Amphetamine is a central nervous system (CNS) stimulant commonly used in both medical and non-medical settings. It affects chemicals in the brain and nerves that contribute to hyperactivity and impulse control. While it has therapeutic applications, its misuse carries risks of dependence and adverse health effects.

Pharmacology and Mechanism of Action

• Amphetamine works by increasing the levels of neurotransmitters such as dopamine, norepinephrine, and serotonin in the brain.
• It achieves this by:
• Promoting the release of these neurotransmitters from nerve endings.
• Blocking their reuptake into presynaptic neurons.
• Inhibiting the enzyme monoamine oxidase (MAO), which breaks down these neurotransmitters.

Medical Uses

1. Treatment of ADHD (Attention-Deficit/Hyperactivity Disorder):

• Amphetamine-based medications, like Adderall (a combination of amphetamine salts), improve focus, attention, and impulse control by increasing dopamine and norepinephrine levels.

1. Narcolepsy:

• Helps reduce excessive daytime sleepiness by stimulating the CNS.

1. Short-Term Treatment of Obesity (Rarely Used):

• Can suppress appetite, but its use for weight loss is limited due to potential for abuse and adverse effects.

Common Forms and Medications

• Adderall (amphetamine/dextroamphetamine salts): Commonly prescribed for ADHD and narcolepsy.
• Vyvanse (lisdexamfetamine): A prodrug of dextroamphetamine, used for ADHD and binge-eating disorder.
• Evekeo: Contains racemic amphetamine sulfate for ADHD and narcolepsy.

Recreational Use and Misuse

1. Stimulant Effects:

• Increased energy, alertness, and euphoria.
• Commonly abused for its cognitive-enhancing effects, especially among students or professionals.

1. Street Names:

• "Speed," "Uppers," "Pep Pills."

1. Forms of Abuse:

• Oral, intranasal (snorting), or intravenous use.

1. Risks of Abuse:

• Dependence and addiction.
• Cardiovascular problems (e.g., high blood pressure, arrhythmias).
• Psychological effects, including paranoia, aggression, and psychosis.

Adverse Effects

• Short-Term:
• Restlessness, insomnia, increased heart rate, dry mouth, and reduced appetite.
• Anxiety, paranoia, or irritability at higher doses.
• Long-Term:
• Dependence and withdrawal symptoms (e.g., fatigue, depression, sleep disturbances).
• Cardiovascular damage and increased risk of stroke.
• Cognitive impairments and mental health issues, such as anxiety and psychosis.

Contraindications

• Pre-existing cardiovascular disease or hypertension.
• Hyperthyroidism.
• Glaucoma.
• History of substance abuse.
• Use of monoamine oxidase inhibitors (MAOIs) within the past 14 days (risk of hypertensive crisis).

Amphetamine Testing and Detection

• Amphetamines can be detected in blood, urine, and saliva.
• Urine Detection Window:
• Typically detectable for 1–4 days after use.
• False Positives:
• Certain medications (e.g., pseudoephedrine, bupropion) and supplements can cause false positives in drug tests.

Treatment of Overdose

1. Symptoms of Overdose:

• Agitation, rapid breathing, severe hypertension, hyperthermia, and seizures.

1. Treatment Measures:

• Supportive care (airway management, IV fluids).
• Benzodiazepines for agitation or seizures.
• Cooling measures for hyperthermia.

Key Considerations

• Amphetamine has significant medical value when used appropriately but carries risks of misuse and dependence.
• Medical supervision and adherence to prescribed doses are critical.
• Abuse can lead to severe physical, psychological, and social consequences.