Dependence on amfetamines

 

 

After prolonged administration, tolerance to the appetite suppression and reduced fatigue occur, however, the user continues to take the drug in order to achieve the euphoria, which in turn makes them want the drug further. This is known as “positive reinforcement”.

 

Prolonged use can be neurotoxic with the destruction of 5-HT and DA neurones due to the build-up of toxic metabolites within nerve terminals.

 

“Amfetamine psychosis” can also be triggered, particularly if the person is genetically predisposed  or under stress. It presents similarly to schizophrenia with repetitive behaviours.

 

Withdrawal symptoms usually occur within 24 hours of the last dose and is worse if the patient is older or has a long history of abuse. It consists of two phases which can last over 3 weeks:-

• Phase 1- severe “crash” lasting one week, increased sleep but of poor quality and increased appetite

• Phase 2- hypersomnia, insomnia and increased appetite, lasts a minimum of 2 weeks