Psychostimulants pharmacology

Psychostimulant pharmacology involves an augmented release of noradrenaline and dopamine into the synaptic cleft. The presence of monoamine neurotransmitters in the synaptic cleft is regulated in a variety of ways in response to an action potential. Around 70-80% of all transmitter molecules return into the presynaptic neuron by uptake using an energy-dependent reuptake transport protein that is embedded in the neuronal membrane. A smaller fraction... 

The most common treatment of ADHD is pharmacological. Psychostimulant diugs such as methylpheni-date and amphetamine or atomoxetin, an inhibitor of the noradrenaline transporter can be prescribed. These agents elicit the non-exocytotic release of... 

Chronic administration of opiates and alcohol leads to physical dependence a phenomenon, which is only weakly expressed following chronic administration of psychostimulants or other drugs of abuse. Physical dependence results from neuroadaptive intracellular changes to an altered pharmacological state. Abstinence from chronic opiate or alcohol use leads to a variety of physiological and psychological withdrawal symptoms based on these adaptations of the neuronal system. 

Thus, for structure-activity studies of MDMA-like substances, emphasis has been placed on the use of (-l-)-MBDB as the training drug, since it seems to possess a primary psychopharmacology similar to that of MDMA, but lacks the psychostimulant component of MDMA. That is, MBDB is pharmacologically less complex. 

Popper, C.W. (2000). Pharmacologic alternatives to psychostimulants for the treatment of attention-deficit/hyperactivity disorder. Child Adolesc Psychaiatr Clin N Amer 9 605-646. 

Joffe RT, Swinson RP Total sleep deprivation in patients with obsessive-compulsive disorder. Acta Psychiatr Scand 77 483-487, 1988 Joffe RT, Swinson RP, Levitt AJ Acute psychostimulant challenge in primary obsessive-compulsive disorder. J Chn Psychopharmacol 11 237-241, 1991 Johns CA, Greenwald BS, Mohs RC, et al The chohnergic treatment strategy in aging and senile dementia. Pharmacological Bulletin 19 185-197, 1983 Johnson BB, Naylor GJ, Dick EG, et al Prediction of chnical course of bipolar manic depressive illness treated with hthium. Psychol Med 10 329-334, 1980... 

Bupropion appears to be pharmacologically unique relative to other conventional antidepressants and most closely resembles the action of psychostimulants. 

ECT should be considered for more severe forms of depression (e.g., those associated with melancholic and psychotic features, particularly when the patient exhibits an increased risk for self-injurious behavior) or when there is a past, well-documented history of nonresponse or intolerance to pharmacological intervention. Limited data indicate that bipolar depressed patients may be at risk for a switch to mania when given a standard TCA. A mood stabilizer alone (i.e., lithium, valproate, carbamazepine, lamotrigine), or in combination with an antidepressant, may be the strategy of choice in these patients. Some elderly patients and those with acquired immunodeficiency syndrome may also benefit from low doses of a psychostimulant only (e.g., methylphenidate) (see also Chapter 14, The HIV-Infected Patient ). Fig. 7-1 summarizes the strategy for a patient whose depressive episode is insufficiently responsive to standard therapies. 

Pulvirenti, Luigi, and George F. Koob. 1994. "Dopamine Receptor Agonists, Partial Agonists, and Psychostimulant Addiction." Trends in Pharmacological Sciences 15 374-79. 

Mach, R., Nader, M., Ehrenkaufer, R., Line, S., Smith, C., Gage, H., et al. (1997). Use of positron emission tomography to study the dynamics of psychostimulant-induced dopamine release. Pharmacology Biochemistry and Behavior, 57, 477—486. 

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