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Amphetamine trials and tribulations.

Larry B Goldstein1

  • 1Department of Medicine (Neurology), Duke Stroke Center, Center for Clinical Health Policy Research, Duke University Medical Center, Durham, NC 27710, USA. golds004@mc.duke.edu

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The combination of amphetamine and physiotherapy shows potential for improving behavioral outcomes after brain injury. However, clinical trial results are inconclusive, leaving its true value uncertain.

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Area of Science:

  • Neuroscience
  • Pharmacology
  • Rehabilitation Medicine

Background:

  • Laboratory studies since the 1940s suggest amphetamine combined with task-relevant experience enhances behavioral recovery following brain injury.
  • Small clinical trials have explored this approach for improving post-stroke recovery outcomes.

Purpose of the Study:

  • To evaluate the clinical utility of combining d-amphetamine with physiotherapy for post-stroke recovery.
  • To synthesize findings from laboratory and clinical studies on amphetamine-assisted rehabilitation.

Main Methods:

  • Review of laboratory experiments detailing factors influencing amphetamine's effect on recovery (injury characteristics, drug parameters, training specifics).
  • Analysis of small clinical trials with varied designs assessing the efficacy of amphetamine and physiotherapy interventions.

Main Results:

  • Laboratory findings indicate amphetamine's efficacy is highly dependent on injury specifics, drug dosage/timing, and training protocols.
  • Existing clinical trials are heterogeneous in design and have yielded largely negative results, indicating limited demonstrated benefit.

Conclusions:

  • The clinical effectiveness of d-amphetamine in conjunction with physiotherapy for stroke recovery remains undetermined.
  • Further well-designed clinical trials are necessary to definitively answer whether this combined approach offers clinical value.