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Drugs and.Pharmacology

Central Nervous System Stimulants And Sport Practice

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Abstract

Background and objectives

Central nervous system (CNS) stimulants may be used to reduce tiredness and increase alertness, competitiveness, and aggression. They are more likely to be used in competition but may be used during training to increase the intensity of the training session. There are several potential dangers involving their misuse in contact sports. This paper reviews the three main CNS stimulants, ephedrine, amfetamine, and cocaine, in relation to misuse in sport.

Methods

Description of the pharmacology, actions, and side effects of amfetamine, cocaine, and ephedrine.

Results

CNS stimulants have psychotropic effects that may be perceived to be ergogenic. Some are prescription drugs, such as Ephedra alkaloids, and there are issues regarding their appropriate therapeutic use. Recently attention has been given to their widespread use by athletes, despite the lack of evidence regarding any ergogenic or real performance benefit, and their potentially serious side effects. Recreational drugs, some of which are illegal (cocaine, amfetamines), are commonly...

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y-Hydroxybutyrate Concentrations in Pre- and Postmortem Blood and Urine

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To the Editor:

With γ-hydroxybutyrate (GHB) becoming popular as a drug of abuse in the US and elsewhere (1), we are receiving increasing requests for the analytical determination of GHB in blood or urine in criminal investigations, especially in sexual assault cases. In a recent report of a fatal poisoning with GHB, the victim had a postmortem blood GHB concentration of 27 mg/L (2), and another three GHB-related fatalities were reported with postmortem blood GHB concentrations of 52–121 mg/L (3).

As a part of a validation study before instituting a GC-MS method described by others (4), we tested for GHB presence in a series of forensic specimens submitted routinely to us by law enforcement agencies and medical examiner offices in cases not known to be GHB-related. No GHB was detected (detection limit, 1 mg/L) in the blood or urine of living persons or in postmortem urine, but very substantial concentrations,...

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Psychotropic Drugs And Homicide: A Prospective Cohort Study From Finland

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After a high-profile homicide case, there is often discussion in the media on whether or not the killing was caused or facilitated by a psychotropic medication. Antidepressants have especially been blamed by non-scientific organizations for a large number of senseless acts of violence, e.g., 13 school shootings in the last decade in the U.S. and Finland [1]. In September 2014, there were more than 139,000 hits from Google for the search terms “antidepressant, homicide”, and more than 1,050,000 hits for the terms “antidepressant, violence”. It is likely that such massive publicity in the lay media has already led a number of patients and physicians to abstain from antidepressant treatment, due to the perceived fear of pharmacologically induced violence.

What is the scientific evidence for an association between psychotropic drugs and homicidal behavior? Most of the available studies are case reports that only suggest a coincidental link between violence or homicide and antidepressants...

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Drug-Induced Liver Injury

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Drug-induced liver injury is an injury of the liver that may occur when you take certain medicines.

Other types of liver injury include:

• Viral hepatitis • Alcoholic hepatitis • Autoimmune hepatitis • Iron overload  • Fatty liver • Causes   The liver helps the body break down certain medicines. These include some drugs that you buy over-the-counter or your health care provider prescribes for you. However, the process is slower in some people. This can make you more likely to get liver damage. Some drugs can cause hepatitis with small doses, even if the liver breakdown system is normal. Large doses of many medicines can damage a normal liver.

Many different drugs can cause drug-induced hepatitis.

Painkillers and fever reducers that contain acetaminophen are a common cause of liver injury, particularly when taken in doses greater than those recommended. People who drink alcohol to excess are more likely to have this problem...

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Drug-Induced Compulsive Behaviors: Exceptions to the Rule

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To the Editor: We are intrigued by the recent article by Bostwick et al1 on the emergence of impulse control behaviors after treatment with dopamine agonists. It is amazing how these gambling and hypersexuality adverse effects occur and then seem to immediately abate simply by discontinuing the Parkinson disease medication without need for any additional addiction-related treatment. Ropinirole was recently investigated in a phase 4 clinical trial as a treatment for sexual dysfunction secondary to antidepressant pharmacotherapy,2 which speaks to its possible effects on sexual behavior. Dopamine agonists may affect the mesolimbic pathway, as do drugs like cocaine and methamphetamine, whose behavioral properties are attributed to this dopaminergic activity; sexual compulsivity is a well-established adverse effect of these medications.3 Furthermore, dopamine dysregulation syndrome, an addictive use pattern of dopamine agonists, causes the same behaviors observed in cocaine-dependent patients, such as punding, a stereotypical motor behavior...

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Presentation of the Steroid Psychoses.

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Abstract

This study suggests that patients receiving daily doses of 40 mg of prednisone or its equivalent, are at greater risk for developing steroid psychosis. Psychotic reactions were twice as likely to occur during the first 5 days of treatment as subsequently. Premorbid personality, history of previous psychiatric disorder, and a history of previous steroid psychosis did not clearly increase the patient's risk of developing psychotic reaction during any given course of therapy. Steroid psychoses present as spectrum psychoses with symptoms ranging from affective through schizophreniform to those of an organic brain syndrome. No characteristic stable presentation was observed in these 14 cases reported here. The most prominent symptom constellation to appear some time during the course of the illness consisted of emotional lability, anxiety, distractibility, pressured speech, sensory flooding, insomnia, depression, perplexity, agitation, auditory and visual hallucinations, intermittent memory impairment, mutism, disturbances of body image, delusions, apathy, and hypomania. Phenothiazines...

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