Potential adverse effects of amphetamine treatment on brain and behavior: a review.
Potential adverse effects of amphetamine treatment on brain and behavior: a review.
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DOI：
10.1038/mp.2008.90
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发表时间：
2009-02
影响因子：
11
通讯作者：
London, E. D.
中科院分区：
文献类型：
--
作者：
Berman, S. M.;Kuczenski, R.;McCracken, J. T.;London, E. D.
自世纪初以来，安非他明兴奋剂一直被用于医疗，但滥用的可能性很大，而且可能具有神经毒性。虽然安非他明长期以来一直被有效地用于治疗儿童和青少年的注意力缺陷多动障碍，但现在安非他明越来越多地被用作成人注意力缺陷多动障碍和嗜睡症的维持疗法，大大延长了潜在接触期。长期兴奋剂治疗的影响尚未得到充分探讨，了解这种影响是研究的优先事项。由于安非他明的药代动力学在儿童和成人之间存在差异，因此必须重新评估成人长期治疗的潜在不良反应。尽管有关于兴奋剂对实验室动物的影响的资料，但在对兴奋剂诱导的神经毒性的敏感性方面存在着深刻的物种差异，这突出表明需要对人类长期接触兴奋剂进行系统研究。早期安非他明治疗与一些儿童身高和体重增长减缓有关。由于安非他明处方数量在过去十年中增加了几倍，含安非他明制剂是北美最常见的处方兴奋剂，值得注意的是，安非他明也是滥用最多的处方药。虽然早期治疗不会增加药物滥用的风险，但很少有研究跟踪成年后开始接受安非他明治疗的个人的依从性和使用情况。总体而言，人们担心持续给药的年轻患者生长缓慢的风险，以及在青春期后期或成年期首次用药的患者的药物滥用风险。虽然大多数成年患者也有效和安全地使用安非他明，但偶尔的病例报告表明，处方使用可产生明显的心理不良事件，包括兴奋剂引起的精神病。有必要对长期接受安非他明治疗的成年人在成年后期和衰老期间的中枢毒性和不良心理影响进行评估。最后，还需要确定造成风险的生物因素和提供保护的生物因素，以便更好地确定成人苯丙胺安全、长期、治疗性给药的参数。
Amphetamine stimulants have been used medically since early in the twentieth century, but they have a high abuse potential and can be neurotoxic. Although they have long been used effectively to treat attention deficit hyperactivity disorder (ADHD) in children and adolescents, amphetamines are now being prescribed increasingly as maintenance therapy for ADHD and narcolepsy in adults, considerably extending the period of potential exposure. Effects of prolonged stimulant treatment have not been fully explored, and understanding such effects is a research priority. Because the pharmacokinetics of amphetamines differ between children and adults, reevaluation of the potential for adverse effects of chronic treatment of adults is essential. Despite information on the effects of stimulants in laboratory animals, profound species differences in susceptibility to stimulant-induced neurotoxicity underscore the need for systematic studies of prolonged human exposure. Early amphetamine treatment has been linked to slowing in height and weight growth in some children. Because the number of prescriptions for amphetamines has increased several-fold over the past decade, an amphetamine-containing formulation is the most commonly prescribed stimulant in North America, and it is noteworthy that amphetamines are also the most abused prescription medications. Although early treatment does not increase risk for substance abuse, few studies have tracked the compliance and usage profiles of individuals who began amphetamine treatment as adults. Overall, there is concern about risk for slowed growth in young patients who are dosed continuously, and for substance abuse in patients first medicated in late adolescence or adulthood. Although most adult patients also use amphetamines effectively and safely, occasional case reports indicate that prescription use can produce marked psychological adverse events, including stimulant-induced psychosis. Assessments of central toxicity and adverse psychological effects during late adulthood and senescence of adults who receive prolonged courses of amphetamine treatment are warranted. Finally, identification of the biological factors that confer risk and those that offer protection are also needed to better specify the parameters of safe, long-term, therapeutic administration of amphetamines to adults.
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DOI：
10.1016/s0165-3806(98)00116-3
发表时间：
1998-11-01
期刊：
DEVELOPMENTAL BRAIN RESEARCH
影响因子：
--
作者：
Bolanos, CA;Glatt, SJ;Jackson, D
通讯作者：
Jackson, D
影响因子：
3.3
作者：
CARLSSON, A;WINBLAD, B
通讯作者：
WINBLAD, B
影响因子：
7.6
作者：
Brandon, CL;Marinelli, M;White, FJ
通讯作者：
White, FJ
影响因子：
7.6
作者：
BORCHERDING, BG;KEYSOR, CS;RAPOPORT, JL
通讯作者：
RAPOPORT, JL
影响因子：
3.6
作者：
BOWYER, JF;GOUGH, B;HOLSON, RR
通讯作者：
HOLSON, RR