What Are the Benefits of Stimulants for Depression?

Central nervous system stimulants are a class of drugs that can improve the functional activity of the central nervous system. The abuse of central stimulants has been increasing year by year in recent years. Cocaine, methamphetamine (methamphetamine), and methylenedioxymethamphetamine (ecstasy) are the mainstays in Europe and the Americas. "Mercine" is the mainstay in Asia. Much abuse of methyl cathinone. There was an abuse of methamphetamine in China in the 1950s (then called anti-fatigue tablets, that is, ephedrine).

Central nervous system stimulant

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CNS stimulants are a class of drugs that can enhance the central nervous system's functional activities

In conventional dosages, this class of drugs has certain selective effects on different parts of the central nervous system. According to their main parts, they can be divided into three categories:

Main excitement

The abuse of central stimulants has been increasing year by year in recent years. Cocaine, methamphetamine (methamphetamine), and methylenedioxymethamphetamine (ecstasy) are the mainstays in Europe and the Americas. "Mercine" is the mainstay in Asia. Much abuse of methyl cathinone. There was an abuse of methamphetamine in China in the 1950s (then called anti-fatigue tablets, that is, ephedrine). Since the 1990s, some cities in the south have experienced the abuse of methamphetamine. In recent years, some large cities have also abused ecstasy. Some people have predicted that the next century will be the era of doping abuse. Therefore, the issue of central doping abuse should be given enough attention.

1. Pharmacological effects of central stimulants

Central stimulants have a wide range of pharmacological effects. In addition to the central nervous system, they also have a strong excitatory effect on the cardiovascular system; suppress appetite and fever; cocaine also has a strong local paralysis and vasoconstrictor effect. Generally small doses of stimulants can keep people alert, energetic and confident, so small doses of amphetamine and cocaine have been used to reduce fatigue, improve the efficiency of simple mental work, and also improve athletic performance in the short term; above in large doses Each effect is enhanced and leads to irritability, impulsivity, and emotional change, sometimes "talkative" annoying. The main reason for amphetamine weight loss is to suppress appetite and reduce food intake. In addition, increasing physical activity also consumes physical energy, which has the effect of reducing weight. Small doses of amphetamines can increase both systolic and diastolic blood pressure, but the cardiac output is unchanged due to the slowing of the reflex heartbeat. Contracts smooth muscles, excites the brain's respiratory center, and reduces the inhibition of the central nervous system by various sedative and hypnotic drugs.

Central stimulants have obvious effects on a variety of neurotransmitter systems, and the mechanism of central excitability is also very complicated. At present, the mechanism of acute central excitability of these drugs is clear in three points:

(1) Increase the content of intersynaptic excitatory neurotransmitters such as norepinephrine (NE) and dopamine (DA): such as promoting the release of NE and DA from catecholamine nerve endings (mainly amphetamines use this pathway) and block NE and DA re-uptake (mainly cocaine); inhibition of monoamine oxidase, reduction of damage to NE and DA, etc.

(2) Acts directly on NE and DA receptors (such as hallucinogenic amphetamines MDMA).

(3) Reduce the content of the inhibitory neurotransmitter serotonin (5-HT) (MDMA is the main one).

In addition to the effects of central stimulants on the nervous system such as DA, NE, and 5-HT, it also has a significant effect on cholinergic.

The effects of central stimulants vary greatly from individual to individual. Some people not only have no excitatory effects but also show central inhibition after use. At present, they cannot be satisfactorily explained from the perspective of central effects.

2. Central stimulant dependence

For a long time, central stimulants were thought to have no physical dependence, so some textbooks included them in the category of drugs with only mental dependence. Experimental research also focuses on their psychological dependence characteristics, such as self-administration behavior and dopamine reward system. Studies have shown that central stimulant tolerance develops quickly, and long-term application causes the body and the central nervous system (CNS) to adapt (depending on the presence of stimulants). After stimulant withdrawal, rebound CNS can inhibit a drowsiness and overeating after waking. Studies have shown that brain function has undergone significant changes in physiology and psychopharmacology, such as short-term application, resulting in changes in transmitter and dopamine reward system function; long-term application not only changes in transmitter and function, but also produces organic lesions. After withdrawal, a series of withdrawal reactions such as lack of pleasure, depression, lethargy, and irritability will occur, but their withdrawal symptoms do not occur immediately, but occur after a few days of psychological craving (actually craving is The most obvious withdrawal response after stopping amphetamine use).

Withdrawal reactions after long-term abuse are generally divided into the following three phases:

(1) Extremely uncomfortable period: Mostly appear immediately after stopping the drug. Such as insanity, anorexia, irritability, depression, insomnia, lethargy, and suicidal tendencies. It is easiest to abuse other substances such as sleeping pills and opioids. Generally mild abusers are lethargic after stopping stimulants, and their appetite (gobble) after waking is also a manifestation of withdrawal response (rebound).

(2) Delay: general symptoms are not severe, feeling close to normal or mild craving, mood swings, irritability or depression, weakness, etc. The euphoric memories of medicines often provoke a strong desire for medication.

(3) Recovery period: During this period, the neurochemical changes in the brain have returned to normal, and the emotions are basically normal, but they are still susceptible to conditions such as the environment, especially companion temptations, drugs, etc., so they should be reabsorbed. Therefore, psychological counseling should be strengthened to fully recover .

Methylphenidate hydrochloride is a type of amphetamine, which has an excitatory effect on the cortex and subcortical center, invigorate the spirit, relieve depression and reduce fatigue. Can produce mild euphoria and mild appetite. Larger doses excite the respiratory center, and toxic doses cause convulsions. It is clinically used in pediatric enuresis and has a good effect on children with ADHD. It can make more than half of the patients concentrate and improve their learning ability. Can also be used for mild depression, narcolepsy and central inhibitory drug overdose.

Fewer adverse reactions during treatment. Occasionally insomnia, excitement, palpitations, anxiety, anorexia and dry mouth. Large doses can increase blood pressure and cause dizziness and headache. Patients with epilepsy, hypertension, and glaucoma are disabled. Long-term use can produce tolerance and dependence, can inhibit children's growth and development, and even cause life threatening.