Amphetamines side effects

Thus it may be concluded that in this group of compounds molecular modification of the amphetamine structure achieved a distinct selectivity of action with regard to psychomotor stimulation and a considerably lessened incidence of the usual amphetamine side effects such as anorexia, jitteriness, apprehension, cardiovascular effects, insomnia, tolerance, and postdrug depression. 

In addition to this serious diet-drug interaction, irreversible MAOIs also potentiate the effects of sympathomimetic drugs like ephedrine found in over-the-counter cold remedies and recreational stimulants like amphetamine. The MAOIs also interact with drugs that increase synaptic concentrations of 5-HT, such as the tricyclic antidepressant clomipramine and the herbal SSRI antidepressant St John s wort (Hypericum spp.). The resulting serotonin syndrome is characterised by hyperthermia and muscle rigidity. While devoid of these side effects the reversible MAO-A inhibitor moclobemide has yet to establish itself as a first-line alternative to the SSRIs. 

Figure 4.1 The chemical structure of amphetamine and fenfluramine are illustrated here. Fenfluramine (bottom) is a diet pill that is very similar in structure to amphetamine (top). Fenfluramine is an appetite suppressant, like amphetamine, but it does not have stimulant effects. Fenfluramine was proposed as a safer alternative to amphetamine and was very effective in causing weight loss, especially when used in combination with phentermine. Unfortunately, fenfluramine eventually led to devastating side effects, which led to its being withdrawn from the U.S. market.

The side effects of amphetamine are related to its stimulant effects, especially at high doses and with long-term use. Side effects include irritability, insomnia, confusion, anxiety, paranoia, hallucinations, seizures, and aggressiveness. Amphetamines cause irreversible destruction of blood vessels in the brain, which can cause stroke—even in young people. These drugs also cause the potentially lethal side effects of increased heart rate, irregular heartbeat, and increased blood pressure. 

Amphetamines are very effective for weight loss but their use is limited by serious side effects and the potential for abuse. Therefore, amphetamine is still FDA approved for other diseases but is no longer permitted for weight loss. Many drugs that are similar to amphetamine have been formulated in an attempt to promote weight loss without causing addiction and dangerous side effects. 

The largest drawback to the use of amphetamines is the often severe side effects that can occur. All amphetamines can cause nervousness, dry mouth, insomnia, anxiety, elevated heart rate, high blood pressure, and heart palpitations. Another side effect of amphetamines is artificially elevated feelings of self-confidence. Abusers of amphetamines have a false sense of well-being they feel like they are invincible and could conquer the world. ... 

Control of feeding behavior involves peripheral peptides (insulin, ghrelin, leptin) plus several peptides in the CNS (orexins/hypocretins, CCK, galanin, MSH, neuropeptide Y, CRH, cocaine-and-amphetamine-regulated transcript (CART)) [35, 36]. Some of the same peptides are involved in reward systems crucial to drug addiction. Specific receptor blockers are being tested for many of these peptide-receptor systems, with the hope of very selective actins with minimal side effects [35], For example, there are two CCK receptor subtypes, CCK-A and... 

The side effects of methylphenidate are very similar to the amphetamines, but because it is somewhat less potent they may be a little milder. The common side effects of methylphenidate are appetite loss, weight loss, insomnia, and nausea. Taking methylphenidate with meals and no later than 6 PM can control most of these. On rare occasions, methylphenidate can cause headache, dizziness, nervousness, increased heart rate, increased blood pressure, tics, and, in extremely rare cases, paranoia. 

The patterns of anabolic-androgenic steroid use by sportspeople and body-builders, and their physical and psychological side-effects and dependence potential, have been very well reviewed by Brower (2002). Much of the use is by injection, and so many of this population attend needle exchanges, with the advice on reducing infection risks relevant. To increase energy, burn fat and to go through the pain barrier some will use amphetamines and opiates, either street preparations or illicit pharmaceutical supplies. In the UK the opioid nalbuphine (Nubain) has been abused in this way and, in cases where dependence becomes established, detoxification treatments can be necessary. 

A number of antidepressants do not fit neatly into the other classes. Among these are bupropion,mirtazapine, amoxapine, and maprotiline (Figure 30-5). Bupropion has a unicyclic aminoketone structure. Its unique structure results in a different side-effect profile than most antidepressants (described below). Bupropion somewhat resembles amphetamine in chemical structure and like the stimulant, has central nervous system (CNS) activating properties. 

Even when effective in controlling behavior, Ritalin and other stimulants have side effects common with use of amphetamines. These include nervousness, insomnia, and perhaps some more long-term problems such as dependency, slowed growth, or depression. Critics sometimes note the similarity between cocaine and the active chemical ingredient in Ritalin, methylphenidate. Both stimulate the dopamine system of the brain, but cocaine does so quickly and methylphenidate does so slowly. The similarities show in the abuse of Ritalin for its pleasure-inducing qualities. 

Amphetamines are definitely drugs which have been and are abused. Notice that the organic modifications in the fundamental amphetamine structure are to make the compound more lipophilic and so speed its delivery to the CNS as well as heighten the stimulant and euphoric effect. Therapeutic doses of amphetamines range from 5 to 10 mg for a maximum of 60 mg per day while abusive doses may be as high as 500-1000 mg every 2-3 hours. The side effects of abuse include tolerance, addiction, malnutrition, heart arrthymias, and... 

The stimulating and mood-altering effects of amphetamines give them a high abuse potential. Side effects include insomnia, irritability, loss of appetite, and paranoia. Amphetamines take a particularly hard toll on the heart. Hyperactive heart muscles are prone to tearing. Subsequent scarring of tissue ultimately leads to a weaker heart. Furthermore, amphetamines cause blood vessels to constrict and blood pressure to rise, conditions that increase the likelihood of heart attack or stroke. 

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