CNS Stimulants

1. CNS Stimulants Facts and Information Created by: Shannon N. Phifer

2. What is a CNS Stimulant? • Definition Central nervous system (CNS) stimulants are medicines that speed up physical and mental processes. • Purpose Central nervous system stimulants are used to treat conditions characterized by lack of adrenergic stimulation, including narcolepsy and neonatal apnea. Additionally, methylphenidate (Ritalin) and dextroamphetamine sulfate (Dexedrine) are used for their paradoxical effect in attention—deficit hyperactivity disorder (ADHD). The anerexiants, benzphetamine (Didrex), diethylpropion (Tenuate), phendimetrazine (Bontril, Plegine), phentermine (Fastin, Ionamine), and sibutramine (Meridia) are CNS stimulants used for appetite reduction in severe obesity. Although these drugs are structurally similar to amphetamine, they cause less sensation of stimulation, and are less suited for use in conditions characterized by lack of adrenergic stimulation. Phenylpropanolamine and ephedrine have been used both as diet aids and as vasoconstrictors. • Description The majority of CNS stimulants are chemically similar to the neurohormone norepinephrine, and simulate the traditional "fight or flight" syndrome associated with sympathetic nervous system arousal. Caffeineis more closely related to the xanthines, such as theophylline. A small number of additional members of the CNS stimulant class do not fall into specific chemical groups. Created by: Shannon N. Phifer

3. Common Prescription CNS Stimulants • Dextroamphetamine (Dexedrine and Adderall) • Methylphenidate (Ritalin and Concerta) • Modafinil (Provigil) • Methamphetamine (Desoxyn or Desoxyn Gradumet) Treats • ADHD • ADD • Narcolepsy (sleep disorder) • Depression Created by: Shannon N. Phifer

4. Common OTC CNS Stimulants Examples of Stimulants Ephedrine, norephedrine, and pseudoephedrine can be found in numerous OTC medications. For many years, ephedrine has been used in numerous OTC drugs as a nasal decongestant and appetite suppressant. Alternative medicines, including herbal supplements, have gained widespread popularity and are currently a multibillion-dollar business. Hundreds of these supplements contain stimulants as active ingredients. • Decongestants (Ephedrine, norephedrine, and pseudoephedrine ) • herbal extracts • caffeinated beverages • Nicotine Created by: Shannon N. Phifer

5. Common Street Names of CNS Stimulant Drugs Amphetamine-type Stimulants • What is it? Amphetamine type stimulants encompass some of the most common, well known and used drugs including Ecstasy, Speed and Base, Ice and Methamphetamine. They are synthetic drugs meaning they are not natural and created by processing chemical ingredients. • What does it look like? Amphetamines come in several varieties and as a result appear in different forms. • They can be different colored powders • Capsules of various colors • Ice comes in sheet like crystals or crystalline powder Street Names • Amphetamine: Speed, whiz, uppers, goey, louee • Dexamphetamine:(ADHD medication used illicitly) Kidi-speed, whiz, uppers, dexies, pep pills • Phentermine:(Illegally imported weight loss medication used illicitly) Adipex-p or fastin • Methylamphetamine (solid): Meth, speed, whiz, fast, uppers, goey, louee, rabbit, tail, pep pills, base, pure, point or wax. • Methylamphetamine (liquid): Leopard's blood, ox blood, red speed or liquid red • Crystal Methylamphetamine: Ice, meth, d-meth, glass, crystal, batu, shabu (from the Philippines) • Paramethoxyamphetamine: Death, PMA, PMMA (often mixed with or marketed as ecstasy, all are known to be fatal) Created by: Shannon N. Phifer

6. Amphetamine Crystals Created by: Shannon N. Phifer

7. Amphetamine Powders Created by: Shannon N. Phifer

8. Amphetamine Tablets Created by: Shannon N. Phifer

9. Therapeutic Uses for CNS Stimulant Medications • Central nervous system (CNS) stimulants, also called psychomotor stimulants or uppers, are a class of drugs that speed up physical and mental processes. They temporarily make patients feel more alert and improve mood. • Stimulants are typically used to treat medical conditions such as attention-deficit hyperactivity disorder (ADHD), attention-deficit disorder (ADD), fatigue, and narcolepsy. Some stimulants have been used as appetite suppressants, although the safety of this use remains controversial. Created by: Shannon N. Phifer

10. Effects of Stimulant Abuse • 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 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. Antidepressants 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. Created by: Shannon N. Phifer

11. Effects (continued)……. • Cardiovascular (chest pain, arrhythmias, hypertension, myocardial infarction, cardiomyopathy, myocarditis, stroke), psychiatric(depression, schizophreniform psychosis, toxic delirium, anxiety, paranoia, suicide), neurological (seizures, headaches, cerebral hemorrhage, cerebral infarctions, cerebral vasculitis), malnutrition, hyperpyrexia, obstetric (placental abruption, lower infant weight, prematurity, microcephaly), pulmonary(pneumothorax, pneumomediastinum, pneumopericardium, pulmonary edema, pulmonary hemorrhage), head and neck (erosion of dental enamel, gingival ulceration, keratitis, chronic rhinitis, perforated nasal septum, midline granuloma, altered olfaction, optic neuropathy, osteolytic sinusitis), sexual dysfunction, rhabdomyolysis, hyperprolactinemia, gastrointestinal (acute ischemic syndrome and hepatoxicity) Created by: Shannon N. Phifer

12. Health Risks from Stimulant Abuse • (Dexedrine, Methamphetamine or "Crystal", "Crank", and "Speed") increase alertness and physical activity. Amphetamines increase heart and breathing rates and blood pressure, dilate pupils and decrease appetite. Side-effects can include sweating, dry mouth, blurred vision, insomnia, loss of appetite, and dizziness. In addition users can feel restless, anxious and moody, become excitable and have a false sense of power and security. Using large amounts of these drugs can result in a condition known as amphetamine psychosis -- which can result in auditory, visual and tactile hallucinations, intense paranoia, irrational thoughts and beliefs, delusions, and mental confusion. • Amphetamine overdose can also cause cardiac arrhythmias, headaches, convulsions, hypertension, rapid heart rate, coma and death. Amphetamines are psychologically and physically addictive. Created by: Shannon N. Phifer

13. Signs and Symptoms of CNS Stimulant Dependence • Signs of CNS Stimulant Use • During use, these drugs generally make the user feel euphoric, super human even, as if they can accomplish anything. The talk fast, move fast and do whatever they’re doing with a focus and speed that is out of character. Their blood pressure, heart rate and body temperature also increase. • Signs of CNS Addiction • Addiction to CNS stimulants is apparent when the following symptoms are seen regularly, whether or not the user is “high” on their drug of choice: • * Decreased appetite and extreme weight loss* Irritability and depression* Restlessness and insomnia* Paranoia and, in extreme cases, psychosis* In those who snort their drugs, a damaged mucous membrane, regular nose bleeds and nasal congestion are common Created by: Shannon N. Phifer

14. Withdrawal Effects from Stimulant Abuse • Stimulant withdrawal, which occurs following cessation of chronic cocaine or amphetamine use, can produce a wide range of dysphoric symptoms: • Following binge use, individuals may initially experience a “crash” period, which is characterized by symptoms of depression, anxiety, agitation and intense drug craving. • During the intermediate withdrawal phase, individuals may experience fatigue, a loss of physical and mental energy, and decreased interest in the surrounding environment. • During the late withdrawal phase, individuals may experience brief periods of intense drug craving, such that objects and people in the addicted person’s life can become a conditioned trigger for craving and relapse. Created by: Shannon N. Phifer

15. References • http://alcoholism.about.com/cs/heal/a/aa990818.htm • http://www.ceida.net.au/stimulants/amphetamine-type.asp • http://www.chce.research.va.gov/docs/pdfs/Doaacutetreatment.pdf • http://medical-dictionary.thefreedictionary.com/Central+Nervous+System+Stimulants • http://teens.drugabuse.gov/peerx/prescription-drug-facts/stimulants • http://thecyn.com/blog/5-signs-of-addiction-to-cns-stimulants/ • http://www.usc.edu/student-affairs/Health_Center/adolhealth/content/b8subs3.html#stimulants • http://www.wellness.com/reference/conditions/cns-stimulants Created by: Shannon N. Phifer