View Full Version : Stimulant usage = Permanent Brain Alterations/Changes? (Evidence/Studies)


dreneeps
03-11-10, 05:07 PM
I'm new to the forum and this is my first post so please forgive and correct any errors or lack of etiquette I may have. I'm hear to learn and hopefully add to the discussion. I have been researching the possibility of any permanent damage/alterations that stimulants may have. I have been trying to focus on the compounds in Adderall and Vyvanse specifically but, much of what I found was more generalized to amphetamines or methamphetamine. Overall, I'm fine dealing with tolerances, side effects, withdrawals, and changes in my body chemistry that will eventually reset or go away with time. (Even if it's months.) I have just been finding things that suggest that various amphetamines or methamphetamines POSSIBLY have permanent effects. Specifically in the parts of the brain that the drugs alter. (Dopamine production, etc)

Here is one article

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mso-fareast-font-family:Calibri; mso-fareast-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} .MsoPapDefault {mso-style-type:export-only; margin-bottom:10.0pt; line-height:115%;} @page Section1 {size:8.5in 11.0in; margin:1.0in 1.0in 1.0in 1.0in; mso-header-margin:.5in; mso-footer-margin:.5in; mso-paper-source:0;} div.Section1 {page:Section1;} --> </style><!--[if gte mso 10]> <style> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} </style> <![endif]--> Partial recovery of brain metabolism in methamphetamine abusers after protracted abstinence:

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Laboratory, Upton, NY
<o></o>Am J Psychiatry. 2004 Feb;161(2):193-4<o></o>

"CONCLUSIONS: The persistent decreases in striatal metabolism in methamphetamine abusers could reflect long-lasting changes in dopamine cell activity, and decreases in the nucleus accumbens could account for the persistence of amotivation and anhedonia in detoxified methamphetamine abusers." ...
"...These results suggest that while protracted abstinence may reverse SOME of the methamphetamine-induced alterations in brain function, other deficits persist. "


1. My question is whether or not many ADHD meds are similar enough to be concerned?

2. How they affect the brains chemistry is similar so would this effect also be similar?

3. Does abuse mean taking excessive amounts or something else?

4. Does anyone know exactly what specifically happens to the brain when these drugs are abused as opposed to taken as prescribed? (Information about this concerning ANY ADD medication similar to or that is present in adderall/vyvanse would be great!)

I would really like to find any studies that conclusively show in animals or humans that FULL recovery or return to the brains previous physiological state happens.

Anyone know of anything?

APSJ
03-11-10, 08:09 PM
Abuse could mean any number of things, but in this context it almost certainly refers to people who used non-pharmaceutical methamphetamine recreationally.

There is an enormous difference between abusing methamphetamine, or any drug, and taking it as prescribed by a doctor. The article you cite talks specifically about people recovering from symptoms of methamphetamine abuse. These symptoms do not normally occur at all when someone takes a stimulant as prescribed by their doctor, so the question of 'recovery' just isn't relevant when talking about medical use: there's nothing to recover from.

Amphetamines are not new drugs that we're just learning about. They've been prescribed for decades, and their safety and usefulness as treatments for ADHD has been confirmed by numerous studies. I can understand that it would be alarming to read something like the article you cite when considering taking a similar substance, but the effects of methamphetamine abuse are really very different from the effects of responsible, medical use of amphetamines.

dreneeps
03-11-10, 10:35 PM
Thank you very much for the fast response. I'm trying to decide what to take and weigh the pros and cons.

So is it just the dosage difference that changes it from "prescribed use" to abuse?

I would be curious to see some studies on the brains and brain chemistry of people that have taken a strong stimulant for ADHD for extended periods of time?

Do you happen to know of any studies or resources that prove this or where I could look for them?

dreneeps
03-11-10, 11:18 PM
This is what I first read that inspired investigation.
Taken from:

Potential Adverse Effects of Amphetamine Treatment on Brain and Behavior: A Review

Departments of Psychiatry and Biobehavioral Sciences, Molecular and Medical Pharmacology, and the Brain Research Institute, School of Medicine, University of California; and Department of Psychiatry, University of California


"...Concerns have been voiced that, in addition to neurobiological adaptations, prolonged exposure to amphetamine could damage components of the central nervous system. These concerns arise, in part, from evidence that exposure of experimental animals to acute, high doses of amphetamine or methamphetamine produces damage, generally referred to as “neurotoxicity”, to dopaminergic neurons innervating the dorsal striatum (caudate-putamen). The evidence for neurotoxicity in rodents derives almost exclusively from studies utilizing very high parenterally administered doses of the drugs, typically administered in a “binge” pattern; i.e., four successive injections at 2-hr intervals <sup>41 (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2670101/#R41)</sup><sup>, </sup><sup>42 (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2670101/#R42)</sup>. The damage is evident as deficits in phenotypic markers for dopaminergic nerve terminals, including dopamine, its biosynthetic enzymes tyrosine hydroxylase and aromatic amino acid decarboxylase, and both the plasma membrane dopamine transporter (DAT) as well as the vesicular monoamine transporter. High doses of amphetamines have produced enlarged chromatolytic medulla neurons in cats <sup>43 (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2670101/#R43)</sup>, and parenteral dosing in rodents can also produce swollen or reduced dopaminergic axons, and serotonin deficits. The deficits in dopaminergic nerve terminals are not accompanied by apparent damage to the dopamine-containing cell bodies within the substantia nigra. Nevertheless, they can persist for years following cessation of drug exposure <sup>44 (http://www.ncbi.nlm.nih.gov/pubmed/16936713)</sup>. Although the relevance of these data to the consequences of low dose, prescription use of amphetamines in humans is not entirely clear, the potential for similar damage following prolonged low dose exposure merits some consideration."

I would just really like to find more fact, studies, and evidence that things can go back to normal after some of these medications. It has to be out there right?

TygerSan
03-13-10, 12:45 PM
The big, big differences between abuse and legitimate use are dose, route of administration, and patterns of use. The binge pattern referenced in the first abstract you cite usually entails limited access to rather high doses of the drugs; the rats tend to go wild under that type of schedule, and will work very hard for a long time to keep going. Most ppl who abuse stimulants tend to either snort or inject the drugs (though taking handfulls of pills is not out of the question), which increases greatly the speed at which the drug reaches the brain, which consequently increases the feelings of "high". The higher doses and more frequent binge uses I could speculate would take a much higher toll on the brain than taking a pill as prescribed. It doesn't mean that there aren't potentially permanent effects, just that they are likely less severe than those of a meth addict who's been abusing their body for years.

Dizfriz
03-13-10, 02:02 PM
dreneeps

If you want to research this then Google Scholar is a good place to start. http://scholar.google.com/

While you are looking, pay attention to the cites.This gives you an idea of the impact the study has had. The more cites, generally the more important the study and the more influence it has.

I did a quick test on "amphetamines adhd brain change" and got over 8000 hits on just that one phrasing

I also did a similar search with this phrase in Google. Lots and lots of hits.

The problem with the general site is that it brings a lot of crank and crackpot stuff. Focus on the ones with .gov or .edu for the most reliable information.

Good luck

Dizfriz

ADHDTigger
03-13-10, 06:30 PM
Dreneeps, I'm going to toss this out as well so that you can consider it.

Methamphetamine is not something that is manufactured to a specific tolerance level or levels. No one is batch testing it to insure consistency. It is cooked up in mobile home-grown "labs" whose primary commonality is a desire to avoid law enforcement. There is simply no way of knowing what ends up in the chemical makeup of the drug. Further to that, the drug may be cut with any of a number of inert substances in order to 'stretch' the yield for greater reward to the 'manufacturer'.

Without taking those unknowns into account, I don't know that any study can be considered equivalent for the stimulant taking population who use a prescribed and regulated supply and are under watchful eyes.

I strongly encourage anyone to be educated about their medications but remind you that the differences between anyone on a standard stimulant medication for ADHD and a methamphetamine addict are extreme.

If you want to read about how impactful the other compounds in a medication can be, read through some of the threads about the difference in Adderall manufacturers.

dreneeps
03-14-10, 01:47 AM
Thanks everyone that is very informative. I just discovered google scholar and I will dig around in it. I think I'm going to stick with it and just keep looking at various studies.

I just like to know everything about what I take. Everything has pros and cons and everything has a price. I will feel much better when I find some solid evidence that whatever price I pay with my medication it will not be anything permanent. Months of re-balancing and recovery are fine. I'm sure this has been studied. If anyone finds anything promising in your reading and research let me know and I'll check it out. I'm encouraged and for the most part satisfied but, I will keep reading and share anything I find. Evidence of complete restoration of previous brain chemistry/function would still give me a little more peace on the matter and perhaps solidify the confidence of any other forum users that seek it. (Maybe someone else is as overly sceptical, critical, and as excessively cautious as I am! ;)

TygerSan
03-31-10, 09:01 AM
Just as a follow up to this: If you are poking around Google Scholar, don't get too discouraged if you don't understand the articles. Scientific language is . . . special (esoteric? . . . obtuse? . . . definitely hard to understand). It's taken me years to get to the point where I can read things quickly in field, and out of field I can still get lost fairly easily.

Most of the take home points are in the abstract (which is the part that you're most likely to read anyway, as a lot of the journals require subscriptions to read). After that, if the article has any conclusions, probably read those, then the introduction. As a researcher, I tend to go for the results before the conclusions, so I can see if my conclusions regarding the results are similar to the ones the authors draw, but that requires some more understanding of the methods used. Incidentally, the methods section is usually something that you *don't* need to read in detail.

(this advice is fairly similar to what my friend was told in a class which requires reading of scientific papers out of his specific field).

Also, if you want full text articles, Pubmed Central is great b/c it allows everyone access to research articles which were made possible by NIH funding.