Spier S A
University of Maryland Medical School, Baltimore, USA.
Int J Psychiatry Med. 1995;25(1):69-79. doi: 10.2190/KW49-885P-EA82-K6K3.
Concerns about the toxicities of psychomotor stimulants originate primarily from effects seen at high doses, when stimulants are abused. Low dose use in the apathetic medically ill patient has been generally associated with only minimal, short lived side effects, which are detailed herein. Confusion may be worsened in already delirious patients. Anxiety, psychosis, cardiovascular effects, insomnia, and tremor may occur but infrequently require discontinuation. Appetite is normally stimulated in the medically ill. In fact, stimulants are frequently utilized in the medically ill largely because of their minimal toxicity. The history of U.S. stimulant abuse in the twentieth century is briefly discussed. Abuse of prescribed stimulants appears to be infrequent. Over-zealous concern regarding abuse has previously led to unfortunate declines in appropriate utilization of stimulants, e.g., for attention deficit disorder. Guidelines for prescribing stimulants in light of abuse potential are included.
对精神运动兴奋剂毒性的担忧主要源于高剂量使用（即滥用兴奋剂）时所出现的效应。在无精打采的患病患者中低剂量使用兴奋剂，通常只会产生轻微的、短暂的副作用，本文对此进行了详细阐述。谵妄患者的意识混乱可能会加重。可能会出现焦虑、精神病、心血管效应、失眠和震颤，但很少需要停药。兴奋剂通常会刺激患病患者的食欲。事实上，兴奋剂在患病患者中经常被使用，很大程度上是因为其毒性极小。本文简要讨论了20世纪美国兴奋剂滥用的历史。滥用处方兴奋剂的情况似乎并不常见。此前，对滥用问题过度热心的关注导致了兴奋剂在诸如注意力缺陷障碍等方面的合理使用出现了令人遗憾的减少。文中还包括了根据滥用可能性开具兴奋剂的指导原则。
