Amphetamines history

Despite public misconceptions, there is little firm evidence that the typical and atypical antidepressants produce dependence in clinical users. A review of 21 case reports of antidepressant addiction revealed that 12 were associated with tranylcypromine, although 8 of these 12 had a previous history of substance misuse (Haddad, 1999). Tranylcypromine s structural similarity to amphetamine may account for the significant number of reports of its addictive potential, but even here the term (mild) discontinuation reaction rather than withdrawal reaction should be used to allay any concerns patients might have (Haddad, 1999). 

These were the largest producers on record of a drug called MDA—methylenedioxyamphetamine. Chemically related to both mescaline and amphetamine, MDA is a potent stimulant with a history of reported fatalities since it was first synthesized in the 1930 s. Its hallucinogenic potency is reported to be three times that of mescaline. 

Dopamine-Stimulating Medications. A variety of drugs that increase the availability of dopamine have been studied in cocaine addicts including L-DOPA, bupropion, amantadine, and methylphenidate. In small uncontrolled trials, these have shown some benefit, but definitive studies have yet to be performed. In addition, some dopamine-stimulating medications (in particular, the stimulants like methylphenidate or the amphetamines) are themselves subject to abuse, though, of note, this is typically not a problem when they are prescribed to patients who do not have a history of substance abuse such as, for example, in the treatment of attention deficit-hyperactivity disorder. 

MDMA s history dates to the early years of the 20th century when researchers at the German pharmaceutical company Merck discovered the compound and a number of related amphetamine analogs, including 3,4-methylenedioxyamphetamine (MDA) and 3,4-methyl-enedioxy-N-ethylamphetamine (MDEA). Merck s research began as an attempt to discover a substance that could be used as a vasoconstrictor, a substance that causes a narrowing of blood vessels and can be used to reduce bleeding. 

Drug abuse and dependence Studies in healthy volunteers, subjects with a history of multiple drug abuse, and depressed patients showed some increase in motor activity and agitation/excitement. In individuals experienced with drugs of abuse, a single dose of 400 mg bupropion produced mild amphetamine-like activity as compared with placebo. 

Stimulants are considered to be among the safest and most effective psychotropic medications prescribed. This view is based on a history of over 60 years of research and clinical use for a variety of physiological and psychiatric conditions. In a ground-breaking article, Bradley (1937) reported that D, L-amphetamine diminished motor activity, increased compliance, and improved academic performance in hyperactive children. Continuing his research throughout the next two decades, Bradley published more case reports of successful amphetamine treatments in children (Bradley and Bowen, 1941). 

Most bulimic patients (60%-80%) have a lifetime history of depression (Braun et ah, 1994). They have problems with interpersonal relationships, self-concept, and impulsive behavior and show high levels of anxiety and compulsivity. Chemical dependency is not unusual in this disorder, alcohol abuse being the most common. Bulimics will abuse amphetamines to reduce their appetite and lose weight (Braun et ah, 1994). 

Dextroamphetamine has a long history of use by the military. After distribution of the drug in the fields and foxholes of World War II, the American Armed Forces started zealously testing the drug on their pilots and other personnel. One study of amphetamine use in the military reported that between 1966 and 1969, the U.S. military consumed more amphetamines than the British and American armed forces combined during World War II. 

In comparison to caffeine, pemoline, and methylphenidate, amphetamine appears to offer a more consistent and prolonged alerting effect (100,192), and both the benefits and drawbacks are fairly well known because amphetamines have a long history of use in real-world settings, particularly in military aviation. It has been concluded that to date, the most promising stimulants to counteract performance decrements attributed to aircrew sustained operations are the amphetamines (191, p. 269). Furthermore, Comum et al. (193) have stated that the proper administration of amphetamines to severely fatigued personnel can make the difference between a mission that ends safely and one that ends in disaster. 

Miller MA. History and epidemiology of amphetamine abuse in the United States. In Klee H, ed. Amphetamine Misuse International Perspectives on Current Trends. Amsterdam Harwood Acad Pub, 1997 113-134. 

Tachycardia, dysrhythmias, and a rise in blood pressure have been described after the administration of centrally acting sympathomimetic amines. Amfetamine acutely administered to men with a history of amfetamine abuse enhanced the pressor effects of tyramine and noradrenaline, while continuous amfetamine led to tolerance of the pressor response to tyramine. As with intravenous amphetamines, cardiomyopathy, cardiomegaly, and pulmonary edema have been reported with smoking of crystal metamfetamine (15-17). 

A 30-year-old woman with a history of bronchial asthma and cocaine abuse had a cardiorespiratory arrest preceded by sudden dyspnea 1 hour after cocaine inhalation. Direct laryngoscopy showed edema of the glottis. After extended cardiopulmonary resuscitation, she went into a deep coma with dilated non-reactive pupils. Toxicological analysis showed cocaine and amphetamines in her urine. She was brain dead 11 hours later and her organs were used for transplantation. Her liver was given to a 14-year-... 

The GC/MS procedures for methamphetamine are described in Table 4. The papers published in Japanese - have corresponding reports in English. - - Methamphetamine was detected and determined by mass fragmentography in rat hair after administration of the substance. Nine methods also detected the metabolite amphetamine or amphetamine alone. Suzuki et al. determined methamphetamine also in nail, sweat and saliva. The workup (EX after acid or alkaline hydrolysis) and derivatization technique (methanol-trifluoroacetic acid [TEA]) is rather uniform in most procedures. Nakahara et al. ° used methoxyphenamine excretion into beard hair to discuss several washing procedures. Alkaline or methanolic extraction are used with one exception. Derivatization is mainly made by fluorinated anhydrides. A review ° gives details on analytical procedures, incorporation rates of amphetamines from blood to hair, and relationship between drug history and drug distribution in hair. 

AMPHETAMINES BUPROPION 1. t plasma concentrations of these substrates, with risk of toxic effects 2. t risk of seizures. This risk is marked in elderly people, patients with a history of seizures, those with an addiction to opiates/ cocaine/stimulants, and those with diabetes treated with oral hypoglycaemics or insulin 1. Bupropion and its metabolite hydroxybupropion inhibit CYP2D6 2. Bupropion is associated with a dose-related risk of seizures. These drugs that lower seizure threshold are individually epileptogenic. They have additive effects when combined 1. Initiate therapy with these drugs, particularly those with a narrow therapeutic index, at the lowest effective dose. Interaction is likely to be important with substrates for which CYP2D6 is considered the only metabolic pathway (e.g. amphetamines) 2. Extreme caution. The dose of bupropion should not exceed 450 mg/day (or 150 mg/day in those with severe hepatic cirrhosis)... 

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