Download Neurotransmitters

Cocaine
Methamphetamine
Ephedrine
Methylphenidate
 resulting
from intoxication or long-term use of
amphetamines or amphetamine derivatives
 Such disorders can also be experienced during
the withdrawal period from amphetamines
 often self-limiting after cessation, though, in
some patients, psychiatric symptoms may last
several weeks after discontinuation.
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exhaustion, apathy and depression—the “down”
that follows the “up.” It is this immediate and
lasting exhaustion that quickly leads the
stimulant user to want the drug again. Soon he is
not trying to get “high,” he is only trying to get
“well”—to feel any energy at all
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Amphetamine-induced anxiety disorder
Amphetamine-induced mood disorder
Amphetamine-induced psychotic disorder with delusions
Amphetamine-induced psychotic disorder with hallucinations
Amphetamine-induced sexual dysfunction
Amphetamine-induced sleep disorder
Amphetamine intoxication
Amphetamine intoxication delirium
Amphetamine withdrawal
Amphetamine-related disorder not otherwise specified
 Use
of amphetamine and methamphetamine is
widespread in the general population
 and common among patients with psychiatric
disorders
 Some
individuals experience paranoia during
withdrawal as well as during sustained use
 Amphetamine use may elicit or be associated
with the recurrence of other psychiatric
disorders
 People addicted to amphetamines sometimes
decrease their use after experiencing paranoia
and auditory and visual hallucinations
 amphetamines can be psychologically but not
physically addictive
 The
symptoms of amphetamine-induced
psychiatric disorders can be differentiated from
those of related primary psychiatric disorders by
time
 If symptoms do not resolve within one month
after the amphetamines are discontinued, a
primary psychiatric disorder should be suspected
 Amphetamine-induced
psychosis (delusions and
hallucinations) can be differentiated from
psychotic disorders when symptoms resolve after
amphetamines are discontinued
 Absence of first-rank Schneiderian symptoms,
anhedonia, avolition, amotivation, flat affect,
further suggests amphetamine psychosis
 Symptoms of amphetamine use may be
indistinguishable from cocaine use.
Amphetamines, unlike cocaine, do not cause
local anesthesia and have a longer psychoactive
duration
 faster
recovery and resolve more
 completely compared to schizophrenic psychosis
 Increased vulnerability for
 acute amphetamine induced psychosis seen
among schizophrenia, schizotypal personality
and, to a certain degree other psychiatric
disorders, non-psychiatric individuals who
previously have experienced
 Amphetamines
may induce symptoms of
psychosis very similar to those of acute
schizophrenia spectrum psychosis
 Amphetamine-induced
delirium follows a
reversible course similar to other causes of
delirium, by its relationship to amphetamine
intoxication
 After the delirium subsides, little to no
impairment is observed
 Delirium is not a condition observed during
amphetamine withdrawal
 Mood
disorders similar to hypomania and mania
can be during intoxication with amphetamines
 Depression can occur during withdrawal, and
repeated use of amphetamines can produce
antidepressant-resistant amphetamine-induced
depression
 Low-dose amphetamines can be used as an
adjunct in the treatment of depression,
especially in patients with medical compromise,
lethargy, hypersomnia, low energy, or decreased
attention.
 Sleep
disturbances appear in a fashion similar to
mood disorders
 During intoxication, sleep can be decreased
markedly
 In withdrawal, sleep often increases
 A disrupted circadian rhythm can result from
late or high doses of prescription amphetamines
or from chronic or intermittent abuse of
amphetamines
 Individuals
who use prescription
amphetamines can easily correct their sleep
disturbance by lowering the dose or taking
their medication earlier in the day than they
have been
 Insomnia is the most common adverse effect
of prescription amphetamines
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Amphetamine-Induced Sleep Disorder
psychostimulants inhibit sleep
drug use patterns frequently associated with
amphetamine-type stimulants (i.e., binges or “runs”)
lead to disruptions of normal sleep–wake cycles,
because drug users forgo sleep for the sake of drug
use
After drug cessation, particularly after continued,
heavy use, amphetamine users develop
hypersomnolence that can persist for weeks (i.e.,
“crashes”)
Because amphetamines have the potential to damage
brain monoaminergic neurons, which are known to
play an important role in sleep modulation (see the
section “Amphetamine-Induced Neurotoxicity”
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common medical condition
as a Sleeping Disorder
complete to partial paralysis of arms, legs and upper
torso, a tight or heavy pressure on your chest sometimes
with a choking sensation and almost always experienced
to fall into sleep or just come out of sleep
The most remarkable symptoms of SP are the
accompanying audio and/or visual hallucinations often
causing extreme terror and panic in it's sufferers, who
more often than not mistakenly believe they are being
visited by aliens, malevolent beings and other evil
presences
 Generalized
anxiety, panic attacks, obsessivecompulsive symptoms, or phobia symptom
 during
intoxication on a substance or during
withdrawal
Prominent anxiety, panic attacks, or obsessions or
compulsions.
 Symptoms develop during, or within one month, of
intoxication or withdrawal from a substance or
medication known to cause anxiety symptoms.
 Symptoms are not actually part of another anxiety
disorder (such as generalized anxiety disorder ,
phobias, panic disorder , or obsessive-compulsive
personality disorder that is not substance induced
 if the anxiety symptoms began prior to substance or
medication use, then another anxiety disorder is
likely.
 Symptoms do not occur only during delirium
 Symptoms cause significant distress
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Anxiety symptoms induced by substance intoxication usually
subside once the substance responsible is eliminated
Symptoms persist depending on the half-life of the
substances (i.e., how long it takes the before the
substance is no longer present in an individual's system)
Symptoms, therefore, can persist for hours, days, or weeks
after a substance is last used
Obsessive-compulsive symptoms induced by substances
sometimes do not disappear, even although the substance
inducing them has been eliminated
More intensive treatment for the obsessive-compulsive
symptoms would be necessary and should include a
combination of medication and behavioral therapy
 cross-addictions
 switch
from one addiction to another
 co-occurring addictions struggle with multiple
addictions simultaneously
 Cross and co-occurring disorders are especially
common with sex addicts
 The most common secondary drugs of choice for
sex addicts are amphetamines
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Crystal methamphetamine is the number one option
 called “the sex drug,”
 meth is the preferred “party favor” for anonymous
Internet and smartphone hookups
 most commonly abused drug among prostitutes (of
both genders)
 Sex addicts also use cocaine, crack cocaine, and
almost any other stimulant
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cocaine-related paranoia is common
with heavy use
the diagnosis of cocaine-induced
psychotic disorder is reserved for
cases in which there is no insight as
to the drug-related nature of the
symptoms, or when symptoms
exceed the quality or severity
characteristic of cocaine
intoxication
abnormalities in brain areas involved in essential
pathways of learning and memory. The
dysfunction in these areas that is seen with
cocaine dependence
Conventional re-inforcers produce a dopamine
response
the response to cocaine does not diminish in this
way, and some laboratory animals will selfadminister cocaine in preference to food and
water and to the point of death.
 Cocaine dependence and related behaviors can
be understood as forms of behavioral
conditioning
Cocaine-induced mood or anxiety disorders are
distinguished from mood and anxiety symptoms
expected during the typical course of
intoxication or withdrawal by their intensity,
onset, and time course
 neurovegetative symptoms suggesting a major
depressive episode may be present, full criteria
for major depressive disorder or hypomania need
not be met
 Similarly, the diagnostic criteria for cocaineinduced anxiety disorder require only the
presence of prominent anxiety, obsessions,
compulsions, or panic attacks in the setting of
recent cocaine use
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 cocaine-induced
sexual dysfunction, sleep
disorder, and cocaine-related disorder
 Stimulants such as cocaine are at times used
for their purported enhancement of sexual
function
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 Cocaine
may also produce a sleep disorder,
typically characterized by periods of
insomnia during intoxication and
hypersomnia during withdrawal
 Insomnia during cocaine withdrawal is also
commonly described
 Sleep cycles may be shifted when binges
extend into the night or when withdrawalinduced hypersomnia leads to daytime
sleeping
 Ecstasy
(emotion), a trance or trance-like
state in which a person transcends normal
consciousness
 Religious ecstasy, a state of consciousness
characterized by expanded spiritual
awareness, visions or absolute euphoria
 Ecstasy (philosophy) , a term used to mean
"outside itself"
 Ecstasy (drug) , a colloquial term for the
drug MDMA
 1970
 chemist
Alexander Shulgin
 introduced ecstasy to those with an interest
in drug-assisted psychotherapy
 The psychotherapists considered the drug to
be moderate in its effects, which were
principally characterised by feelings of
empathic understanding for others and a
release of emotions
 potential for overcoming 'blocks' in
psychotherapy and enhancing insights
a
popular drug
 positive effects that a person experiences
within an hour or so after taking a single
dose
 feelings of mental stimulation, emotional
warmth, empathy toward others, a general
sense of well being, and decreased anxiety.
enhanced sensory perception as a hallmark
of the MDMA experience.
 euphoria,
high energy, and social disinhibition
lasting 3-6 hours
 The drug is often consumed in dance clubs,
where users dance vigorously for long periods
 toxicity and dehydration
 severe hyperthermia
 Substance-induced
affective, anxiety and
cognitive disorders occurred more frequently
among ecstasy users than polydrug controls.
The life-time prevalence of ecstasy
dependence amounted to 73% in the ecstasy
user groups. More than half of the former
ecstasy users and nearly half of the current
ecstasy users met the criteria of substanceinduced cognitive disorders at the time of
testing
 associated
with a number of psychiatric
symptoms that have persisted after cessation
of the drug
 As
with amphetamine
 confusion, anxiety, panic attacks, depression,
sleeping difficulties, depersonalization,
derealization, hallucinations, flashbacks,
paranoia, psychosis, tolerance and
dependency syndromes, and subsequent
addiction to sedatives
 Methylphenidate
is a central nervous system
stimulant drug that has become the primary
drug of choice in treating attentiondeficit/hyperactivity disorder in children
 Abuse
often entails the use of large doses,
which may be taken intranasally or
intravenously
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BRAND NAMES
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Ritalin
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STREET NAMES
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R-ball
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Skippy
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The smart drug
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Vitamin R
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JIF
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Kibbles and bits
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Truck drivers
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Bennies
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Crosses
Concerta
Biphetamine
Speed
Black beauties
Dexedrine
 Intranasal
abuse produces effects rapidly
that are similar to the effects of cocaine in
both onset and type
 Hallucinations
 Paranoia
 Euphoria
 manic-like
states
 delusional disorder
 Out of contol
 Suicide Ideation
 Intravenous
abuse of methylphenidate
associated with psychosis
 Bruxism
 repeated
touching
 stereotypic
 confusion
 disoriented behavior
 obsessive-compulsive tendencies,
aggressiveness
 repetitive behaviors
 the
psychiatric side effects of stimulants
are quite similar giving more support to the
idea that almost all CNS stimulants will
produce a similar clinical picture
 All
participants in therapy need to be
educated about the abuse potential of
stimulants