Psychostimulant drugs

The drug treatment center, which is located in Zaporozhye and the region, has many years of experience and experience in the fight against drug addiction at any stage and length of use . We are ready to provide qualified drug treatment assistance with a guarantee to those addicted to drugs :

• Opium
• Codeine
• Amphetamine
• Butyrate
• Substance abuse
• Tropicamide

• Heroin
• Desomorphine
• Cocaine
• Hashish
• Spice
• Crystalius

• Methadone
• Pervitina
• Mephedrone
• Marijuana
• Soleil
• Psilobicin

Opioid group of surfactants

• Heroin . A narcotic substance, gray in color with a brown or yellow tint, having a sharp, specific odor and bitter taste. It is taken by intravenous injection, dissolved in water.
• Raw opium . A brown cake the size of a tablet, sticky and viscous to the touch. It is made from an unripe poppy head.
• Poppy straw . A dried poppy stem soaked in a chemical solvent that causes euphoria. Causes serious deviations in a person’s mental state, provoking the development of schizophrenia or mental retardation.
• Morphine, codterpine and codeine . The main component of many analgesics, which, when taken regularly, causes addiction and withdrawal symptoms.
• Methadone . A drug of synthetic origin that is instantly addictive after the first dose.

“FARMIndex-Practik” issue 2 year 2001 pp. 19-41
CNS stimulants include drugs that can increase mental and physical performance, endurance, reaction speed, eliminate feelings of fatigue and drowsiness, increase attention span, memory ability and speed of information processing . The most unpleasant characteristics of this group are general fatigue of the body that occurs after the cessation of their influence, a decrease in motivation and performance, as well as a strong psychological dependence that arises relatively quickly. Among the mobilizing type stimulants, the following groups of drugs can be distinguished:

1. Adrenergic agonists of indirect or mixed action:

• phenylalkylamines: amphetamine (phenamine), methamphetamine (pervitin), centedrine and pyriditol;
• piperidine derivatives: meridyl;
• sydnonimine derivatives: mesocarb (sydnocarb), sydnophen;
• purine derivatives: caffeine (caffeine sodium benzoate).

2. Analeptics:

• · acting primarily on the respiratory and vasomotor centers: bemegride, camphor, niketamide (cordiamin), etimizol, lobeline;
• · acting primarily on the spinal cord: strychnine, securinine, echinopsin.

Phenylalkylamines are the closest synthetic analogues of the world-famous psychostimulant - cocaine, but differ from it in less euphoria and a stronger stimulating effect. They are capable of inducing extraordinary elation, a desire for activity, eliminate the feeling of fatigue, create a feeling of vigor, clarity of mind and ease of movement, quick intelligence, confidence in one’s strengths and abilities. The effect of phenylalkylamines is accompanied by an elevated mood. The use of amphetamine began during World War II as a means to relieve fatigue, combat sleep, and increase alertness; then phenylalkylamines entered psychotherapeutic practice and gained mass popularity. The mechanism of action of phenylalkylamines is the activation of adrenergic transmission of nerve impulses at all levels of the central nervous system and in the executive organs due to:

• · displacement of norepinephrine and dopamine into the synaptic cleft from the easily mobilized pool of presynaptic endings;
• · increased release of adrenaline from chromaffin cells of the adrenal medulla into the blood;
• · inhibition of the reverse neuronal uptake of catecholamines from the synaptic cleft;
• · reversible competitive inhibition of MAO.

Phenylalkylamines easily penetrate the BBB and are not inactivated by COMT and MAO.
They implement the sympatho-adrenal mechanism of urgent adaptation of the body to emergency conditions. Under conditions of prolonged tension of the adrenergic system, under severe stress, debilitating loads, and in a state of fatigue, the use of these drugs can lead to depletion of the catecholamine depot and disruption of adaptation. Phenylalkylamines have psychostimulating, actoprotective, anorexigenic and hypertensive effects. Drugs in this group are characterized by accelerated metabolism, activation of lipolysis, increased body temperature and oxygen consumption, and decreased resistance to hypoxia and hyperthermia. During physical activity, lactate increases excessively, which indicates inadequate expenditure of energy resources. Phenylalkylamines suppress appetite, cause constriction of blood vessels and increase blood pressure. Dry mouth, dilated pupils, and rapid pulse are observed. Breathing deepens and ventilation of the lungs increases. Methamphetamine has a more pronounced effect on peripheral vessels. Phenylalkylamines are used in very small doses in the United States to treat sexual disorders. Methamphetamine causes a sharp increase in libido and sexual potency, although amphetamine has little activity. Table 1. Main advantages and disadvantages of phenylalkylamines

Phenylalkylamines are indicated:

• · for a temporary rapid increase in mental performance (operator activity) in emergency conditions;
• · for a one-time increase in physical endurance in extreme conditions (rescue operations);
• · to weaken the side psychosedative effect of drugs that depress the central nervous system;
• · for the treatment of enuresis, adynamia, depression, withdrawal syndrome in chronic alcoholism.

In psychoneurological practice, amphetamine is used to a limited extent in the treatment of narcolepsy, the consequences of encephalitis and other diseases accompanied by drowsiness, lethargy, apathy, and asthenia.
For depression, the drug is ineffective and inferior to antidepressants. The following drug interactions are possible for amphetamine:

·

• enhancing pain relief and reducing the sedative effect of narcotic analgesics;
• · weakening of the peripheral sympathomimetic effects of amphetamine under the influence of tricyclic depressants due to the blockade of amphetamine entry into adrenergic axons, as well as an increase in the central stimulating effect of amphetamine due to a decrease in its inactivation in the liver;
• · it is possible to potentiate the euphoric effect when used in combination with barbiturates, which increases the likelihood of developing drug dependence;
• Lithium preparations can reduce the psychostimulant and anorexigenic effects of amphetamine;
• · neuroleptic drugs also reduce the psychostimulant and anorexigenic effect of amphetamine by blocking dopamine receptors and can be used for amphetamine poisoning;
• amphetamine reduces the antipsychotic effect of phenothiazine derivatives;
• · amphetamine increases the body's endurance to the action of ethyl alcohol (although the inhibition of motor activity remains);
• · under the influence of amphetamine, the hypotensive effect of clonidine decreases; Amphetamine enhances the stimulating effect of midantan on the central nervous system.

Side effects
include tachycardia, hypertension, arrhythmias, addiction, drug dependence, exacerbation of anxiety, tension, delirium, hallucinations, and sleep disturbances. With repeated use, depletion of the nervous system, disruption of the regulation of cardiovascular functions, and metabolic disorders are possible. Contraindications to the use of phenylalkylamines are severe cardiovascular diseases, diabetes mellitus, obesity, and productive psychopathological symptoms. Due to a variety of side effects, the main thing being the possibility of developing drug dependence, phenylalkylamines find limited use in medical practice. At the same time, the number of drug and substance abuse patients using various phenylalkylamine derivatives is constantly growing. The use of mesocarb (sydnocarb) causes a psychostimulating effect more slowly than that of amphetamine, and it is not accompanied by euphoria, speech and motor disinhibition, and does not cause such a deep depletion of the energy reserve of nerve cells. According to the mechanism of action, mesocarb is also somewhat different from amphetamine, since it stimulates mainly the noradrenergic systems of the brain, causing the release of norepinephrine from stable depots.

Table 2.
Main advantages and disadvantages of mesocarb

Unlike amphetamine, mesocarb has less pronounced stimulation with a single dose, and its gradual increase is observed from dose to dose. Sidnocarb is usually well tolerated, does not cause dependence or addiction, and its use may increase blood pressure, decrease appetite, and also hyperstimulation phenomena. Mesocarb is used for various types of asthenic conditions, after fatigue, central nervous system injuries, infections and intoxications. It is effective for sluggish schizophrenia with a predominance of asthenic disorders, withdrawal syndrome in chronic alcoholism, developmental delay in children as a result of organic lesions of the central nervous system with adynamia. Mesocarb is an effective remedy that relieves asthenic phenomena associated with the use of antipsychotic drugs and tranquilizers. Sidnofen is close in structure to mesocarb, but stimulates the central nervous system weaker and has pronounced antidepressant activity (due to a reversible inhibitory effect on MAO activity), therefore it is used for the treatment of asthenodepressive conditions. Meridil is similar to mesocarb, but is less active. Increases activity, associative abilities, has an analeptic effect.

Caffeine

is a mild psychostimulant, the effects of which are realized by inhibiting the activity of phosphodiesterase and, therefore, prolonging the life of secondary intracellular mediators, mostly cAMP and somewhat less cGMP in the central nervous system, heart, smooth muscle organs, adipose tissue, and skeletal muscles. The effect of caffeine has a number of features: it does not excite adrenergic transmission in all synapses, but enhances and prolongs the work of those neurons that are currently involved in ongoing physiological reactions and in which cyclic nucleotides are synthesized in response to the action of their mediators. There is information about the antagonism of xanthines towards endogenous purines: adenosine, inosine, hypoxanthine, which are ligands of inhibitory benzodiazepine receptors. Coffee contains substances that are antagonists of endorphins and enkephalins. Caffeine acts only on neurons that can respond to neurotransmitters by producing cyclic nucleotides. These neurons are sensitive to adrenaline, dopamine, acetylcholine, neuropeptides, and only a few neurons are sensitive to serotonin and norepinephrine.

Under the influence of caffeine the following are realized:

• · stabilization of dopaminergic transmission - psychostimulating effect;
• · stabilization of b-adrenergic transmission in the hypothalamus and medulla oblongata - increased tone of the vasomotor center;
• · stabilization of cholinergic synapses of the cortex - activation of cortical functions;
• · stabilization of cholinergic synapses of the medulla oblongata - stimulation of the respiratory center;
• · stabilization of noradrenergic transmission - increased physical endurance.

Caffeine has complex effects on the cardiovascular system.
Due to the activation of the sympathetic influence on the heart, contractility and conductivity are increased (in healthy people, when taken in small doses, the frequency of contractions may slow down due to excitation of the vagus nerve nuclei; in large doses, tachycardia may occur due to peripheral influences). Caffeine has a direct antispasmodic effect on the vascular wall in the vessels of the brain, heart, kidneys, skeletal muscles, skin, but not limbs! (stabilization of cAMP, activation of the sodium pump and hyperpolarization of membranes), increases venous tone. Caffeine increases the secretion of digestive glands, diuresis (reduces tubular reabsorption of metabolites), increases basal metabolism, glycogenolysis, lipolysis. The drug increases the level of circulating fatty acids, which promotes their oxidation and utilization. However, caffeine does not suppress appetite, but, on the contrary, stimulates it. In addition, it increases the secretion of gastric juice so that drinking caffeine without food can lead to gastritis and even peptic ulcers. Caffeine is indicated:

• · to improve mental and physical performance;
• · for emergency care for hypotension of various origins (trauma, infection, intoxication, overdose of ganglion blockers, sympatho- and adrenergic agents, deficiency of circulating blood volume);
• · with spasms of cerebral vessels;
• · in mild forms of bronchial obstruction as a bronchodilator.

The following side effects are characteristic of caffeine: increased excitability, cardiac arrhythmias, chest pain, insomnia, tachycardia, with long-term use - myocarditis, trophic disorders in the limbs, hypertension, caffeineism.
Acute caffeine poisoning produces early symptoms of anorexia, tremors and restlessness. Nausea, tachycardia, hypertension and confusion then appear. Severe intoxication can cause delirium, seizures, supraventricular and ventricular tachyarrhythmias, hypokalemia and hyperglycemia. Chronic use of high doses of caffeine can lead to nervousness, irritability, anger, persistent tremors, muscle twitching, insomnia and hyperreflexia. Contraindications to the use of the drug

states of excitement, insomnia, hypertension, atherosclerosis, glaucoma. Caffeine also has various types of drug interactions. The drug weakens the effect of central nervous system depressants, so it is possible to combine caffeine with histamine blockers, antiepileptic drugs, and tranquilizers to prevent central nervous system depression. Caffeine reduces the depression of the central nervous system caused by ethyl alcohol, but does not eliminate the impairment of psychomotor reactions (coordination of movements). Caffeine and codeine preparations are used in combination for headaches. Caffeine can enhance the analgesic effect of acetylsalicylic acid and ibuprofen, and enhances the effect of ergotamine in the treatment of migraines. In combination with midantan, it is possible to enhance the stimulating effect on the central nervous system. When taken simultaneously with cimetidine, the side effects of caffeine are likely to increase due to a decrease in its inactivation in the liver. Oral contraceptives also slow down the inactivation of caffeine in the liver, and symptoms of overdose may occur. When taken together with theophylline, the total clearance of theophylline decreases almost 2 times. If it is necessary to use drugs together, the dose of theophylline should be reduced.

Analeptics

(from the Greek analeptikos - restorative, strengthening) - a group of medicines that help restore consciousness in a patient who is in a state of fainting or coma. Among analeptic drugs, there is a group of drugs that primarily stimulate the centers of the medulla oblongata: vasomotor and respiratory. In large doses, they can stimulate the motor areas of the brain and cause seizures. In therapeutic doses they are usually used for weakening of vascular tone, collapse, respiratory depression, circulatory disorders in infectious diseases, in the postoperative period, poisoning with sleeping pills and narcotic drugs. Previously, a special subgroup of respiratory analeptics (lobeline) was identified from this group, which have a reflex stimulating effect on the respiratory center. Currently, these drugs have limited use.

Table 3. Comparative characteristics of analeptics acting on the respiratory and vasomotor centers of the brain

One of the safest analeptics is cordiamine

.
Its structure is similar to nicotinamide and has a weak antipellagritic effect. Cordiamine stimulates the central nervous system by direct action on the respiratory center and reflexively through the chemoreceptors of the carotid sinus. In small doses, the drug has no effect on the cardiovascular system. Toxic doses can increase blood pressure, cause tachycardia, vomiting, cough, arrhythmias, muscle rigidity, and tonic and clonic seizures. Etimizole,
in addition to stimulating the respiratory center, induces the secretion of corticoliberin in the hypothalamus, which leads to an increase in the level of glucocorticoids in the blood; inhibits phosphodiesterase, which promotes the accumulation of intracellular cAMP, enhances glycogenolysis, and activates metabolic processes in the central nervous system and muscle tissue. Inhibits the cerebral cortex, eliminates anxiety. Due to the stimulation of the adrenocorticotropic function of the pituitary gland, etimizol can be used as an anti-inflammatory agent for arthritis. Analeptics that primarily increase reflex excitability include: strychnine (an alkaloid from the seeds of the African chilibuha vine), securinine (an alkaloid from the herb of the Far Eastern shrub securinega) and echinopsin (obtained from the seeds of the common echinops). According to the mechanism of action, they are direct antagonists of the inhibitory mediator glycine, blocking receptors of brain neurons sensitive to it. Blockade of inhibitory influences leads to an increase in the flow of impulses in the afferent pathways of activation of reflex reactions. The drugs stimulate the sense organs, excite the vasomotor and respiratory centers, tone the skeletal muscles, and are indicated for paresis, paralysis, fatigue, and functional disorders of the visual apparatus.

The main effects of drugs in this group are:

• · increased muscle tone, acceleration and strengthening of motor reactions;
• · improving the functions of the pelvic organs (for paralysis and paresis, after injuries, strokes, polio);
• · increased visual and hearing acuity after intoxication, injury;
• · increase in general tone, activation of metabolic processes, functions of the endocrine glands;
• · slight increase in blood pressure and heart function.

The main indications for use in this group
are: paresis, paralysis, fatigue, asthenic conditions, functional disorders of the visual apparatus. Previously, strychnine was used to treat acute barbiturate poisoning; now the main drug used in this case is bemegride.

Securinin

less active compared to strychnine, but also much less toxic, it is also used for hypo- and asthenic forms of neurasthenia, for sexual impotence due to functional nervous disorders. An overdose of drugs causes tension in the masticatory and occipital muscles, difficulty breathing, swallowing, and attacks of clonic-tonic convulsions. They are contraindicated in case of increased convulsive readiness, bronchial asthma, thyrotoxicosis, coronary artery disease, arterial hypertension, atherosclerosis, hepatitis, glomerulonephritis. Due to their high toxicity, reflex-type analeptics are used extremely rarely and only in hospital settings.

Signs of intoxication from taking an opioid drug

• A narrow pupil of the eye that does not respond to light.
• Deterioration of vision.
• High level of sleepiness.
• Inhibited reactions.
• Pale skin.
• Monotony when speaking or moving.

Opioid withdrawal manifests itself in a runny nose and body aches; the addict's bones become twisted and his muscles ache. Depression and neurosis may develop, as well as severe vomiting and excessive sweating. At the first symptoms of drug use of this group or signs of withdrawal, you must contact a narcologist for qualified help in Zaporozhye.

Cannabinoids

• Marijuana . “Weed”, “sham”, “anasha”, “potion”, this is how experienced drug addicts also call it. The green dried part of hemp, similar in appearance to tobacco. Consumed as a smoke or added to food.
• Hashish . A plastic mixture of resins, pollen and the upper part of the cannabis plant. Used in the form of smoke, mixing the substance with tobacco using special devices.

Cannabinoids are illegal surfactants and are prohibited by the legislation of our country.

Signs of intoxication from cannabinoid drugs

• Redness of the eyes and dilated pupils.
• Rapid speech and increased talkativeness.
• Excessive and unreasonable gaiety.
• Increased appetite and thirst.

An overdose of cannabinoids may result in hallucinations, unreasonable fear and paranoia, as well as behavioral inhibition, apathy and aggression towards others. Cannabinoids cause a change in the perception of the outside world, and when used systematically, they destroy brain cells, provoking dementia in the addict.

Psychostimulants

• Ephedrine. The prepared solution is pinkish in color and has a pleasant odor; it is administered intravenously to addicts.
• Cocaine . A drug of plant origin that causes persistent addiction to its use. The powder is usually snorted, which gives the addict a feeling of numbness and numbness throughout the body.
• Amphetamine. In most cases, they are administered intravenously, and the drug is obtained from medications containing ephedrine.
• Ecstasy . They are distributed in the form of multi-colored tablets that are taken orally. They provide the addict with temporary energy and provoke pleasant hallucinations.
• Crack. Drug addicts nicknamed him (“the stone”). It is purchased in the form of fragile plates of an evaporated solution of cocaine with baking soda. It is used for smoking and leads to the development of rapid physical and psychological dependence.

Psychostimulants are a type of drugs that affect the human nervous system, causing it to become overexcited, which leads to depletion of the body and internal organs and leads to various diseases.

Classification of psychostimulants

Psychostimulants are classified primarily by their mechanism of action and chemical structure:

• Centrally acting sympathomimetics: methylphenidate, atomoxetine, armodafinil
• Methylxanthine derivatives: caffeine sodium benzoate, caffeine citrate
• Sydnonimine derivatives: mesocarb

In addition, many psychoactive substances can have a psychostimulating effect. Such drugs include analeptics (awakening agents) in low doses, nootropics (improving memory and mental processes), some antidepressants (citalopram, escitalopram, sertraline, fluoxetine, venlafaxine).

Alcohol in low doses has a mild psychostimulating effect.

Symptoms of addiction to sedatives

All drugs are medicinal and are prescribed for medicinal purposes. Abuse of them can lead to addiction and the development of serious complications:

• Dysfunction of the brain and its parts.
• Mental dysfunction.
• Diseases of the liver, kidneys, heart and reproductive system.

Intoxication from sedatives is reminiscent of alcohol. Refusal to systematically take sedatives leads to withdrawal syndrome , which is characterized by aggression, anger, irritability and suicidality.

pharmachologic effect

Psychostimulants have a stimulating effect on brain functions, improve the transmission of impulses between neurons, which manifests itself in increased mental and motor activity.

Drugs from the group of psychostimulants increase mental performance, increase attention, and reduce the number of errors. In addition, psychostimulants increase the speed of all reflexes, physical endurance, and also reduce fatigue, hunger, drowsiness and the need for sleep and rest.

In high doses, psychostimulants have an analeptic (awakening, revitalizing) effect by stimulating vital centers in the brain - respiratory and vasomotor.

Group of volatile drugs or inhalants

• Glue
• Solvent
• Petrol
• Dyes
• Hair and nail polish
• Mosquito sprays

They are not recognized as drugs, but lead to a feeling of euphoria when ingested in large quantities. Those addicted to inhalants are called substance abusers, who inhale vapors of volatile drugs using a plastic bag over which they breathe rhythmically.

Severe intoxication with chemicals leads to poisoning of the blood and body, which leads to the failure of the normal functioning of internal organs and systems. Attachment to this type of activity entails a premature, painful death at a young age.

Cost of services:

Indications for use

Psychostimulants are used for general weakness, increased fatigue (asthenia), and excessive daytime sleepiness (narcolepsy).

Psychostimulants are also used for poisoning with alcohol and other substances that depress consciousness (hypnotics, sedatives), and various infections.

Drugs with a psychostimulant effect are additionally used to treat bedwetting in children and adults (enuresis) - by making sleep more sensitive, they enable the patient to wake up in time when there is an urge to urinate.

Certain psychostimulants (methylphenidate, atomoxetine, armodafinil) are used in children and adolescents with attention deficit hyperactivity disorder (when a child cannot concentrate on one activity for a long time - attention deficit, and is excessively mobile, cannot sit still even for a short time - hyperactivity).

In healthy people, psychostimulants (most often caffeine-based drugs) are used to improve performance, to treat fatigue, to eliminate morning drowsiness, and to reduce blood pressure (hypotension).