What are the long-term effects of using ADD medications
recreationally?
Jessica Garner
Biological Psychology 3061
Spring 2005
Background:
Over the last several years, the recreational use of medications commonly prescribed to treat Attention Deficit Disorder and Attention Deficit Hyperactivity Disorder (ADD and ADHD, respectively), such as Adderall, Ritalin and Dexedrine, has become an epidemic. These medications, when appropriately prescribed, can be invaluable tools in treating ADD and ADHD and allow those afflicted to lead normal lives. When used improperly, though, the results can ultimately be catastrophic. Some ways in which Adderall, Ritalin or Dexedrine can be misused include:
· As a means of weight loss
· For increased energy
· As a means to increase attention, such as when one is studying for a test (especially when pulling an all-nighter)
· As a self-medicating means of relieving depression
This problem has gone so far as to now be material for TV
dramas. On the show Desperate Housewives, the character Lynette Scavo, a
stay-at-home mom, is addicted to Adderall. According to a recent article of People
magazine, stay-at-home moms are a significant portion of the population who
misuse ADD medications. These women want to be “supermoms,” and therefore use
these drugs as a source of unlimited energy. In addition to stay-at-home moms,
another major population of Adderall, Ritalin and Dexedrine abusers includes
college students. Not only are these medications used to increase energy and
attention when studying, they are also used simply to get high. The pills are often
crushed and snorted, which increases the effect of the drug.(1)
Lynette Scavo on Desperate Housewives
Definitions:
Attention
Deficit Hyperactivity Disorder: According to the textbook, ADHD “is characterized
by attention deficits (distractibility), hyperactivity(fidgetiness),
impulsivity, mood swings, short temper, high sensitivity to stress, and
impaired ability to make and follow plans”.(3)
AD/HD: A
way of referring to Attention Deficit Disorder and Attention Deficit
Hyperactivity Disorder in a combined acronym.(1)
Adderall: The
brand name of amphetamine mixed salts.
Ritalin:
The brand name of methylphenidate hydrochloride.
Dexedrine:
The brand name of dextroamphetamine sulfate.
*Chemically, these drugs are similar to cocaine, as all are
CNS stimulants and exert the same effect by increasing the amount of dopamine
available to receptors.
How ADD
medications work:
As stated before, when used properly, AD/HD medications are extremely effective in allowing those diagnosed with these disorders to lead fairly normal lives. It seems paradoxical, though, that a disorder that causes that brain to be over-stimulated to be treated with a stimulant. The reason this works is that Adderall, Ritalin and Dexedrine “release dopamine from vesicular storage pools into the cytoplasm…”(6) Dopamine ultimately has a calming effect on the body. In the short term, when these medications are abused, the effects are not especially serious. These include, but are not limited to(4):
· Paranoia
· Insomnia
· Feelings of Hostility
· Anorexia
The long terms effects, however, are much more severe.
The Long-Term Effects of ADD Medication
Abuse:
According to a study by Thompson et al., long-term use of ADD medications causes dopamine to become more readily available to the cytoplasm “…where it can be oxidized to produce neurotoxic quinines and additional reactive oxygen species that are thought to cause neurite degeneration.”(6) Their research was conducted on patients who had abused methamphetamines for 10+ years. Based on MRI scans and mapping of the brain, it was found that the brain was actually physically altered by years of stimulant abuse. Their research showed that the same drug that stimulated cells to release excess dopamine actually began to destroy dopaminergic terminals, therefore making dopamine less effective. In addition, there were significant losses in the amount of grey matter in the brain, especially the areas surrounding the corpus callosum, which is responsible for communication between hemispheres. Furthermore, there were deficits found in the hippocampus, which is responsible for such basic functions as feeding, drinking, activity level, etc.(3), and an increase in the amount of white matter, which is made up of myelinated axons.
Changes to the grey matter of the medial surface(6)
Although an increase in white matter may not seem like such a bad thing, it may “reflect adaptive glial changes or altered myelination in response to repeated drug exposure.”(6) It was found that “chronic M[eth]A[mphetamine] abuse is associated with a pattern of abnormal brain structure that is comparable with or greater than MRI deficits in early dementia and schizophrenia in terms of effect size.”(6)
Changes in amount of grey matter on the lateral surface(6)
A,B,C=Left to Left-medial
surface
D,E,F=Right to Right-medial
surface
Therefore, all of these physical changes account for the symptoms experienced by long-term abusers of ADD medications, which include behaviors characteristic of schizophrenic patients or those with Alzheimer’s. These include(5):
· Psychosis
· Memory loss
· Hallucinations
· Mood disturbances
· Stroke
The reason I chose this topic is because my mother has been taking Dexedrine inappropriately for about 11 years. I have seen firsthand the toll these drugs can take on a person. In 1994, my grandpa, my mom’s dad, passed away and my mom had a lot of unresolved issues with him. Not long after he died, she sunk into a depression and couldn’t find her way out. She was prescribed an antidepressant by her doctor, but apparently she decided it wasn’t working (after being on it for about a week) and thought she would try taking my brother’s (then appropriately prescribed) Dexedrine. She continued to take Dexedrine over the years and steadily increased the amount she took. At the time, though, I had no idea this was going on, but I knew there was something different about my mom. She was moodier, and acted very much like I would imagine someone with manic-depression would act. She would be fine one minute and the next she would be in a rage. These symptoms slowly got worse as time went on, until late 2003. At that point, my parents got divorced and my mom lost all touch with reality. Today, she continues to make outrageous claims about how all of my family members and her former friends are “out to get her,” and is completely paranoid, believing she is being followed and that she is under surveillance (by who, I have no idea). She’ll call me to tell me about all these conspiracy theories she has, then call me back five minutes later, not remembering she had just called me. She lives a very sad life, but because she literally believes that the entire world has gone crazy and she is the only sane one, she will not get help and as a result has lost all her family and friends. Though she has never been officially diagnosed, my family and I believe that her symptoms most closely resemble what is known as amphetamine-induced psychosis, and at this point, the damage is beyond repair.
My family at my high school graduation in 2000
Project Analogy:
My analogy compares the abuse of AD/HD medications to a cell phone. When you first buy a cell phone, when it’s charged for the first time, the charge lasts for a really long time and it does not need to be recharge for several days. The reception is great, and the phone casing doesn’t have any scratches or dings. After you’ve had it a while though, it begins to need to be charged more often. It requires more time spent charging than it did in the beginning. Maybe the antenna broke off, so the reception isn’t as good anymore, and the casing starts getting scratched and dented. The longer you have it, the more charging it requires, the worse the reception is and the more scratches and dents the casing gets. Finally, by the end of its run, you begin to get worried about it not working when you are out. What if you get into an emergency and really need to call someone for help?
In this
analogy, the cell phone battery that requires more and more charging represents
the higher and higher doses a person needs to take to get the same effect he
got the first time he used Adderall. The reception that begins to get worse is
analogous to the emotional state of the individual abusing ADD medications as
it begins to get more erratic, and the scratches and dents that the casing
accumulates represent the physical changes that occur in the brain of the user.
Resources:
(1) Drejka, M. Adderall, Ritalin, AD/HD and Abuse. http://serendip.brynmawr.edu/bb/neuro/neuro02/web1/mdrejka.html
(2) Ellison, G. Stimulant-induced Psychosis, the Dopamine Theory of Schizophrenia and the Habeula. UCLA. May 1994.
(3) Kalat, J.
Biological Psychology 8th edition.
(4) NIDA. http://www.drugabuse.gov/PDF/RRPrescription.pdf. July 2001.
(5) NIDA. http://www.drugabuse.gov/ResearchReports/methamph/methamph3.html#long
(6) Thompson et al. Structural Abnormalities in the Brains of Human Subjects Who Use Methamphetamine. Journal of Neuroscience, 24(26). June 2003.