Stimulants abuse

The development of psychosis is the most striking clinical characteristic of high-dose stimulant abuse. The amphetamines, methylphenidate, and phen-metrazine all produce psychosis (Ellinwood et al. 1973 Harris and Batki 2000 Iversen et al. 1978 Lucas and Weiss 1971 McCormick and McNeil 1962). 

The development of effective pharmacotherapy has lagged behind progress in understanding the reward mechanisms and chronic impairments underlying stimulant abuse. Pharmacological and behavioral treatment approaches that have been used for cocaine abuse have not been as widely tested for the treatment of amphetamine abuse, limiting what can be offered for treatment of this disorder. No treatment agents are approved by the FDA for treatment of cocaine or amphetamine dependence. 

Table 5-2. Strategies for medication development in stimulant abuse... 

Opioids Buprenorphine, K agonists Buprenorphine probably not effective in treating stimulant abuse. K Agonists have not been adequately smdied. 

The rates of comorbid psychiatric disorders such as depression, ADHD, and antisocial personality disorder are significantly higher in stimulant abusers... 

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