CNS stimulants, such as dextroamphetamine (Dexedrine) and methylphenidate (Ritalin), are prescribed for attention-deficit hyperactivity disorder (ADHD), narcolepsy (a sleeping disorder), and depression that has not responded to other treatments. Stimulants copy the activity of the neurotransmitters dopamine and norepinephrine by stimulating their specific receptors. This results in increased alertness, attention, and energy. Stimulants also result in increased feelings of pleasure, higher blood pressure and heart rate, and increased blood glucose levels.

Scientists propose that there is less dopamine transmission in the brains of persons with ADHD when compared to other individuals. Because stimulants correct this shortfall, individuals with ADHD better able to pay attention and concentrate their focus on a task. It is premature to draw solid conclusions, but studies so far have not shown a difference in later substance use in young people with ADHD treated with prescription stimulants compared with those who didn't receive such treatment. This suggests that treatment with ADHD medication does not positively or negatively affect a person's risk of developing problem use. Individuals who misuse Ritalin often do so by taking more than prescribed, taking pills not prescribed for them, or by crushing and then snorting the tablets. This causes wakefulness and euphoria. The increased dopamine transmission caused by ingesting Ritalin reinforces the behavior of taking the drug, putting a user at risk of addiction.

What are stimulants?

As the name suggests, stimulants increase alertness, attention, and energy, as well as elevate blood pressure, heart rate, and respiration. Stimulant medications are often prescribed to treat children, adolescents, or adults diagnosed with ADHD.

Stimulants used to treat ADHD include:

• Methylphenidate
• Amphetamine
• Dextroamphetamine
• Lisdexamfetamine Dimesylate

Note: In 2002, the FDA approved the non-stimulant medication atomoxetine for use as a treatment for ADHD. Two other non-stimulant antihypertensive medications, clonidine and guanfacine, are also approved for treatment of ADHD in children and adolescents. One of these non-stimulant medications is often tried first in a young person with ADHD, and if response is insufficient, then a stimulant is prescribed.

Stimulants are also prescribed to treat other health conditions, including narcolepsy, and occasionally depression (especially in older or chronically medically ill people and in those who have not responded to other treatments).

How do people respond to stimulants?

Prescription stimulants have a calming and “focusing” effect on individuals with ADHD. Stimulant medications are safe when given under a doctor's supervision. Some children taking them may feel slightly different or "funny."

Some parents worry that stimulant medications may lead to drug abuse or dependence, but there is little evidence of this when they are used properly as prescribed. Additionally, research shows that teens with ADHD who took stimulant medications were less likely to abuse drugs than those who did not take stimulant medications.

What are the possible side effects of stimulants?

Stimulants may cause side effects. Most side effects are minor and disappear when dosage levels are lowered. The most common side effects include:

• Difficulty falling asleep or staying asleep
• Loss of appetite
• Stomach pain
• Headache

Less common side effects include:

• Motor tics or verbal tics (sudden, repetitive movements or sounds)
• Personality changes, such as appearing “flat” or without emotion

Call your doctor right away if you have any of these symptoms, especially if they are new, become worse, or worry you.

Stimulants may cause other side effects that are not included in the list above. To report any serious adverse effects associated with the use of stimulants, please contact the FDA MedWatch program using the contact information at the bottom of this page. For more information about the risks and side effects for each medication, please see Drugs@FDA.

Medications that increase alertness, attention, energy, blood pressure, heart rate, and breathing rate.

What is prescription stimulant (amphetamine) misuse?

Also known as: Bennies, Black Beauties, Hearts, Roses, Skippy, Speed, Study Drugs, The Smart Drug, Uppers, and Vitamin R

Prescription stimulants increase—or "stimulate"—activities and processes in the body. This increased activity can boost alertness, attention, and energy. It also can raise your blood pressure and make your heart beat faster. When prescribed by a doctor for a specific health condition, they can be relatively safe and effective. However, dependence and addiction are still potential risks when taking prescription stimulants. These risks increase when these drugs are misused. Taking someone else's prescription drugs or taking the drugs to get “high” can have serious health risks.

There are two commonly misused types of stimulants: amphetamines (e.g., Adderall) and methylphenidate (e.g., Ritalin). In the past, stimulants were used to treat a variety of conditions, including asthma and other breathing problems, obesity, and health problems that affect your nervous system. Now, because the risk for misuse and addiction is better understood, doctors prescribe them less often and only for a few health conditions. They are still prescribed for attention deficit hyperactivity disorder (ADHD), narcolepsy (a sleep disorder), and, in some instances, depression that has not responded to other treatments.

How Stimulants Are Misused

Prescription stimulants are normally taken in pill form, but some people who misuse them to get "high" crush the tablets and snort or inject them. This can be dangerous because ingredients in the tablets can block small blood vessels, damaging the heart and other organs.

Some teens are prescribed stimulants to manage their ADHD. But if they share their medication with friends, it is considered misuse. People misuse stimulants by taking them in a way that is not intended, such as:

• Taking someone else’s prescription stimulant medication.
• Taking a prescription stimulant medication in a way other than prescribed.
• Taking the prescription stimulant to get high.
• Mixing them with alcohol and certain other drugs. A pharmacist can tell you which drugs are not safe to mix with stimulants.

Stimulants have been misused as an "academic performance enhancer," (for example, to stay awake all night to cram for an exam). That's why people sometimes refer to them as "study drugs." However, studies have found that stimulants do not increase learning or thinking ability when taken by people who have not been diagnosed with a medical condition like ADHD.

What happens to your brain when you use prescription stimulants?

The brain is made up of nerve cells that send messages to each other by releasing chemicals called neurotransmitters. Common stimulants, such as amphetamines and methylphenidate, have chemical structures that are similar to certain key brain neurotransmitters including dopamine and norepinephrine. Stimulants boost the effects of these chemicals in the brain and body.

When doctors prescribe stimulants for a medical condition, they start with low doses and increase them slowly until they find the dose that works best. However, when taken in amounts or ways other than prescribed, like snorting or injecting, stimulants can increase the dopamine in the brain very quickly. This changes the normal communication between brain cells, producing a ‘high’ while also increasing the risk for dangerous side effects. Over time, this can lead to addiction, which is when you continue to use the drug despite negative consequences.

What happens to your body when you use prescription stimulants?

Stimulant use can have side effects, even when prescribed by a doctor. Misuing them can be especially dangerous. Taking high doses of a stimulant can cause:

• increased blood pressure
• irregular heartbeat
• dangerously high body temperatures
• decreased sleep
• lack of interest in eating, which can lead to poor nutrition
• intense anger or paranoia (feeling like someone is going to harm you even though they aren’t)
• risk for seizures and stroke at high doses

Can you overdose or die if you use prescription stimulants?

Yes, it is possible to die from stimulant misuse. Taking high doses of a stimulant can raise a person’s body temperature and blood pressure to dangerous levels and make the heart beat irregularly. This can lead to seizures, heart failure, and death. Stimulants should not be mixed with medicines used to treat depression or over-the-counter medicines that contain decongestants.

Are prescription stimulants addictive?

Yes, misusing stimulants can lead to addiction. Addiction is when you continue to seek out and take the drug even though you know it is damaging you health and life, even ruining your relationships and causing you problems in school or at work.

When a person who regularly misuses stimulants stops taking them, they may experience withdrawal symptoms. Stimulant withdrawal can cause:

• an inability to feel pleasure
• thoughts of suicide
• anxiety and irritability
• feeling very tired, lack of energy, and changes in sleep patterns
• intense drug cravings

People who have these symptoms should seek medical help.

What should I do if someone I know needs help?

If you, or a friend, are in crisis and need to speak with someone now:

• Call National Suicide Prevention Lifeline at 1-800-273-TALK (they don't just talk about suicide—they cover a lot of issues and will help put you in touch with someone close by)

If you need information on drug treatment and where you can find it, the Substance Abuse and Mental Health Services Administration can help.

• Call Substance Abuse Treatment Facility Locatorat 1-800-662-HELP
• Visit the locator online at www.findtreatment.samhsa.gov

What are prescription stimulants?

Prescription stimulants are medicines generally used to treat attention-deficit hyperactivity disorder (ADHD) and narcolepsy—uncontrollable episodes of deep sleep. They increase alertness, attention, and energy.

What are common prescription stimulants?

• dextroamphetamine (Dexedrine^®)
• dextroamphetamine/amphetamine combination product (Adderall^®)
• methylphenidate (Ritalin^®, Concerta^®).

Popular slang terms for prescription stimulants include Speed, Uppers, and Vitamin R.

Do prescription stimulants make you smarter?

Some people take prescription stimulants to try to improve mental performance. Teens and college students sometimes misuse them to try to get better grades, and older adults misuse them to try to improve their memory. Taking prescription stimulants for reasons other than treating ADHD or narcolepsy could lead to harmful health effects, such as addiction, heart problems, or psychosis.

How do people use and misuse prescription stimulants?

Most prescription stimulants come in tablet, capsule, or liquid form, which a person takes by mouth. Misuse of a prescription stimulant means:

• taking medicine in a way or dose other than prescribed
• taking someone else's medicine
• taking medicine only for the effect it causes—to get high

When misusing a prescription stimulant, people can swallow the medicine in its normal form. Alternatively, they can crush tablets or open the capsules, dissolve the powder in water, and inject the liquid into a vein. Some can also snort or smoke the powder.

How do prescription stimulants affect the brain and body?

Prescription stimulants increase the activity of the brain chemicals dopamine and norepinephrine. Dopamine is involved in the reinforcement of rewarding behaviors. Norepinephrine affects blood vessels, blood pressure and heart rate, blood sugar, and breathing.

Short-Term Effects

People who use prescription stimulants report feeling a "rush" (euphoria) along with the following:

• increased blood pressure and heart rate
• increased breathing
• decreased blood flow
• increased blood sugar
• opened-up breathing passages

At high doses, prescription stimulants can lead to a dangerously high body temperature, an irregular heartbeat, heart failure, and seizures.

What are the other health effects of prescription stimulants?

Repeated misuse of prescription stimulants, even within a short period, can cause psychosis, anger, or paranoia. If the drug is injected, it is important to note that sharing drug injection equipment and having impaired judgment from drug misuse can increase the risk of contracting infectious diseases such as HIV and hepatitis.

Risk of Later Substance Use

Some people may be concerned about later substance misuse in children and teens who've been prescribed stimulant drugs to treat ADHD. Studies so far have not shown a difference in later substance use in young people with ADHD treated with prescription stimulants compared with those who didn't receive such treatment. This suggests that treatment with ADHD medication does not positively or negatively affect a person's risk of developing problem use.

Can a person overdose on prescription stimulants?

Yes, a person can overdose on prescription stimulants. An overdose occurs when the person uses enough of the drug to produce a life-threatening reaction or death.

When people overdose on a prescription stimulant, they most commonly experience several different symptoms, including restlessness, tremors, overactive reflexes, rapid breathing, confusion, aggression, hallucinations, panic states, abnormally increased fever, muscle pains and weakness.

They also may have heart problems, including an irregular heartbeat leading to a heart attack, nerve problems that can lead to a seizure, abnormally high or low blood pressure, and circulation failure. Stomach issues may include nausea, vomiting, diarrhea, and abdominal cramps. In addition, an overdose can result in convulsions, coma, and fatal poisoning.

How can a prescription stimulant overdose be treated?

Because prescription stimulant overdose often leads to a heart attack or seizure, the most important step to take is to call 911 so a person who has overdosed can receive immediate medical attention. First responders and emergency room doctors try to treat the overdose with the intent of restoring blood flow to the heart and stopping the seizure with care or with medications if necessary.

Can prescription stimulant use lead to substance use disorder and addiction?

Yes, misuse of prescription stimulants can lead to a substance use disorder (SUD), which takes the form of addiction in severe cases. Long-term use of stimulants, even as prescribed by a doctor, can cause a person to develop a tolerance, which means that he or she needs higher and/or more frequent doses of the drug to get the desired effects. An SUD develops when continued use of the drug causes issues, such as health problems and failure to meet responsibilities at work, school, or home. Concerns about use should be discussed with a health care provider.

If a person develops an SUD and stops use of the prescription stimulant, he or she can experience withdrawal. Withdrawal symptoms can include:

• fatigue
• depression
• sleep problems

How can people get treatment for prescription stimulant addiction?

Behavioral therapies, including cognitive-behavioral therapy and contingency management (motivational incentives), can be effective in helping to treat people with prescription stimulant addiction. Cognitive-behavioral therapy helps modify the patient's drug-use expectations and behaviors, and it can effectively manage triggers and stress. Contingency management provides vouchers or small cash rewards for positive behaviors such as staying drug-free.

Points to Remember

• Prescription stimulants are medicines used to treat ADHD and narcolepsy.
• Most prescription stimulants come in tablet, capsule, or liquid form, which a person takes by mouth. When misusing a prescription stimulant, a person can swallow, snort, smoke, or inject the drug.
• Prescription stimulants increase the activity of the brain chemicals dopamine and norepinephrine.
• Prescription stimulants increase alertness, attention, and energy. Their misuse, including overdose, can also lead to psychosis, anger, paranoia, heart, nerve, and stomach problems. These issues could lead to a heart attack or seizures.
• Prescription stimulant misuse can lead to a substance use disorder, which takes the form of addiction in severe cases, even when used as prescribed by a doctor.
• Withdrawal symptoms include fatigue, depression, and sleep problems. Concerns about use should be discussed with a health care provider.
• Behavioral therapies can be effective in helping people stop prescription stimulant misuse, including cognitive-behavioral therapy and contingency management.

What is it?

Stimulant drug made from the leaves and twigs, evergreen shrub. Active ingredients are cathine and cathinone.

Street Names

Abyssinian Tea, African Salad, Catha, Chat, Kat, Miraa, Oat, Qat, Quaadka

How is it used?

• Chewed
• Dried Khat is used as a tea or chewable paste
• Smoked, sprinkled on food

Paphernalia

How does it affect the body?

• Manic behavior with grandiose delusions
• Chronic use can cause depression and suicide
• Hallucinations, paranoia, nightmares
• Euphoria, increased alertness and energy, hyperactivity
• Increase in blood pressure and heart rate
• Cardiac complications
• Insomnia, gastric disorders