Neurobiological Approaches to Brain-Behavior Interaction,” Held on September 5-6, 1990, in Bethesda, MD
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Methylphenidate Hydrochloride
Application for Inclusion to the 22nd Expert Committee on the Selection and Use of Essential Medicines: METHYLPHENIDATE HYDROCHLORIDE December 7, 2018 Submitted by: Patricia Moscibrodzki, M.P.H., and Craig L. Katz, M.D. The Icahn School of Medicine at Mount Sinai Graduate Program in Public Health New York NY, United States Contact: [email protected] TABLE OF CONTENTS Page 3 Summary Statement Page 4 Focal Point Person in WHO Page 5 Name of Organizations Consulted Page 6 International Nonproprietary Name Page 7 Formulations Proposed for Inclusion Page 8 International Availability Page 10 Listing Requested Page 11 Public Health Relevance Page 13 Treatment Details Page 19 Comparative Effectiveness Page 29 Comparative Safety Page 41 Comparative Cost and Cost-Effectiveness Page 45 Regulatory Status Page 48 Pharmacoepial Standards Page 49 Text for the WHO Model Formulary Page 52 References Page 61 Appendix – Letters of Support 2 1. Summary Statement of the Proposal for Inclusion of Methylphenidate Methylphenidate (MPH), a central nervous system (CNS) stimulant, of the phenethylamine class, is proposed for inclusion in the WHO Model List of Essential Medications (EML) & the Model List of Essential Medications for Children (EMLc) for treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) under ICD-11, 6C9Z mental, behavioral or neurodevelopmental disorder, disruptive behavior or dissocial disorders. To date, the list of essential medications does not include stimulants, which play a critical role in the treatment of psychotic disorders. Methylphenidate is proposed for inclusion on the complimentary list for both children and adults. This application provides a systematic review of the use, efficacy, safety, availability, and cost-effectiveness of methylphenidate compared with other stimulant (first-line) and non-stimulant (second-line) medications. -
House Bill No. 2191
SECOND REGULAR SESSION HOUSE BILL NO. 2191 99TH GENERAL ASSEMBLY INTRODUCED BY REPRESENTATIVE QUADE. 5582H.01I D. ADAM CRUMBLISS, Chief Clerk AN ACT To repeal section 579.060, RSMo, and to enact in lieu thereof one new section relating to controlled substances, with penalty provisions. Be it enacted by the General Assembly of the state of Missouri, as follows: Section A. Section 579.060, RSMo, is repealed and one new section enacted in lieu 2 thereof, to be known as section 579.060, to read as follows: 579.060. 1. A person commits the offense of unlawful sale, distribution, or purchase of 2 over-the-counter methamphetamine precursor drugs if he or she knowingly: 3 (1) Sells, distributes, dispenses, or otherwise provides any number of packages of any 4 drug product containing detectable amounts of ephedrine, levomethamphetamine, 5 phenylpropanolamine, propylhexedrine, or pseudoephedrine, or any of their salts, optical 6 isomers, or salts of optical isomers, in a total amount greater than nine grams to the same 7 individual within a thirty-day period, unless the amount is dispensed, sold, or distributed 8 pursuant to a valid prescription; or 9 (2) Purchases, receives, or otherwise acquires within a thirty-day period any number of 10 packages of any drug product containing any detectable amount of ephedrine, 11 levomethamphetamine, phenylpropanolamine, propylhexedrine, or pseudoephedrine, or any 12 of their salts or optical isomers, or salts of optical isomers in a total amount greater than nine 13 grams, without regard to the number of transactions, unless the amount is purchased, received, 14 or acquired pursuant to a valid prescription; or 15 (3) Purchases, receives, or otherwise acquires within a twenty-four-hour period any 16 number of packages of any drug product containing any detectable amount of ephedrine, 17 levomethamphetamine, phenylpropanolamine, propylhexedrine, or pseudoephedrine, or any EXPLANATION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is intended to be omitted from the law. -
Molecular Signatures of G-Protein-Coupled Receptors A
REVIEW doi:10.1038/nature11896 Molecular signatures of G-protein-coupled receptors A. J. Venkatakrishnan1, Xavier Deupi2, Guillaume Lebon1,3,4,5, Christopher G. Tate1, Gebhard F. Schertler2,6 & M. Madan Babu1 G-protein-coupled receptors (GPCRs) are physiologically important membrane proteins that sense signalling molecules such as hormones and neurotransmitters, and are the targets of several prescribed drugs. Recent exciting developments are providing unprecedented insights into the structure and function of several medically important GPCRs. Here, through a systematic analysis of high-resolution GPCR structures, we uncover a conserved network of non-covalent contacts that defines the GPCR fold. Furthermore, our comparative analysis reveals characteristic features of ligand binding and conformational changes during receptor activation. A holistic understanding that integrates molecular and systems biology of GPCRs holds promise for new therapeutics and personalized medicine. ignal transduction is a fundamental biological process that is comprehensively, and in the process expand the current frontiers of required to maintain cellular homeostasis and to ensure coordi- GPCR biology. S nated cellular activity in all organisms. Membrane proteins at the In this analysis, we objectively compare known structures and reveal cell surface serve as the communication interface between the cell’s key similarities and differences among diverse GPCRs. We identify a external and internal environments. One of the largest and most diverse consensus structural scaffold of GPCRs that is constituted by a network membrane protein families is the GPCRs, which are encoded by more of non-covalent contacts between residues on the transmembrane (TM) than 800 genes in the human genome1. GPCRs function by detecting a helices. -
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European Review for Medical and Pharmacological Sciences 2019; 23: 3-15 Use of cognitive enhancers: methylphenidate and analogs J. CARLIER1, R. GIORGETTI2, M.R. VARÌ3, F. PIRANI2, G. RICCI4, F.P. BUSARDÒ2 1Unit of Forensic Toxicology, Sapienza University of Rome, Rome, Italy 2Section of Legal Medicine, Universita Politecnica delle Marche, Ancona, Italy 3National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy 4School of Law, University of Camerino, Camerino, Italy Abstract. – OBJECTIVE: In the last decades, phenidate analogs should be undertaken to re- several cognitive-enhancing drugs have been duce the uprising threat, and education efforts sold onto the drug market. Methylphenidate and should be made among high-risk populations. analogs represent a sub-class of these new psy- choactive substances (NPS). We aimed to re- Key Words: view the use and misuse of methylphenidate and Cognitive enhancers, Methylphenidate, Ritalin, Eth- analogs, and the risk associated. Moreover, we ylphenidate, Methylphenidate analogs, New psycho- exhaustively reviewed the scientific data on the active substances. most recent methylphenidate analogs (methyl- phenidate and ethylphenidate excluded). MATERIALS AND METHODS: Literature Introduction search was performed on methylphenidate and analogs, using specialized search engines ac- cessing scientific databases. Additional reports Consumption of various pharmaceutical drugs were retrieved from international agencies, in- by healthy individuals in an attempt to improve stitutional websites, and drug user forums. cognitive faculties is on the rise, whether for aca- RESULTS: Methylphenidate/Ritalin has been demic or recreational purposes1. These substances used for decades to treat attention deficit disor- are stimulants that preferentially target the cate- ders and narcolepsy. More recently, it has been used as a cognitive enhancer and a recreation- cholamines of the prefrontal cortex of the brain to al drug. -
FSI-D-16-00226R1 Title
Elsevier Editorial System(tm) for Forensic Science International Manuscript Draft Manuscript Number: FSI-D-16-00226R1 Title: An overview of Emerging and New Psychoactive Substances in the United Kingdom Article Type: Review Article Keywords: New Psychoactive Substances Psychostimulants Lefetamine Hallucinogens LSD Derivatives Benzodiazepines Corresponding Author: Prof. Simon Gibbons, Corresponding Author's Institution: UCL School of Pharmacy First Author: Simon Gibbons Order of Authors: Simon Gibbons; Shruti Beharry Abstract: The purpose of this review is to identify emerging or new psychoactive substances (NPS) by undertaking an online survey of the UK NPS market and to gather any data from online drug fora and published literature. Drugs from four main classes of NPS were identified: psychostimulants, dissociative anaesthetics, hallucinogens (phenylalkylamine-based and lysergamide-based materials) and finally benzodiazepines. For inclusion in the review the 'user reviews' on drugs fora were selected based on whether or not the particular NPS of interest was used alone or in combination. NPS that were use alone were considered. Each of the classes contained drugs that are modelled on existing illegal materials and are now covered by the UK New Psychoactive Substances Bill in 2016. Suggested Reviewers: Title Page (with authors and addresses) An overview of Emerging and New Psychoactive Substances in the United Kingdom Shruti Beharry and Simon Gibbons1 Research Department of Pharmaceutical and Biological Chemistry UCL School of Pharmacy -
Educational Commentary – Testing for Amphetamines and Related Compounds
EDUCATIONAL COMMENTARY – TESTING FOR AMPHETAMINES AND RELATED COMPOUNDS Learning Outcomes Upon completion of this exercise, participants will be able to: • list amphetamine-like compounds that may be detected by immunoassay screening tests for amphetamines. • describe the 3 types of amphetamine immunoassays based on their antibody specificity. • discuss common causes of false-positive results when testing for amphetamines. Correct interpretation of testing results for amphetamines and related compounds is dependent on many factors including an understanding of the nomenclature, structure, and metabolism of these compounds. The class of phenethylamine compounds having varying degrees of sympathomimetic activity include amphetamine, methamphetamine, and many other compounds known by several names including amphetamines (as a group), designer drugs often grouped together as ecstasy [3,4- methylenedioxymethamphetamine (MDMA); 3,4-methylenedioxyamphetamine (MDA), and 3,4- methylenedioxy-N-ethylamphetamine (MDEA)], and sympathomimetic amines including ephedrine, pseudoephedrine, and phenylpropanolamine found in over-the-counter (OTC) medications. Amphetamine, a primary amine, and methamphetamine, a secondary amine, have a stereogenic center and have enantiomers or optical isomers designated d (or +) for dextrorotatory and l (or -) for levorotatory. In general, the d isomers are the more physiologically active compounds, but pharmaceutical preparations may consist of either isomer or a mixture of both isomers. When the mixture contains equal concentrations of the 2 enantiomers, it is known as a racemic mixture. The existence of enantiomers for amphetamines creates analytical and interpretative problems. Immunoassay Screening The primary screening methods for detecting amphetamines are immunoassays. The structural similarity to amphetamine or methamphetamine of the compounds previously mentioned makes it difficult to produce antibodies specific for amphetamine, methamphetamine, or both. -
The Stimulants and Hallucinogens Under Consideration: a Brief Overview of Their Chemistry and Pharmacology
Drug and Alcohol Dependence, 17 (1986) 107-118 107 Elsevier Scientific Publishers Ireland Ltd. THE STIMULANTS AND HALLUCINOGENS UNDER CONSIDERATION: A BRIEF OVERVIEW OF THEIR CHEMISTRY AND PHARMACOLOGY LOUIS S. HARRIS Dcparlmcnl of Pharmacology, Medical College of Virginia, Virginia Commonwealth Unwersity, Richmond, VA 23298 (U.S.A.) SUMMARY The substances under review are a heterogenous set of compounds from a pharmacological point of view, though many have a common phenylethyl- amine structure. Variations in structure lead to marked changes in potency and characteristic action. The introductory material presented here is meant to provide a set of chemical and pharmacological highlights of the 28 substances under con- sideration. The most commonly used names or INN names, Chemical Abstract (CA) names and numbers, and elemental formulae are provided in the accompanying figures. This provides both some basic information on the substances and a starting point for the more detailed information that follows in the individual papers by contributors to the symposium. Key words: Stimulants, their chemistry and pharmacology - Hallucinogens, their chemistry and pharmacology INTRODUCTION Cathine (Fig. 1) is one of the active principles of khat (Catha edulis). The structure has two asymmetric centers and exists as two geometric isomers, each of which has been resolved into its optical isomers. In the plant it exists as d-nor-pseudoephedrine. It is a typical sympathomimetic amine with a strong component of amphetamine-like activity. The racemic mixture is known generically in this country and others as phenylpropanolamine (dl- norephedrine). It is widely available as an over-the-counter (OTC) anti- appetite agent and nasal decongestant. -
KHAT Latest Revision: June 11, 2005
KHAT Latest Revision: June 11, 2005 O CH3 NH2 Cathinone OH CH3 NH2 Cathine N CH3 H3C N 3,6-dimethyl-2,5-diphenylpyrazine (dimer of Cathinone) 1. SYNONYMS CFR: Cathinone Cathine CAS #: Cathinone Hydrochloride: 71031-15-7 Cathine Hydrochloride: 2153-98-2 Cathine Base: 492-39-7 Other Names: Catha edulis Kat Mutsawhari Mutsawari Mdimamadzi Musitate Mirungi Miraa Ol meraa Tumayot Liruti Ikwa Arabian Tea 2. CHEMICAL AND PHYSICAL DATA Khat is used as a stimulant or as a medicine in parts of Africa and the Arabian Peninsula. The plant is thought to have been in cultivation before the coffee plant; historical references date the use of the plant to the fourteenth century. Peter Forsskal, a physician and botanist, collected khat specimens in an expedition organized by the King of Denmark in the eighteenth century. Forsskal assigned the name Catha edulis to the plant. The effects produced by the drug include excitation, hypersensitivity, anorexia, insomnia, euphoria, increased respiration, and hyperthermia. These effects closely parallel the effects of d-amphetamine. Khat is a bush or tree that grows naturally in the humid mountainous regions (elevations of 5000 to 6500 feet) of East and South Africa. The trees can grow naturally to over 60 ft; however, cultivated khat trees are pruned and their height to kept to approximately 16 feet. Khat also grows to a height of 3 feet as a small bush in arid regions. Like opium, the alkaloid content of khat will vary with the soil, climatic conditions, and cultivation. Khat belongs to the genus Catha edulis. It is recognized that the genus consists of only one species; however, the plant exhibits extreme polymorphism. -
(19) United States (12) Patent Application Publication (10) Pub
US 20130289061A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2013/0289061 A1 Bhide et al. (43) Pub. Date: Oct. 31, 2013 (54) METHODS AND COMPOSITIONS TO Publication Classi?cation PREVENT ADDICTION (51) Int. Cl. (71) Applicant: The General Hospital Corporation, A61K 31/485 (2006-01) Boston’ MA (Us) A61K 31/4458 (2006.01) (52) U.S. Cl. (72) Inventors: Pradeep G. Bhide; Peabody, MA (US); CPC """"" " A61K31/485 (201301); ‘4161223011? Jmm‘“ Zhu’ Ansm’ MA. (Us); USPC ......... .. 514/282; 514/317; 514/654; 514/618; Thomas J. Spencer; Carhsle; MA (US); 514/279 Joseph Biederman; Brookline; MA (Us) (57) ABSTRACT Disclosed herein is a method of reducing or preventing the development of aversion to a CNS stimulant in a subject (21) App1_ NO_; 13/924,815 comprising; administering a therapeutic amount of the neu rological stimulant and administering an antagonist of the kappa opioid receptor; to thereby reduce or prevent the devel - . opment of aversion to the CNS stimulant in the subject. Also (22) Flled' Jun‘ 24’ 2013 disclosed is a method of reducing or preventing the develop ment of addiction to a CNS stimulant in a subj ect; comprising; _ _ administering the CNS stimulant and administering a mu Related U‘s‘ Apphcatlon Data opioid receptor antagonist to thereby reduce or prevent the (63) Continuation of application NO 13/389,959, ?led on development of addiction to the CNS stimulant in the subject. Apt 27’ 2012’ ?led as application NO_ PCT/US2010/ Also disclosed are pharmaceutical compositions comprising 045486 on Aug' 13 2010' a central nervous system stimulant and an opioid receptor ’ antagonist. -
82 Acts, Ch 1044, §1, 2
93 LA WS OF THE SIXTY-NINTH G.A., 1982 SESSION CH. 1044 CHAPTER 1044 SCHEDULE OF CONTROLLED SUBSTANCES S.F.2101 AN ACT amending the schedule of controlled substances. Be It Enacted by the General Assembly of the State of Iowa: Section 1. Section 204.204, subsection 2, Code 1981, is amended by adding the following new lettered paragraphs in alphabetical sequence and relettering the remaining paragraphs: NEW LETTERED PARAGRAPH. Alpha-Methylfentanyl (N-( l-(alpha-methyl-beta-phenyl) ethyl-4-piperidyI) propionanilide; 1-(1-methyl-2-phenylethyI)-4-(N -propanilido)piperidine). NEW LETTERED PARAGRAPH. Sufentanil. NEW LETTERED PARAGRAPH. Tilidine. Sec. 2. Section 204.204, Code 1981, is amended by adding after subsection 5 the following new subsection and renumbering the remaining subsections: NEW SUBSECTION. 6. Unless specifically excepted or unless listed in another schedule, any material, compound, mixture, or preparation which contains any quantity of the following substance having a stimulant effect on the central nervous system, including its salts, isomers, and salts of isomers: a. Fenethylline. Sec. 3. Section 204.206, subsection 3, Code 1981, is amended by adding after paragraph c the following new lettered paragraph: NEW LETTERED PARAGRAPH. d. Bulk dextropropoxyphene (nondosage forms). Sec. 4. Section 204.206, Code 1981, is amended by adding the following new subsection: NEW SUBSECTION. Unless specifically excepted or unless listed in another schedule, any material, compound, mixture, or preparation which contains any quantity of the following substances: a. Immediate precursor to amphetamine and methamphetamine: (1) Phenylacetone. Sec. 5. Section 204.208, subsection 6, paragraph c, Code 1981, is amended by striking the paragraph. -
Pharmacology and Toxicology of Amphetamine and Related Designer Drugs
Pharmacology and Toxicology of Amphetamine and Related Designer Drugs U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES • Public Health Service • Alcohol Drug Abuse and Mental Health Administration Pharmacology and Toxicology of Amphetamine and Related Designer Drugs Editors: Khursheed Asghar, Ph.D. Division of Preclinical Research National Institute on Drug Abuse Errol De Souza, Ph.D. Addiction Research Center National Institute on Drug Abuse NIDA Research Monograph 94 1989 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service Alcohol, Drug Abuse, and Mental Health Administration National Institute on Drug Abuse 5600 Fishers Lane Rockville, MD 20857 For sale by the Superintendent of Documents, U.S. Government Printing Office Washington, DC 20402 Pharmacology and Toxicology of Amphetamine and Related Designer Drugs ACKNOWLEDGMENT This monograph is based upon papers and discussion from a technical review on pharmacology and toxicology of amphetamine and related designer drugs that took place on August 2 through 4, 1988, in Bethesda, MD. The review meeting was sponsored by the Biomedical Branch, Division of Preclinical Research, and the Addiction Research Center, National Institute on Drug Abuse. COPYRIGHT STATUS The National Institute on Drug Abuse has obtained permission from the copyright holders to reproduce certain previously published material as noted in the text. Further reproduction of this copyrighted material is permitted only as part of a reprinting of the entire publication or chapter. For any other use, the copyright holder’s permission is required. All other matieral in this volume except quoted passages from copyrighted sources is in the public domain and may be used or reproduced without permission from the Institute or the authors. -
Methamphetamine (Canadian Drug Summary)
www.ccsa.ca • www.ccdus.ca March 2020 Canadian Drug Summary Methamphetamine Key Points • The prevalence of methamphetamine use in the Canadian population is low (~0.2%). • Several jurisdictions report at least a three-fold increase in the use of methamphetamine over the past five years among individuals accessing treatment or harm reduction services. • Notable increases for rates of criminal violations involving methamphetamine have been observed in the last five years (2013–2018). Introduction Methamphetamine is a synthetic drug classified as a central nervous system (CNS) stimulant or psychostimulant. CNS stimulants cover a wide range of substances that act on the body by increasing the level of activity of the CNS and include caffeine, nicotine, amphetamine (e.g., Adderall®), methylphenidate (e.g., Ritalin®), MDMA (“ecstasy”), cocaine (including crack cocaine) and methamphetamine (including crystal meth).1,2 While both methamphetamine and amphetamine are psychostimulants and often grouped together, they are different drugs. A slight chemical modification of amphetamine produces methamphetamine, which has a different pharmacological profile that results in a larger release of certain neurochemicals in the brain and a stronger and more rapid physiological response. Some amphetamines are prescribed in Canada for attention-deficit hyperactivity disorder (ADHD) and narcolepsy (e.g., Adderall and Vyvanse®), but methamphetamine use is currently illegal. Methamphetamine is often made in illegal, clandestine laboratories with commonly available, inexpensive chemicals, such as ephedrine and pseudoephedrine, found in medications, among other sources. The use of these medications as precursor chemicals for methamphetamine led to stricter regulations introduced in Canada in 2006, limiting access to them by requiring they be kept behind the counter of pharmacies.3 Illegal production can be dangerous due to the toxicity of the chemicals used and the high risk of explosions.