Clinical Information

Stimulants are sympathomimetic amines that stimulate the central nervous system activity and, in part, suppress the appetite. Amphetamine and methamphetamine are also prescription drugs used in the treatment of narcolepsy and attention-deficit disorder/attention-deficit hyperactivity disorder (ADHD). Methylphenidate is another stimulant used to treat ADHD. Phentermine is indicated for the management of obesity. All other amphetamines (eg, methylenedioxymethamphetamine [MDMA]) are Drug Enforcement Administration scheduled Class I compounds. Due to their stimulant effects, the drugs are commonly sold illicitly and abused. Physiological symptoms associated with very high amounts of ingested amphetamine or methamphetamine include elevated blood pressure, dilated pupils, hyperthermia, convulsions, and acute amphetamine psychosis.

Gabapentinoids (pregabalin, gabapentin) are widely used in neurology, psychiatry, and primary care, with increasing reports of misuse. They decrease central neuronal excitability by binding to the calcium channel of hyperexcited neurons which results in a reduction in the release of excitatory molecules including glutamate and noradrenaline.

Gabapentin is not metabolized or protein bound and is primarily excreted and detectable in the urine for up to four days. Pregabalin is also largely excreted unchanged in the urine and detectable for up to 6 days.