View source for Stimulant

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[[Image:Dexedrine Spansules.jpg|250px|thumb|left|Sustained-Release 15mg Dexedrine Spansules ]]

==Overview==
'''Stimulants''' are [[drugs]] that temporarily increase alertness and awareness. They usually have increased side-effects with increased effectiveness, and the more powerful variants are therefore often [[prescription medicines]] or illegal drugs.

== Function ==
[[Image:Ritalin-SR-20mg-full.jpg|thumb|left|200px|Ritalin SR 20mg]]
Stimulants increase the activity of either the [[sympathetic nervous system]], the [[central nervous system]] ([[CNS]]) or both. Some stimulants produce a sense of [[Euphoria (emotion)|euphoria]], in particular the stimulants which exert influence on the [[CNS]].  Stimulants are used therapeutically to increase or maintain alertness, to counteract fatigue in situations where sleep is not practical (''e.g.'' while operating vehicles), to counteract abnormal states that diminish alertness consciousness, (such as in [[narcolepsy]]), to promote weight loss ([[phentermine]]) as well as to enhance the ability to concentrate in people diagnosed with attentional disruptions (especially [[ADHD]]).  Occasionally, they are also used to treat depression. Stimulants are sometimes used to boost endurance and productivity as well as to [[anorectic|suppress appetite]]. The euphoria produced by some stimulants leads to their recreational use, although this is illegal in the majority of jurisdictions.

[[Caffeine]], found in beverages such as[coffee and soft drinks, as well as [[nicotine]], which is found in [[tobacco]], are among some of the world's most commonly used stimulants.

Examples of other well known stimulants include [[ephedrine]], [[amphetamine]]s, [[cocaine]], [[methylphenidate]], [[MDMA]], and [[modafinil]].  Stimulants are commonly referred in slang as "uppers". 

Stimulants with significant abuse potential are very carefully controlled substances in America and most other jurisdictions.  Some may be legally available only by prescription (e.g. [[methamphetamine]], brand name [[Desoxyn]], mixed [[amphetamine]] salts, brand name [[Adderall]], [[dexamphetamine]], brand name [[Dexedrine]]) or not at all (e.g. [[methcathinone]]).

==Phenethylamines==

[[Phenethylamine]] is an [[alkaloid]] and [[monoamine]] and believed to be a [[neuromodulator]] or [[neurotransmitter]]. Furthermore it is the basic chemical structure behind most stimulants, especially [[sympathomimetic amine]]s. Common phenethylamines include:
* [[catecholamines]]: [[dopamine]], [[epinephrine]], and [[norepinephrine]]
* plant [[alkaloid]]s: [[ephedrine]], [[pseudoephedrine]], [[cathinone]], [[cathine]]
* [[amphetamine]]s and [[substituted amphetamine]]s: [[amphetamine]], [[methamphetamine]], [[MDA]], [[MDMA]], [[MDMC]], [[DOM]], [[2,5-Dimethoxy-4-bromoamphetamine|DOB]], [[DOI]]
* [[methylphenidate]]
* [[bronchodilators]]: [[albuterol]], [[clenbuterol]] 
* [[psychedelics]]: [[2C (psychedelics)]], [[mescaline]] 

'''Amphetamines'''

Amphetamines (prescribed as either racemic [[amphetamine]] or [[dextroamphetamine]]) increase the heart and respiration rates, increase blood pressure and in some users, dilate the pupils of the eyes and decrease appetite.  Like [[NDRI]]s, amphetamine increases the levels of norepinephrine and dopamine in the brain via reuptake inhibition; however, the more important mechanism by which amphetamines cause stimulation is through the direct release of these [[catecholamine]]s from storage [[vesicles]] in cells.  Amphetamines are known to cause elevated mood and euphoria as well as rebound depression and anxiety.  Other possible effects include blurred vision, insomnia, and dizziness.

Amphetamines are sometimes prescribed therapeutically by physicians and their availability makes them prime candidates for misuse [http://www.drugabuse.gov/Testimony/7-26-06Testimony.html].  Used properly, amphetamines increase alertness, concentration and physical endurance.  They are often prescribed to counter the effects of [[narcolepsy]], a disorder marked by episodes of uncontrollable sleep, and to help patients with learning disabilities such as [[ADHD | ADD and ADHD]].  Dextrorotary [[methamphetamine]] is occasionally used in the treatment of AD(H)D that does not respond sufficiently to traditional [[amphetamine]]s.  On occasion, [[major depression]] is treated with [[amphetamine]]s as well. [[Amphetamine]]s can be used as an add-on to antidepressant therapy as well, with some success in certain populations.
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Abuse

Abuse of amphetamines can cause irregular heartbeat and even physical collapse. A common form of abuse of amphetamines is by people who use them to counter the effects of [[barbiturate]]s or [[benzodiazepine]]s taken the previous night for sleep.  Barbiturates and [[benzodiazepines]] (eg. [[Valium]], [[Ativan]], etc.) are often used as a means of "coming down" from amphetamines.  This &ldquo;[[roller-coaster]]&rdquo; has the potential to put stress on the heart, and potentially damaging to the body.{{Fact|date=February 2007}} 

While amphetamine users may feel a temporary boost in self-confidence and power, the abuse of the drug can lead to delusions, hallucinations, and paranoia. These feelings can cause a person to act in bizarre fashion, and on occasion even violently. In most people, these effects disappear within hours of the cessation of use. There are some reports of this condition, called "Amphetamine Psychosis" lasting much longer in sensitive individuals.

Amphetamines are stolen or acquired through scams involving pharmacists or physicians who will then be manipulated into writing prescriptions for the drugs. These illegally acquired drugs are either sold as is or are converted to other forms of amphetamine.

The most notable effects of large dosages of amphetamines are increased heart rate, increased blood pressure, increased wakefulness and concentration, increased motivation and physical energy, a sense of empowerment, euphoria, decreased appetite, and an increase in urine excretion.  Some of the "come-down" effects include depression, lack of motivation and energy, crawling skin, and occasionally amphetamine psychosis (including paranoia, delirium, and visual and auditory hallucinations).

**A common report from users who are coming down after a long binge is the appearance of "shadow people". This is a visual hallucination where the dark shapes of people appear around the user. It is notable because it is one of the most common hallucinations but is often described as interesting and not at all frightening (apparently not frightening because the user is able to easily distinguish between reality and hallucination despite their lack of control over these hallucinations).

Another means of illegal sale of amphetamines involves "look-a-like" drugs produced in illicit laboratories. One danger in these look-a-likes is that the potency may vary from batch to batch. A person accustomed to using a weak look-alike may unwittingly suffer an overdose taking the same volume of a stronger look-alike. 

Amphetamines can be psychologically addictive in many people. Users become dependent on the drug to avoid the "down" feeling they often experience when the drug's effect wears off. 

People who abruptly stop using amphetamines often experience the physical signs of addiction, such as fatigue, long periods of sleep, irritability, and depression. How severe and prolonged these withdrawal symptoms are depends on the degree of abuse.-->

'''Methylenedioxymethamphetamine'''
{{main|Methylenedioxymethamphetamine}}
Methylenedioxymethamphetamine (MDMA) is a drug that comes either in tablet or capsule form (known as [[ecstasy (drug)|ecstasy, zoom, scrap]]), as a powder or crystal. Stimulant effects of MDMA include increased blood pressure and heart rate, loss of appetite, rapid sweating, and a dry mouth and throat. Ecstasy pills often contain amounts of other drugs which may include any of a wide range of substances such as [[3,4-Methylenedioxyamphetamine|MDA]], [[MDEA]], [[MBDB]], [[Phencyclidine|PCP]], [[DXM]], [[Ketamine]], [[Caffeine]], [[Amphetamine]], [[Methamphetamine]], [[Ephedrine]], [[Pseudoephedrine]], [[Aspirin]], [[Paracetamol]], and, in a small number of cases, [[PMA]] [http://ecstasy.org/testing/pma.html], [[Cocaine]] [http://www.ecstasydata.org/results.php?A=SearchAll&Start=0&S=cocaine&OldSort=DTD&NewSort=&SField=Substance], [[Fentanyl]] [http://erowid.org/chemicals/mdma/mdma_info11.shtml], [[mCPP]], [[benzylpiperazine|BZP]]+[[TFMPP]], [[2,5-Dimethoxy-4-bromoamphetamine|DOB]] [http://www.ecstasydata.org/results.php?A=SearchAll&Start=0&S=dob&OldSort=DTD&NewSort=&SField=Substance], and [[2C-B]] [http://www.pillreports.com/index.php?page=search_reports&sent=1&username=&name=&logo=&colour=&state=&region=all&percent_rating=0&pp=100&suspected_contents=17&rating=all&imagesOnly=1&submit2.x=53&submit2.y=17&submit2=Search+Reports]. In some cases the substance sold as ecstasy may not contain MDMA at all.

MDMA was historically used in a therapeutic setting by a small number of psychiatrists for marriage counseling, before it was outlawed by the DEA because of its widespread recreational use. As of 2001, it is being considered by the FDA in the treatment of [[Post-traumatic stress disorder]].  It is also being evaluated for possible usages in palliative care [http://www.maps.org/mdma/].

==Norepinephrine and Dopamine Reuptake Inhibitors (NDRIs)==
These compounds inhibit the uptake of the monoamines dopamine and norepinephrine into storage vesicles, effectively increasing their amounts in the brain and causing a stimulating effect.  Many of these compounds are effective [[ADHD]] medications and [[antidepressants]].  The most popular and well-known dopamine and norepinephrine reuptake inhibitor antidepressant is [[bupropion]] (Wellbutrin).  Other examples of NDRIs include [[MDPV]], ciclazindol, [[pyrovalerone]], [[mazindol]], [[pipradrol]], and amfonelic acid. Although these medicines have similar methods of action to stimulants, they are less popular for abuse (thus not [[Controlled Substances Act | scheduled]]) and have an extended release mechanism or a very long half life.  Many NDRIs are also phenethylamines.

==Cocaine==
{{main|Cocaine}}
Cocaine is made from the leaves of the [[coca]] shrub, which grows in the mountain regions of South American countries such as Bolivia, Colombia, and Peru. In Europe and North America, the most common form of cocaine is a white crystalline powder. Cocaine is a stimulant but is not normally prescribed therapeutically for its stimulant properties, although it sees clinical use as a local anesthetic, particularly in [[ophthalmology]].  Most cocaine use is recreational and its abuse potential is high, and so its sale and possession are strictly controlled in most jurisdictions.
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===Abuse===

[[Crack cocaine]] is a smokeable form of cocaine. It is usually smoked in a pipe, glass tube, or foil. Cocaine in recreational forms and crack are powerful, but short-acting stimulant drugs. Crack in particular has strong but short-lived effects. Both drugs tend to make users feel more alert and energetic. Many users say that they feel very confident and physically strong. Common effects include dry mouth, sweating, loss of appetite, and increased heart and pulse rates. Both drugs are highly addictive. Excessive doses can cause death from respiratory failure or heart failure.---->

==Caffeine==
{{main|Caffeine}}
Caffeine is a drug that is found naturally in coffee, tea, and to a small extent cocoa. It is also found in many soft drinks particularly energy drin]s. Caffeine stimulates the body, increasing [[heart rate]] and [[blood pressure]], and alertness, making some people feel better and able to concentrate. Caffeine is also a [[diuretic]]. The vast majority (over 80%) of people in the United States consume caffeine on a daily basis. As a result, few jurisdictions restrict its sale and use. 

Caffeine is also sold in some countries as an isolated drug (as opposed to its natural occurrence in many foods). It serves as a mild stimulant to ward off sleepiness and sees wide use among people who must remain alert in their work (''e.g.,'' truck drivers). Some medications contain caffeine as one of their minor active ingredients, often for the purpose of enhancing the effect of the main ingredient or reducing one of its side effects.
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===Abuse===
Excessive caffeine intake can cause anxiety, headaches, and tremors (see main article for full list of overuse symptoms).  Caffeine also induces mild physical dependence and can cause withdrawal symptoms if use is abruptly terminated.[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3003150] Combining caffeine with other stimulants can be hazardous.---->

==Nicotine==
{{main|Nicotine}}
[[Nicotine]] is an [[alkaloid]] found in the nightshade family of plants ([[Solanaceae]]), predominantly in tobacco, and in lower quantities in tomato, potato, eggplant (aubergine), and green pepper. Nicotine alkaloids are also found in the leaves of the coca plant. Nicotine constitutes 0.3 to 5% of the tobacco plant by dry weight, with biosynthesis taking place in the roots, and accumulates in the leaves. It is a potent nerve poison and is included in many insecticides. The primary therapeutic use of nicotine is in treating nicotine dependence in order to eliminate smoking with its risks to health.

In very low concentrations, nicotine acts as a stimulant, and it is one of the main factors responsible for the dependence-forming properties of tobacco smoking. Although pure nicotine is noncarcinogenic, its presence may inhibit the body's ability to cull aberrant cells [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=9666281].

==Ampakines==
Recently, there have been improvements in the area of stimulant pharmacology, producing a class of chemicals known as Ampakines, or ''[[eugeroic]]s'', (''good arousal''). These stimulants tend to increase alertness without the peripheral (body) effects or addiction/tolerance/abuse potential of the traditional stimulants. They have minimal effect on sleep structure, and do not cause rebound hypersomnolence or "come down" effects. Currently, there are two stimulants in this class being used: [[modafinil]] and [[adrafinil]], marketed as Provigil and Olmifon, respectively.

In Russia, [[Carphedon]] is sold as a general stimulant under the brand name Phenotropil.

== See also ==
* [[Psychoactive drug]]
* [[Depressants]]
* [[Narcotic]]

== External links ==
* [http://purecaffeine.info/info.html Pure caffeine information]
* [http://www.licadd.org/aboutdrugs.htm Long Island Council on Alcohol & Drug Dependence - About Drugs - Stimulants] 	 
* [http://www.health.org/govpubs/rpo926/#Stim Prevention Online - Publications - Drugs of Abuse - Stimulants] 
* [http://www.apaic.org Asia & Pacific Amphetamine-Type Stimulants Information Centre (APAIC)]	
{{Phenethylamines}}
{{stimulants}}
{{Major Drug Groups}} 

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[[Category:Stimulants]]
[[Category:Psychoactive drugs]]

[[ar:منشطات]]
[[da:Stimulans]]
[[de:Stimulans]]
[[et:Erguti]]
[[es:Estimulante]]
[[fa:انگیزنده]]
[[fr:Stimulant]]
[[gl:Estimulantes]]
[[hu:Stimuláns]]
[[nl:Genotmiddel]]
[[ja:覚醒剤]]
[[pl:Stymulanty]]
[[pt:Estimulante]]
[[sr:Психостимуланси]]
[[fi:Piriste]]

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