Stimulants and ADHD Flashcards
What are the uses of stimulants?
- Counteract lethargy and fatigue
- Reduce sleepiness/keep awake when necessary; treat narcolepsy
- Decrease appetite and promote weight loss
- Improve focus and concentrations at school/work
- Used off-label to treat depression
What are some examples of stimulants?
- Xanthines (purine derivative)
- Nicotine
- Amphetamines
- MDMA
- Cocaine
- NRIs & NDRIs
- Methylphenidate to treat ADHD
- Modafinil, Adrafinil, & Armodoafinil (drugs for narcolepsy)
- Yohimbine (alpha1, and alpha2 antagonist)
ADHD
People with ADHD show a persistent pattern of inattention with/or hyperactivity/impulsivity that interferes with functioning or development
What are some symptoms of inattention?
- Often fails to close attention to details or makes careless mistakes
- Often has trouble holding attention on tasks or play activities
- Often does not seem to listen when spoken directly
- Often does not follow through on instructions and fails to finish schoolwork
- Often has trouble organizing tasks and activities
- Often avoids, dislikes, or is reluctant to do tasks that require metnal effort over a long period of time
- Often loses things necessary for tasks and activities
- Is often easily distracted
- Is often forgetful in daily activities
What are the symptoms of hyperactivity and impulsivity?
- Often fidgets with or taps hands or feet, or squirms in seat
- Often leaves sat in situations when remaining seated is expected
- Often runs about or climbs in situations where it is not appropriate
- Is often “on the go” activiting as if “driven by a motor”
- Often talks excessively
- Often blurts out an answer before a question has been completed
- Often has trouble waiting his/her turn
- Often interrupts or intrudes on others
What are the diagnostic criteria of ADHD for children less than 17 years of age?
> = 6 symptoms of inattention and/or >= 6 symptoms of hyperactivity-impulsivity, for 6 months prior to assessment and inappropriate for development level
What are the diagnostic criteria of ADHD for adults and adolescents age 17+?
> = 5 symptoms of inattention and/or >=5 symptoms of hyperactivity-impulsivity, for 6 months prior to assessment and inappropriate for developmental level
What does the MRI and PET studies show in regards to neuroanatomical changes in ADHD?
DECREASE activation in prefrontal cortex, especially right side, and parts of the corpus callosum and basal ganglia
and lower levels of dopamine function in striatum and prefrontal cortex
What does the functional neuroimaging show in regards to neuroanatomical changes in ADHD?
DECREASED activation of medial prefrontal cortex
What is the correlation between motivational deficits and dopamine function in the nucleus accumbens?
The more D2/D3 and DAT present, the better the motivation score
What are the psychostimulants?
- Methylphenidate
- Amphetamine
Which antidepressants treat ADHD?
- Atomoxetine
- Bupropion
- Tricyclic antidepressants
What central alpha2-adrenergic agonists treat ADHD?
- Clonidine
- Guanfacine
What is the MOA of amphetamines?
- Indirect-acting sympathmimetic drugs that promote of endogenous bioamines including dopamine (DA) & norepinephrine
- Produce their effects by causing intracellular release from vesicles, thus reversing the action of biogenic amine transporters at the plasma membrane, resulting in transmitter release
- Enter the cell via DAT transporter
- Inside the cell amphetamine interferes with the vesicular monoamine transporter (vMAT)
- This depletes synaptic vesicles of DA and NE
- Levels of DA or NE increase in the cytoplasm causing reversal of the DAT direction and release of neurotransmitter into the synapse
Dextroamphetamine (Dexedrine, DextroStat)
- DEA schedule II
- Duration: about 5 hrs
- Equally effective as methylphenidate
- Used mostly for children intolerant to methylphenidate
