Stimulants (also called psychostimulants^[1]) are psychoactive drugs A psychoactive drug, psychopharmaceutical or psychotropic is a chemical substance that crosses the blood-brain barrier and acts primarily upon the central nervous system where it alters brain function, resulting in changes in perception, mood, consciousness, cognition, and behavior. These drugs may be used recreationally, to purposefully alter one' which induce temporary improvements in either mental or physical function or both. Examples of these kinds of effects may include enhanced alertness, wakefulness, and locomotion, among others. Due to their effects typically having an "up" quality to them, stimulants are also occasionally referred to as "uppers". Depressants Barbiturates are effective in relieving the conditions they are designed to address; they are also readily abused, physically addictive, and have serious potential for overdose. When, in the late 1960s, it became clear that the social cost of barbiturates were beginning to outweigh the medical benefits, a serious search began for a replacement or "downers", which decrease mental and/or physical function, are in stark contrast to stimulants and are considered to be their functional opposites. Stimulants are widely used throughout the world as prescription medicines A prescription medication is a licensed medicine that is regulated by legislation to require a prescription before it can be obtained. The term is used to distinguish it from over-the-counter drugs which can be obtained without a prescription. Different jurisdictions have different definitions of what constitutes a prescription drug and as illicit substances The prohibition of drugs through sumptuary legislation or religious law is a common means of attempting to control drug use. Prohibition of drugs has existed at various levels of government or other authority, from the Middle Ages to the present of recreational use Recreational drug use is the use of a psychoactive substance with the intention of creating or enhancing recreational experience. Such use is controversial, however, often being considered to be also drug abuse, and it is often illegal. Also, it may overlap with other uses, such as medicinal , performance enhancement, and entheogenic (spiritual) or abuse Substance abuse, also known as drug abuse, refers to a maladaptive pattern of use of a substance that is not considered dependent. The term "drug abuse" does not exclude dependency, but is otherwise used in a similar manner in nonmedical contexts. The terms have a huge range of definitions related to taking a psychoactive drug or.

Effects

Stimulants (Analeptics) produce a variety of different kinds of effects by enhancing the activity of the central The central nervous system is the part of the nervous system that coordinates the activity of all parts of the bodies of bilaterian animals—that is, all multicellular animals except sponges and radially symmetric animals such as jellyfish. It contains the majority of the nervous system and consists of the brain and the spinal cord, as well as and peripheral nervous systems The Peripheral Nervous System resides or extends outside the central nervous system (CNS), which consists of the brain and spinal cord. The main function of the PNS is to connect the CNS to the limbs and organs. Unlike the central nervous system, the PNS is not protected by bone or by the blood-brain barrier, leaving it exposed to toxins and. Common effects, which vary depending on the substance in question, may include enhanced alertness Alertness is the state of paying close and continuous attention, being watchful and prompt to meet danger or emergency, or being quick to perceive and act. It is related to psychology as well as to physiology. A lack of alertness is a symptom of a number of conditions, including narcolepsy, attention deficit disorder, chronic fatigue syndrome,, awareness Awareness is the state or ability to perceive, to feel, or to be conscious of events, objects or sensory patterns. In this level of consciousness, sense data can be confirmed by an observer without necessarily implying understanding. More broadly, it is the state or quality of being aware of something. In biological psychology, awareness is, wakefulness Wakefulness is a daily recurring brain state in which an individual is conscious and engages in coherent cognitive and behavior responses to the external world such as communication, ambulation, nutritional ingestion and procreation. Being awake is the opposite of being asleep in which most external inputs to the brain are excluded from neural, endurance Endurance is the ability for an animal to exert itself for a long period of time. In humans, it is usually used in aerobic or anaerobic exercise. The definition of 'long' varies according to the type of exertion - minutes for high intensity anaerobic exercise, hours or days for low intensity. Training for endurance can have a negative impact on, productivity Productivity is a measure of output from a production process, per unit of input. For example, labor productivity is typically measured as a ratio of output per labor-hour, an input. Productivity may be conceived of as a metric of the technical or engineering efficiency of production. As such, the emphasis is on quantitative metrics of input, and, and motivation Motivation is the activation or energization of goal-orientated behavior. Motivation is said to be intrinsic or extrinsic. The term is generally used for humans but, theoretically, it can also be used to describe the causes for animal behavior as well. This article refers to human motivation. According to various theories, motivation may be rooted, increased arousal, locomotion Animal locomotion, which is the act of self-propulsion by an animal, has many manifestations, including running, jumping and flying. Animals move for a variety of reasons, such as to find food, a mate, or a suitable microhabitat, and to escape predators. For many animals the ability to move is essential to survival and, as a result, selective, heart rate Heart rate is the number of heartbeats per unit of time - typically expressed as beats per minute - which can vary as the body's need for oxygen changes, such as during exercise or sleep. The measurement of heart rate is used by medical professionals to assist in the diagnosis and tracking of medical conditions. It is also used by individuals,, and blood pressure Blood pressure is a force exerted by circulating blood on the walls of blood vessels, and is one of the principal vital signs. During each heartbeat, BP varies between a maximum (systolic) and a minimum (diastolic) pressure. The mean BP, due to pumping by the heart and resistance in blood vessels, decreases as the circulating blood moves away from, and the perception of a diminished requirement for food Food is any substance or materials eaten or drunk to provide nutritional support for the body or for pleasure. It usually consists of plant or animal origin, that contains essential nutrients, such as carbohydrates, fats, proteins, vitamins, or minerals, and is ingested and assimilated by an organism to produce energy, stimulate growth, and and sleep Sleep is a naturally recurring altered state of consciousness with relatively suspended sensory and motor activity, characterized by the inactivity of nearly all voluntary muscles. It is distinguished from quiet wakefulness by a decreased ability to react to stimuli, but it is more easily reversible than hibernation or coma. Sleep is a heightened. Many stimulants are also capable of improving mood and relieving anxiety, and some can even induce feelings of euphoria Euphoria is medically recognized as a mental/emotional state defined as a profound sense of well-being. Technically, euphoria is an affect, but the term is often colloquially used to define emotion as an intense state of transcendent happiness combined with an overwhelming sense of contentment. The word derives from Greek εὐφορία, ". It should be noted, however, that many of these drugs are also capable of causing anxiety, even the ones that may paradoxically reduce it to a degree at the same time. Stimulants exert their effects through a number of different pharmacological mechanisms, the most prominent of which include facilitation of norepinephrine Norepinephrine (abbreviated norepi or NE) or noradrenaline (BAN) (abbreviated NA or NAd) is a catecholamine with multiple roles including as a hormone and a neurotransmitter (noradrenaline) and/or dopamine Dopamine is a catecholamine neurotransmitter present in a wide variety of animals, including both vertebrates and invertebrates. In the brain, this phenethylamine functions as a neurotransmitter, activating the five types of dopamine receptors—D1, D2, D3, D4, and D5—and their variants. Dopamine is produced in several areas of the brain, activity (e.g., via monoamine transporter Monoamine transporters are structures in nerve-cell membranes that function as neurotransmitter transporters transferring monoamine neurotransmitters in or out of cells inhibition or reversal^[2]), adenosine receptor antagonism A receptor antagonist is a type of receptor ligand or drug that does not provoke a biological response itself upon binding to a receptor, but blocks or dampens agonist-mediated responses. In pharmacology, antagonists have affinity but no efficacy for their cognate receptors, and binding will disrupt the interaction and inhibit the function of an, and nicotinic acetylcholine receptor Nicotinic acetylcholine receptors, or nAChRs, are cholinergic receptors that form ligand-gated ion channels in the plasma membranes of certain neurons and on the postsynaptic side of the neuromuscular junction . Being ionotropic receptors, nAChRs are directly linked to an ion channel and do not make use of a second messenger as metabotropic agonism An agonist is a chemical that binds to a receptor of a cell and triggers a response by that cell. Agonists often mimic the action of a naturally occurring substance. Whereas an agonist causes an action, an antagonist blocks the action of the agonist and an inverse agonist causes an action opposite to that of the agonist.

Indications

Stimulants are used both individually and clinically for therapeutic purposes in the treatment of a number of indications, including the following:

• To counteract lethargy and fatigue throughout the day while at work or while doing other activities.
• To reduce sleepiness and to keep the person awake when necessary, as well as to treat narcolepsy Narcolepsy is a chronic sleep disorder, or dyssomnia, characterized by excessive daytime sleepiness in which a person experiences extreme fatigue and possibly falls asleep at inappropriate times, such as while at work or at school. Narcoleptics usually experience disturbed nocturnal sleep and an abnormal daytime sleep pattern, which is often.
• To decrease appetite and promote weight loss, as well as to treat obesity Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems. Body mass index , a measurement which compares weight and height, defines people as overweight (pre-obese) when their BMI is between 25 kg/m2 and 30.
• To improve concentration and focus while at work or school, especially for those with attentional disorders such as ADHD Attention-Deficit Hyperactivity Disorder is a neurobehavioral developmental disorder. It is primarily characterized by "the co-existence of attentional problems and hyperactivity, with each behavior occurring infrequently alone" and symptoms starting before seven years of age.
• Occasionally, they are also used to treat clinical depression Major depressive disorder is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities. The term "major depressive disorder" was selected by the American Psychiatric Association to designate this symptom cluster as a mood disorder.

Types

Caffeine

Caffeine is a mild stimulant compound that is found naturally in coffee Coffee is a brewed drink prepared from roasted seeds, commonly called coffee beans, of the coffee plant. They are seeds of coffee cherries that grow on trees in over 70 countries. Green unroasted coffee is one of the most traded agricultural commodities in the world. Due to its caffeine content, coffee can have a stimulating effect in humans, tea Tea is the agricultural product of the leaves, leaf buds, and internodes of the Camellia sinensis plant, prepared and cured by various methods. "Tea" also refers to the aromatic beverage prepared from the cured leaves by combination with hot or boiling water, and is the common name for the Camellia sinensis plant itself, and to a lesser degree, in cocoa The separation of the two components may be accomplished by a press, or by the Broma process. The resulting powder, sold as natural cocoa powder, is more reddish than the traditional "chocolate" color, and relatively low in pH, causing a sour or acidic taste. Dutch process chocolate has been treated so as to neutralize the acidity and or chocolate Chocolate (pronounced /ˈtʃɒklɨt/ or /ˈtʃɒkəlɨt/) comprises a number of raw and processed foods produced from the seed of the tropical Theobroma cacao tree. Cacao has been cultivated for at least three millennia in Mexico, Central and South America, with its earliest documented use around 1100 BC. The majority of the Mesoamerican people. It is included in many soft drinks A soft drink is a drink that typically contains no alcohol, though may contain small amounts (typically less than 0.5% by volume). More than this is a "hard drink." Soft drinks are often carbonated and commonly consumed while chilled or at room temperature. Some of the most common soft drinks include cola, flavored water, sparkling water,, particularly energy drinks Energy drinks are soft drinks advertised as boosting energy. These drinks usually do not emphasize energy derived from the calories they contain, but rather through a choice of caffeine, vitamins, and herbal supplements the manufacturer has combined. Caffeine is the world's most widely used psychoactive drug and by far the most common stimulant. The vast majority (over 80%) of people in the United States consume caffeine on a daily basis. Few jurisdictions restrict its sale and use. Caffeine is also included in some medications, usually for the purpose of enhancing the effect of the primary ingredient, or reducing one of its side effects (especially drowsiness). Pure caffeine tablets are also widely available.

Nicotine

Nicotine Nicotine is an alkaloid found in the nightshade family of plants that constitutes approximately 0.6–3.0% of dry weight of tobacco, with biosynthesis taking place in the roots and accumulation occurring in the leaves. It functions as an antiherbivore chemical with particular specificity to insects; therefore nicotine was widely used as an is the active chemical constituent in tobacco Tobacco is an agricultural product processed from the leaves of plants in the genus Nicotiana. It can be consumed, used as an organic pesticide and, in the form of nicotine tartrate, it is used in some medicines. It is most commonly used as a recreational drug, and is a valuable cash crop for countries such as Cuba, China and United States, of which is available in many forms, including cigarettes A Cigarette is a small roll of finely cut tobacco leaves wrapped in a cylinder of thin paper for smoking. The cigarette is ignited at one end and allowed to smoulder; its smoke is inhaled from the other end, which is held in or to the mouth and in some cases a cigarette holder may be used as well. Most modern manufactured cigarettes are filtered, cigars A cigar is a tightly-rolled bundle of dried and fermented tobacco that is ignited so that its smoke may be drawn into the mouth. Cigar tobacco is grown in significant quantities in Brazil, Cameroon, Cuba, the Dominican Republic, Honduras, Indonesia, Mexico, Nicaragua, Philippines, and the Eastern United States, and chewing tobacco Chewing tobacco refers to a form of smokeless tobacco furnished as long strands of whole leaves and consumed by placing a portion of the tobacco between the cheek and gum or teeth and chewing. Unlike dipping tobacco, it isn't ground and must be mechanically crushed with the teeth to release flavour and nicotine. Unwanted juices are then, among others. Nicotine is used widely throughout the world for its stimulating effects.

Amphetamines

Amphetamines Amphetamine or amfetamine (INN) is a psychostimulant drug that is known to produce increased wakefulness and focus in association with decreased fatigue and appetite. Amphetamine is chemically related to methamphetamine and lisdexamfetamine, a class of potent drugs that act by increasing levels of dopamine and norepinephrine in the brain, inducing are a group of phenylethylamine Phenethylamine is a natural monoamine alkaloid, trace amine, and psychoactive drug with stimulant effects. In the mammalian central nervous system, phenethylamine is believed to function as a neuromodulator or neurotransmitter. It is biosynthesized from the amino acid phenylalanine by enzymatic decarboxylation. Besides mammals, phenethylamine is stimulants such as amphetamine and methamphetamine. Like NDRIs A norepinephrine-dopamine reuptake inhibitor is a drug which acts as a reuptake inhibitor for the neurotransmitters norepinephrine and dopamine by blocking the action of the norepinephrine transporter (NET) and the dopamine transporter (DAT), respectively. This in turn leads to increased extracellular concentrations of both norepinephrine and, amphetamine increases the levels of norepinephrine and dopamine in the brain via reuptake inhibition; however, the more important mechanism by which amphetamines cause stimulation is through the direct release of these catecholamines Catecholamines are sympathomimetic "fight-or-flight" hormones released by the adrenal glands in response to stress. They are part of the sympathetic nervous system from storage vesicles A vesicle like a liposome can be visualised as a bubble of liquid within another liquid, a supamolecular assembly made up of many different molecules. More technically, a vesicle is a small membrane-enclosed sac that can store or transport substances. Vesicles can form naturally because of the properties of lipid membranes , or they may be in cells. Amphetamines are known to cause elevated mood and euphoria as well as rebound depression and anxiety.^[3]

Amphetamines are often used for their therapeutic effects; physicians occasionally prescribe amphetamines to treat major depression, where subjects do not respond well to tradition SSRI medications, and numerous studies have demonstrated the effectiveness of drugs such as Adderall in controlling symptoms associated with ADD/ADHD. In rare cases, ADD/ADHD patients who are not responding sufficiently to traditional amphetamines are prescribed Dextrorotary methamphetamine^{[citation needed]}. Due to their availability and fast-acting effects, amphetamines are prime candidates for abuse [1].

MDMA ("Ecstasy")

Methylenedioxymethamphetamine (MDMA), known by its common street name "Ecstasy", is an illicit substance that typically comes in either tablet, capsule, or powder/crystal form. Medical application as a treatment for depression until 1985 when studies shown the unrecoverable seratonin levels when used as daily perscription. After one year of use, two tablets biweekly the levels were stable. MDMA is said to be a cross between an amphetamine stimulant and a psychedelic hallucinogen. Notably, MDMA is also unique and very popular for its entactogenic properties. The stimulant effects of MDMA include hypertension, anorexia (appetite loss), euphoria, social disinhibition, insomnia (or enhanced wakefulness), improved energy, increased arousal, and increased perspiration, among others.

Cocaine

Cocaine is made from the leaves of the coca shrub, which grows in the mountain regions of South American countries such as Bolivia, Colombia, and Peru. In Europe, North America, and in some part of Asia, the most common form of cocaine is a white crystalline powder. Cocaine is a stimulant but is not normally prescribed therapeutically for its stimulant properties, although it sees clinical use as a local anesthetic, particularly in ophthalmology. Most cocaine use is recreational and its abuse potential is high, and so its sale and possession are strictly controlled in most jurisdictions. Other tropane derivative drugs related to cocaine are also known such as troparil and lometopane but have not been widely sold or used recreationally.^[4]

NRIs & NDRIs

These drugs inhibit the reuptake of norepinephrine and/or dopamine, resulting in increased extracellular levels and therefore enhanced neurotransmission, ultimately producing a stimulant effect. Many of these compounds are used as ADHD medications and antidepressants. The two most well known NDRIs are methylphenidate (Ritalin, Concerta) and bupropion (Wellbutrin, Zyban), and the two most well known NRIs are atomoxetine (Strattera) and reboxetine (Edronax). Many of these drugs have a considerably lower abuse potential in comparison to other stimulants like the amphetamines and cocaine.

Modafinil

Modafinil (Provigil/Alertec/Modavigil) is an analeptic drug approved by the (FDA) for the treatment of narcolepsy, shift work sleep disorder, and excessive daytime sleepiness associated with obstructive sleep apnea. Modafinil, like other stimulants, increases the release of monoamines but also elevates hypothalamic histamine levels, leading some researchers to consider Modafinil a "wakefulness promoting agent" rather than a classic amphetamine-like stimulant . Modafinil has been shown to be effective in the treatment of Attention-Deficit Hyperactivity Disorder (ADHD), depression, cocaine addiction, Parkinson's Disease, schizophrenia, shift workers' sleep disorder and disease-related fatigue.

Ampakines

Recently, there have been improvements in the area of stimulant pharmacology, producing a class of chemicals known as ampakines, or eugeroics, (good arousal). These stimulants tend to increase alertness without the peripheral (body) effects or addiction/tolerance/abuse potential of the traditional stimulants. They have minimal effect on sleep structure, and do not cause rebound hypersomnolence or "come down" effects. Ampakines such as ampalex and CX717 have been developed but are still in clinical trials and have not yet been sold commercially. Another compound with similar effects to these drugs is carphedon, which is sold as a general stimulant in Russia under the brand name Phenotropil.

Yohimbine

Yohimbine is a psychoactive drug of the tryptamine chemical class with stimulant and aphrodisiac effects.

Abuse

Abuse of central nervous system stimulants is common. Addiction to CNS stimulants can quickly lead to medical, psychiatric and psychosocial deterioration. Drug tolerance, dependence, sensitisation as well as a withdrawal syndrome can occur.^[5]

Testing

The presence of stimulants in the body may be tested by a variety of procedures. Serum and urine are the common sources of testing material although saliva is sometimes used. Commonly used tests include chromatography, immunologic assay and mass spectrometry.^[6]

See also

• Depressants
• Hallucinogens

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