Parrott Andrew C
Department of Psychology, Swansea University, Swansea, South Wales, UK.
Hum Psychopharmacol. 2015 Jul;30(4):213-24. doi: 10.1002/hup.2468.
Stimulant drugs such as nicotine and Ecstasy/3, 4-methylenedioxymethamphetamine (MDMA) are taken for positive reasons, yet their regular use leads to deficits rather than gains. This article outlines the psychobiological rationale for this paradox.
The empirical literature on nicotine, cocaine, amphetamine, Ecstasy/MDMA, and mephedrone are reviewed. A theoretical explanation for why they are problematic to humans is then described.
The acute effects of central nervous system (CNS) stimulants are typically positive, with greater alertness and emotional intensity. However, in the post-drug recovery period, the opposite feelings develop, with lethargy and low moods. All recreational stimulants cause mood fluctuation, although it is most pronounced in drugs with rapid onset and comedown (e.g. nicotine and cocaine), explaining why they are the most addictive. Parallel fluctuations occur across many psychological and neurocognitive functions, with users suffering various off-drug deficits. CNS stimulants also affect the hypothalamic-pituitary-adrenal axis, impairing sleep, disrupting homeostasis, and exacerbating psychiatric distress. Neuroimaging studies reveal altered brain activity patterns in regular users. These problems are related to lifetime usage but commence in novice users.
Repetitive CNS stimulation is potentially damaging to the organism, both acutely and chronically. The review describes the various psychobiological systems through which recreational stimulant drugs impair human well-being.
尼古丁和摇头丸/3,4-亚甲基二氧甲基苯丙胺（MDMA）等刺激性药物的使用初衷是积极的，但长期使用却会导致机能缺失而非益处。本文概述了这一矛盾现象背后的心理生物学原理。
回顾了关于尼古丁、可卡因、苯丙胺、摇头丸/MDMA和甲氧麻黄酮的实证文献。随后阐述了它们对人类造成问题的理论解释。
中枢神经系统（CNS）兴奋剂的急性效应通常是积极的，会带来更高的警觉性和更强的情绪强度。然而，在药物作用消退期，会出现相反的感觉，即无精打采和情绪低落。所有消遣性兴奋剂都会导致情绪波动，不过在起效快和消退快的药物（如尼古丁和可卡因）中最为明显，这就解释了为什么它们最容易上瘾。许多心理和神经认知功能都会出现类似的波动，使用者会出现各种停药后的机能缺失。CNS兴奋剂还会影响下丘脑-垂体-肾上腺轴，损害睡眠，扰乱体内平衡，并加剧精神痛苦。神经影像学研究显示，长期使用者的大脑活动模式发生了改变。这些问题与终生使用有关，但在新手使用者中就已开始出现。
重复性的CNS刺激对机体可能具有急性和慢性损害。本综述描述了消遣性兴奋剂损害人类健康的各种心理生物学系统。
