Psychiatry and social medicine
Jagdish M. Gupta, John Beveridge in MCQs in Paediatrics, 2020
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.
Cognition Enhancers
Sahab Uddin, Rashid Mamunur in Advances in Neuropharmacology, 2020
Cognitive enhancement refers to the improvements in emotional, motivational and cognitive. The drugs which enhance the cognition are usually called “cognition enhancers,” “memory enhancing drugs,” “nootropic drugs,” and “smart drugs” (Giurgea, 1972). CE are the drugs that affect the cognitive functions positively like vigilance, learning, attention, executive functions, and memory. Psychostimulants are the category of drugs which are extensively used as a cognitive enhancer; yet, nootropic drugs have particular neuroprotective effect without producing stimulation or sedation. Cognitive enhancement is a prevalent subject that attracts attention both from the scientists and general public (Eickenhorst et al., 2012, Heinz et al., 2012). The stimulants which are prescribed like amphetamines and methylphenidate (MPH) are regularly used as a smart drug in college campuses, wherein 5–35% of students have reported of consuming them for cognitive enhancement (Wilens et al., 2008). Though, the use of MPH is just not limited to students, but also surgeons because of its use like wakefulness and high cognitive performance (Franke et al., 2013). The placebo-controlled trial substantiates the advantages of some neuroenhancers, but claims are not tested formally. Additionally, the concerns include toxicity, adverse consequences, and addiction as these drugs are consumed for a long term and without any medical follow-ups.
Attention and Executive Function Disorders
Christopher J. Nicholls in Neurodevelopmental Disorders in Children and Adolescents, 2018
Medication treatment for ADHD can also take a different approach, such as the use of non-stimulant medications. The norepinephrine reuptake inhibitor atomoxetine (Strattera) is increasingly being utilized in the management of ADHD. Likewise, comorbid conditions may require a combination of medications such as a stimulant combined with guanfacine (Intuniv) or clonidine. The take-home message is that, for many individuals, the self-regulatory difficulties which we describe as ADHD reflect underlying brain circuitries and a lack of fine tuning of nerve circuits. Medication treatment for ADHD is, according to current evidence, the most effective means of treating this biological dysfunction. Medication is not, however, a “one-size-fits-all” process, and clinicians will benefit from building a relationship with a physician expert in understanding these issues. It is gratifying to have a follow-up appointment with a family who, following a recommendation to speak to their physician about a trial of medications, comes back with smiles and says, “He’s a new child!”
What value do norepinephrine/dopamine dual reuptake inhibitors have to the current treatment of adult attention deficit hyperactivity disorder (ADHD) treatment armamentarium?
Published in Expert Opinion on Pharmacotherapy, 2022
Giulio Perugi, Ugo De Rosa, Margherita Barbuti
In youths and adults with ADHD, currently approved pharmacological agents act by increasing catecholaminergic transmission and include stimulant and non-stimulant medications [6]. Psychostimulant agents (i.e. methylphenidate and amphetamines) are the mainstay of ADHD treatment both in pediatric and adult populations, and act as norepinephrine/dopamine dual reuptake inhibitors. On the other hand, most non-stimulant compounds (i.e. atomoxetine, viloxazine) target mostly the noradrenergic system. Nonetheless, atomoxetine also seems to indirectly increase dopaminergic tone in the prefrontal cortex in animal models [7], while viloxazine, which has recently been approved for the treatment of ADHD in children and adolescents, acts as a serotonin and norepinephrine modulating medication [8]. Third-line drugs include alpha 2A-adrenergic receptor agonists (guanfacine, clonidine), bupropion, modafinil, and tricyclic antidepressant (e.g. desipramine, nortriptyline).
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).
The mutagenic effect of psychostimulant modafinil in Wistar rats in vivo
Published in Drug and Chemical Toxicology, 2020
Lívia Maria de Castro Penna, Elisângela Düsman, Veronica Elisa Pimenta Vicentini
An example of psychostimulant is Modafinil, a central nervous system stimulant which increases wakefulness. Modafinil acts by stimulation of histamine norepinephrine, serotonin, dopamine, and orexin systems on the brain, but the precise mechanism of action remains unclear (Novotna et al.2014). It was approved by the American Food and Drug Administration (FDA) agency in 1988, but was only authorized by the National Health Surveillance Agency (ANVISA) in Brazil in September of 2007. This medicine has mild side-effects on the central nervous system, on the cardio-vascular system, on adverse gastrointestinal events, headache, upper respiratory tract infection, nausea, vomiting, nervousness, anxiety, insomnia, aggressive behavior, and even shows a small risk of abuse and dependence (Mitler et al.2000).
Related Knowledge Centers
- Amphetamine
- Central Nervous System
- Lisdexamfetamine
- Sympathomimetic Drug
- Methylphenidate
- Drug
- Prescription Drug
- Performance-Enhancing Substance
- Recreational Drug Use
- Comedown