Over-the-counter stimulants: abuse and addiction

A widely held belief is that amphetamine-like stimulants have abuse potential, but addiction to these drugs is seldom mentioned. We describe seven patients who fulfilled criteria for amphetamine-like abuse or dependence, based on the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders. This case series lends clinical support to the research findings that amphetamine-like drugs are reinforcing and therefore can be addictive. The use of standardized criteria to classify excessive over-the-counter stimulant use as abuse or dependence distinguishes these case reports from others in the medical literature. Public concern about the misuse of this class of drugs is discussed. We propose that clinicians use standardized criteria to diagnose accurately abuse of or dependence on over-the-counter stimulants for a better understanding of the extent of this problem.