Explore chapters and articles related to this topic
Psychiatry and social medicine
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
13.33. A physically healthy 6-year-old boy presents with a history of inattention, behavioural disturbance, declining school performance and social isolation from peers. He has recurrent nightmares and has started wetting the bed. The symptoms commenced 6 months ago following the sudden death of his father. Your initial management strategy includestricyclic antidepressant medication.behaviour therapy.further family interviews.psychostimulant medication.individual interviews with the child.
The Amphetamine Psychosis
Published in John Caldwell, S. Joseph Mulé, Amphetamines and Related Stimulants: Chemical, Biological, Clinical, and Sociological Aspects, 2019
John M. Davis, R. Francis Schlemmer
Nevertheless, these studies point out that some schizophrenic patients seem to be particularly sensitive to the psychotogenic effect of amphetamine. Physicians should be wary of prescribing amphetamines to patients with a history of psychosis. Also, the same individuals who indulge in street drug use of psychostimulants may be particularly vulnerable to these drugs showing a rapid development of psychosis.
Metabolic Mapping of the Effects of Psychomotor Stimulants
Published in Edythe D. London, Imaging Drug Action in the Brain, 2017
Linda J. Porrino, Francesco E. Pontieri
The neural circuits activated by low dose intravenous administration of psychostimulants are also analogous. In each case, low doses, those which produce some stimulation of locomotor and exploratory behavior, increase metabolic activity in the nucleus accumbens and other portions of the me-socorticolimbic system. Although this dose-dependent pattern of effects within the mesocorticolimbic and nigrostriatal dopaminergic systems seems to be typical of psychostimulants, such a pattern is not characteristic of other dopaminergic drugs (Figure 4). Apomorphine, a direct dopamine receptor agonist, for example, does not significantly alter glucose utilization in the mesocorticolimbic system even though a broad range of doses was tested (McCulloch et al., 1982). It was without effect in such areas as the nucleus accumbens and prefrontal cortex (McCulloch et al., 1982). This pattern is similar to that obtained following the administration of bromocriptine, another dopamine receptor agonist (Pizzolato et al., 1985). It is interesting to note that psychostimulants are self-administered by humans and in animal models, but directly acting dopaminergic agonist drugs generally are not. The unique metabolic action of psychostimulants in the mesocorticolimbic dopaminergic system, then, may be related to their reinforcing properties. This conclusion is supported by other studies with different methodologies in which this system has also been identified as a critical substrate of psychostimulant reinforcement.
Considerations when selecting an antidepressant: a narrative review for primary care providers treating adults with depression
Published in Postgraduate Medicine, 2023
C. Brendan Montano, W. Clay Jackson, Denise Vanacore, Richard Weisler
Augmentation typically involves the addition of a non-antidepressant to a current antidepressant. As we have mentioned, multiple comorbidities can drive the patient to experience symptoms of depression, which must be kept in mind when approaching augmentation and combination strategies. Augmentation with lithium and atypical antipsychotics (e.g. aripiprazole, cariprazine [85], brexpiprazole, risperidone, quetiapine, or olanzapine) may be appropriate strategies to consider for non- or partial responders who may have mixed features, TRD, or BPD, for example [3,8,48]. For adults with MDD who have comorbid ADHD, most antidepressants can be combined (with monitoring) with long- or short-acting stimulants to treat ADHD symptoms [16,63,77,79]. Long-acting preparations are preferred when using psychostimulants.
Stimulant storm – state health department psychostimulant age-adjusted mortality rate correlates with psychostimulant-based Michigan Poison Center case exposures over time
Published in Clinical Toxicology, 2021
Varun Vohra, Andrew King, Sydney Daviskiba, Brian Reed, Sarah Rockhill, Perri Kern, Diana Dean
To mirror existing data collected by MDHHS, we queried the ToxSentry® database for all cases involving psychostimulant exposures from January 1, 2012 to December 31, 2018. We performed the MiPC database query between May 12, 2020 and May 20, 2020. We included patients of all ages and both sexes in the review. We defined “psychostimulant” as drugs including amphetamine-derived phenethylamine (i.e., methamphetamine), other phenethylamine derivatives (e.g., cathinones, 2C family, substituted benzofurans, etc.), and stimulant medications not structurally related to amphetamines, namely methylphenidate. Our database search included terms for both prescription and illicit psychostimulants, including “hallucinogenic amphetamines”, “methamphetamine”, “methylphenidate”, and “synthetic phenethylamines”, “phenethylamine analogs”, and “phenethylamine precursors”; all terms were pre-defined categories in the ToxSentry® database. To align our study as closely with pre-defined MDHHS data, we excluded certain stimulants. We excluded caffeine to reflect the study goal of identifying trends in psychostimulant abuse and misuse (the authors felt that an inaccurate population would be targeted if included), despite its inclusion in MDHHS data. Additionally, although bupropion is a phenethylamine derivative, we excluded it as it is not collected in corresponding state data. Cocaine was also excluded as it is collected separately by MDHHS and not of interest in the current study. Information requests and animal calls were excluded from analysis (Figure 1).
Review of lisdexamfetamine dimesylate in children and adolescents with attention deficit/hyperactivity disorder
Published in Current Medical Research and Opinion, 2020
Jadwiga Najib, Ekaterina Didenko, Daria Meleshkina, Kamila Yusupov, Kateryna Maw, Justin Ramnarain, Maliha Tabassum
Psychostimulants as a group have a potential for abuse and clinicians should be vigilant when prescribing stimulants as they may be abused or diverted. Long-acting stimulants may be less likely to be abused then their short-acting counterparts. LDX has demonstrated a lack of clinically significant psychoactive effects when administered intravenously or intranasally, potentially reducing the risk for abuse and misuse. The abuse liability of intravenous LDX was less than that of intravenous d-amphetamine as assessed in adult stimulant abusers. LDX 50 mg intravenously did not result in significant abuse-related craving scores compared to placebo (p=.290)85. In another study using craving scores on the Drug Rating Questionnaire-Subject scale in adults with a history of stimulant abuse, subjects significantly favored orally administered d-amphetamine 40 mg vs. orally administered LDX 100 mg (p < .05), and there was no significant difference in liking scores between d-amphetamine 40 mg and LDX 150 mg86. The pro-drug technology associated with LDX may also contribute to lower inter- and intra-patient variability compared to other controlled-release formulations. The slow release of d-amphetamine produced by hydrolysis of LDX leads to a slow steady therapeutic effect which may potentially avoid the rapid increases in dopamine often associated with the reinforcing effects of drug abuse87,88.