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Amphetamines: amphetamine addiction
Last reviewed: 07.07.2025
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Amphetamines enhance dopaminergic activity primarily by stimulating presynaptic dopamine release rather than by blocking dopamine reuptake as cocaine does. In some areas of the United States, methamphetamine is the most commonly abused substance, injected intravenously or inhaled. It causes amphetamine dependence, which is similar to cocaine dependence. A different clinical picture is observed with the use of oral psychostimulants prescribed for weight loss. These drugs reduce appetite, which leads to short-term weight loss, but their effect quickly diminishes due to the development of tolerance. Experiments on rats have shown that when amphetamine use is stopped, there is a rebound increase in appetite, resulting in weight gain above the pre-amphetamine level. Therefore, anorexigens cannot be used alone as a stand-alone treatment for obesity, but are used as a temporary adjunct in combination with specific behavioral techniques. A small proportion of patients prescribed psychostimulants to facilitate weight loss subsequently developed addiction to the drugs, expressed in persistent attempts to obtain the drug to obtain a stimulating effect. Over time, the condition of these patients begins to meet the criteria for abuse or dependence. Mazindol also reduces appetite, but has a weaker stimulating effect than amphetamine. In contrast, fenfluramine and phenylpropanolamine reduce appetite without any significant risk of abuse. Unfortunately, fenfluramine (racemic mixture) and dexfenfluramine have caused several tragic cases of primary pulmonary hypertension and heart valve pathology. Fenfluramine has also been shown to reduce serotonin granulation in monkey brains, although the significance of this phenomenon for humans remains unclear. In 1997, the FDA banned the sale of both drugs due to concerns about serious side effects.
"Khat" is a plant substance used in East Africa and Yemen, chewed to produce a stimulant effect. "Khat" contains the alkaloid cathinone, which is similar to amphetamine. More recently, methcathinone, a related substance with similar effects, has been synthesized in clandestine labs in the Midwest. However, neither drug has reached the epidemic proportions that cocaine did in the 1980s.
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