Psychoestimulants drugs use in dependence disorders
DOI:
https://doi.org/10.20882/adicciones.340Keywords:
stymulants drugs, drug dependence, methylphenidate, modafinilAbstract
Stimulant drugs prescription is a controversial and current topic in psychiatry. Drugs such as methylphenidate, amphetamine compounds and modafinil have been trialed and used in attention deficit hyperactivity disorder (ADHD), sleep conditions, cocaine dependence and as an adjunct to antidepressants for depression. All these drugs, like stimulant drugs abuse, increase extracellular dopamine in the brain.This effect is associated with reinforcing as well as therapeutic effects. Methylphenidate and modafinil treatment of ADHD are associated with a reduced risk for later substance abuse among ADHD patients. There is evidence of the beneficial effects of the use of modafinil in cocaine dependence, altough there isn´t conclusive evidence for the stimulants´ efficacy in treatment of the stimulants´ dependence. At this time, the physiopathology of drug abuse and dependence is unknown, but it´s known that the very critical point is that the reinforcing effects are associated with rapid changes in dopamine increases, whereas the therapeutic effects are associated with slowly and smoothly rising dopamine levels, such as are achieved with low doses and oral administration. Due to this, it´s necessary to study the neurobiological bases on which stimulants drugs are related, and their clinical use in dependence treatments.References
Ballon JS, Feifel D. A systematic review of modafinil: Potential clinical uses and mechanisms of action. J Clin Psychiatry. 2006; 67: 554-66.
Biederman J, Wigal SB, Spencer TJ, McGough JJ, Mays DA. A post hoc subgroup analysis of an 18-day randomized controlled trial comparing the tolerability and efficacy of mixed amphetamine salts extended release and atomoxetine in school-age girls with attention-deficit/hyperactivity disorder. Clin Ther. 2006a; 28: 280-93.
Biederman J, Mick E, Spencer T, Surman C, Hammerness P, Doyle R, et al. An open- label trial of OROS methylphenidate in adults with late-onset ADHD. CNS Spectr. 2006b; 11: 390-6.
Biederman J, Mick E, Surman C, Doyle R, Hammerness P, Harpold T, et al. A randomized, placebo-controlled trial of OROS methylphenidate in adults with attentiondeficit/hyperactivity disorder. Biol Psychiatry. 2006c 1; 59: 829-35.
Katusic SK, Barbaresi WJ, Colligan RC, Weaver AL, Leibson CL, Jacobsen SJ. Psychostimulant treatment and risk for substance abuse among young adults with a history of attention deficit/hyperactivity disorder: a population-based, birth cohort study. J Child Adolesc Psychopharmacol. 2005; 15: 764-76.
Kollins SH. Comparing the abuse potential of methylphenidate versus other stimulants: a review of available evidence and relevance to the ADHD patient. J Clin Psychiatry. 2003; 64 Suppl 11: 14-8.
Volkow ND, Swanson JM. Variables that affect the clinical use and abuse of methylphenidate in the treatment of ADHD. Am J Psychiatry. 2003; 160: 1909-18.
Wilens TE, Hammerness PG, Biederman J, Kwon A, Spencer TJ, Clark S, et al. Blood pressure changes associated with medication treatment of adults with attention-deficit/hyperactivity disorder. J Clin Psychiatry. 2005; 66: 253-9.


