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Industry: Email Alert RSS FeedCentral nervous system stimulants
Encyclopedia of Medicine by Nancy Ross-Flanigan
Definition
Central nervous system (CNS) stimulants are medicines that speed up physical and mental processes.
Purpose
Central nervous system stimulants, such as amphetamines and methylphenidate (Ritalin), are used to treat attention-deficit hyperactivity disorder (ADHD), a condition in which people have unusually high activity levels and short attention spans. People with this condition are easily distracted and may have trouble sitting still, planning ahead, or finishing what they start. They may also act recklessly and impulsively, and have behavioral and emotional problems. Central nervous system stimulants increase attention, decrease restlessness, and improve physical coordination in people who have ADHD. The drugs may also curb impulsive behavior. When used to treat ADHD, central nervous system stimulants are just one part of the total treatment program, which also includes social, educational, and psychological help.
Although central nervous system stimulants are effective in treating ADHD, their use is controversial, especially in children. Because they may cause unwanted side effects, parents and doctors of children who need the drugs must carefully weigh the risks and benefits. There is also concern that these drugs are being prescribed for some children who do not need them. Other physical and mental conditions can have some of the same symptoms as ADHD, so it is important to rule out other causes before starting treatment with central nervous system stimulants.
This type of medicine is also used to treat narcolepsy, in which people have an uncontrollable desire to sleep or may suddenly fall into a deep sleep. The medication is prescribed in an effort to reduce the frequency and severity of attacks of narcolepsy.
Central nervous system stimulants should not be used to increase alertness or to substitute for sleep. Although they can cause loss of appetite and weight loss, they should not be used as "diet pills."
Description
Commonly used central nervous system stimulants are amphetamine, dextroamphetamine (Dexedrine, DextroStat), methamphetamine (Desoxyn), pemoline (Cylert), and methylphenidate (Ritalin).
Amphetamines and methylphenidate are available only with a doctor's prescription. Because of their high potential for abuse, sale of these drugs is strictly controlled. Prescriptions cannot be refilled. Patients must get a new prescription from the doctor each time they need a new supply of medicine.
Recommended dosage
The recommended dosage depends on the type of central nervous system stimulant and the condition for which it is being prescribed. Check with the doctor who prescribed the drug or the pharmacist who filled the prescription for the correct dosage.
Always take central nervous system stimulants exactly as directed. Never take larger or more frequent doses, and do not take the drug for longer than directed. This medicine may be habit forming if taken in large doses or over long periods.
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Be sure to follow directions for when to take the medicine. Some forms of central nervous system stimulants should not be taken too close to bedtime, for example, because they will interfere with sleep.
It may take several weeks for the effects of this medicine to be felt. Be sure to keep taking it as directed, even if it doesn't seem to be helping.
Do not stop taking this medicine suddenly after taking it for several weeks or more. It may be necessary to taper down gradually. If it is necessary to stop taking the drug, check with the doctor who prescribed it for instructions on how to stop.
Precautions
It is important to see a doctor regularly while taking central nervous system stimulants. The doctor will check to make sure the medicine is working as it should and will watch for unwanted side effects.
Some people feel drowsy, dizzy, lightheaded, or less alert when using these drugs. The drugs may also give some people a false sense of well-being. Because of these possible effects, anyone who takes these drugs should not drive, use machines, or do anything else that might be dangerous until they have found out how the drugs affect them.
Central nervous system stimulants may change the results of certain medical tests. Before having medical tests, anyone taking this medicine should alert the health care professional in charge.
These drugs may cause physical or mental dependence when taken over long periods. Anyone who shows these signs of dependence should check with his or her doctor right away:
- The need to take larger and larger doses of the medicine to get the same effect
- A strong desire to keep taking the medicine
- Withdrawal symptoms, such as depression, nausea or vomiting, stomach cramps or pain, trembling, or unusual tiredness or weakness when the medicine is stopped.
When used over long periods in children, central nervous system stimulants may interfere with growth and cause unwanted behavioral effects. Parents whose children need to take these drugs should thoroughly discuss the risks and benefits with the child's doctor. The doctor may recommend periodic "drug holidays," during which time the child stops taking the medicine.
Children may be more sensitive than adults to the effects of methylphenidate. This sensitivity may increase the chances of unwanted side effects, such as loss of appetite, stomach pain, sleep problems, and weight loss.
Special conditions
People with certain medical conditions or who are taking certain other medicines can have problems if they take central nervous system stimulants. Before taking these drugs, be sure to let the doctor know about any of these conditions:
AllergiesAnyone who has had unusual reactions to amphetamine, dextroamphetamine, ephedrine, epinephrine, isoproterenol, metaproterenol, methamphetamine, norepinephrine, phenylephrine, phenylpropanolamine, pseudoephedrine, terbutaline, or methylphenidate in the past should let his or her doctor know before taking a central nervous system stimulant. The doctor should also be told about any allergies to foods, dyes, preservatives, or other substances.
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