Amphetamines withdrawal

Stimulant Withdrawal (Cocaine Withdrawal and Amphetamine Withdrawal)... 

Harrison AA, Liem YT, Markou A (2001) Fluoxetine combined with a serotonin-lA receptor antagonist reversed reward deficits observed during nicotine and amphetamine withdrawal in rats. Neuropsychopharmacology 25 55-71... 

Semenova S, Markou A (2003) Clozapine treatment attenuated somatic and affective signs of nicotine and amphetamine withdrawal in subsets of rats exhibiting hyposensitivity to the initial effects of clozapine, Biol Psychiatry 54 1249-1264 Semenova S, Bespalov A, Markou A (2003) Decreased prepulse inhibition during nicotine withdrawal in DBA/2J mice is reversed by nicotine self-administration. Eur J Pharmacol 472 99-110... 

Cassens, Geraldine, Carol Actor, Mitchel Kling, and Joseph J. Schildkraut. 1981. "Amphetamine Withdrawal Effects on Threshold of Intracranial Reinforcement." Psychopharmacology 73 318-22. 

Frequent symptoms of amphetamine withdrawal include excessive fatigue and depression. These may also occur nausea, vomiting, chills, cramps, headaches, and arrhythmia (a change in the rhythm of the heartbeat). A physician may prescribe antidepressants to help alleviate depression during amphetamine withdrawal. Also during withdrawal, if psychosis and/or hallucinations are experienced, treatment with chlorpromazine (Thorazine) or haloperidol (Haldol) may be necessary. Finally, ammonium chloride may be prescribed to more quickly remove amphetamines through the urine. 

The symptoms of Ritalin and amphetamine withdrawal can include psychosis, depression, exhaustion, withdrawal, irritability, suicidal feelings, excitability, euphoria, and hyperactivity. 

Chan-Ob T, Kuntawogse N, Boonyanaruthee V. Bupropion for amphetamine withdrawal syndrome. J Med Assoc Thai 2001 84 1763-5. 

Srisurapanont M, Jarusuraisin N, Jittiwutikan J. Amphetamine withdrawal I. Reliability, validity and factor structure of a measure. Aust NZ J Psychiatry 1999 33 89-93. 

Modafinil was effective in narcolepsy in a 9-week, randomized, placebo-controlled, double-bhnd, 21-center trial in 271 patients (4). During treatment withdrawal, the patients did not have symptoms associated with amphetamine withdrawal. Nausea and rhinitis were significantly more common in the treatment group in contrast, in a previous multicenter study in the USA there was a higher incidence of headache (5). Modafinil was also effective in the treatment of somnolence due to pramipexole in a patient with Parkinson s disease (6). 

Srisurapanont M, jarusuraisin N, Kittirattanapaiboon P. Treatment for amphetamine withdrawal. Cochrane Database Syst Rev. 2001 (4) CD003021. 

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. 

Garden City, NY, Medical Examination Publishing, 1981 Snyder SH, Faillace L 2,3-Dimethoxy-4-methyl-amphetamine (STP) a new hallucinogenic drug. Science 1388 669-670, 1967 Spielewoy C, Markou A Withdrawal from chronic phencyclidine treatment induces long-lasting depression in brain reward function. Neuropsychopharmacology 28 1106-1116,2003... 

Amphetamine effects on aggression are markedly modulated by opiates and opioid peptides. Withdrawal from prolonged exposure to opiates may lead to increased defensive and aggressive responses in mice and rats and increased hostility in humans (Lai et al. 1971 Gossop and Roy 1976 ... 

Kantak and Miczek 1986). Amphetamine and cocaine, as well as dopaminergic agonists, increase further the already high levels of defensive responses in aggregated rats undergoing withdrawal from opiates, leading in extreme cases to the death of the subjects (Lai et al. 1971 Puri and Lai 1973). 

Recently, it was found that single-housed mice that had been undergoing withdrawal for 48 hours (after removal of a subcutaneously implanted 75-mg morphine pellet) showed an elevation of attack and threat behavior that was doubled when these mice were challenged with amphetamine, cocaine, /-dopa, or apomorphine (figure 4) (Kantak and Miczek 1986 ... 

Lai, H. O Brien, J. and Puri, S.K. Morphine-withdrawal aggression Sensitization by amphetamines. Psychopharmacologia 2 217-223, 1971. 

Thor, D.H. Amphetamine induced fighting during morphine withdrawal. 

COMMENT I would favor the view that lethargy and fatigue of postamphetamine withdrawal during the withdrawal phase would be consistent with the shutting off of the dopamine neuron. Still, it is hard to imagine how that would be. First, the amphetamine-induced release is not regulated by the autoreceptor. And, as you say, if it would be impulse related, however weak, it would be regulated. But we do know that after a period of amphetamine intoxication, an individual is supersensitive behaviorally. 

Uni 1ke other drugs of abuse, the diagnosis of PCP intoxication is often difficult because of the wide spectrum of clinical findings that occurs with this drug. PCP toxicity sometimes can be mistaken for delirium tremens, acute psychiatric illness, sedative/ hypnotic overdosage, amphetamine intoxication, or sedative/ hypnotic withdrawal syndromes. 

The treatment goals for withdrawal from ethanol, cocaine/ amphetamines, and opioids include (1) a determination if pharmacologic treatment of withdrawal symptoms is necessary, (2) management of medical manifestations of withdrawal such as hypertension, seizures, arthralgias, and nausea, and (3) referral to the appropriate program for substance abuse treatment. 

There are no proven pharmacotherapies for treatment of cocaine or amphetamine dependence. Disulfiram, however, shows some promise in randomized controlled trials for treating cocaine dependence at doses of 250 mg daily, especially in combination with CBT.45 Its mechanism of action for treating cocaine dependence is not known, but may be due to its inhibition of the dopamine P-hydroxylase enzyme that converts DA to NE in the brain. The resulting increase in DA levels may counter the DA-deficient state that is believed to underlie cocaine withdrawal and craving. 

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