Amphetamine disorder

Glassification of Substance-Related Disorders. The DSM-IV classification system (1) divides substance-related disorders into two categories (/) substance use disorders, ie, abuse and dependence and (2) substance-induced disorders, intoxication, withdrawal, delirium, persisting dementia, persisting amnestic disorder, psychotic disorder, mood disorder, anxiety disorder, sexual dysfunction, and sleep disorder. The different classes of substances addressed herein are alcohol, amphetamines, caffeine, caimabis, cocaine, hallucinogens, inhalants, nicotine, opioids, phencyclidine, sedatives, hypnotics or anxiolytics, polysubstance, and others. On the basis of their significant socioeconomic impact, alcohol, nicotine, cocaine, and opioids have been selected for discussion herein. 

Antipsychotic medications are indicated in the treatment of acute and chronic psychotic disorders. These include schizophrenia, schizoaffective disorder, and manic states occurring as part of a bipolar disorder or schizoaffective disorder. The co-adminstration of antipsychotic medication with antidepressants has also been shown to increase the remission rate of severe depressive episodes that are accompanied by psychotic symptoms. Antipsychotic medications are frequently used in the management of agitation associated with delirium, dementia, and toxic effects of both prescribed medications (e.g. L-dopa used in Parkinson s disease) and illicit dtugs (e.g. cocaine, amphetamines, andPCP). They are also indicated in the management of tics that result from Gilles de la Tourette s syndrome, and widely used to control the motor and behavioural manifestations of Huntington s disease. 

The development of effective pharmacotherapy has lagged behind progress in understanding the reward mechanisms and chronic impairments underlying stimulant abuse. Pharmacological and behavioral treatment approaches that have been used for cocaine abuse have not been as widely tested for the treatment of amphetamine abuse, limiting what can be offered for treatment of this disorder. No treatment agents are approved by the FDA for treatment of cocaine or amphetamine dependence. 

King GR, Ellinwood EH Amphetamines and other stimulants, in Substance Abuse A Comprehensive Textbook, 3rd Edition. Edited by Lowinson JH, Ruiz P, Mill-man RB, et al. Baltimore, MD, Williams Wilkins, 1997, pp 207—233 Klawans HE, Margolin Dl Amphetamine-induced dopaminergic hypersensitivity in guinea pigs implications in psychosis and human movement disorders. Arch Gen Psychiatry 32 725—732, 1975... 

A variety of drugs have been developed that act as sedatives, antidepressants, or stimulants some of these are effective in treating psychiatric disorders. Many of these drugs are weak bases. Examples are barbiturates such as phenobarbital, tranquilizers like diazepam (Valium), and amphetamines derived from phenylethylamine. 

Reductions in aggressive behavior after treatment with amphetamine and other psyehomotor stimulants are seen in children and adolescents who have been diagnosed with hyperkinesis or attention deficit disorder. There is considerable disagreement about these diagnostic categories and about whether the violent outbursts and uncontrolled episodes of aggressive behavior are limited to the early developmental period or continue into adulthood (Mendelson et al. 1971 Minde et al. 1972). 

Miezek, K.A., and Gold, L. Ethologieal analysis of amphetamine aetion on soeial behavior in squirrel monkeys (saimiri sciureus). In Miezek, K.A., ed. Ethopharmacology Primate Models of Neuropsychiatric Disorders. New York Liss, 1983. pp. 137-155. 

Nonetheless, the amphetamine-1ike actions of PCP are of considerable interest for the following reasons. Malfunction of the dopaminergic system has been implicated as having considerable importance in schizophrenia. PCP s interactions with this system may be responsible in large measure for its schizophreniform manifestations in humans. Like amphetamines, PCP would be expected to exacerbate schizophrenia, and users with this or related disorders, or with latent psychiatric diseases, may be at... 

Amphetamine Clinically used for narcolepsy (sudden day-time onset sleep) and Attention Deficit Hyperactivity Disorder (ADHD) formerly used as a short-term slimming agent, as an antidepressant and to boost athletic performance recreational use widespread tolerance develops readily highly addictive regular users suffer many health problems and a reduced life expectancy amphetamine psychosis may develop, with similar symptoms to acute paranoid schizophrenia. 

Attention Deficit Hyperactivity Disorder (ADHD) A learning and behavioural disorder characterised by reduced attention span and hyperactivity. ADHD is a diagnosis applied to young children and is typically treated with the amphetamine derivative methylphenidate (Ritalin). 

Psychosis, often clinically indistinguishable from schizophrenia (a mental disorder)—this is the most serious sign of amphetamine addiction. 

The answer is a. (Hardman, p 22L Katzang, p L3L) Methylphenidate is similar to amphetamine and acts as a CN5 stimulant, with more pronounced effects on mental than on motor activities. It is effective in the treatment of narcolepsy and attention-deficit hyperactivity disorders. 

The dopamine transporter has been a target for developing pharmacotherapies for a number of CNS disorders including ADHD, stimulant abuse, depression and Parkinson s disease. Several excellent reviews in this area have been recently published [28-30]. The dopamine reuptake inhibitor methylphenidate has been successfully used for decades in the management of ADHD in children and adolescents. It remains a first-line treatment along with amphetamine for this disorder [31,32]. 

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