Psychostimulants

Psychostimulants

ADHD (Attention Deficit-Hyperactivity Disorder)

Indications

  • Attention deficit/hyperactivity disorder (A D H D) in children and adults
  • Medications are also used to treat narcolepsy and exogenous obesity

Medication action

  • The C N S stimulants increase levels of norepinephrine, dopamine, and serotonin in the C N S. Their effectiveness in the treatment of ADHD is thought to be based on the activation of dopamine D4 receptors in the basal ganglia and thalamus, which depress, rather than enhance, motor activity.
  • Atomoxetine inhibits the reuptake of norepinephrine, and bupropion blocks the neuronal uptake of serotonin, norepinephrine, and dopamine.
  • Clonidine and guanfacine stimulate central alpha-adrenergic receptors in the brain, resulting in reduced sympathetic outflow from the CNS.
  • The exact mechanism by which these non-stimulant drugs produce the therapeutic effect in ADHD is unclear.

Contraindications

C N S stimulants

  • Contraindicated in clients with hypersensitivity to sympathomimetic amines; clients with advanced arteriosclerosis, cardiovascular disease, hypertension, hyperthyroidism, glaucoma, agitated or hyper-excitability states; clients with a history of drug abuse; clients during or within 14 days of receiving therapy with MAOI’s; in children younger than 3 years of age; and in pregnancy and lactation

Atomoxetine and bupropion

  • Contraindicated in clients with hypersensitivity to the drugs, in lactation, and in concomitant use with or within 2 weeks of using MAOI’s

Alpha agonists

  • Contraindicated in clients with known hypersensitivity to the drugs

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