Central nervous system (CNS) stimulants, also called psychomotor stimulants or uppers, are a class of drugs that speed up physical and mental processes. They temporarily make patients feel more alert and improve mood.
Stimulants are typically used to treat medical conditions such as attention-deficit hyperactivity disorder (ADHD), attention-deficit disorder (ADD), fatigue, and narcolepsy. Some stimulants have been used as appetite suppressants, although the safety of this use remains controversial.
Examples of CNS stimulants include amphetamines, such as methylphenidate (Ritalin®), methamphetamine (e.g. Desoxyn® or Desoxyn Gradumet®), caffeine (e.g. coffee or tea), nicotine (cigarettes or cigars), and the illegal drug cocaine.
Side effects of stimulants vary depending on the specific dose and type of drug. In general, side effects of short-term use may include anxiety, insomnia, dry mouth, depersonalization, feeling of euphoria, increased heartbeat, crying, dysphoria, decreased appetite, hyperventilation, irritability, depression, nervousness, paranoia, mood swings, restlessness, and shaking or trembling.
Most CNS stimulants are highly addictive. However, some newer drugs, such as modafinil (Provigil®) are less addictive.
Because stimulants are highly addictive and have euphoric effects on the brain, they are often abused and taken as recreational drugs. Long-term abuse of stimulants can cause changes in the brain and lead to serious health problems, including severe mental illness and memory loss.
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types of central nervous system (cns) stimulants
Schedule I stimulants: Schedule I stimulants, including aminoxaphen (Aminorex®), cathinone, fenethylline (Captagon®), methcathinone, methylaminorex, and amphetamine variants (e.g. 3,4-methylenedioxymethamphetamine), have no medicinal value and have a high potential for abuse. Therefore, these drugs are not prescribed for medical conditions.
Schedule II stimulants: Schedule II stimulants also have a high abuse potential. Patients are likely to become psychologically and/or physically dependent on these drugs. Unless it is an emergency, prescriptions for schedule II stimulants must be made in writing and signed by a healthcare professional. If it is a medical emergency, the healthcare professional must provide written confirmation of the verbal prescription within 72 hours. Prescriptions for schedule II stimulants cannot be renewed. Examples of schedule II stimulants include dextroamphetamine (Dexedrine®),
phenmetrazine (Preludin®), and biphetamine. An illegal drug, called cocaine, also falls under this category.
Schedule III stimulants: Schedule III drugs are less likely to be abused than schedule I and II drugs. Healthcare professionals can give oral or written prescriptions and up to five renewals within six months. Examples of class III stimulants include benzphetamine (Didrex®), chlorphentermine,
and phendimetrazine tartrate (Plegine® or Prelu 2®).
Schedule IV stimulants: Schedule IV stimulants are less likely to be abused than schedule III stimulants. Healthcare professionals can give oral or written prescriptions and up to five renewals within six months. Examples of schedule IV stimulants include armodafinil (Nuvigil®), norpseudoephedrine,
diethylpropion hydrochloride (Tenuate®), fencamfamin, fenproporex, phentermine (Fastin®, Lonamin®, or Adipex®), mazindol (Sanorex® or Mazanor®), mefenorex,
modafinil (Provigil®), pipradrol, and sibutramine (Meridia®).
Schedule V stimulants: Schedule V stimulants, includes one class of drugs called pyrovalerone. These drugs are less likely to be abused than class IV stimulants. These drugs are regulated by the state. In some areas, a prescription may not be needed.
Appetite suppressant: A common side effect of central nervous system (CNS) stimulants is decreased appetite. For this reason, several stimulants that have low risks for abuse and dependency have been prescribed to help treat obesity. Examples of these drugs include dexfenfluramine, sibutramine, phentermine, fenfluramine, mazindol, diethylpropion, and fenproporex. However, stimulants cause limited weight loss because patients eventually develop tolerances to long-term treatment.
Many stimulants are unsafe when taken as appetite suppressants. Therefore, stimulants should only be taken to lose weight under the strict supervision of a qualified healthcare professional.
Amphetamines, including methylphenidate (Ritalin®), dextroamphetamine (Dexedrine® or Dextrostat®), dextroamphetamine sustained-release capsules (Dexedrine Spansules®), benzphetamine (Didrex®), and lisdexamfetamine (Vyvanse®), are prescription medications that are taken by mouth to treat attention-deficit hyperactivity disorder (ADHD) and attention-deficit disorder (ADD).
Amphetamines help treat attention disorders by increasing attention and decreasing restlessness in patients who are overactive, unable to concentrate for very long or are easily distracted, and have unstable emotions. These medications are usually used in combination with social, educational, and psychological therapies.
A stronger, more potent type of amphetamine, called methamphetamine (Desoxyn® or Desoxyn Gradumet®), is sometimes used to treat ADHD.
Narcolepsy: Patients with narcolepsy, a condition that causes individuals to have sudden attacks of deep sleep or the uncontrollable desire to sleep, also receive stimulants. These drugs help narcoleptic patients stay awake during the day. Modafinil (Provigil®), a newer stimulant, is less addictive and better tolerated than other older types of stimulants.
However, some patients need treatment with methylphenidate (Ritalin®) or other types of amphetamines.
Fatigue: Caffeine is a stimulant that is found in coffee and various teas, soft drinks, and energy drinks. Caffeine is also available in pill form (e.g. No Doze®). Caffeine has been used to decrease fatigue. It has been shown to increase alertness, reduce sleepiness, enhance mental performance, and improve mood.
Methylphenidate (Ritalin® or Concerta®) has also been suggested as a possible treatment for chronic fatigue syndrome (CFS). This disorder causes extreme fatigue that does not improve with bed rest. Methylphenidate appears to increase and balance levels of the brain chemicals. Some research has shown that methylphenidate may help improve symptoms of fatigue and increase concentration in some people with CFS.
Recreational drug use: Many stimulants are used recreationally, for no medical purpose. However, abusing stimulants can lead to serious and potentially life-threatening health conditions.
For instance, nicotine is a stimulant that is found in tobacco products, such as cigarettes or cigars. The nicotine makes patients temporarily feel good or energized after smoking. Although this stimulant is legal, it can cause serious health problems, including cancer and emphysema.
Because methamphetamines are stronger, longer-lasting, and even more addictive than most other types of amphetamines, they are often abused. Methamphetamines can be smoked, injected, inhaled, or taken by mouth. Methamphetamine affects the brain and can create feelings of pleasure, increase energy, and elevated mood. Some individuals illegally create their own homemade methamphetamines, using various over-the-counter cold or allergy medicines, as well as household products, such as cleaning fluids and paint thinners. When used recreationally, methamphetamines, are often called chalk, crystal, glass, ice, meth, speed, and Tina.
Cocaine is an illegal CNS stimulant that is also commonly abused. The powdered, hydrochloride salt form of cocaine can either be snorted or dissolved in water and injected into a vein.
Crack is an unprocessed form of cocaine. Crack is cocaine that has not been neutralized to make the hydrochloride salt. This form of cocaine looks like a rock crystal. Individuals typically heat crack and inhale the vapors.
Addiction can be difficult to overcome without help. Rehabilitation treatment programs are available to help patients recover from addiction. Programs are tailored to specific individuals. Treatment may include group therapy, motivational interviewing, family therapy, and one-on-one counseling. The duration of rehabilitation treatment usually lasts several months. However, treatment varies among individuals.
Unfortunately, relapse after treatment is common. Therefore, it is important to educate patients, as well as their friends and family members, about addiction. Individual, group, and family counseling may also help patients identify possible triggers for relapse. Support groups, such as Narcotics Anonymous, may help individuals stay sober once they have completed a rehabilitation program.
In addition, researchers have studied the use of newer, less addictive stimulants as a way to treat cocaine addictions. These new medications, such as modafinil (Provigil®), may allow cocaine addicts to gradually take less and less stimulants until they overcome their addictions.