“If addiction is judged by how long a dumb animal will sit pressing a lever to get a "fix" of something, to
its own detriment, then I would conclude that net news is far more addictive than cocaine” Rob Stampfli
Fact Sheet on CNS Stimulants
Physiological Complication in
Psychopharmacology
Missy Beckwith
2011
Fact Sheet on CNS Stimulants.
What are Central Nervous System (CNS) Stimulants ?
Central nervous system (CNS) stimulants are medicines that speed up physical and
mental processes. (1) This includes the two most frequently-used drugs on the planet,
caffeine and nicotine. (2) Amphetamines, methamphetamine, cocaine and methylphenidate
(Ritalin) are all stimulants. (6) As the name suggests, stimulants increase alertness, attention,
and energy, as well as elevate blood pressure, heart rate, and respiration. Stimulants historically
were used to treat asthma and other respiratory problems, obesity, neurological disorders, and a
variety of other ailments. But as their potential for abuse and addiction became apparent, the
medical use of stimulants began to wane. Now, stimulants are prescribed to treat only a few
health conditions, including ADHD, narcolepsy, and occasionally depression—in those who
have not responded to other treatments. (3)
All stimulant drugs cause an increase in general behavioral activity. When taken short-term (one
or two weeks), stimulant drugs cause states of euphoria, optimism, and general feelings of wellbeing. Initial feelings of anorexia are frequent, a quality that leads to their use/abuse in weight
loss products. Insomnia is also frequent. These responses indicate that the part of the brain which
controls these functions, the hypothalamus, is strongly affected by these drugs and that the
dopamine transmitter system is primarily involved in many of these effects.
Other effects are:
 decreased feelings of depression
 increased thoughts and associations
 increased talkativeness
 increased blood pressure
 anxiety
 irritability
 decreased fatigue (2)
What are names of prescription, OTC, common and illicit CNS
Stimulants?
Examples include cocaine, methamphetamine, amphetamines, methylphenidate (Ritalin),
nicotine, caffeine, and MDMA (3,4-methylenedioxymethamphetamine), better known as
“Ecstasy” (12) caffeine, nicotine, over the counter cold medicines, chocolate, diet pills, like
ephedrine, or ma huang, and the class of drugs known as amphetamines- both legally prescribed
and illegal. (18)
Cocaine comes in two forms. Powder cocaine is a hydrochloride salt, made from the leaf of the
coca plant. “Crack” is a smokeable form of cocaine that is processed with ammonia or baking
soda and water, and heated to remove the hydrochloride. (12) Khat is a flowering evergreen
shrub that is abused for its stimulant-like effect. Khat has two active ingredients, cathine
and cathinone. (17) Synthetic stimulants that are marketed as “bath salts” are often found in a
number of retail products. These synthetic stimulants are chemicals. The chemicals are synthetic
derivatives of cathinone, a central nervous system
stimulant, which is an active chemical found naturally in the khat plant. Mephedrone and MDPV
(3-4 methylenedioxypyrovalerone) are two of the designer cathinones most commonly found in
these “bath salt” products. Many of these products are sold over the Internet, in convenience
stores, and in “head shops.”(17)
What are street names for various CNS Stimulants?
Cocaine is generally
sold on the street as a fine,
white, crystalline powder,
known as “coke,” “C,“
“snow,” “flake,“ “blow,”
“bump,“ “candy,“ “Charlie,”
“rock,” Soda Cot, and “toot.”
“Crack,” the street name for
the smokeable form of cocaine, got its name from the crackling sound made when it’s smoked. A
“speedball” is cocaine or crack combined with heroin, or crack and heroin smoked together.
Methamphetamine is commonly known as “speed,” “meth,” “chalk,” and “tina.” Ice, Crystal,
Crank, Tweak, Uppers, Black Beauties, Glass, Bikers Coffee, Methlies Quick, Poor Man's
Cocaine, Chicken Feed, Shabu, Crystal Meth, Stove Top, Trash, Go-Fast, Yaba, and Yellow
Bam, “glass,” “fire,” and “go fast.” (15)
Street names for amphetamines include “speed,” “bennies,” “black beauties,” “crosses,”
“hearts,” “LA turnaround,” “truck drivers,” and “uppers.”
Khat : Abyssinian Tea, African Salad, Catha, Chat, Kat, and Oat. (17)
"Bath Salt": Bilss, Blue Silk, Cloud Nine, Drone, Energy-1, Ivory Wave, Lunar Wave, Meow
Meow, Ocean Burst, Pure Ivory, Purple Wave, Red Dove, Snow Leopard, Stardust, Vanilla Sky,
White Dove, White Knight, White Lightening. (17)
Street names for methylphenidate include “rits,” “vitamin R,” and “west coast.” (12)
Stimulants
Type
• Dextroamphetamine
(Dexedrine and Adderall) •
Methylphenidate (Ritalin
and Concerta)
Conditions They Treat
• ADHD • Narcolepsy
(sleep disorder) •
Depression
Street Names
Skippy, the smart drug,
vitamin r, bennies, black
beauties, roses, hearts,
speed, or uppers
What are the therapeutic uses of prescription Stimulants?
Stimulants help people with attention-deficit hyperactivity disorder (ADHD) focus their
attention. (10) Methamphetamine hydrochloride has been marketed as a prescription drug for
quite some time. The primary use of the drug is for the treatment of Attention Deficit Disorder
(ADD) with Hyperactivity and for the treatment of Exogenous Obesity. (13) Some
psychostimulants have been found to have uses that are not typical for other drugs in the same
class. Although bupropion is a phenylalkylamine, the structural dissimilarity with amphetamine
is significant enough to produce considerably different physiologic effects. Bupropion is an
example of a weak psychostimulant that has found use as an antidepressant (Wellbutrin®) and is
also marketed as a smoking cessation aid (Zyban®). (14) Methamphetamine was originally used in
nasal decongestants and bronchial inhalers (the levo isomer of methamphetamine is still utilized for
these indications). Later it was available in tablets and injectable formulations and used for weight
control, depression, and to increase alertness and prevent sleep. A broad segment of society used
methamphetamine products for stimulant effects. Today there is only one product, Desoxyn®, currently
marketed in 5 mg tablets. Desoxyn® has very limited use in the treatment of obesity, and attention
deficit hyperactivity disorder. IMS Health® reports that 14,000 total prescriptions for methamphetamine
were dispensed in the U.S. in 2009. (16)
What are the Neurological (Brain) Effects of Stimulant Abuse?
The effects of amphetamines and methamphetamine are similar to cocaine, but their onset
is slower and their duration is longer. In contrast to cocaine, which is quickly removed from the
brain and is almost completely metabolized, methamphetamine remains in the central nervous
system longer, and a larger percentage of the drug remains unchanged in the body, producing
prolonged stimulant effects. Chronic abuse produces a psychosis that resembles schizophrenia
and is characterized by: Paranoia, picking at the skin, preoccupation with one’s own thoughts,
and auditory and visual hallucinations. Violent and erratic behavior is frequently seen among
chronic abusers of
amphetamines and
methamphetamine.(17) Short
term effects of stimulants
exert their effects on the brain
by disrupting or modifying
the normal communication that occurs among brain neurons and brain circuits. Cocaine and MA
have both been shown to specifically disrupt the dopamine neurotransmitter system. This
disruption is accomplished by over stimulating the receptors on the postsynaptic neuron, either
by increasing the amount of dopamine in the synapse through excessive presynaptic release or by
inhibiting dopamine's pattern of reuptake or chemical breakdown .(4) Stimulants help to increase
chemicals found in the brains neurotransmitters. The chemicals cause the brain to become more
active, which results in more alertness, energy, and attention. The user may have a feeling of
euphoria; chasing this feeling can lead to addiction. (9)
The use of cocaine and MA increases the amount of available dopamine in the brain, which leads
to mood elevation (e.g., feelings of elation or euphoria) and increased motor activity. With
cocaine, the effects are short-lived; with MA the duration of effect is much longer. As the
stimulant level in the brain decreases, the dopamine levels subside to normal, and the pleasurable
feelings dwindle away.(4) Other neurological effects, including strokes, seizures, headaches, and
coma; and gastrointestinal complications, abdominal pain and nausea. In rare instances, sudden
death can occur on the first use of cocaine or unexpectedly thereafter. Cocaine-related deaths are
often a result of cardiac arrest or seizures followed by respiratory arrest.
Khat can induce manic behavior with: Grandiose delusions, paranoia, nightmares,
hallucinations, and hyperactivity (17)
In addition research has also revealed a potentially dangerous interaction between cocaine and
alcohol. This mixture is the most common two-drug combination that results in drug-related
death. (5)
What are the Physiological Effects from Stimulant Abuse?
The short-term physiological effects of cocaine use include constricted blood vessels;
dilated pupils; and increased body temperature, heart rate, and blood pressure. Large amounts of
cocaine may intensify the user's high but can also lead to bizarre, erratic, and violent behavior.
Some cocaine users report feelings of restlessness, irritability, anxiety, panic, and paranoia.
Users may also experience tremors, vertigo, and muscle twitches. (5) The immediate
psychological effects of stimulant administration include a heightened sense of well-being,
euphoria, excitement, heightened alertness, and increases in motor activity. Stimulants also
reduce food intake. (4) Long-term abuse of stimulants changes the way the brain functions and
may lead to severe mental disorders and memory loss. Research also suggests that stimulants
impair the ability of specific brain circuits to change in response to experiences. This new
evidence may help explain some of the behavioral and cognitive deficits that are often seen in
people who are addicted to stimulants. (8) Khat causes an immediate increase in blood pressure
and heart rate. Khat can also cause a brown staining of the teeth, insomnia, and gastric disorders.
Chronic abuse of Khat can cause physical exhaustion.(17)
What are Signs and Symptoms of CNS Stimulant Dependence?
Stimulants are substances that induce a number of characteristic symptoms. CNS effects
include alertness with increased vigilance, a sense of well-being, and euphoria. Many users
experience insomnia and anorexia, and some may develop psychotic symptoms. Stimulants have
peripheral cardiovascular activity, including increased blood pressure and heart rate. They
encompass a broad category of substances, including those prescribed for medical conditions;
those manufactured for illicit substance abuse; and those found in over-the-counter (OTC)
decongestants, herbal extracts, caffeinated beverages, and cigarettes. (7) Signs and symptoms of
use and dependence on these drugs include:
 Euphoria
 Decreased appetite
 Rapid speech
 Irritability
 Restlessness
 Depression as the drug wears off
 Nasal congestion and damage to the mucous membrane of the nose in users who snort
drugs
 Insomnia
 Weight loss
 Increased heart rate, blood pressure and temperature
 Paranoia (6)
What are the Withdrawal Effects from Stimulant Abuse?
In general, symptoms of withdrawal may include irritability, headaches, nausea,
vomiting, and mood swings. The severity of withdrawal symptoms varies, depending on the
specific drug. For instance, individuals who are addicted to caffeine may experience symptoms
of fatigue or headaches when they stop drinking coffee. In contrast, individuals who abuse
methamphetamines experience much more severe withdrawal symptoms that may even be life
threatening. Examples of these symptoms include intense cravings for the drug, psychotic
reactions, anxiety, moderate to severe depression, intense hunger, irritability, fatigue, mental
confusion, and insomnia.
Withdrawal symptoms associated in general with discontinuing stimulant use include fatigue,
depression, and disturbance of sleep patterns. Repeated abuse of some stimulants (sometimes
within a short period) can lead to feelings of hostility or paranoia, even psychosis. Further, taking
high doses of a stimulant may result in dangerously high body temperature and an irregular
heartbeat. There is also the potential for cardiovascular failure or seizures. (3)
What are the Health Risks of Stimulant Abuse?
The general acute effects of stimulants have been well documented. Among a range of
physiological responses, stimulants are known to raise both systolic and diastolic blood pressure,
increase heart rate, increase respiration rate, increase body temperature, cause pupillary dilation,
heighten alertness, and increase motor activity.
Acute effects from excessive doses include dangerously rapid and erratic heartbeat, cerebral
hemorrhaging, seizures/convulsions, respiratory failure, stroke, heart failure, brain damage,
coma, and death. (4)
Although the effects of chronic stimulant abuse in humans has not
been well documented, some of the chronic effects include organ
toxicity, compromised health (e.g., underfed, malnourished, poor
hygiene), dental problems, and dermatitis. (4)
References
(1) http://www.healthline.com/galecontent/central-nervous-system-stimulants
(2) www.castaliapub.com/drugsandclients/pdf/CNS_Stimulants.pdf · PDF file
(3) http://www.drugabuse.gov/ResearchReports/Prescription/prescription4.html
(4) http://www.addictioninfo.org/articles/672/1/How-Stimulants-Affect-the-Brain-andBehavior/Page1.html
(5) http://www.nida.nih.gov/ResearchReports/Cocaine/effects.html#how
(6) http://www.cpcwa.org/InformationAndResources/cdsigns.html
(7) http://emedicine.medscape.com/article/289007-overview
(8) http://www.wellness.com/reference/conditions/cns-stimulants/symptoms-and-causes
(9) http://www.thecabinchiangmai.com/site/prescription-addiction/cns-stimulant-medicationsaddiction-other-health-effects/
(10) http://www.drugabuse.gov/Infofacts/PainMed.html
(11) http://teens.drugabuse.gov/peerx/pdf/PEERx_Toolkit_FactSheets_Stimulants.pdf
(12) http://teens.drugabuse.gov/facts/facts_stim1.php
(13) http://health.utah.gov/meth/html/Healthconcerns/TherapeuticUse.html
(14) http://findarticles.com/p/articles/mi_qa3890/is_200504/ai_n13636397/
(15) http://www.justice.gov/dea/concern/meth.html#3
(16) http://www.deadiversion.usdoj.gov/drugs_concern/meth.htm
(17) http://www.justice.gov/dea/pubs/drugs_of_abuse.pdf
(18) http://www.healthandgoodness.com/article/the-affect-of-stimulants-on-your-health.html