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Chronic Fatigue Syndrome: Limbic Encephalopathy in a Dysregulated Neuroimmune Network
Published in Jay A. Goldstein, Chronic Fatigue Syndromes, 2020
Patients frequently complain of problems with attention and concentration. Attentional mechanisms are complex, involving a feedback circuit between the reticular activating system, the thalamic reticular nuclei, the parietal cortex, and the frontal lobes. As a stimulus loses its novelty, there is less input from the frontal lobes to maintain the activity of the attentional circuit, even though the unimodal sensory areas can still be shown to be firing. Norepinephrine and dopamine modulate this circuit, and stimulant drugs enhance attention by increasing levels of these neurotransmitters. Be-sides being easily distracted, another attentional disorder in CFS may be called “ideational apraxia,” in which there is impairment of intent of the performance of complex motor tasks. Putting garbage in the refrigerator may be an example of such an impairment.
Stimulants and psychedelics
Published in Ilana B. Crome, Richard Williams, Roger Bloor, Xenofon Sgouros, Substance Misuse and Young People, 2019
Stimulants (or psycho-stimulants) are psychoactive drugs that produce a variety of effects by enhancing the activity of the peripheral and central nervous systems. They produce a characteristic ‘up’ feeling, thus, they are occasionally referred to as ‘uppers’. They are widely used throughout the world as prescription medicines and as over-the-counter medications, but they are also used illicitly as recreational drugs of abuse.
Sympathomimetics
Published in Frank A. Barile, Barile’s Clinical Toxicology, 2019
The sporadic use of amphetamines reflects the competition and availability of other drugs of abuse, the desires of the particular socioeconomic group (generation) interested in the substance, and the efforts of law enforcement to eliminate the accessibility of any particular substance of abuse. The amphetamines made their appearance for use in weight reduction and control of obesity. Their stimulant/euphoric effects improved their popularity, which eventually gave rise to common street names such as ups, bennies, dexies, and speed, among others. Today, related stimulants such as methamphetamine and methylphenidate are available as prescription drugs due to their frequent use in the treatment of attention-deficit hyperactivity disorder (ADHD). The stimulants are also approved for the treatment of short-term depression. Their “off-label” use is frequently exploited for reducing fatigue among truck drivers and college students.
Stimulant use for self-management of pain among safety-net patients with chronic non-cancer pain
Published in Substance Abuse, 2022
Cathleen M. Beliveau, Vanessa M. McMahan, Justine Arenander, Martin S. Angst, Margot Kushel, Andrea Torres, Glenn-Milo Santos, Phillip O. Coffin
Considering the links between chronic pain and depression37 it is possible that stimulants may not only be used to self-manage pain, but to also help alleviate associated mood symptoms. While not significant in the multivariable analysis, in the bivariate analysis we saw a higher proportion of participants who reported moderate to severe depression among people who used stimulants to treat pain in the past year compared to those who used stimulants in the past year but not to treat pain. Previous studies have shown that prescription stimulants could have some efficacy treating depression, especially when prescribed as adjuvants to traditional antidepressants; however, results have been mixed.38–40 Our findings indicate that non-prescribed stimulants are used to treat pain among people with co-occurring depression. It is possible that stimulants are being used to self-manage chronic pain, depressive symptoms, or both among this group. The use of stimulants in self-management of depression and other mood symptoms deserves further exploration.
Sensitivity, specificity and predictive values of ICD-10 substance use codes in a cohort of substance use-related endocarditis patients
Published in The American Journal of Drug and Alcohol Abuse, 2022
Yael Campanile, Michael Silverman
A review of patient medical records was conducted to determine infective endocarditis status. We used hospital documents such as admission, discharge and consult notes as well as laboratory, radiologic, echocardiographic, and microbiologic data to confirm the infective endocarditis status. We defined infective endocarditis according to the modified Duke criteria for the diagnosis of Definite infective endocarditis. In our local institutions, questions about substance use and the types of drugs used are routinely asked and the responses are routinely recorded as part of general medical care. Substance use was assigned based on documentation in the medical record of self-reported recent or current injection drug use. Patients were categorized as using opioids, stimulants (Methamphetamine or Cocaine), or mixed substance, based on self-reported drug use within 3 months of presentation, as reported within clinical documentation, and informed by drug screening (available in 66% of cases). If urine drug screening demonstrated substances that the patient denied using, the urine drug screen was used to define drugs used. Opioids included hydromorphone (controlled and immediate release), morphine, fentanyl, heroin, and oxycodone. Stimulants included methamphetamine, cocaine, bupropion, and methylphenidate. Reported use of methadone or buprenorphine orally for opioid substitution therapy for previous opioid use was not categorized as opioid use for the purpose of analysis, as these drugs were not generally injected.
Medical students and stimulants; they have enough knowledge but they still use non prescribed stimulants
Published in Journal of Substance Use, 2022
Afsaneh Rezaei Kalat, Atiyeh Taghavi, Emran Askari, Seyyed Mostafa Parizadeh, Ali Jafarzadeh Esfehani, Zahra Rajaei, Reza Jafarzadeh Esfehani, Ali Talaei
Stimulant drugs are known for their role in the management of psychiatric disorders, especially attention deficit hyperactivity disorder (ADHD). Stimulants, including methylphenidate-based agents, are considered the first-line treatment for ADHD in children and adolescents (Faraone, 2018). Methylphenidate can improve attention primarily through increasing dopamine activity in the brain, especially in the cortex and striatum (Faraone, 2018). Despite the promising role of this drug in managing psychiatric disorders, the potential non-prescribed use or dependency related to methylphenidate has become a great concern (Faraone, 2018; Kollins et al., 2001). This concern is highlighted mainly in the youth, and especially students (Poulin, 2007). Although some countries use community guidelines to limit non-prescribed use of stimulants, there is still a growing concern regarding the use of such drugs by the students (Fond et al., 2016). A recent systematic review demonstrated that 5% to 35% of college students use non-prescribed stimulants within a year (Willens et al., 2008). While there could be many reasons behind the non-prescribed use of stimulants by students, the critical role of social media and friends as the primary source of providers has been previously highlighted in the literature (Emanuel et al., 2013; Habibzadeh et al., 2011).