NMAM 9106: METHAMPHETAMINE and Illicit Drugs, Precursors
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WELLBUTRIN SR Safely and Effectively
HIGHLIGHTS OF PRESCRIBING INFORMATION psychosis, hallucinations, paranoia, delusions, homicidal ideation, These highlights do not include all the information needed to use aggression, hostility, agitation, anxiety, and panic, as well as suicidal WELLBUTRIN SR safely and effectively. See full prescribing ideation, suicide attempt, and completed suicide. Observe patients information for WELLBUTRIN SR. attempting to quit smoking with bupropion for the occurrence of such symptoms and instruct them to discontinue bupropion and contact a WELLBUTRIN SR (bupropion hydrochloride) sustained-release tablets, healthcare provider if they experience such adverse events. (5.2) for oral use • Initial U.S. Approval: 1985 Seizure risk: The risk is dose-related. Can minimize risk by gradually increasing the dose and limiting daily dose to 400 mg. Discontinue if WARNING: SUICIDAL THOUGHTS AND BEHAVIORS seizure occurs. (4, 5.3, 7.3) See full prescribing information for complete boxed warning. • Hypertension: WELLBUTRIN SR can increase blood pressure. Monitor blood pressure before initiating treatment and periodically during • Increased risk of suicidal thinking and behavior in children, treatment. (5.4) adolescents and young adults taking antidepressants. (5.1) • Activation of mania/hypomania: Screen patients for bipolar disorder and • Monitor for worsening and emergence of suicidal thoughts and monitor for these symptoms. (5.5) behaviors. (5.1) • Psychosis and other neuropsychiatric reactions: Instruct patients to contact a healthcare professional if such reactions occur. (5.6) --------------------------- INDICATIONS AND USAGE ---------------------------- • Angle-closure glaucoma: Angle-closure glaucoma has occurred in WELLBUTRIN SR is an aminoketone antidepressant, indicated for the patients with untreated anatomically narrow angles treated with treatment of major depressive disorder (MDD). (1) antidepressants. -
Concomitant Drugs Associated with Increased Mortality for MDMA Users Reported in a Drug Safety Surveillance Database Isaac V
www.nature.com/scientificreports OPEN Concomitant drugs associated with increased mortality for MDMA users reported in a drug safety surveillance database Isaac V. Cohen1, Tigran Makunts2,3, Ruben Abagyan2* & Kelan Thomas4 3,4-Methylenedioxymethamphetamine (MDMA) is currently being evaluated by the Food and Drug Administration (FDA) for the treatment of post-traumatic stress disorder (PTSD). If MDMA is FDA-approved it will be important to understand what medications may pose a risk of drug– drug interactions. The goal of this study was to evaluate the risks due to MDMA ingestion alone or in combination with other common medications and drugs of abuse using the FDA drug safety surveillance data. To date, nearly one thousand reports of MDMA use have been reported to the FDA. The majority of these reports include covariates such as co-ingested substances and demographic parameters. Univariate and multivariate logistic regression was employed to uncover the contributing factors to the reported risk of death among MDMA users. Several drug classes (MDMA metabolites or analogs, anesthetics, muscle relaxants, amphetamines and stimulants, benzodiazepines, ethanol, opioids), four antidepressants (bupropion, sertraline, venlafaxine and citalopram) and olanzapine demonstrated increased odds ratios for the reported risk of death. Future drug–drug interaction clinical trials should evaluate if any of the other drug–drug interactions described in our results actually pose a risk of morbidity or mortality in controlled medical settings. 3,4-Methylenedioxymethamphetamine (MDMA) is currently being evaluated by the Food and Drug Adminis- tration (FDA) for the treatment of posttraumatic stress disorder (PTSD). During the past two decades, “ecstasy” was illegally distributed and is purported to contain MDMA, but because the market is unregulated this “ecstasy” may actually contain adulterants or no MDMA at all1. -
Investigating Interactions Between Phentermine, Dexfenfluramine, and 5-HT2C Agonists, on Food Intake in the Rat
Psychopharmacology DOI 10.1007/s00213-014-3829-2 ORIGINAL INVESTIGATION Investigating interactions between phentermine, dexfenfluramine, and 5-HT2C agonists, on food intake in the rat Andrew J. Grottick & Kevin Whelan & Erin K. Sanabria & Dominic P. Behan & Michael Morgan & Carleton Sage Received: 2 October 2014 /Accepted: 20 November 2014 # The Author(s) 2014. This article is published with open access at Springerlink.com Abstract Conclusions Dex-phen synergy in the rat is caused by a Rationale Synergistic or supra-additive interactions between pharmacokinetic interaction, resulting in increased central the anorectics (dex)fenfluramine and phentermine have been concentrations of phentermine. reported previously in the rat and in the clinic. Studies with 5- HT2C antagonists and 5-HT2C knockouts have demonstrated Keywords Synergy . BELVIQ® . Lorcaserin . Isobologram . dexfenfluramine hypophagia in the rodent to be mediated by Fen-phen actions at the 5-HT2C receptor. Given the recent FDA approv- al of the selective 5-HT2C agonist lorcaserin (BELVIQ®) for weight management, we investigated the interaction between Introduction phentermine and 5-HT2C agonists on food intake. Objectives This study aims to confirm dexfenfluramine- Fenfluramine (Pondimin) and dexfenfluramine (Redux) are phentermine (dex-phen) synergy in a rat food intake assay, anorectic agents which act to enhance serotonergic transmission to extend these findings to other 5-HT2C agonists, and to both through inhibition of 5-HT reuptake by the parent com- determine whether pharmacokinetic interactions could ex- pounds, and through their major circulating des-ethylated me- plain synergistic findings with particular drug combinations. tabolite, (dex)norfenfluramine, which is a 5-HT reuptake inhib- Methods Isobolographic analyses were performed in which itor, a 5-HT and noradrenaline releasing agent, and a potent phentermine was paired with either dexfenfluramine, the 5- agonist at postsynaptic 5-HT2 receptors (Curzon et al. -
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. -
Endogenous Metabolites: JHU NIMH Center Page 1
S. No. Amino Acids (AA) 24 L-Homocysteic acid 1 Glutaric acid 25 L-Kynurenine 2 Glycine 26 N-Acetyl-Aspartic acid 3 L-arginine 27 N-Acetyl-L-alanine 4 L-Aspartic acid 28 N-Acetyl-L-phenylalanine 5 L-Glutamine 29 N-Acetylneuraminic acid 6 L-Histidine 30 N-Methyl-L-lysine 7 L-Isoleucine 31 N-Methyl-L-proline 8 L-Leucine 32 NN-Dimethyl Arginine 9 L-Lysine 33 Norepinephrine 10 L-Methionine 34 Phenylacetyl-L-glutamine 11 L-Phenylalanine 35 Pyroglutamic acid 12 L-Proline 36 Sarcosine 13 L-Serine 37 Serotonin 14 L-Tryptophan 38 Stachydrine 15 L-Tyrosine 39 Taurine 40 Urea S. No. AA Metabolites and Conjugates 1 1-Methyl-L-histidine S. No. Carnitine conjugates 2 2-Methyl-N-(4-Methylphenyl)alanine 1 Acetyl-L-carnitine 3 3-Methylindole 2 Butyrylcarnitine 4 3-Methyl-L-histidine 3 Decanoyl-L-carnitine 5 4-Aminohippuric acid 4 Isovalerylcarnitine 6 5-Hydroxylysine 5 Lauroyl-L-carnitine 7 5-Hydroxymethyluracil 6 L-Glutarylcarnitine 8 Alpha-Aspartyl-lysine 7 Linoleoylcarnitine 9 Argininosuccinic acid 8 L-Propionylcarnitine 10 Betaine 9 Myristoyl-L-carnitine 11 Betonicine 10 Octanoylcarnitine 12 Carnitine 11 Oleoyl-L-carnitine 13 Creatine 12 Palmitoyl-L-carnitine 14 Creatinine 13 Stearoyl-L-carnitine 15 Dimethylglycine 16 Dopamine S. No. Krebs Cycle 17 Epinephrine 1 Aconitate 18 Hippuric acid 2 Citrate 19 Homo-L-arginine 3 Ketoglutarate 20 Hydroxykynurenine 4 Malate 21 Indolelactic acid 5 Oxalo acetate 22 L-Alloisoleucine 6 Succinate 23 L-Citrulline 24 L-Cysteine-glutathione disulfide Semi-quantitative analysis of endogenous metabolites: JHU NIMH Center Page 1 25 L-Glutathione, reduced Table 1: Semi-quantitative analysis of endogenous molecules and their derivatives by Liquid Chromatography- Mass Spectrometry (LC-TripleTOF “or” LC-QTRAP). -
(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. -
Reflections on Contagious Off-Label Use of Phentermine and Fenfluramine
University of Massachusetts Medical School eScholarship@UMMS Population and Quantitative Health Sciences Publications Population and Quantitative Health Sciences 2008 Weighing in 10 Years Later: Reflections on Contagious Off-Label Use of Phentermine and Fenfluramine Regina C. Grebla Brown University Et al. Let us know how access to this document benefits ou.y Follow this and additional works at: https://escholarship.umassmed.edu/qhs_pp Part of the Bioinformatics Commons, Biostatistics Commons, Epidemiology Commons, and the Health Services Research Commons Repository Citation Grebla RC, Waring ME. (2008). Weighing in 10 Years Later: Reflections on Contagious Off-Label Use of Phentermine and Fenfluramine. Population and Quantitative Health Sciences Publications. Retrieved from https://escholarship.umassmed.edu/qhs_pp/379 This material is brought to you by eScholarship@UMMS. It has been accepted for inclusion in Population and Quantitative Health Sciences Publications by an authorized administrator of eScholarship@UMMS. For more information, please contact [email protected]. Looking Back, Learning Forward History doesn’t repeat itself -- at best it sometimes rhymes. Mark Twain Weighing in 10 years later: Reflections on Contagious off-label use of Phentermine and Fenfluramine Contributed by Regina C. Grebla, MGA, MPH PhD(c) Molly E. Waring AM PhD(c) Graduate students, Brown Medical School The piece for this edition of Scribe focuses on the phentermine and fenfluramine story. This edition comes to you from two students in my advanced pharmacoepidemiology course, shortened significantly to meet the needs of this column. I welcome contributions which stay true to the theme of reflecting and learning about past challenges in pharmacoepidemiology. Please forward ideas to : [email protected] . -
Street Names: Khat, Qat, Kat, Chat, Miraa, Quaadka) September 2019
Drug Enforcement Administration Diversion Control Division Drug & Chemical Evaluation Section KHAT (Street Names: Khat, Qat, Kat, Chat, Miraa, Quaadka) September 2019 Introduction: User Population: Khat, Catha edulis, is a flowering shrub native to East Abuse of khat in the United States is most prevalent among Africa and the Arabian-Peninsula. Khat often refers to the immigrants from Somalia, Ethiopia, and Yemen. Abuse of khat is leaves and young shoot of Catha edulis. It has been widely highest in cities with a substantial population of these immigrants. used since the thirteenth century as a recreational drug by the These cities include Boston (MA), Columbus (OH), Dallas (TX), indigenous people of East Africa, the Arabian Peninsula and Detroit (MI), Kansas City (MO), Los Angeles (CA), Minneapolis (MN), throughout the Middle East. Nashville (TN), New York (NY), and Washington D.C. Licit Uses: Illicit Distribution: There is no accepted medical use in treatment for khat in Individuals of Somali, Ethiopian, and Yemeni descent are the the United States. primary transporters and distributors of khat in the United States. The khat is transported from Somalia into the United States and distributed Chemistry and Pharmacology: in the Midwest, West and Southeast (Nashville, Tennessee) regions Khat contains two central nervous system (CNS) of the United States. According to the National Drug Intelligence stimulants, namely cathinone and cathine. Cathinone (alpha- Center, Somali and Yemen independent dealers are distributing khat aminopriopiophenone), which is considered to be the principal in Ann Arbor, Detroit, Lansing and Ypsilanti, Michigan; Columbus, active stimulant, is structurally similar to d-amphetamine and Ohio; Kansas City, Missouri; and Minneapolis/St. -
Toxicology Times
TOXICOLOGY (800) 677-7995 TIMES www.sdrl.com A FREE Monthly Newsletter for Substance Abuse and Opioid Treatment Volume 5, Issue 7 Programs from San Diego Reference Laboratory July, 2015 Amphetamines (Part 1) Dr. Joseph E. Graas, Scientific Director most often used in inhalers and does not tite, increased stamina and physical energy, Dr. Edward Moore, Medical Director have the central nervous system activity nor increased sexual response/drive, involuntary any addictive properties. All of the com- body movements, increased perspiration, The term “amphetamines” has come to mean pounds that have the structure of hyperactivity, nausea and increased heart rate. a class of endogenous neurotransmitters that phenylethylamine will have this mixture of d This drug is highly addictive and tolerance stimulate the sympathetic nervous system. and l molecules. In the production of these develops quickly. Withdrawal is an extremely This is a broad class of various substituted drugs they are usually noted as a racemic unpleasant experience. A few street names derivatives of phenylethylamine. This grow- mixture, or specifically, as the d or l com- for the drug are amp, speed, crank, dolls and ing class of structurally related molecules may pound. To properly evaluate this family of crystal. also stimulate the sympathetic nervous sys- compounds known as sympathomimetic tem in many different ways, such as affecting amines, amphetamines or phenylethylamine, Methamphetamine was developed by the the re-release of neurotransmitters or pre- it is best done by describing each member of Japanese in 1919 and used during World War venting the re-uptake of neurotransmitters, the class: amphetamine , methampheta- II to help soldiers stay alert and energize hallucinogens, anorectics, bronchodilators mine , phentermine , phenylpropanola- factory workers. -
MEDICATION GUIDE WELLBUTRIN® (WELL Byu-Trin) (Bupropion Hydrochloride) Tablets
NDA 018644/S-041 NDA 020358/S-048 Page 6 MEDICATION GUIDE WELLBUTRIN® (WELL byu-trin) (bupropion hydrochloride) Tablets Read this Medication Guide carefully before you start using WELLBUTRIN and each time you get a refill. There may be new information. This information does not take the place of talking with your doctor about your medical condition or your treatment. If you have any questions about WELLBUTRIN, ask your doctor or pharmacist. IMPORTANT: Be sure to read the three sections of this Medication Guide. The first section is about the risk of suicidal thoughts and actions with antidepressant medicines; the second section is about the risk of changes in thinking and behavior, depression and suicidal thoughts or actions with medicines used to quit smoking; and the third section is entitled “What Other Important Information Should I Know About WELLBUTRIN?” Antidepressant Medicines, Depression and Other Serious Mental Illnesses, and Suicidal Thoughts or Actions This section of the Medication Guide is only about the risk of suicidal thoughts and actions with antidepressant medicines. Talk to your, or your family member’s, healthcare provider about: • all risks and benefits of treatment with antidepressant medicines • all treatment choices for depression or other serious mental illness What is the most important information I should know about antidepressant medicines, depression and other serious mental illnesses, and suicidal thoughts or actions? 1. Antidepressant medicines may increase suicidal thoughts or actions in some children, teenagers, and young adults within the first few months of treatment. 2. Depression and other serious mental illnesses are the most important causes of suicidal thoughts and actions. -
Antidepressant & Psychedelic Drug Interaction Chart
Copyright Psychedelic School 8/2020 Antidepressant & Psychedelic Drug Interaction Chart This chart is not intended to be used to make medical decisions and is for informational purposes only. It was constructed using data whenever possible, although extrapolation from known information was also used to inform risk. Any decision to start, stop, or taper medication and/or use psychedelic drugs should be made in conjunction with your healthcare provider(s). It is recommended to not perform any illicit activity. This chart the intellectual property of psychedelic school and is for personal use only. Please do not copy or distribute this chart. Antidepressant Phenethylamines Tryptamines MAOI-containing Ketamine Ibogaine -MDMA, mescaline -Psilocybin, LSD -Ayahuasca, Syrian Rue SSRIs Taper & discontinue at least 2 Consider taper & Taper & discontinue at least 2 Has been studied and Taper & discontinue at · Paroxetine (Paxil) weeks prior (all except discontinuation at least 2 weeks weeks prior (all except found effective both with least 2 weeks prior (all · Sertraline (Zoloft) fluoxetine) or 6 weeks prior prior (all except fluoxetine) or 6 fluoxetine) or 6 weeks prior and without concurrent except fluoxetine) or 6 · Citalopram (Celexa) (fluoxetine only) due to loss of weeks prior (fluoxetine only) (fluoxetine only) due to use of antidepressants weeks prior (fluoxetine · Escitalopram (Lexapro) psychedelic effect due to potential loss of potential risk of serotonin only) due to risk of · Fluxoetine (Prozac) psychedelic effect syndrome additive QTc interval · Fluvoxamine (Luvox) MDMA is unable to cause Recommended prolongation, release of serotonin when the Chronic antidepressant use may Life threatening toxicities can to be used in conjunction arrhythmias, or SPARI serotonin reuptake pump is result in down-regulation of occur with these with oral antidepressants cardiotoxicity · Vibryyd (Vilazodone) blocked.