&OldSort=DTD&NewSort=&SField=Substance], and [[2C-B]] [http://www.pillreports.com/index.php?page=search_reports&sent=1&username=&name=&logo=&colour=&state=&region=all&percent_rating=0&pp=100&suspected_contents=17&rating=all&imagesOnly=1&submit2.x=53&submit2.y=17&submit2=Search+Reports]. In some cases the substance sold as ecstasy may not contain MDMA at all. MDMA was historically used in a therapeutic setting by a small number of psychiatrists for marriage counseling, before it was outlawed by the DEA because of its widespread recreational use. As of 2001, it is being considered by the FDA in the treatment of [[Post-traumatic stress disorder]]. It is also being evaluated for possible usages in palliative care [http://www.maps.org/mdma/]. == Norepinephrine and Dopamine Reuptake Inhibitors (NDRIs) == {{main|Norepinephrine-dopamine reuptake inhibitor}} These compounds inhibit the uptake of the monoamines dopamine and norepinephrine into storage vesicles, effectively increasing their amounts in the brain and causing a stimulating effect. Many of these compounds are effective [[ADHD]] medications and [[antidepressants]]. The most popular and well-known dopamine and norepinephrine reuptake inhibitor antidepressant is [[bupropion]] (Wellbutrin). Other examples of NDRIs include [[MDPV]], [[pyrovalerone]], [[mazindol]] and [[pipradrol]]. Although these medicines have similar methods of action to stimulants, they are less popular for abuse (thus not [[Controlled Substances Act| scheduled]]) and have an extended release mechanism or a very long half life. Many NDRIs are also phenethylamines. == Cocaine == {{main|Cocaine}} Cocaine is made from the leaves of the [[coca]] shrub, which grows in the mountain regions of South American countries such as [[Bolivia]], [[Colombia]], and [[Peru]]. In Europe and North America, the most common form of cocaine is a white crystalline powder. Cocaine is a stimulant but is not normally prescribed therapeutically for its stimulant properties, although it sees clinical use as a local anesthetic, particularly in [[ophthalmology]]. Most cocaine use is recreational and its abuse potential is high, and so its sale and possession are strictly controlled in most jurisdictions. Other [[tropane]] derivative drugs related to cocaine are also known such as [[troparil]] and [[lometopane]] but have not been widely sold or used recreationally<ref>.AJ Giannini, WC Price. Contemporary drugs of abise. American Family Physician.33:207-213,1986</ref> == Caffeine == {{main|Caffeine}} Caffeine is a drug that is found naturally in [[coffee]], [[tea]], and to a small extent [[cocoa]]. It is also found in many [[soft drinks]], particularly [[energy drink]]s. Caffeine stimulates the body, increasing [[heart rate]] and [[blood pressure]], and alertness, making some people feel better and able to concentrate. Caffeine is also a [[diuretic]]. The vast majority (over 80%) of people in the United States consume caffeine on a daily basis. As a result, few jurisdictions restrict its sale and use. Caffeine is also sold in some countries as an isolated drug (as opposed to its natural occurrence in many foods). It serves as a mild stimulant to ward off sleepiness and sees wide use among people who must remain alert in their work (''e.g.,'' truck drivers, military members). Some medications contain caffeine as one of their minor active ingredients, often for the purpose of enhancing the effect of the main ingredient or reducing one of its side effects. == Nicotine == {{main|Nicotine}} [[Nicotine]] is an [[alkaloid]] found in the nightshade family of plants ([[Solanaceae]]), predominantly in tobacco, and in lower quantities in tomato, potato, eggplant (aubergine), and green pepper. Nicotine alkaloids are also found in the leaves of the coca plant. Nicotine constitutes 0.3 to 5% of the tobacco plant by dry weight, with biosynthesis taking place in the roots, and accumulates in the leaves. It is a potent nerve poison and is included in many insecticides. The primary therapeutic use of nicotine is in treating nicotine dependence in order to eliminate smoking with its risks to health. In very low concentrations, nicotine acts as a stimulant, and it is one of the main factors responsible for the dependence-forming properties of tobacco smoking. Although pure nicotine is noncarcinogenic, its presence may inhibit the body's ability to cull aberrant cells [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=9666281]. == Ampakines == {{main|Ampakine}} Recently, there have been improvements in the area of stimulant pharmacology, producing a class of chemicals known as [[ampakine]]s, or ''[[eugeroic]]s'', (''good arousal''). These stimulants tend to increase alertness without the peripheral (body) effects or addiction/tolerance/abuse potential of the traditional stimulants. They have minimal effect on sleep structure, and do not cause rebound hypersomnolence or "come down" effects. Currently, there are two stimulants in this class being used: [[modafinil]] and [[adrafinil]], marketed as Provigil and Olmifon, respectively. Modafinil and adrafinil also have some amphetamine like actions, in terms that they increase [[dopamine]] and [[norepinephrine]], but they also have another mode of action as [[GABA]] antagonists. Newer ampakines such as [[ampalex]] and [[CX717]] have been developed but are still in clinical trials and have not yet been sold commercially. Another compound with similar effects to these drugs is [[carphedon]], which is sold as a general stimulant in Russia under the brand name Phenotropil. == See also == * [[Psychoactive drug]] * [[Recreational drug use|Recreational drugs]] * [[Depressant]]s * [[Narcotic]] == External links == {{Wiktionarypar|stimulant|upper}} * [http://www.licadd.org/aboutdrugs.htm Long Island Council on Alcohol & Drug Dependence - About Drugs - Stimulants] * [http://ncadistore.samhsa.gov/catalog/results.aspx?h=drugs&topic=68 Online - Publications - Drugs of Abuse - Stimulants] * [http://www.apaic.org Asia & Pacific Amphetamine-Type Stimulants Information Centre (APAIC)] {{stimulants}} {{Major Drug Groups}} <!--Interlanguage--> <!--Categories--> [[Category:Stimulants]] [[Category:Psychoactive drugs]] [[ar:منشطات]] [[da:Stimulans]] [[de:Stimulans]] [[et:Erguti]] [[es:Estimulante]] [[fa:انگیزنده]] [[fr:Stimulant]] [[gl:Estimulantes]] [[id:Stimulan]] [[hu:Stimuláns]] [[nl:Genotmiddel]] [[ja:覚醒剤]] [[pl:Stymulanty]] [[pt:Estimulante]] [[sr:Психостимуланси]] [[fi:Piriste]] [[tr:Stimülan]]