Cocaine, Amphetamines, and
Other Behavioral Stimulants
Chapter 7
Tamyra Frazier & Sarah
Massamore
Comparison
Powerful psychostimulants
that markedly affect one’s
mental functioning and
behavior
They augment the synaptic
action of several
neurotransmitters (dopamine,
norepinephrine, and
serotonin)
Widely known as drugs of
abuse
What is Crack? What is ICE?
Crack is a streetname for a smokeable form
of potent, concentrated cocaine.
ICE is a streetname for a smokeable, freebase form of potent, concentrated
methamphetamine.
The three major actions of cocaine
It is potent local anesthetic
It is a vasoconstrictor, strongly
constricting blood vessels
It is a powerful psychostimulant with
strong reinforcing qualities
The effects of cocaine and a fetus:
Direct organ toxicity can involve the heart,
the CNS, the urinary system and the GI tract.
Increase blood pressure in the fetus which
leads to intracerebral hemorrhage, thickening
of the heart muscle and various vascular and
structural abnormalities
Destructive lesions on the brain which causes
neonatal neurological problems
The behavioral states observed in high-dose
amphetamine users:
Stereotypical behaviors include continual,
purposeless, repetitive acts, sudden outburst
of aggression and violence, paranoid
delusions and severe anorexia
The effects of amphetamines on
neurotransmission, neurotransmitters and the
CNS reward system.
Exert all their CNS effects by causing the
release of newly synthesized norepinephrine
and dopamine from presynaptic storage sites
in nerve terminals.
Why use amphetamine like drugs in treating
adults, children and adolescents with ADHD?
It is used to reduce aggressive behavior and
activities characteristic of ADHD in children
and in adults behavioral calming can also
occur.
What is meant by the phrase “Speed kills”?
It refers not only to a direct fatal effect of
single doses of amphetamines but also to the
deteriorating mental and physical condition
that occurs in the addicted user
What is Modafinil? How does is differ from
amphetamines and what are its potential uses?
It is a nonamphetamine psychostimulant
whose exact mechanism of psychostimulant
action remains unclear, but is unique. It may
potentiate excitatory glutamate
neurotransmission and inhibit the activity of
GABA neurons in the cerebral cortex and the
nucleus accumbens, altering the balance
between glutamate and GABA transmission.
Potential uses of Modafinil:
Cognitive improvement in patients with Alzheimer’s
disease
Use in treatment of ADHD
Potentiation of the action of anitdepressant drugs
Issues and Therapeutic Approaches to Cocaine
Dependency
Intensity of both the drug effect and the
intense behavior-reinforcing action of cocaine.
Pronounced tendency toward relapse, with
cocaine-related activities as a cue to an
increased craving for the drug.
Most cocaine addicts have a coexisting
disorder; involving drug dependencies and/or
psychiatric disorders (major depression,
anxiety disorder, bipolar disorder, borderline
personality disorder and/or antisocial
personality disorder.
Treatment Approaches to Cocaine Dependency:
Antiwithdrawal agents intended to restore or enhance
the dopaminergic tone of hypoactive limbic system
regions. Such agents might be beneficial to
ameliorate withdrawal depression.
Anticraving agents that block limbic dopaminergic
receptors may either reduce cue-induced craving or
blunt the euphoric effect of subsequently
administered cocaine.
Treatment of comorbid psychological disorders may
help reduce the drive that propels a person to selfmedicate with cocaine to ameliorate psychological
distress.
Treatment Approaches to ADHD
The management of treatment-resistant
youths.
The combination of drugs in ADHD
management.
The management of adults with ADHD and
comorbid substance abuse.
Treatment Approaches to ADHD
Stimulant Drugs are used primarily used and include
drugs such as methylphenidate, amphetamines, and
pemoline; other drugs such as buspirone (BuSpar)
and bupropion (Welbutrin) are used in refractory
cases.
Methyphenidates have a rapid onset and short
duration when compared to amphetamines such as
dextroamphetamine (Dexedrine) and amphetamine
mixture (Adderall).
Sometimes there are treatment alternative such as
antidepressants (Prozac, BuSpar and Welbutrin)
Carbamazepine (Tegretol), catecholamine agonists
(Clonidine) and guanfacine (Tenex) also are effective.