One study [45] did not report the sample by those randomised, only by completers (in a non-intention-to-treat analysis) and so the total randomised figure of men versus women was not able to be determined based on randomisation (authors did not respond to a request for further data). Stimulant drugs are second only to cannabis as the most widely used class of illicit drug globally, accounting for 68 million past-year consumers. Dependence on amphetamines (AMPH) or methamphetamine (MA) is a growing global concern. A comprehensive assessment of the research literature on pharmacotherapy for AMPH/MA dependence may inform treatment guidelines and future research directions. These results are complemented by those of Ermer et al. (2011), who reported that the PK profiles were identical when lisdexamfetamine was administered intranasally or orally, indicating that attempts to increase its potential for recreational abuse by ‘snorting’ would similarly be futile. Although the findings do not demonstrate that lisdexamfetamine lacks any potential for recreational abuse, they do indicate that its attractiveness to abusers will be reduced compared with IR d-amphetamine.
Types of Amphetamine
Participants in the Cruickshank 2008 study were those that met DSM‐IV criteria for amphetamine dependence, reported using amphetamine or methamphetamine within the last 72 hours, and were recruited from two drug and alcohol out‐patient clinics. In 2006, 24.7 million individuals aged 15‐64 consumed amphetamine type stimulants (UNODC 2008). Among chronic users of amphetamines, evidence is accruing to describe the range of public health problems attributable to sustained heavy use of the drug. Medical consequences of chronic use of amphetamines include cardiovascular insults, cognitive dysfunction and infectious disease (Meredith 2005; Pasic 2007).
3. Eligibility criteria
For discontinuation rates, we judged that lack of blinding was unlikely to influence data collection. Amphetamine abuse remains prevalent in the United States (US), with significant implications for public health and individual well-being. The ramifications of amphetamine toxicity and overdose are profound, contributing to substantial morbidity and mortality rates. Notably, amphetamines’ sympathomimetic https://ecosoberhouse.com/ properties precipitate adverse cardiovascular and neurological effects, with studies indicating their involvement in a significant proportion of drug-related deaths in the US. Symptoms of amphetamine toxicity span a spectrum, encompassing tachycardia, hypertension, impulsivity, aggression, serotonin syndrome, psychosis, and seizures, underscoring the complexity of its clinical manifestations.
Meth, cocaine and other stimulants
The desired goal of pharmacotherapy will likely vary depending on the patient, and must be patient-focused and clinically relevant. Nearly a quarter of the reviewed studies had no female participants, and male sex made up over 70% of the population across all studies. In nine of the studies reviewed here (20.9%), women were excluded by design. In some cases, this was due to the setting (e.g. male-only residential treatment centres), or studies conducted in specific populations (e.g. men who have sex with men), and in others the reason is not clearly stated. Research suggests women who take stimulants are more likely to become dependent consumers than men who take stimulants [77]. While women are underrepresented in the reviewed studies as a proportion of the population overall, they may not be underrepresented as a proportion of the population who present for treatment.
Following brief exposure to the treatment, the medication is discontinued regardless of response as there is no evidence to suggest a pharmacotherapy for amphetamine withdrawal would have efficacy for amphetamine abuse or dependence. There was no difference in MA use by UDS in the treatment arm compared with placebo in the extended-release studies [29, 56]. We systematically reviewed the peer-reviewed literature via the electronic databases PubMed, EMBASE, CINAHL and SCOPUS for randomised controlled trials reported in the English language examining a pharmacological treatment for AMPH/MA dependence or use disorder. The selected studies were evaluated for design; methodology; inclusion and exclusion criteria; sample size; pharmacological and (if included) psychosocial interventions; length of follow-up and follow-up schedules; outcome variables and measures; results; overall conclusions and risk of bias.
What dosage strengths does amphetamine come in?
Bupropion was examined in six studies (14%) [26, 33, 39, 41, 60, 66]; four reported on AMPH/MA abstinence as the primary outcome, and two on reduction of AMPH/MA use. None of the six studies achieved a statistically significant difference in abstinence or reduction in use between the bupropion and placebo arm in planned primary outcome analyses. Of the 4065 participants reported on in the reviewed studies, 2858 (70.3%) were male. Nine of the 43 studies (21%) enrolled only males [24, 29, 30, 34, 46, 52, 55, 57, 58], however not all of these were by design.
They received their optimal dose of MES-amphetamine XR, an equivalent dose of lisdexamfetamine in terms of d-amphetamine base, or placebo. On the primary and secondary efficacy variables of behaviour, attention and problem solving, lisdexamfetamine delivered equivalent or better efficacy than MES-amphetamine XR with both drugs being maximally effective at 2 h post-dose (Biederman et al., 2007a). However, on the problem-solving endpoints, it was also evident that lisdexamfetamine maintained its maximum effect for at least 12 h, whereas the effect of MES-amphetamine amphetamine addiction XR showed a clear decline after 6–8 h (Biederman et al., 2007a). A post-hoc analysis of the data also showed that the sex and age of the subjects had no significant influence on the efficacy of lisdexamfetamine (Wigal et al., 2010b). All randomised controlled and clinical trials evaluating pharmacological and or psychosocial treatments (alone or combined) for people with amphetamine withdrawal symptoms. The world of technology is continuously advancing, with innovations reshaping every aspect of human life, including healthcare and substance abuse treatment.
- An intervention presents a loved one with a structured opportunity to make changes before things get even worse and can motivate someone to seek or accept help.
- If your health care provider prescribes a drug with the potential for addiction, use care when taking the drug and follow instructions.
- Barbiturates, benzodiazepines and hypnotics are prescription central nervous system depressants.
- In addition to this, patients who have an amphetamine use disorder and are entering substance abuse treatment centers have a higher likelihood of being referred by the criminal justice system than patients with all other substance use disorders combined (59% versus 38%).
- Two studies (Srisurapanont 1999b; Jittiwutikan 1997) used the Clinical Global Impression or CGI (Guy 1976) and one (Cruickshank 2008) used the Brief Symptom Inventory Global Severity Index sub scale or BSI‐GSI (Derogatis 1993) to measure global state.
- The most compelling evidence for a causal association was between the use of amphetamines and increased risk of psychosis, with consistent moderate to large effects across various populations, including in well-controlled population-level studies and longitudinal studies.
2. Relationship between the use of amphetamines and mental health outcomes
When the in vivo pharmacological profiles of amphetamine’s isomers are compared, d-amphetamine is three to fivefold more potent than l-amphetamine (Figure 4). Kuczenski et al. (1995) determined the effects of both amphetamine enantiomers on caudate 5-HT release. The effect was considerably smaller than found for dopamine and there was a smaller potency separation between the two isomers. The chemical structure, particularly the 3-dimensional (3-D) structure of amphetamine, is critical in determining the pharmacological effects that underpin its considerable therapeutic benefits and also its liability for recreational abuse. Amphetamines belong to a class of compounds called phenethylamines which induce catecholaminergic effects in the CNS and peripheral circulation. Recreational use of amphetamines has reached epidemic proportions in Asia, Australasia, and the United States.
- Stress has been shown to precipitate spontaneous recurrence of methamphetamine psychosis in formerly psychotic methamphetamine abusers.
- A person may have a stroke, heart problems, or liver or kidney damage due to misuse of amphetamines.
- Inhibition of MAO would further augment the quantity of neurotransmitter that is available for retro-transport into the synapse.
- You should only take the amount of amphetamine as prescribed by your healthcare provider.
It becomes a cycle — you seek out these experiences because they reward you with good feelings. Citations were uploaded to an online systematic review tool (© 2019 Covidence, ; Veritas Health Innovation Ltd.). Following the removal of duplicates, titles and abstracts were screened by one researcher for relevance. Full text reports were then reviewed by two independent reviewers against the inclusion criteria. Conflicts were discussed and if consensus was not achieved a third reviewer decided. Three studies examined sustained/extended-release oral methylphenidate in addition to the study reporting methylphenidate versus aripiprazole discussed earlier.
