Misuse, Recreational Use, and Addiction in Relation to Prescription Medicines
Ornella Corazza, Andres Roman-Urrestarazu in Handbook of Novel Psychoactive Substances, 2018
Amphetamine derivatives are a wide range of medications whose chemical structure is similar to that of amphetamine, a potent CNS stimulant (Hernandez & Nelson, 2010). Overall, all the medications of this class act as ‘stimulants’, i.e., they are able to enhance alertness by increasing circulating catecholamines, particularly dopamine, norepinephrine, and, at higher doses, serotonin (Hernandez & Nelson, 2010); amphetamine enantiomers (dextroamphetamine and levoamphetamine), both ingredients of commonly prescribed medications, bind to the same biological targets although with different binding affinities and therefore may have different degrees of CNS stimulation (Lewin, Miller, & Gilmour, 2011; R. C. Smith & Davis, 1977). Methylphenidate is a CNS stimulant of the phenethylamine and piperidine classes; its proposed mechanism of action is the release and increase of CNS dopamine, secondary to its effect on the dopamine transport mechanism, which results in an increased amount of postsynaptic dopamine (Morton & Stockton, 2000). Both classes of medications (amphetamines and methylphenidate) are mainly used for the treatment of attention deficit/hyperactivity disorder (ADHD) and have a strong potential of misuse (Hernandez & Nelson, 2010; Morton & Stockton, 2000).
Clinical Psychopharmacology of Amphetamine and Related Compounds
John Caldwell, S. Joseph Mulé in Amphetamines and Related Stimulants: Chemical, Biological, Clinical, and Sociological Aspects, 2019
There are a number of adverse effects, the most important of which is impairment of growth, which has been reported to occur in up to three quarters of the children treated with amphetamine.93 Whether or not such effects on growth are related in any way to the action of amphetamine on GH remains to be determined. Levoamphetamine is as effective as dextroamphetamine but is just as likely to stunt growth.94 Among other frequently reported effects are insomnia and tachycardia, and a few cases of amphetamine psychosis have occurred. Methylphenidate is less likely than dextroamphetamine to cause such unwanted effects and is therefore to be preferred.
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
Reporting to the MDHHS database is mandatory. The ME determines, using post-mortem confirmatory toxicology testing, clinical information, patient history, and scene investigation to determine contributing factors to the cause of death. The MDHHS data do not contain autopsy information beyond what is captured in the underlying and related causes of death. We performed the MDHHS database query on a timeline spanning between February 25, 2020 and March 27, 2020. We recorded manner of death (i.e., intentional, unintentional, other, undetermined) in each MDHHS case; a distinction being that “intentional” was defined as death resulting from “self-harm” in contrast to “unintentional”, involving unanticipated fatal consequences. Psychostimulants included in MDHHS reports were methamphetamine, 3,4-methylenedioxy-methamphetamine (MDMA), dextroamphetamine, levoamphetamine, caffeine, and methylphenidate (Figure 1). Based on how MDHHS Vital Statistics are collected and aggregated, codified by International Classification of Disease – Tenth Revision (ICD-10) diagnoses, we were unable to identify which type of psychostimulant(s) were a contributing cause of death or perform separate analyses by substance.
A randomized, double-blind, 3-way crossover, analog classroom study of SHP465 mixed amphetamine salts extended-release in adolescents with ADHD
Published in Postgraduate Medicine, 2019
Sharon Wigal, Frank Lopez, Glen Frick, Brian Yan, Brigitte Robertson, Manisha Madhoo
SHP465 mixed amphetamine salts (SHP465 MAS) extended-release is a once-daily, single-entity MAS product for oral administration approved in the United States for the treatment of ADHD in patients 13 years and older [8]. It contains equal amounts (by weight) of four salts: dextroamphetamine sulfate, amphetamine sulfate, dextroamphetamine saccharate, and amphetamine aspartate monohydrate. This results in a 3:1 mixture of dextro- to levoamphetamine base equivalent. Each capsule contains three types of drug-releasing beads, an immediate-release bead and two different types of delayed-release beads. The efficacy and tolerability of SHP465 MAS in individuals with ADHD has been demonstrated in four phase three efficacy studies: three conducted in adults [9–11] and one in children and adolescents [12]. Across all short-term efficacy studies, dose-optimized and fixed-dose SHP465 MAS met the primary efficacy endpoint of significant reductions in ADHD Rating Scale (ADHD-RS) total score from baseline versus placebo [9–12]. SHP465 MAS has also been shown to have a safety and tolerability profile consistent with other long-acting stimulants [13–15].
Effects of SHP465 mixed amphetamine salts in adults with ADHD in a simulated adult workplace environment
Published in Postgraduate Medicine, 2018
Timothy Wigal, Ann Childress, Glen Frick, Brian Yan, Sharon Wigal, Manisha Madhoo
SHP465 mixed amphetamine salts (SHP465 MAS) extended-release is a once-daily, single-entity MAS product for oral administration approved in the USA for the treatment of ADHD in patients 13 years and older. It contains equal amounts (by weight) of four salts: dextroamphetamine sulfate, amphetamine sulfate, dextroamphetamine saccharate and amphetamine aspartate monohydrate. This results in a 3:1 mixture of dextro- to levoamphetamine base equivalent. Each capsule contains 3 types of drug-releasing beads, an immediate-release bead and two different types of delayed-release beads.