Psychostimulants

Psychomotor stimulants possess intrinsic reinforcing properties that may lead to dependence and abuse. Epidemics of stimulant abuse have occurred historically in cycles related to introduction of new stimulants or new routes of administration. The actions and toxic effects of stimulants are related primarily to interaction with the central and peripheral SNS. The most common complications of stimulant use that result in visits to emergency rooms and hospital admissions are referrable to psychiatric, cardiopulmonary, and neurologic symptoms. Neurologic complications most commonly include seizure and stroke, but relative to the prevalence of stimulant abuse in most cities, the incidence of stroke and seizures is small. Cocaine-associated stroke can be linked to underlying abnormalities of the cerebrovascular system in almost one half of the cases. Other complications such as sudden death, movement disorders, and infection are rare. With repeated use of stimulants, a state of drug dependence develops for which there is at present inadequate treatment. As a consequence, pharmacotherapeutic strategies for treatment of dependence are being explored.