Amphetamine Therapy Research Articles

Marked Improvement of Nightmare Disorder and Backaches Following Treatment with Amphetamine Salts

Rationale: A relative deficiency of dopamine in various tissues leading to increased tissue permeability allowing infiltration of irritants to cause inflammation with subsequent pain, or disrupt normal function of organs, may be the etiologic factor in a wide variety of medical conditions. Evidence to support this hypothesis has been shown by quick improvement of symptomatology after treatment with dopaminergic drugs especially dextroamphetamine sulfate, but also cabergoline, for both corporeal conditions and psychological ones. Objective: To determine not only if treatment with dextroamphetamine may ameliorate backaches (which has been previously reported) but also improve chronic nightmare syndrome which has never been previously reported. Findings: A total daily dosage of 18.8mg of dextroamphetamine sulfate was not only able to immediately completely relieve the backache, but while taking it he did not have one nightmare during three months of treatment. Previously he never had one week for 30 years without at least 1-3 nightmares. Conclusion: Sometimes one case report provides more valid conclusions of the efficacy of a given drug than a randomized controlled study. The standard medication used for chronic nightmares is prazosin which may not be very effective in ameliorating chronic nightmares. The dramatic complete improvement of chronic nightmare syndrome, though it was only one patient, is sufficient for a treating physician to try dextroamphetamine therapy for prazosin failures or for patients who only had partial relief from prazosin and/or side effects, to try amphetamine therapy. Certainly, it would make sense to try dextroamphetamine for chronic nightmares if the patient also has other manifestations of the increased cellular permeability disorder.

Eradication of Long-Term Vaginismus Type of Genito-Pelvic Pain/ Penetration Disorder by Treating with Dextroamphetamine Sulfate

There are many therapies for the vaginismus type of genito-pelvic pain/penetration disorder. However, as frequently found when there are multiple treatments for a given pathological disorder, not any of them are highly effective for this problem. It has been hypothesized that increased tissue permeability may be the etiologic factor causing inflammation in various tissues leading to a variety of different pain syndromes in various organ systems, including, but not limited to, the pelvis. Treatment with dextroamphetamine sulfate has resulted in significant palliation of the pain in the majority of cases treated. The hypothesized mechanism is that this amphetamine releases dopamine from sympathetic nerve fibers, which, in turn, diminishes excessive infiltration of irritants, which are the etiologic factor for the pain. Ideally, the best proof of efficacy for the treatment of this type of vaginismus/dyspareunia syndrome by dextroamphetamine sulfate would be to conduct a randomized prospective double-blinded multi-center study. However, because of the generic status of this drug, it is highly unlikely that any pharmaceutical company would fund such a study. The most practical feasible method to determine efficacy would be to try the drug on a very convincing cases of long-term severe vaginismus/dyspareunia syndrome that failed to respond to standard therapy. Indeed, such a case was found in a 32-year-old woman whose vaginismus was detected at puberty, that was associated with severe dyspareunia 10 years later, so that neither insertion of tampons nor intercourse had been possible. Within one month of treatment her vulvodynia/dyspareunia were eradicated. The relief has persisted for three years. Hopefully this case report may encourage treating physicians who treat a lot of similar cases to evaluate a large series or conduct a randomized study comparing amphetamine therapy vs. their best treatment option to date.

A novel effective treatment for menière’s disease – dextroamphetamine sulfate

Purpose: To determine if treatment with dextroamphetamine sulfate could ameliorate the symptoms of long-standing Menière’s disease in a menopausal woman with a past history of dysmenorrhea. Methods: Dextroamphetamine sulfate was started at 9.4 mg extended release tablets and eventually increased to 18.8 mg (Adzenys®). Results: The symptoms of constant ear fullness and severe tinnitus abated and have not returned for 2 years. In addition, the edema of the fingers and ankles have abated along with an 11 pound weight loss. Conclusions: Menière’s disease can be added to the long list of chronic treatment resistant conditions lumped together under the name of the increased cellular permeability syndrome. This syndrome may or may not be associated with pelvic pain. The common denominator is that these seemingly unrelated conditions affecting many organ systems all respond markedly well to amphetamine therapy. The hypothesis of the efficacy of dextroamphetamine sulfate is that it releases dopamine from sympathetic nerve fibers, which, in turn, diminishes cellular permeability.

General Anesthesia and Chronic Amphetamine Use: Should the Drug Be Stopped Preoperatively?

Prescription amphetamines are being used more often for several medical conditions. Anesthesia concerns focus on the cardiovascular stability of patients who may be catecholamine-depleted and thus have a blunted response to intraoperative hypotension. Previously we reported one case of a patient receiving chronic amphetamine therapy who had a stable intraoperative course. We now report eight additional patients taking chronic prescription amphetamines who underwent a safe general anesthesia and outcome. Predominantly prescribed for narcolepsy and attention deficit hyperactivity disorder, amphetamine drugs had been given to these 8 patients for 2 to 10 yr. Ages ranged from 22 to 77 yr and genders were equally divided. All required general anesthesia for their surgical procedures and 6 of the 8 patients were tracheally intubated. Anesthesia operating room times ranged from 30 min to 4.25 h. The authors conclude that amphetamine use need not be stopped before surgery and anesthesia.

General Anesthesia in a Patient on Long-Term Amphetamine Therapy: Is There Cause for Concern?

Implications Amphetamines are powerful, sympathomimetic amines that, when used chronically, can profoundly effect a patient’s cardiovascular stability during anesthesia and surgery. Amphetamines are the third most widely abused class of drugs in the United States. They also have legitimate medical use for attention deficit disorder with hyperactivity, exogenous obesity, and narcolepsy. We report a case of a patient with a 40-yr history of chronic amphetamine use having undergone two general anesthesias without complication.

Enhanced neocortical neural sprouting, synaptogenesis, and behavioral recovery with D-amphetamine therapy after neocortical infarction in rats.

D-Amphetamine administration increases behavioral recovery after various cortical lesions including cortical ablations, contusions, and focal ischemia in animals and after stroke in humans. The purpose of the present study was to test the enhanced behavioral recovery and increased expression of proteins involved in neurite growth and synaptogenesis in D-amphetamine-treated rats compared with vehicle-treated controls after a focal neocortical infarct. Unilateral neocortical ischemia was induced in male spontaneously hypertensive Wistar rats (n=8 per time point per group) by permanently occluding the distal middle cerebral artery and ipsilateral common carotid artery in 2 groups of rats: D-amphetamine treated (2 mg/kg IP injections) and vehicle treated (saline IP injections). To determine the spatial and temporal distribution of neurite growth and/or synaptogenesis, growth-associated protein (GAP-43), a protein expressed on axonal growth cones, and synaptophysin, a calcium-binding protein found on synaptic vesicles, were examined by immunohistochemical techniques, and both density and distribution of reaction product were measured. Since the resulting infarction included a portion of the forelimb neocortex, behavioral assessments of forelimb function using the foot-fault test of Hernandez and Schallert were performed on the same rats used for immunohistochemical studies during the period of drug action and 24 hours later. A Morris water maze and other indices of behavioral assays were also measured similarly. Recovery times were 3, 7, 14, 30, and 60 days postoperatively. Both GAP-43 and synaptophysin proteins demonstrated statistically significant increases in density and distribution of immunoreaction product as determined by optical density measurements in the neocortex of the infarcted group treated with D-amphetamines compared with vehicle-treated infarcted controls. The GAP-43 was elevated to statistically significant levels in forelimb, hindlimb, and parietal neocortical regions ipsilateral to the infarction only at days 3, 7, and 14. By contrast, the synaptophysin demonstrated no statistically significant changes in expression at 3 or 7 days but demonstrated statistically significant increases at 14, 30, and 60 days in the forelimb, hindlimb, and parietal neocortical regions ipsilateral to the infarction as well as increased distribution in the contralateral parietal neocortex. Behavioral assessment of forelimb function indicated that improved recovery of forelimb placement on the side contralateral to the infarction was statistically significant in the D-amphetamine-treated group compared with the vehicle-treated group (P<0.025). Spatial memory, as measured with the Morris water maze, worsened in the vehicle-treated group compared with the D-amphetamine-treated group at 60 days (P<0.025). These data support the occurrence of neurite growth followed by synaptogenesis in the neocortex in a pattern that corresponds both spatially and temporally with behavioral recovery that is accelerated by D-amphetamine treatment. While the specific mechanisms responsible for D-amphetamine-promoted expression of proteins involved in neurite growth and synaptogenesis and of enhanced behavioral recovery are not known, it is suggested that protein upregulation occurs as a result of functional activation of pathways able to remodel in response to active behavioral performance.

A Randomized Comparison of the Effect of Two Diuretics, a Converting Enzyme Inhibitor, and a Sympathomimeticamine on Weight Loss in Diet-Refractory Patients

We hypothesized that women refractory to dietary weight loss may have a type of idiopathic edema. In a study of 200 women, we compared four drugs, used previously for treating idiopathic edema, to determine their efficacy in causing weight reduction. After 6 months of treatment, the percentage of treated groups losing at least 10% of baseline weight was 6% for hydrochlorothiazide, 8% for spironolactone, 68% for dextroamphetamine sulfate, and 4% for captopril. The percentage losing >20% and >30% of baseline weight in the same treatment groups was 28% and 10% for dextroamphetamine therapy but 0% for the other three groups. Of the women who failed to lose weight with one of the nonamphetamine therapies during the first 6 months, 132 were then treated with dextroamphetamine; 68% lost =10% of their baseline weight, and 30% and 7% of patients lost =20% and =30%, respectively. With use of the classic definition of idiopathic orthostatic edema (urinary output of <55% of ingested water load in 4 hours), only 58 of the 200 study patients had this diagnosis; however, 144 patients excreted <75% of the load. Comparison of the efficacy of amphetamine therapy in patients with <75% versus =75% urinary excretion showed 120 of 131 (92%) lost =10% in the former category versus only 4 of 51 (8%) in the latter. Of the 58 patients who excreted <55% of the water load, 52 (90%) lost =10% of baseline weight with amphetamine therapy. The patients noted no effects of therapy on dietary consumption. The responsiveness of the patients to amphetamine therapy during the second 6-month period despite failing to lose weight with the three other therapies suggests that no inadvertent bias was present in the randomization process. Thus, the results suggest that some women who are recalcitrant to dietary weight loss may have a mild type of water retention that is refractory to diuretics but responsive to amphetamines.

Acute Myocardial Infarction Complicated by Chronic Amphetamine Use

To the Editor. —To our knowledge, the occurrence of acute myocardial infarction in a patient with proved narcolepsy receiving long-term amphetamine treatment has not been previously reported. Our treatment of such a patient might provide useful information for other clinicians. Report of a Case. —A 58-year-old man was admitted to the hospital to be examined for myocardial infarction after initially being seen with severe epigastric pain. His pain was transient, but serial ECGs and enzyme levels clearly verified an acute inferior myocardial infarction. Findings from his examination and medical history were normal, except for a 15-year history of verified narcolepsy. His narcolepsy was well controlled for many years while he received 10 mg of dextroamphetamine sulfate orally four times a day. Amphetamine therapy was abruptly discontinued on hospital admission, and his initial hospital course was uneventful except for extreme physician annoyance, since the patient was always asleep during rounds,

Dextroamphetamine for Epilepsy

OUR EXPERIENCE supports the findings of the Boston Collaborative Drug Surveillance Program, prepared by Jick,¹which did not confirm the relationship of amphetamine therapy to the development of Hodgkin disease described by Newell et al.² Over the past 30 years, we have prescribed the amphetamines, primarily dextroamphetamine sulfate (Dexedrine), to at least 10,000 epileptic patients and are impressed with their singular freedom from untoward reactions. Some of these patients have taken with impunity an amphetamine daily for periods ranging from 20 to 30 years. It is noteworthy that we have not observed the occurrence of lymphadenopathy, pseudolymphoma, lymphocytic or lymphoblastic lymphosarcoma, or Hodgkin disease in any of our patients receiving amphetamines during this period of time. We have also treated approximately 1,300 children with the hyperkinetic behavioral syndrome, including 400 without a concomitant seizure disorder, with daily amphetamine therapy. Prolonged follow-up study of this group did not disclose

Effects of Amphetamine Therapy and Prescriptive Tutoring on the Behavior and Achievement of Lower Class Hyperactive Children

The present study had two primary objectives: (1) to evaluate the relatively long-term (4-6 months) effects of dextroamphetamine on the behavior, achievement, and perceptual-cognitive functioning of hyperkinetic children; (2) to compare the effects of dextroamphetamine and prescriptive perceptual-cognitive tutoring. Sixty-eight children matched for intelligence and degree of hyperactivity were assigned to the following groups: placebolno tutoring; placebo/tutoring; dextroamphetamine/no tutoring; and dextroamphetamine /tutoring. Double-blind procedures were used in the administration of medication. Results indicate that dextroamphetamine contributed to a reduction of hyperkinetic behavioral symptoms and to improvement in performance on various measures of perceptual motor and cognitive development. Twice-a-week tutoring for an average of 20 weeks resulted in gains on some WISC subtests but was clearly not as effective as medication. Neither experimental condition significantly influenced academic achievement as measured by the Wide Range Achievement Test. Implications for the management and instruction of hyperkinetic children are discussed.

Anticipating the Response to Amphetamine Therapy in the Treatment of Hyperkinetic Children

It appears that there are two kinds of significant variables pertinent to a positive response to amphetamines: (1) organic factors, which appear primary, and (2) emotional factors, which, if present, counteract or interfere with the drugs' action. In general, those children responded positively to the drug who showed an organic background, positive parent-child relationship, and the absence of severe psychiatric problems in the parents. Seventy-five percent of the O and OE children with parents who were not grossly deviant improved while none became worse. As with all retrospective studies the absence of a control group prevents examination of such factors as "placebo effect" or the effect of other services received at the Center or in school. However, since positive responses were usually immediate and were maintained over extended periods of time, often after other forms of treatment were unsuccessful, it is felt that these other variables were not significant contaminants.

Cerebral palsy‐a pharmacologic approach

Rehabilitation of the cerebral palsied child demands a multiplicity of modalities to deal with the complex disabilities: neurological dysfunction, behavioral difficulties, perceptual distortion, emotional disturbances, and learning disabilities. Pharmacologic agents represent but one of many aids in a comprehensive program of effective rehabilitation. A practical drug approach is presented as an adjuvant to physical therapy and other modes of treatment. The electroencephalic photo‐Metrazol technique was used for objective differentiation between behavior symptoms of organic origin and those of emotional disorders in 192 children with cerebral palsy and related disorders. ApprOXimately 60 per cent had abnormal or borderline photo‐Metrazol thresholds, indicating diencephalic dysfunction. These were candidates for amphetamine therapy; those with narmal levels despite hyperkinetic behavior were nat. In a double‐blind study, diazepam was tested in 25 children with cerebral palsy, with an over‐all improvement in 36 per cent; in those who were nonambulatory, with rigidity and moderate degrees of mental retardation, a 60 per cent improvement was observed.

Post-encephalitic behavior disorder; a forgotten entity: a report of 100 cases.

Back to table of contents Previous article Next article ArticleNo AccessPOST-ENCEPHALITIC BEHAVIOR DISORDER—A FORGOTTEN ENTITY: A REPORT OF 100 CASESSOL LEVYSOL LEVYSearch for more papers by this authorPublished Online:1 Apr 2006https://doi.org/10.1176/ajp.115.12.1062AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail PDFThis content is only available as a PDF. Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - American Journal of Psychiatry $35.00 Add to cart PPV Articles - American Journal of Psychiatry Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited byFunctional Neurologic Disorders, disorders to be managed by neurologists, or are neurologists wandering in a dangerous field with inadequate resources?17 March 2023 | Frontiers in Psychiatry, Vol. 14A case of Sars-Cov-2-related mania with prominent psychosis>Psychiatry Research, Vol. 306REAd. Revista Eletrônica de Administração (Porto Alegre), Vol. 21, No. 1ADHD Attention Deficit and Hyperactivity Disorders, Vol. 6, No. 3Acta Psychiatrica Scandinavica, Vol. 125, No. 1Determinismo biológico e as neurociências no caso do transtorno de déficit de atenção com hiperatividadePhysis: Revista de Saúde Coletiva, Vol. 22, No. 3Developmental Medicine & Child Neurology, Vol. 10, No. 3Journal of the History of the Behavioral Sciences, Vol. 42, No. 4Journal of the History of the Behavioral Sciences, Vol. 36, No. 2Topical Review: La Crosse and Other Forms of California Encephalitis2 July 2016 | Journal of Child Neurology, Vol. 14, No. 1Acta Psychiatrica Scandinavica, Vol. 85, No. s368Journal of Child Psychology and Psychiatry, Vol. 18, No. 2Adaptive and Learning Skills in Juvenile Delinquents19 August 2016 | Journal of Learning Disabilities, Vol. 9, No. 9American Journal of Orthopsychiatry, Vol. 42, No. 3Hyperkinesia Delineation of Two Patterns24 July 2016 | Exceptional Children, Vol. 38, No. 5Effects of Amphetamine Therapy and Prescriptive Tutoring on the Behavior and Achievement of Lower Class Hyperactive Children18 August 2016 | Journal of Learning Disabilities, Vol. 4, No. 9Proceedings of the Royal Society of Medicine, Vol. 62, No. 1Journal of the American Academy of Child Psychiatry, Vol. 5, No. 3Hyperactivity in Twins26 April 2017 | Canadian Psychiatric Association Journal, Vol. 10, No. 5Studies on the Hyperactive Child I: Some Preliminary Findings26 April 2017 | Canadian Psychiatric Association Journal, Vol. 9, No. 2The “Brain-Injured” Child in a Clinic Population: A Statistical Description24 July 2016 | Exceptional Children, Vol. 30, No. 6American Journal of Orthopsychiatry, Vol. 32, No. 3 Volume 115Issue 12 June 1959Pages 1062-1067 Metrics PDF download History Published online 1 April 2006 Published in print 1 June 1959