Amphetamines and Other Stimulants

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Amphetamines, traditionally known as SPEED have been abused for a long times.  Thes are drugs that lead to an increase in one of three neurotransmitters in the brain: dopamine, norepinephrine and/or seratonin.

Cocaine is included in this group but has been addressed in a different article.  The other two types of drugs that are commonly abused are Methamphetamine and MDMA, which is more commonly known as Ecstasy.  Methamphetamine dependency has become a significant problem in recent years especially in the West and South East.  In the Northeast, it has not been as significant a problem but will clearly become one.

Other drugs can be included in this group but they are far less addictive.  This is because they have slightly different chemical structures.  This affects the speed at which they begin to work.  These drugs include the hyperactivity drugs such as Ritalin (methylphenidate), Cylert (pemoline), and Adderall (dextroamphetamine)

Phentiramine, phenmetrazine and other pills used for appetite control have also been included in this drug; as well as phenylpropylamine-a commonly used decongestant that has recently been taken off the market secondary to side effects.  However, these last drugs act on norepinephrine to a much greater than they act on dopamine.  For this reason, they do not seem to lead to abuse or addiction even though they have similar side effects as the first group such as irritability, tremors, insomnia and anxiety.

Methamphetamine works primarily on the dopamine molecule  It increases its’ concentration in the Nucleus Accumbens, the pleasure center of the brain.  (See Why We Use Drugs).  While this is similar to the effect of cocaine, the mechanism by which this is accomplished is different.  It is able to act inside the cell, forcing the dopamine stored there to be secreted into the synapse.  

This effect may be of slower onset than that of cocaine so that cocaine gives a faster high.  However, the drug sticks around a lot longer and this can cause progressive accumulation and/or prolonged symptoms.  The accumulated effects seem to lead to much more profound imbalances in dopamine levels and dopamine nerve function.  

Most of the drugs mentioned above have a similar mechanism in that they get inside the dopamine nerves and force it to release dopamine.  However, they also have effects on the norepinephrine nerves to release norepinephrine.   It is the for the norepinephrine effects that we use the various prescriptive medications. As the norepinephrine effects predominate, the drugs become less addictive.  Dextroamphetamine(Adderall) is less addictive than methamphetamine for this reason.      

MDMA's (Ecstasy) mechanism of action is different however.  It has a significant effect on nerves that secrete seratonin.  It causes them to release significant amounts of Seratonin into the synapse.  This causes activation of the Nucleus Accumbens albeit by a more roundabout and not as well mapped out mechanism.   The seratonin effect makes it more potentially hallucinogenic.

Common side effects include irritability, anxiety, increased blood pressure and heart rate (which can lead to heart attack and stroke), chest pain, shortness of breath, lung damage, fevers and seizures.

The stronger amphetamine drugs can cause permanent damage in the brain especially Ecstasy.  Animal studies have shown brain cell death with even a single exposure to the drug.  While we have often heard that drug use kills brain cells, this is usually a cliche.  It is true, however, with Ecstasy.  The user loses Seratonin producing cells.  As a result, there can be long-lasting (or permanent) psychological consequences with depression, anxiety, paranoia, insomnia.

After chronic use, the addict is left with a long-term imbalance in the cells directly responsible for regulating mood, motivation and anxiety.  Treatment needs to focus on these imbalances.

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