Stimulant Dependence

An editorial comment in the 1995 Archives of General Psychiatry stated, Cocaine, one of the most reinforcing and addictive of abuse drugs, has pharmacological actions very similar to those of MPH [methylphenidate], one of the most commonly prescribed psychotropic medications for children in the United States ( Editorial, 1995). Using PET, Volkow et al. (1995) found that the distributions of cocaine and methylphenidate in the brain were identical, but that the latter remained for a longer period of time. 

Youngsters selling their prescribed Ritalin made The Washington Post (Welsh, 1995) in a discussion of conditions at local private schools  

Students report that at two prestigious Virginia boarding schools, boys with prescriptions for Ritalin—a drug for attention deficit disorder— have been selling their pills to classmates looking to get high. At one school, a student said, Ritalin rivals acid and marijuana.  

Like any addictive stimulant, methylphenidate and amphetamine can cause withdrawal symptoms such as crashing with depression, exhaustion, withdrawal, irritability, and suicidal feelings. However, parents and teachers almost never recognize a withdrawal reaction when their student or child gets upset after missing a single dose. Instead, they mistakenly believe that the child needs to be kept on the medication. 

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Assessment of the patient receiving a CNS stimulant depends on the drug, the patient, and the reason for administration. 

A comprehensive assessment of the stimulant-dependent patients psychological, medical, forensic, and drug use history may be difficult, because information may be incomplete or unreliable. In recognition of this deficiency, it is important that the patient receives a thorough physical examination, as well... 

In humans, a comparative examination of the positive reinforcing effects of solvents showed that among inhalant-dependent subjects, solvents induced a more intense sensation of pleasant feelings than that induced by alcohol and nicotine in subjects addicted to these substances (Kono et al. 2001). Solvent-dependent subjects reported pleasant feelings comparable to those reported by stimulant-dependent subjects after use of methamphetamine. However,... 

Holtzman, E., Freeman, A. R. and Kashner, A. Stimulation-dependent alterations in peroxidase uptake at lobster neuromuscular junctions. Science 173 733-736,1971. 

Many other signaling pathways are activated in response to SIP stimulation, depending on the specific cell type and the EDG receptors expressed (Pyne and Pyne, 2000). Examples include phospholipase C-catalysed inositol phosphates formation, mobilisation, translocation of... 

Prisinzano, T. E., Tidgewell, K. and Harding, W. W. 2005. k Opioids as potential treatments for stimulant dependence. The AAPS Journal, 73(61) E592-E599. 

Kampman KM (2008). The search for medications to treat stimulant dependence. Addiction Science Clinical Practice, 4, 28-35... 

Rawson RA, McCann MJ, Flammino F, Shoptaw S, Mitto K, Reiber C Ling W (2006). A comparison of contingency management and cognitive-behavioural approaches for stimulant-dependent individuals. Addiction 101, 267-74... 

The pharmacodynamic effects of all volatile agents on body systems may be modified by surgical stimulation depending on the depth of anaesthesia. The pharmacological properties of the drugs described below are those of the agents in the absence of surgical stimulation unless otherwise stated. 

An effect on enzyme activity, an inhibition or stimulation depending on the enzyme and its source. 

Chocolate contains only a small amount of caffeine, but has a lot of theobromine, a close relative with similar effects. By itself, theobromine cannot account for all aspects of chocolate addiction, because chocolate addiction looks different from other forms of stimulant dependence. Most chocoholics are women and many of them crave chocolate most intensely just before their menstrual periods. Women who develop an addictive relationship with chocolate usually eat it in cyclic binges rather than continually and often say it acts on them like an instant antidepressant. As there is no reason to think that theobromine affects men and women differently, other components of chocolate must be involved. Very little research has been done on chocolate, so no one knows for sure. 

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