MEDICATION GUIDE Adderall (ADD-Ur-All) (CII
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EL PASO INTELLIGENCE CENTER DRUG TREND Synthetic Stimulants Marketed As Bath Salts
LAW ENFORCEMENT SENSITIVE EPIC Tactical Intelligence Bulletins EL PASO INTELLIGENCE CENTER DRUG TREND TACTICAL INTELLIGENCE BULLETIN EB11-16 ● Synthetic Stimulants Marketed as Bath Salts ● March 8, 2011 This document is the property of the Drug Enforcement Administration (DEA) and is marked Law Enforcement Sensitive (LES). Further dissemination of this document is strictly forbidden except to other law enforcement agencies for criminal law enforcement purposes. The following information must be handled and protected accordingly. Summary Across the United States, synthetic stimulants that are sold as “bath salts”¹ have become a serious drug abuse threat. These products are produced under a variety of faux brand names, and they are indirectly marketed as legal alternatives to cocaine, amphetamine, and Ecstasy (MDMA or 3,4-Methylenedioxymethamphetamine). Poison control centers nationwide have received hundreds of calls related to the side-effects of, and overdoses from, the use of these potent and unpredictable products. Numerous media reports have cited bath salt stimulant overdose incidents that have resulted in emergency room visits, hospitalizations, and severe psychotic episodes, some of which, have led to violent outbursts, self-inflicted wounds, and even suicides. A number of states have imposed emergency measures to ban bath salt stimulant products (or the chemicals in them) including Florida, Louisiana, North Dakota, and West Virginia; and similar measures are pending in Hawaii, Kentucky, Michigan, and Mississippi. A prominent U.S. -
Subchronic Continuous Phencyclidine Administration Potentiates Amphetamine-Induced Frontal Cortex Dopamine Release
Neuropsychopharmacology (2003) 28, 34–44 & 2003 Nature Publishing Group All rights reserved 0893-133X/03 $25.00 www.neuropsychopharmacology.org Subchronic Continuous Phencyclidine Administration Potentiates Amphetamine-Induced Frontal Cortex Dopamine Release Andrea Balla1, Henry Sershen1,2, Michael Serra1, Rajeth Koneru1 and Daniel C Javitt*,1,2 1 2 Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA; Department of Psychiatry, New York University School of Medicine, New York, NY, USA Functional dopaminergic hyperactivity is a key feature of schizophrenia. Etiology of this dopaminergic hyperactivity, however, is unknown. We have recently demonstrated that subchronic phencyclidine (PCP) treatment in rodents induces striatal dopaminergic hyperactivity similar to that observed in schizophrenia. The present study investigates the ability of PCP to potentiate amphetamine-induced dopamine release in prefrontal cortex (PFC) and nucleus accumbens (NAc) shell. Prefrontal dopaminergic hyperactivity is postulated to underlie cognitive dysfunction in schizophrenia. In contrast, the degree of NAc involvement is unknown and recent studies have suggested that PCP-induced hyperactivity in rodents may correlate with PFC, rather than NAc, dopamine levels. Rats were treated with 5–20 mg/kg/day PCP for 3–14 days by osmotic minipump. PFC and NAc dopamine release to amphetamine challenge (1 mg/kg) was monitored by in vivo microdialysis and HPLC-EC. Doses of 10 mg/kg/day and above produced serum PCP concentrations (50–150 ng/ml) most associated with PCP psychosis in humans. PCP-treated rats showed significant, dose-dependent enhancement in amphetamine-induced dopamine release in PFC but not NAc, along with significantly enhanced locomotor activity. Enhanced response was observed following 3-day, as well as 14-day, treatment and resolved within 4 days of PCP treatment withdrawal. -
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. -
Effects of Mephedrone and Amphetamine Exposure During Adolescence on Spatial Memory in Adulthood: Behavioral and Neurochemical Analysis
International Journal of Molecular Sciences Article Effects of Mephedrone and Amphetamine Exposure during Adolescence on Spatial Memory in Adulthood: Behavioral and Neurochemical Analysis Pawel Grochecki 1, Irena Smaga 2 , Malgorzata Lopatynska-Mazurek 1, Ewa Gibula-Tarlowska 1, Ewa Kedzierska 1, Joanna Listos 1, Sylwia Talarek 1, Marta Marszalek-Grabska 3 , Magdalena Hubalewska-Mazgaj 2, Agnieszka Korga-Plewko 4 , Jaroslaw Dudka 5, Zbigniew Marzec 6, Małgorzata Filip 2 and Jolanta H. Kotlinska 1,* 1 Department of Pharmacology and Pharmacodynamics, Medical University, 20-093 Lublin, Poland; [email protected] (P.G.); [email protected] (M.L.-M.); [email protected] (E.G.-T.); [email protected] (E.K.); [email protected] (J.L.); [email protected] (S.T.) 2 Department of Drug Addiction Pharmacology, Polish Academy of Sciences, 31-343 Krakow, Poland; [email protected] (I.S.); [email protected] (M.H.-M.); mal.fi[email protected] (M.F.) 3 Department of Experimental and Clinical Pharmacology, Medical University, 20-090 Lublin, Poland; [email protected] 4 Independent Medical Biology Unit, Medical University, 20-090 Lublin, Poland; [email protected] 5 Department of Toxicology, Medical University, 20-090 Lublin, Poland; [email protected] 6 Department of Food and Nutrition, Medical University, 20-093 Lublin, Poland; [email protected] Citation: Grochecki, P.; Smaga, I.; * Correspondence: [email protected] Lopatynska-Mazurek, M.; Gibula-Tarlowska, E.; Kedzierska, E.; Abstract: A synthetic cathinone, mephedrone is widely abused by adolescents and young adults. Listos, J.; Talarek, S.; Despite its widespread use, little is known regarding its long-term effects on cognitive function. -
A Comparison of Ritalin and Adderall: Efficacy and Time-Course in Children with Attention-Deficit/Hyperactivity Disorder
A Comparison of Ritalin and Adderall: Efficacy and Time-course in Children With Attention-deficit/Hyperactivity Disorder William E. Pelham, PhD*; Helen R. Aronoff, MD‡; Jill K. Midlam, MA*; Cheri J. Shapiro, PhD*; Elizabeth M. Gnagy, BS*; Andrea M. Chronis, BS*; Adia N. Onyango, BS*; Gregory Forehand, BS*; Anh Nguyen, BS*; and James Waxmonsky, MD‡ ABSTRACT. Objective. Very little research has fo- ratings were also made for evening behavior to assess cused on the efficacy of Adderall (Shire-Richwood Inc, possible rebound, and side effects ratings were obtained Florence, KY) in the treatment of children with attention- from parents, counselors, and teachers. Parents, counsel- deficit/hyperactivity disorder (ADHD), and no studies ors, and teachers also rated their perceptions of medica- have compared it with standardized doses of Ritalin tion status and whether they recommended the contin- (Novartis Pharmaceuticals, East Hanover, NJ). It is ued use of the medication given that day. Finally, a thought that Adderall has a longer half-life than Ritalin clinical team made recommendations for treatment tak- and might minimize the loss of efficacy that occurs 4 or 5 ing into account each child’s individual response. hours after Ritalin ingestion. We compared two doses of Results. Both drugs were routinely superior to pla- Ritalin and Adderall in the treatment of ADHD in chil- cebo and produced dramatic improvements in rates of dren in an acute study and assessed the medications’ negative behavior, academic productivity, and staff/par- time courses. ent ratings of behavior. The doses of Adderall that were Design. Within-subject, double-blind, placebo-con- assessed produced greater improvement than did the as- trolled, crossover design lasting 6 weeks. -
(Adhd) Quantity Limitation Utilization Management Criteria
ATTENTION- DEFICIT HYPERACTIVITY DISORDER (ADHD) QUANTITY LIMITATION UTILIZATION MANAGEMENT CRITERIA DRUG CLASS: Stimulants and Non-Stimulants BRAND (generic) NAMES: Adderall® (amphetamine/dextroamphetamine) Adderall XR® (amphetamine/ dextroamphetamine ER) Adzenys XR-ODTTM (amphetamine ER dispersible) Aptensio XR® (methylphenidate ER) Concerta® (methylphenidate ER) Daytrana® (methylphenidate transdermal patch) Dextroampthetamine (DextroStat®) Dexedrine® (dextroamphetamine ER) DyanavelTM XR (amphetamine ER) Focalin XR® (dexmethylphenidate ER) Focalin® (dexmethylphenidate) Intuniv® (guanfacine ER) Kapvay® (clonidine ER) Metadate CD® (methylphenidate ER) Metadate ER® (methylphenidate ER) Methylin® (methylphenidate) Procentra® (dextroamphetamine) QuillichewTM (methylphenidate ER) Quillivant XR® (methylphenidate ER) Ritalin® (methylphenidate) Ritalin® LA (methylphenidate ER) Ritalin® SR (methylphenidate ER) Strattera® (atomoxetine) Vyvanse® (lisdexamphetamine) Zenzedi® (dextroamphetamine) COVERAGE AUTHORIZATION CRITERIA Non-formulary medications - Medications included in this criterion that are not part of ASO Net Results or Essential Formularies are subject to a trial and failure of up to TWO formulary alternatives that are clinically appropriate, to treat the same condition, prior to approval (see Non-formulary Exception Criteria for detailed limitations). Quantities above the program set limit (see pgs 2-4) for ADHD agents will be approved when the following is met: 1. The quantity (dose) requested is for documented titration purposes at the initiation of therapy (authorization for a 90 day titration period); AND 2. The prescribed dose cannot be achieved using a lesser quantity of a higher strength; AND 3. The quantity (dose) requested does not exceed the maximum FDA labeled dose, when specified, or to the safest studied dose per the manufacturer’s product insert; OR BLUE CROSS®, BLUE SHIELD® and the Cross and Shield Symbols are registered marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. -
Ring-Substituted Amphetamine Interactions with Neurotransmitter Receptor Binding Sites in Human Cortex
208 NeuroscienceLetters, 95 (1988) 208-212 Elsevier Scientific Publishers Ireland Ltd. NSL O5736 Ring-substituted amphetamine interactions with neurotransmitter receptor binding sites in human cortex Pamela A. Pierce and Stephen J. Peroutka Deparmentsof Neurologyand Pharmacology, Stanford University Medical Center, StanJbrd,CA 94305 (U.S.A.) (Received 31 May 1988; Revised version received 11 August 1988; Accepted 12 August 1988) Key words.' Ring-substituted amphetamine; (_+)-3,4-Methylenedioxyamphetamine; ( +_)-3,4-Methylene- dioxyethamphetamine; (_+)-3,4-Methylenedioxymethamphetamine; Ecstasy; 4-Bromo-2,5- dimethoxyphenylisopropylamine binding site; Human cortical receptor The binding affinities of 3 ring-substituted amphetamine compounds were determined at 9 neurotrans- mitter binding sites in human cortex. (_+)-3,4-Methylenedioxyamphetamine (MDAk (_+)-3,4-methylene- dioxyethamphetamine (MDE), and (_+)-3,4-methylenedioxymethamphetamine (MDMA or 'Ecstasy') all display highest affinity (approximately 1 /tM) for the recently identified 'DOB binding site' labeled by ['TBr]R(-)4-bromo-2,5-dimethoxyphenylisopropylamine ([77Br]R(-)DOB). MDA displays moderate affinity (4-5/iM) for the 5-hydroxytryptaminetA (5-HTr^), 5-HT_D,and =,-adrenergic sites in human cor- tex. MDE and MDMA display lower affinity or are inactive at all other sites tested in the present study. These observations are discussed in relation to the novel psychoactive effects of the ring-substituted amphetamines. A series of ring-substituted amphetamine derivatives exist which are structurally related to both amphetamines and hallucinogens. However, drugs such as (+)-3,4- methylenedioxyamphetamine (MDA), (_+)-3,4-methylenedioxyethamphetamine (MDE), and (+)-3,4-methylenedioxymethamphetamine (MDMA or 'Ecstasy') ap- pear to produce unique psychoactive effects which are distinct from the effects of both amphetamines and hallucinogens [13, 15]. -
Stimulant and Related Medications: US Food and Drug
Stimulant and Related Medications: U.S. Food and Drug Administration-Approved Indications and Dosages for Use in Adults The therapeutic dosing recommendations for stimulant and related medications are based on U.S. Food and Drug Administration (FDA)-approved product labeling. Nevertheless, the dosing regimen is adjusted according to a patient’s individual response to pharmacotherapy. The FDA-approved dosages and indications for the use of stimulant and related medications in adults are provided in this table. All medication doses listed are for oral administration. Information on the generic availability of the stimulant and related medications can be found by searching the Electronic Orange Book at https://www.accessdata.fda.gov/scripts/cder/ob/default.cfm on the FDA website. Generic Medication Indication Dosing Information Other Information Availability amphetamine/dextroamphetamine ADHD Initial dose: May increase daily dose by 5 mg at Yes mixed salts[1] 5 mg once or twice a day; weekly intervals until optimal response Maximum dose: 40 mg per day is achieved. Only in rare cases will it be necessary to exceed a total of 40 mg per day. amphetamine/dextroamphetamine narcolepsy Initial dose: 10 mg per day; May increase daily dose by 10 mg at Yes mixed salts Usual dose: weekly intervals until optimal response 5 mg to 60 mg per day is achieved. Take first dose in divided doses upon awakening. amphetamine/dextroamphetamine ADHD Recommended dose: Patients switching from regular-release Yes mixed salts ER*[2] 20 mg once a day amphetamine/dextroamphetamine mixed salts may take the same total daily dose once a day. armodafinil[3] narcolepsy Recommended dose: Take as a single dose in the morning. -
What Every Clinician Should Know Before Starting a Patient on Meds
CARING FOR CHILDREN WITH ADHD: A RESOURCE TOOLKIT FOR CLINICIANS, 2ND EDITION Basic Facts: What Every Clinician Should Know Before Starting a Patient on Medication Studies have shown that treatment for attention-deficit/ • If you reach the maximum recommended dose without • hyperactivity disorder (ADHD) with medication is effective in noticeable improvement in symptoms, try a different stimulant treating the symptoms of ADHD alone or in combination with medication class. Approximately 80% of children will respond to behavioral interventions. at least 1 of the 2 stimulant classes tried. • Stimulant medications also improve academic productivity but • When changing medications, be careful about the dose not cognitive abilities or academic skills. equivalence of different stimulant medication classes; in general, equivalent doses for dexmethylphenidate and Stimulants can help reduce oppositional, aggressive, impulsive, • amphetamine-based stimulants are approximately half of a and delinquent behaviors in some children. methylphenidate dose. Several types of medications are Food and Drug Administration Non-stimulant medications may require 2 or more weeks to see • (FDA)-approved for the treatment of ADHD. • effects, so you should titrate up more slowly than you would • Stimulant medications: methylphenidate, dexmethylphenidate, for stimulant medications. Obtaining follow-up rating scales is dextroamphetamine, mixed amphetamine salts, even more important than for stimulant medications because lisdexamfetamine changes are more gradual. • Non-stimulant medications: atomoxetine, and extended-release • Managing side effects effectively can improve adherence to and guanfacine and clonidine satisfaction with stimulant medications. When choosing which stimulant and dose to start first, consider • Common side effects to discuss with families include • stomachache, headache, decreased appetite, sleep problems, Family preference and experience with the medication, including • and behavioral rebound. -
Alcohol Mixed with Other Drugs
Alcohol Mixed with Other Drugs Stimulants Stimulants or “uppers”: Drugs that temporarily +increase alertness and energy Examples: Adderall, Ritalin, cocaine, methamphetamine FOCUS: Alcohol + Adderall Adderall: Used to treat ADHD and narcolepsy. Some students misuse Adderall in hopes it will help them study. “Misuse” is defined as taking a medication that was not prescribed to you, taking more Alcohol than what was prescribed to you or taking it for a dierent purpose than prescribed. Eects: Because alcohol is a depressant Use CUPS to remember the and Adderall is a stimulant, Adderall will symptoms of alcohol poisoning: mask alcohol’s eects. Mixing alcohol with • Cold, clammy, pale or bluish skin. a stimulant makes you less aware of alcohol's • Unconscious or unable to be roused. intoxicating eects, which can result in an • Puking repeatedly or uncontrollably. overdose or death. Additionally, mixing alcohol with Adderall (or any other stimulant) • Slow or irregular breathing. can cause an irregular heartbeat and cause cardiovascular complications. Stat: 4.3 percent of UC Davis undergraduates reported using a prescription stimulant in the last 12 months that was not prescribed to them. Sedative Depressants or “downers”: Sedating drugs +that reduce stimulation Examples: opiates, Xanax, Valium FOCUS: Alcohol + Opiates/Opioids Opiates: A group of drugs that are used for treating pain -examples: heroin, morphine, codeine, oxycontin, vicodin, fentanyl Alcohol Eects: When alcohol and opioids are Symptoms: taken at the same time, the sedative • Slow or irregular breathing eects of both drugs will magnify. This • Lowered pulse and can depress or even stop involuntary blood pressure functions, such as breathing, and will • Unconscious or unable increase the risk of overdose and death. -
Phenylmorpholines and Analogues Thereof Phenylmorpholine Und Analoge Davon Phenylmorpholines Et Analogues De Celles-Ci
(19) TZZ __T (11) EP 2 571 858 B1 (12) EUROPEAN PATENT SPECIFICATION (45) Date of publication and mention (51) Int Cl.: of the grant of the patent: C07D 265/30 (2006.01) A61K 31/5375 (2006.01) 20.06.2018 Bulletin 2018/25 A61P 25/24 (2006.01) A61P 25/16 (2006.01) A61P 25/18 (2006.01) (21) Application number: 11723158.9 (86) International application number: (22) Date of filing: 20.05.2011 PCT/US2011/037361 (87) International publication number: WO 2011/146850 (24.11.2011 Gazette 2011/47) (54) PHENYLMORPHOLINES AND ANALOGUES THEREOF PHENYLMORPHOLINE UND ANALOGE DAVON PHENYLMORPHOLINES ET ANALOGUES DE CELLES-CI (84) Designated Contracting States: • DECKER, Ann Marie AL AT BE BG CH CY CZ DE DK EE ES FI FR GB Durham, North Carolina 27713 (US) GR HR HU IE IS IT LI LT LU LV MC MK MT NL NO PL PT RO RS SE SI SK SM TR (74) Representative: Hoeger, Stellrecht & Partner Patentanwälte mbB (30) Priority: 21.05.2010 US 347259 P Uhlandstrasse 14c 70182 Stuttgart (DE) (43) Date of publication of application: 27.03.2013 Bulletin 2013/13 (56) References cited: WO-A1-2004/052372 WO-A1-2008/026046 (73) Proprietors: WO-A1-2008/087512 DE-B- 1 135 464 • Research Triangle Institute FR-A- 1 397 563 GB-A- 883 220 Research Triangle Park, North Carolina 27709 GB-A- 899 386 US-A1- 2005 267 096 (US) • United States of America, as represented by • R.A. GLENNON ET AL.: "Beta-Oxygenated The Secretary, Department of Health and Human Analogues of the 5-HT2A Serotonin Receptor Services Agonist Bethesda, Maryland 20892-7660 (US) 1-(4-Bromo-2,5-dimethoxyphenyl)-2-aminopro pane", JOURNAL OF MEDICINAL CHEMISTRY, (72) Inventors: vol.