Sections
Psychostimulants and Wakefulness-Promoting Agents: Introduction | Amphetamines | Lisdexamfetamine | Methylphenidate | Modafinil | Armodafinil | Clinical Uses of Stimulants and Wakefulness-Promoting
Agents | Conclusion | References
Excerpt
Amphetamine, first discovered in 1887, and the
subsequently developed stimulants have been used in clinical psychiatry
with varying results. Beyond their use for attention-deficit/hyperactivity
disorder (ADHD), they have been used for symptomatic relief based
on their effects on mood and hedonic drive. Research into the use
of stimulants as adjunctive agents in the treatment of specific symptoms
and syndromes has been increasing. Evaluation of new medications,
such as modafinil and armodafinil, which are classified as wakefulness-promoting
agents, has further heightened interest in a possible therapeutic role
for such agents in treatment of neurobehavioral disorders. Various
common adjunctive psychotherapeutic uses for stimulants, such as
depression, have not been well researched, while other indications,
such as narcolepsy, are backed by considerable clinical data. Nonetheless, much
more data are needed on the safety and efficacy of traditional psychostimulants
as well as the newer agents in the treatment of psychiatric disorders.
In this chapter, we review the pharmacology of these medications
and their indications (Tables 43–1 and 43–2).