Abstract
Psychostimulant, cardiovascular, and temperature actions of stimulants involve adrenergic (norepinephrine), dopaminergic (dopamine), and serotonergic (serotonin) pathways. Stimulants such as amphetamine, 3,4-methylenedioxymethamphetamine (MDMA), or mephedrone can act on the neuronal membrane monoamine transporters NET, DAT, and SERT and/or the vesicular monoamine transporter 2 to inhibit reuptake of neurotransmitter or cause release by reverse transport. Stimulants may have additional effects involving pre- and postsynaptic/junctional receptors for norepinephrine, dopamine, and serotonin and other receptors. As a result, stimulants may have a wide range of possible actions. Agents with cocaine or MDMA-like actions can induce serious and potentially fatal adverse events via thermodysregulatory, cardiovascular, or other mechanisms. MDMA-like stimulants may cause hyperthermia that can be life threathening. Recreational users of stimulants should be aware of the dangers of hyperthermia in a rave/club environment.
© 2021 The Authors. The Journal of Clinical Pharmacology published by Wiley Periodicals LLC on behalf of American College of Clinical Pharmacology.
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Publication types
- Research Support, Non-U.S. Gov't
- Review
MeSH terms
- Central Nervous System Stimulants / pharmacology*
- Dopamine / metabolism
- Humans
- Neurotransmitter Transport Proteins / metabolism
- Norepinephrine / metabolism
- Serotonin / metabolism
- Substance-Related Disorders / epidemiology
- Substance-Related Disorders / pathology
Substances
- Central Nervous System Stimulants
- Neurotransmitter Transport Proteins
- Serotonin
- Dopamine
- Norepinephrine
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