Chapter 39: Central Nervous System Stimulants and Attention-Deficit / Hyperactivity Disorder

Question 1

What are the most common adverse effects of amphetamines?

Answer 1

CNS stimulation (insomnia, restlessness), weight loss (appetite suppression), increased heart rate/BP, and risk of psychosis.

Question 2

What are signs of acute amphetamine toxicity, and how is it managed?

Answer 2

Toxicity symptoms include confusion, hallucinations, hypertension, dysrhythmias, seizures. Manage with antipsychotics, alpha-blockers (e.g., phentolamine), diazepam for seizures, and acidify urine to speed excretion.

Question 3

What are the risks of tolerance, dependence, and abuse with amphetamines?

Answer 3

Tolerance develops to mood, appetite, and CV effects. Abrupt withdrawal can cause abstinence syndrome. Amphetamines have high abuse potential due to euphoria.

Question 4

What are the primary drug treatments for ADHD?

Answer 4

• CNS stimulants (most effective): Methylphenidate, Dexmethylphenidate, Adderall, Vyvanse, Desoxyn.
• Non-stimulants: Atomoxetine, Guanfacine, Clonidine.
• Second-line: TCAs (Desipramine, Imipramine), Bupropion.

Question 5

Why are CNS stimulants like amphetamines and methylphenidate helpful in ADHD?

Answer 5

They increase norepinephrine and dopamine in the brain, improving attention and reducing hyperactivity and impulsiveness.