Amphetamine used in ADHD for the long term can cause?

NORCET 1 - 2020

Pharmacology

Easy

Appeared in: NORCET 1 - 2020

Explanation

Amphetamines are central nervous system (CNS) stimulants that increase the brain's levels of dopamine and norepinephrine.
Long-term use, especially at high doses, can lead to excessive brain stimulation.
This overstimulation can manifest as severe psychiatric symptoms, including mania, a state of abnormally elevated mood and energy.
Amphetamine-induced psychosis, characterized by paranoia and hallucinations, is also a significant risk with long-term use.

Option A: While confusion can be a symptom of acute amphetamine toxicity or delirium, it is not a characteristic long-term psychiatric effect. Mania and psychosis are more specific to chronic overstimulation.
Option B: Amphetamines are well-known for causing appetite suppression (anorexia) and weight loss during active use.
Option D: As CNS stimulants, amphetamines increase metabolic rate and body temperature, leading to hyperthermia (elevated temperature).

Visual 1: Flowchart: Mechanism of Action of Amphetamines - Illustrating how amphetamines increase the release and block the reuptake of dopamine and norepinephrine in the synaptic cleft.
Visual 2: Table: Side Effects of Amphetamine Use vs. Withdrawal - Comparing and contrasting the symptoms of active use (e.g., decreased appetite, insomnia, mania) with withdrawal symptoms (e.g., increased appetite, fatigue, depression).

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Long-term psychiatric side effects of amphetamine therapy for ADHD as background academic context rather than a clinical decision trigger.
Nurses must diligently monitor patients on long-term amphetamine therapy for behavioral changes, including euphoria, irritability, and signs of emerging mania or psychosis.
Patient education is a critical nursing responsibility. This includes teaching about the risks of misuse, the importance of adhering to prescribed doses, and how to recognize early signs of adverse psychiatric effects.
What if the patient suddenly stops taking their amphetamine medication? The nurse should anticipate and manage withdrawal symptoms, which are often the opposite of the drug's effects, such as severe fatigue, depression, and increased appetite (hyperphagia).

How to Approach the Question

First, identify the core of the question: it asks for a long-term effect of amphetamine use.
Next, recall the drug class: amphetamines are Central Nervous System (CNS) stimulants.
Analyze the options based on the 'stimulant' effect. Stimulants generally increase metabolic rate, suppress appetite, and can cause hyper-arousal.
Evaluate 'Increased appetite': This is contrary to the known anorectic (appetite-suppressing) effect of stimulants. This is a withdrawal symptom.
Evaluate 'Hypothermia': This is the opposite of the expected effect. Stimulants cause hyperthermia (increased temperature).
Compare 'Confusion' and 'Mania'. While confusion can occur, mania is a more specific and well-documented psychiatric complication of long-term or high-dose stimulant use due to excessive dopamine activity.

Concept Tested & Keywords

Concept Tested: Long-term psychiatric side effects of amphetamine therapy for ADHD.
Stem keywords: Amphetamine, ADHD, long term
Lead-in keywords: can cause

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