Consistent with 交大附小

Stimulants

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Warning

Stimulants can trigger substance-induced psychosis, especially in individuals with high-dose, daily use, and/or other risk factors for psychosis.

Decreased appetite and insomnia are the most common adverse effects of stimulant medications

Caffeine

• Has MAOI effects → ↑ levels of epinephrine, norepinephrine, serotonin, and dopamine

Nicotine

• Effects of caffeine + opioids receptor

Smoking cessation

• Varenicline
  • Nicotine receptor (alpha-4-beta-2 nACHR) partial agonist
  • Reduces positive symptoms, cravings, and withdrawal symptoms
• Bupropion
  • Reduces craving and withdrawal symptoms

Mnemonic

Varenicline helps to quit nicotine.

Amphetamines

• Substances
  • Alpha-methylphenethylamine (“speed”)
  • Methamphetamine (“meth,” “crank”)
  • 3,4-Methylenedioxymethamphetamine (“MDMA,” “ecstasy,” “molly”)
  • Cathinone (“bath salts”)
• Mechanism of action: ↑ release and ↓ reuptake of presynaptic monoamine neurotransmitters (e.g., adrenaline, norepinephrine, serotonin, and dopamine)
  • Central effect: CNS sympathetic stimulation and hallucinogenic effects

Cocaine

• Famously was the “Coca” in Coca-Cola

Tip

Withdrawal from stimulants will not cause morbidity or morality. However, withdrawal from depressants like benzodiazepines or alcohol will. Common withdrawal symptoms:

• Increased appetite, hypersomnia, fatigue, intense psychomotor retardation, severe depression (“crash”)

Depressants

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Alcohol

Alcohol withdrawal

Opioids

Opioid withdrawal

Benzodiazepines

• Benzos increase the FREQUENCY of chloride channel opening
• Barbiturates increase the DURATION of chloride channel opening

Mnemonic

Ben wants it to happen more often (frequency) Barbie wants it to last longer (duration)

Inhalants

Hallucinogens

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Cannabis

Phencyclidine (PCP)

• Street names: angel dust, peace pill, elephant tranquilizer, hog
• Mechanism of action
  • Inhibits dopamine, serotonin, and norepinephrine reuptake
  • Antagonizes NMDA receptors → stimulant or depressive neurological effects (dose dependent)
• Clinical features
  • Violence
    • K 粉 → Kick
  • Rotary nystagmus
  • impulsivity, psychomotor agitation, tachycardia, hypertension, analgesia, psychosis, delirium, seizures.

Mnemonic

Phencyclidine → Rotary nystagmus