side effects and safety
General: Central nervous system (CNS) stimulants should be taken under the supervision of a healthcare professional. Stimulants should not be taken for reasons other than their intended medicinal use.
Although CNS stimulants decrease appetite, they should not be used for weight loss or weight control, unless otherwise directed by a healthcare professional. When used for these purposes, many stimulants may cause dangerous side effects.
Side effects: Side effects of central nervous system stimulants (CNS) vary depending on the specific drug. In general, short-term use may cause side effects such as 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.
Long-term use of stimulants may cause side effects such as difficulty breathing, dizziness, changes in mood, and increased or pounding heartbeat.
Patients should talk to their healthcare providers if they experience any of these symptoms.
Interactions: Patients should tell their healthcare providers if they have any other medical conditions or if they are taking any other drugs (prescription or over-the-counter), herbs, or supplements because they may interact with treatment.
Stimulants should not be taken with other drugs, herbs, or supplements that have stimulant properties because they may cause additive effects. Examples of herbs and supplements that act as stimulants include ephedra, caffeine, betel nut, DHEA, evening primrose oil, folate (folic acid), ginseng, glyconutrients, liver extract, sandalwood, and taurine.
Stimulants should not be taken with appetite suppressants. This combination produces additive results and may have serious adverse effects.
Pregnancy and breastfeeding: Animal studies suggest that CNS stimulants are not safe during pregnancy. These studies have shown that stimulants may increase the risk of birth defects and premature delivery.
Stimulants have been shown to pass into the breast milk. Stimulants are not recommended during breastfeeding.
Children: Long-term use of amphetamines, such as methylphenidate (Ritalin®), may cause serious side effects in children, including stunted growth and behavioral problems. Therefore, caregivers should discuss the potential health risks and benefits associated with stimulants before making a decision about a child's treatment.
Addiction: Central nervous system (CNS) stimulants are addictive, even if they are not abused. Many factors, including the patient's personal history, the type of stimulant that is being taken, the dose of the drug, and duration of use, influence how likely an individual is to become addicted. Therefore, patients with a history of drug dependence should use stimulants cautiously. Patients should take stimulants exactly as prescribed by their healthcare providers. Patients should also visit their healthcare professionals regularly to monitor their conditions.
Signs of addiction include a strong desire to continue taking the medication, desire to increase the dose of the drug, and withdrawal symptoms after the medication is stopped.
Abuse: CNS stimulants are abused if a patient takes them more frequently or at higher doses than recommended by a healthcare professional. Abuse also occurs if a patient uses stimulants for purposes other than the intended medical use.
Individuals who abuse CNS stimulants may become addicted quickly and usually require higher doses more frequently. When CNS stimulants are abused, they can cause serious adverse effects, including increased blood pressure, difficulty breathing, irregular heartbeat, and a wide range of psychological problems. 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.
Withdrawal: Individuals who stop taking stimulants after they become addicted to them usually experience withdrawal symptoms. 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.