Stimulant

Drug that increases alertness

Stimulant

Drug class

Chemical structure of amphetamine, one of the most well-known and widely used stimulants.

Class identifiers
Synonyms| Psychostimulant; Central nervous system stimulant; CNS stimulant; Upper
Use| Recreational, medical
Mechanism of action| Various
Biological target| Various
Chemical class| Various
Legal status
Legal status|

* Variable

In Wikidata
Ritalin: 20 mg sustained-release (SR) tablets

Stimulants (also known as central nervous system stimulants, or psychostimulants, or colloquially as uppers) are a class of drugs that increase alertness. They are used for various purposes, such as enhancing attention, motivation, cognition, mood, and physical performance. Some stimulants occur naturally, while others are exclusively synthetic. Common stimulants include caffeine, nicotine, amphetamines, cocaine, methylphenidate, and modafinil. Stimulants may be subject to varying forms of regulation, or outright prohibition, depending on jurisdiction.

Stimulants increase activity in the sympathetic nervous system, either directly or indirectly. Prototypical stimulants increase synaptic concentrations of excitatory neurotransmitters, particularly norepinephrine and dopamine (e.g., methylphenidate). Other stimulants work by binding to the receptors of excitatory neurotransmitters (e.g., nicotine) or by blocking the activity of endogenous agents that promote sleep (e.g., caffeine). Stimulants can affect various functions, including arousal, attention, the reward system, learning, memory, and emotion. Effects range from mild stimulation to euphoria, depending on the specific drug, dose, route of administration, and inter-individual characteristics.

Stimulants have a long history of use, both for medical and non-medical purposes. Archeological evidence from Peru shows that cocaine use dates back as far as 8000 B.C.E.[1] Stimulants have been used to treat various conditions, such as narcolepsy, attention deficit hyperactivity disorder (ADHD), obesity, depression, and fatigue. They have also been used as recreational drugs, performance-enhancing substances, and cognitive enhancers, by various groups of people, such as students, athletes, artists, and workers. They have also been used to promote aggression of combatants in wartime, both historically and in the present day.[2][3][4]

Stimulants have potential risks and side effects, such as addiction, tolerance, withdrawal, psychosis, anxiety, insomnia, cardiovascular problems, and neurotoxicity. The misuse and abuse of stimulants can lead to serious health and social consequences, such as overdose, dependence, crime, and violence. Therefore, the use of stimulants is regulated by laws and policies in most countries, and requires medical supervision and prescription in some cases.

## Definition

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A stimulant is an overarching term that covers many drugs including those that increase the activity of the central nervous system and the body,[5] drugs that are pleasurable and invigorating, or drugs that have sympathomimetic effects.[6] Sympathomimetic effects are those effects that mimic or copy the actions of the sympathetic nervous system. The sympathetic nervous system is a part of the nervous system that prepares the body for action, such as increasing the heart rate, blood pressure, and breathing rate. Stimulants can activate the same receptors as the natural chemicals released by the sympathetic nervous system (namely epinephrine and norepinephrine) and cause similar effects.[7]

## Effects

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### Acute

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Stimulants in therapeutic doses, such as those given to patients with attention deficit hyperactivity disorder (ADHD), increase ability to focus, vigor, sociability, libido and may elevate mood. However, in higher doses, stimulants may actually decrease the ability to focus, a principle of the Yerkes-Dodson Law.[8] In higher doses, stimulants may also produce euphoria, vigor, and a decreased need for sleep.

Many, but not all, stimulants have ergogenic effects; that is, they enhance physical performance. Drugs such as ephedrine, pseudoephedrine, amphetamine and methylphenidate have well documented ergogenic effects, while cocaine has the opposite effect.[9]

Neurocognitive enhancing effects of stimulants, specifically modafinil, amphetamine and methylphenidate have been reported in healthy adolescents by some studies,[10] and is a commonly cited reason among illicit drug users for use, particularly among college students in the context of studying.[10] Still, results of these studies is inconclusive: assessing the potential overall neurocognitive benefits of stimulants among healthy youth is challenging due to the diversity within the population, the variability in cognitive task characteristics, and the absence of replication of studies.[10] Research on the cognitive enhancement effects of modafinil in healthy non-sleep-deprived individuals has yielded mixed results, with some studies suggesting modest improvements in attention and executive functions while others show no significant benefits or even a decline in cognitive functions.[11][12][13]

In some cases, psychiatric phenomena may emerge such as stimulant psychosis, paranoia, and suicidal ideation. Acute toxicity has been reportedly associated with hyperhydrosis, panic attacks, severe anxiety, mydriasis, paranoia, aggressive behavior, excessive motor activity, psychosis, rhabdomyolysis, and punding. The violent and aggressive behavior associated with acute stimulant toxicity may partially be driven by paranoia.[14] Most drugs classified as stimulants are sympathomimetic, meaning that they stimulate the sympathetic branch of the autonomic nervous system. This leads to effects such as mydriasis (dilation of the pupils), increased heart rate, blood pressure, respiratory rate and body temperature.[6] When these changes become pathological, they are called arrhythmia, hypertension, and hyperthermia, and may lead to rhabdomyolysis, stroke, cardiac arrest, or seizures. However, given the complexity of the mechanisms that underlie these potentially fatal outcomes of acute stimulant toxicity, it is impossible to determine what dose may be lethal.[15]

### Chronic

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Assessment of the effects of stimulants is relevant given the large population currently taking stimulants. A systematic review of cardiovascular effects of prescription stimulants found no association in children, but found a correlation between prescription stimulant use and ischemic heart attacks.[16] A review over a four-year period found that there were few negative effects of stimulant treatment, but stressed the need for longer-term studies.[17] A review of a year long period of prescription stimulant use in those with ADHD found that cardiovascular side effects were limited to transient increases in blood pressure only.[18] However, a 2024 systematic review of the evidence found that stimulants overall improve ADHD symptoms and broadband behavioral measures in children and adolescents, though they carry risks of side effects like appetite suppression and other adverse events.[19] Initiation of stimulant treatment in those with ADHD in early childhood appears to carry benefits into adulthood with regard to social and cognitive functioning, and appears to be relatively safe.[20]

Abuse of prescription stimulants (not following physician instruction) or of illicit stimulants carries many negative health risks. Abuse of cocaine, depending upon route of administration, increases risk of cardiorespiratory disease, stroke, and sepsis.[21] Some effects are dependent upon the route of administration, with intravenous use associated with the transmission of many disease such as Hepatitis C, HIV/AIDS and potential medical emergencies such as infection, thrombosis or pseudoaneurysm,[22] while inhalation may be associated with increased lower respiratory tract infection, lung cancer, and pathological restricting of lung tissue.[23] Cocaine may also increase risk for autoimmune disease[24][25][26] and damage nasal cartilage. Abuse of methamphetamine produces similar effects as well as marked degeneration of dopaminergic neurons, resulting in an increased risk for Parkinson's disease.[27][28][29][30]

## Medical uses

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Stimulants are widely used throughout the world as prescription medicines as well as without a prescription (either legally or illicitly) as performance-enhancing or recreational drugs. Among narcotics, stimulants produce a noticeable crash or comedown at the end of their effects. In the US, the most frequently prescribed stimulants as of 2013 were lisdexamfetamine (Vyvanse), methylphenidate (Ritalin), and amphetamine (Adderall).[31] It was estimated in 2015 that the percentage of the world population that had used cocaine during a year was 0.4%. For the category "amphetamines and prescription stimulants" (with "amphetamines" including amphetamine and methamphetamine) the value was 0.7%, and for MDMA 0.4%.[32]

Stimulants have been used in medicine for many conditions including obesity, sleep disorders, mood disorders, impulse control disorders, asthma, nasal congestion and, in case of cocaine, as local anesthetics.[33] Drugs used to treat obesity are called anorectics and generally include drugs that follow the general definition of a stimulant, but other drugs such as cannabinoid receptor antagonists also belong to this group.[34][35] Eugeroics are used in management of sleep disorders characterized by excessive daytime sleepiness, such as narcolepsy, and include stimulants such as modafinil and pitolisant.[36][37] Stimulants are used in impulse control disorders such as ADHD[38] and off-label in mood disorders such as major depressive disorder to increase energy, focus and elevate mood.[39] Stimulants such as epinephrine,[40] theophylline and salbutamol[41] orally have been used to treat asthma, but inhaled adrenergic drugs are now preferred due to less systemic side effects. Pseudoephedrine is used to relieve nasal or sinus congestion caused by the common cold, sinusitis, hay fever and other respiratory allergies; it is also used to relieve ear congestion caused by ear inflammation or infection.[42][43]

### Depression

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Stimulants were one of the first classes of drugs to be used in the treatment of depression, beginning after the introduction of the amphetamines in the 1930s.[44][45][46] However, they were largely abandoned for treatment of depression following the introduction of conventional antidepressants in the 1950s.[44][45] Subsequent to this, there has been a resurgence in interest in stimulants for depression in recent years.[47][48]

Stimulants produce a fast-acting and pronounced but transient and short-lived mood lift.[49][50][47][45] In relation to this, they are minimally effective in the treatment of depression when administered continuously.[49][50] In addition, tolerance to the mood-lifting effects of amphetamine has led to dose escalation and dependence.[48] Although the efficacy for depression with continuous administration is modest, it may still reach statistical significance over placebo and provide benefits similar in magnitude to those of conventional antidepressants.[51][52][53][54] The reasons for the short-term mood-improving effects of stimulants are unclear, but may relate to rapid tolerance.[49][50][45][55] Tolerance to the effects of stimulants has been studied and characterized both in animals[55][56][57][58] and humans.[59][60][61][62] Stimulant withdrawal is remarkably similar in its symptoms to those of major depressive disorder.[63][55][64][65]

## Chemistry

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For details on stimulant classes, see Substituted phenethylamine, Substituted amphetamine, Substituted phenylmorpholine, and Substituted cathinone.

A chart comparing the chemical structures of different amphetamine derivatives

Classifying stimulants is difficult, because of the large number of classes the drugs occupy, and the fact that they may belong to multiple classes; for example, ecstasy can be classified as a substituted methylenedioxyphenethylamine, a substituted amphetamine and consequently, a substituted phenethylamine.[citation needed]

Major stimulant classes include phenethylamines and their daughter class substituted amphetamines.[66][67]

### Amphetamines (class)

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Main article: Substituted amphetamines

Substituted amphetamines are a class of compounds based upon the amphetamine structure;[68] it includes all derivative compounds which are formed by replacing, or substituting, one or more hydrogen atoms in the amphetamine core structure with substituents.[68][69][70] Examples of substituted amphetamines are amphetamine (itself),[68][69] methamphetamine,[68] ephedrine,[68] cathinone,[68] phentermine,[68] mephentermine,[68] bupropion,[68] methoxyphenamine,[68] selegiline,[68] amfepramone,[68] pyrovalerone,[68] MDMA (ecstasy), and DOM (STP). Many drugs in this class work primarily by activating trace amine-associated receptor 1 (TAAR1);[71] in turn, this causes reuptake inhibition and effluxion, or release, of dopamine, norepinephrine, and serotonin.[71] An additional mechanism of some substituted amphetamines is the release of vesicular stores of monoamine neurotransmitters through VMAT2, thereby increasing the concentration of these neurotransmitters in the cytosol, or intracellular fluid, of the presynaptic neuron.[72]

Amphetamine-type stimulants are often used for their therapeutic effects. Physicians sometimes prescribe amphetamine to treat major depressive disorder, where subjects do not respond well to traditional selective serotonin reuptake inhibitor (SSRI) medications,[citation needed] but evidence supporting this use is mixed.[48] Two large phase III studies of lisdexamfetamine (a prodrug to amphetamine) as an adjunct to an SSRI or serotonin–norepinephrine reuptake inhibitor (SNRI) in the treatment of major depressive disorder showed no further benefit relative to placebo in effectiveness.[73] Numerous studies have demonstrated the effectiveness of drugs like Adderall (a mixture of salts of amphetamine and dextroamphetamine) in controlling symptoms associated with ADHD. Non-stimulants such as atomoxetine have also found to be effective.[74] Due to their availability and fast-acting effects, substituted amphetamines are prime candidates for abuse.[75]

### Cocaine analogs

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Main article: List of cocaine analogs

Hundreds of cocaine analogs have been created, all of them usually maintaining a benzyloxy connected to the 3 carbon of a tropane. Various modifications include substitutions on the benzene ring, as well as additions or substitutions in place of the normal carboxylate on the tropane 2 carbon. Various compound with similar structure activity relationships to cocaine that aren't technically analogs have been developed as well.

## Mechanisms of action

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Most stimulants exert their activating effects by enhancing catecholamine neurotransmission. Catecholamine neurotransmitters are employed in regulatory pathways implicated in attention, arousal, motivation, task salience and reward anticipation. Classical stimulants either block the reuptake or stimulate the efflux of these catecholamines, resulting in increased activity of their circuits. Some stimulants, specifically those with entactogenic and hallucinogenic effects, also affect serotonergic transmission. Some stimulants, such as some amphetamine derivatives[which?] and, notably, yohimbine, can decrease negative feedback by antagonizing regulatory autoreceptors.[76] Adrenergic agonists, such as, in part, ephedrine, act by directly binding to and activating adrenergic receptors, producing sympathomimetic effects.[citation needed]

There are also more indirect mechanisms of action by which a drug can elicit activating effects. Caffeine is an adenosine receptor antagonist, and only indirectly increases catecholamine transmission in the brain.[77] Pitolisant is an histamine 3 (H3)-receptor inverse agonist. As histamine 3 (H3) receptors mainly act as autoreceptors, pitolisant decreases negative feedback to histaminergic neurons, enhancing histaminergic transmission.

The precise mechanism of action of some stimulants, such as modafinil, for treating symptoms of narcolepsy and other sleep disorders, remains unknown.[78][79][80][81][82]

## Notable stimulants

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### Amphetamine

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Main article: Amphetamine

Amphetamine is a potent central nervous system (CNS) stimulant of the phenethylamine class that is approved for the treatment of attention deficit hyperactivity disorder (ADHD) and narcolepsy.[83] Amphetamine is also used off-label as a performance and cognitive enhancer, and recreationally as an aphrodisiac and euphoriant.[84][85][86][87] Although it is a prescription medication in many countries, unauthorized possession and distribution of amphetamine is often tightly controlled due to the significant health risks associated with uncontrolled or heavy use.[88][89] As a consequence, amphetamine is illegally manufactured in clandestine labs to be trafficked and sold to users.[90] Based upon drug and drug precursor seizures worldwide, illicit amphetamine production and trafficking is much less prevalent than that of methamphetamine.[90]

The first pharmaceutical amphetamine was Benzedrine, a brand of inhalers used to treat a variety of conditions.[91][92] Because the dextrorotary isomer has greater stimulant properties, Benzedrine was gradually discontinued in favor of formulations containing all or mostly dextroamphetamine. Presently, it is typically prescribed as mixed amphetamine salts, dextroamphetamine, and lisdexamfetamine.[91][93]

Amphetamine is a norepinephrine-dopamine releasing agent (NDRA). It enters neurons through dopamine and norepinephrine transporters and facilitates neurotransmitter efflux by activating TAAR1 and inhibiting VMAT2.[71] At therapeutic doses, this causes emotional and cognitive effects such as euphoria, change in libido, increased arousal, and improved cognitive control.[85][86][94] Likewise, it induces physical effects such as decreased reaction time, fatigue resistance, and increased muscle strength.[84] In contrast, supratherapeutic doses of amphetamine are likely to impair cognitive function and induce rapid muscle breakdown.[83][85][95] Very high doses can result in psychosis (e.g., delusions and paranoia), which very rarely occurs at therapeutic doses even during long-term use.[96][97] As recreational doses are generally much larger than prescribed therapeutic doses, recreational use carries a far greater risk of serious side effects, such as dependence, which only rarely arises with therapeutic amphetamine use.[83][95][96]

### Caffeine

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Main article: Caffeine

Roasted coffee beans, a common source of caffeine.

Caffeine is a stimulant compound belonging to the xanthine class of chemicals naturally found in coffee, tea, and (to a lesser degree) cocoa or chocolate. It is included in many soft drinks, as well as a larger amount in energy drinks. Caffeine is the world's most widely used psychoactive drug and by far the most common stimulant. In North America, 90% of adults consume caffeine daily.[98]

A few jurisdictions restrict the sale and use of caffeine. In the United States, the FDA has banned the sale of pure and highly concentrated caffeine products for personal consumption, due to the risk of overdose and death.[99] The Australian Government has announced a ban on the sale of pure and highly concentrated caffeine food products for personal consumption, following the death of a young man from acute caffeine toxicity.[100][101] In Canada, Health Canada has proposed to limit the amount of caffeine in energy drinks to 180 mg per serving, and to require warning labels and other safety measures on these products.[100]

Caffeine is also included in some medications, usually for the purpose of enhancing the effect of the primary ingredient,[102] or reducing one of its side-effects (especially drowsiness).[103] Tablets containing standardized doses of caffeine are also widely available.[104]

Caffeine's mechanism of action differs from many stimulants, as it produces stimulant effects by inhibiting adenosine receptors.[105] Adenosine receptors are thought to be a large driver of drowsiness and sleep, and their action increases with extended wakefulness.[106] Caffeine has been found to increase striatal dopamine in animal models,[107] as well as inhibit the inhibitory effect of adenosine receptors on dopamine receptors,[108] however the implications for humans are unknown. Unlike most stimulants, caffeine has no addictive potential. Caffeine does not appear to be a reinforcing stimulus, and some degree of aversion may actually occur, per a study on drug abuse liability published in an NIDA research monograph that described a group preferring placebo over caffeine.[109] In large telephone surveys only 11% reported dependence symptoms. However, when people were tested in labs, only half of those who claim dependence actually experienced it, casting doubt on caffeine's ability to produce dependence and putting societal pressures in the spotlight.[110]

Coffee consumption is associated with a lower overall risk of cancer.[111] This is primarily due to a decrease in the risks of hepatocellular and endometrial cancer, but it may also have a modest effect on colorectal cancer.[112] There does not appear to be a significant protective effect against other types of cancers, and heavy coffee consumption may increase the risk of bladder cancer.[112] A protective effect of caffeine against Alzheimer's disease is possible, but the evidence is inconclusive.[113][114][115] Moderate coffee consumption may decrease the risk of cardiovascular disease,[116] and it may somewhat reduce the risk of type 2 diabetes.[117] Drinking 1–3 cups of coffee per day does not affect the risk of hypertension compared to drinking little or no coffee. However those who drink 2–4 cups per day may be at a slightly increased risk.[118] Caffeine increases intraocular pressure in those with glaucoma but does not appear to affect normal individuals.[119] It may protect people from liver cirrhosis.[120] There is no evidence that coffee stunts a child's growth.[121] Caffeine may increase the effectiveness of some medications including ones used to treat headaches.[122] Caffeine may lessen the severity of acute mountain sickness if taken a few hours prior to attaining a high altitude.[123]

### Ephedrine

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Main article: Ephedrine

Ephedrine is a sympathomimetic amine similar in molecular structure to the well-known drugs phenylpropanolamine and methamphetamine, as well as to the important neurotransmitter epinephrine (adrenaline). Ephedrine is commonly used as a stimulant, appetite suppressant, concentration aid, and decongestant, and to treat hypotension associated with anesthesia.[citation needed]

In chemical terms, it is an alkaloid with a phenethylamine skeleton found in various plants in the genus Ephedra (family Ephedraceae). It works mainly by increasing the activity of norepinephrine (noradrenaline) on adrenergic receptors.[124] It is most usually marketed as the hydrochloride or sulfate salt.

The herb má huáng (Ephedra sinica), used in traditional Chinese medicine (TCM), contains ephedrine and pseudoephedrine as its principal active constituents. The same may be true of other herbal products containing extracts from other Ephedra species.

### MDMA

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Tablets containing MDMA

Main article: MDMA

See also: Its parent class and MDA

3,4-Methylenedioxymethamphetamine (MDMA, ecstasy, or molly) is an entactogen, euphoriant, and stimulant of the amphetamine class.[125] Briefly used by some psychotherapists as an adjunct to therapy, the drug became popular recreationally and the DEA listed MDMA as a Schedule I controlled substance, prohibiting most medical studies and applications. MDMA is known for its entactogenic properties. The stimulant effects of MDMA include hypertension, anorexia (appetite loss), euphoria, social disinhibition, insomnia (enhanced wakefulness/inability to sleep), improved energy, increased arousal, and increased perspiration, among others. Relative to catecholaminergic transmission, MDMA enhances serotonergic transmission significantly more, when compared to classical stimulants like amphetamine. MDMA does not appear to be significantly addictive or dependence forming.[126]

Due to the relative safety of MDMA, some researchers such as David Nutt have criticized the scheduling level, writing a satirical article finding MDMA to be 28 times less dangerous than horseriding, a condition he termed "equasy" or "Equine Addiction Syndrome".[127]

### MDPV

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Main article: MDPV

Methylenedioxypyrovalerone (MDPV) is a psychoactive drug with stimulant properties that acts as a norepinephrine-dopamine reuptake inhibitor (NDRI).[128] It was first developed in the 1960s by a team at Boehringer Ingelheim.[129] MDPV remained an obscure stimulant until around 2004, when it was reported to be sold as a designer drug. Products labeled as bath salts containing MDPV were previously sold as recreational drugs in gas stations and convenience stores in the United States, similar to the marketing for Spice and K2 as incense.[130][131]

Incidents of psychological and physical harm have been attributed to MDPV use.[132][133]

### Mephedrone

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Main article: Mephedrone

Mephedrone is a synthetic stimulant drug of the amphetamine and cathinone classes. Slang names include drone[134] and MCAT.[135] It is reported to be manufactured in China and is chemically similar to the cathinone compounds found in the khat plant of eastern Africa. It comes in the form of tablets or a powder, which users can swallow, snort, or inject, producing similar effects to MDMA, amphetamines, and cocaine.

Mephedrone was first synthesized in 1929, but did not become widely known until it was rediscovered in 2003. By 2007, mephedrone was reported to be available for sale on the Internet; by 2008 law enforcement agencies had become aware of the compound; and, by 2010, it had been reported in most of Europe, becoming particularly prevalent in the United Kingdom. Mephedrone was first made illegal in Israel in 2008, followed by Sweden later that year. In 2010, it was made illegal in many European countries, and, in December 2010, the EU ruled it illegal. In Australia, New Zealand, and the US, it is considered an analog of other illegal drugs and can be controlled by laws similar to the Federal Analog Act. In September 2011, the USA temporarily classified mephedrone as illegal, in effect from October 2011.

Mephedrone is neurotoxic and has abuse potential, predominantly exerted on 5-hydroxytryptamine (5-HT) terminals, mimicking that of MDMA with which it shares the same subjective sensations on abusers.[136][137][138]

### Methamphetamine

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Main article: Methamphetamine

Methamphetamine (contracted from N-methyl-alpha-methylphenethylamine) is a potent psychostimulant of the phenethylamine and amphetamine classes that is used to treat attention deficit hyperactivity disorder (ADHD) and obesity.[139][140][141] Methamphetamine exists as two enantiomers, dextrorotary and levorotary.[142][143] Dextromethamphetamine is a stronger CNS stimulant than levomethamphetamine;[95][142][143] however, both are addictive and produce the same toxicity symptoms at high doses.[143] Although rarely prescribed due to the potential risks, methamphetamine hydrochloride is approved by the United States Food and Drug Administration (USFDA) under the trade name Desoxyn.[140] Recreationally, methamphetamine is used to increase sexual desire, lift the mood, and increase energy, allowing some users to engage in sexual activity continuously for several days straight.[140][failed verification][144][unreliable source?]

Methamphetamine may be sold illicitly, either as pure dextromethamphetamine or in an equal parts mixture of the right- and left-handed molecules (i.e., 50% levomethamphetamine and 50% dextromethamphetamine).[144] Both dextromethamphetamine and racemic methamphetamine are schedule II controlled substances in the United States.[140] Also, the production, distribution, sale, and possession of methamphetamine is restricted or illegal in many other countries due to its placement in schedule II of the United Nations Convention on Psychotropic Substances treaty.[145][146] In contrast, levomethamphetamine is an over-the-counter drug in the United States.[note 1]

In low doses, methamphetamine can cause an elevated mood and increase alertness, concentration, and energy in fatigued individuals.[95][140] At higher doses, it can induce psychosis, rhabdomyolysis, and cerebral hemorrhage.[95][140] Methamphetamine is known to have a high potential for abuse and addiction.[95][140] Recreational use of methamphetamine may result in psychosis or lead to post-withdrawal syndrome, a withdrawal syndrome that can persist for months beyond the typical withdrawal period.[149] Unlike amphetamine and cocaine, methamphetamine is neurotoxic to humans, damaging both dopamine and serotonin neurons in the central nervous system (CNS).[139][141] Unlike the long-term use of amphetamine in prescription doses, which may improve certain brain regions in individuals with ADHD, there is evidence that methamphetamine causes brain damage from long-term use in humans;[139][141] this damage includes adverse changes in brain structure and function, such as reductions in gray matter volume in several brain regions and adverse changes in markers of metabolic integrity.[150][151][141] However, recreational amphetamine doses may also be neurotoxic.[152]

### Methylphenidate

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Main article: Methylphenidate

Methylphenidate is a stimulant drug that is often used in the treatment of ADHD and narcolepsy and occasionally to treat obesity in combination with diet restraints and exercise. Its effects at therapeutic doses include increased focus, increased alertness, decreased appetite, decreased need for sleep and decreased impulsivity. Methylphenidate is not usually used recreationally, but when it is used, its effects are very similar to those of amphetamines.

Methylphenidate acts as a norepinephrine-dopamine reuptake inhibitor (NDRI), by blocking the norepinephrine transporter (NET) and the dopamine transporter (DAT). Methylphenidate has a higher affinity for the dopamine transporter than for the norepinephrine transporter, and so its effects are mainly due to elevated dopamine levels caused by the inhibited reuptake of dopamine, however increased norepinephrine levels also contribute to various of the effects caused by the drug.

Methylphenidate is sold under a number of brand names including Ritalin. Other versions include the long lasting tablet Concerta and the long lasting transdermal patch Daytrana.

### Cocaine

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Lines of cocaine, a popular stimulant

Main article: Cocaine

Cocaine is an SNDRI. Cocaine is made from the leaves of the coca shrub, which grows in the mountain regions of South American countries such as Bolivia, Colombia, and Peru, regions in which it was cultivated and used for centuries mainly by the Aymara people. In Europe, North America, and some parts of Asia, the most common form of cocaine is a white crystalline powder. Cocaine is a stimulant but is not normally prescribed therapeutically for its stimulant properties, although it sees clinical use as a local anesthetic, in particular in ophthalmology.[153] Most cocaine use is recreational and its abuse potential is high (higher than amphetamine), and so its sale and possession are strictly controlled in most jurisdictions. Other tropane derivative drugs related to cocaine are also known such as troparil and lometopane but have not been widely sold or used recreationally.[154]

### Nicotine

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Main article: Nicotine

Nicotine is the active chemical constituent in tobacco, which is available in many forms, including cigarettes, cigars, chewing tobacco, and smoking cessation aids such as nicotine patches, nicotine gum, and electronic cigarettes. Nicotine is used widely throughout the world for its stimulating and relaxing effects. Nicotine exerts its effects through the agonism of nicotinic acetylcholine receptors, resulting in multiple downstream effects such as increase in activity of dopaminergic neurons in the midbrain reward system, and acetaldehyde one of the tobacco constituent decreased the expression of monoamine oxidase in the brain.[155] Nicotine is addictive and dependence forming. Tobacco, the most common source of nicotine, has an overall harm to user and self score 3 percent below cocaine, and 13 percent above amphetamines, ranking 6th most harmful of the 20 drugs assessed, as determined by a multi-criteria decision analysis.[156]

### Phenylpropanolamine

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Main article: Phenylpropanolamine

Phenylpropanolamine (PPA; Accutrim; β-hydroxyamphetamine), also known as the stereoisomers norephedrine and norpseudoephedrine, is a psychoactive drug of the phenethylamine and amphetamine chemical classes that is used as a stimulant, decongestant, and anorectic agent.[157] It is commonly used in prescription and over-the-counter cough and cold preparations. In veterinary medicine, it is used to control urinary incontinence in dogs under trade names Propalin and Proin.

In the United States, PPA is no longer sold without a prescription due to a possible increased risk of stroke in younger women. In a few countries in Europe, however, it is still available either by prescription or sometimes over-the-counter. In Canada, it was withdrawn from the market on 31 May 2001.[158] In India, human use of PPA and its formulations were banned on 10 February 2011.[159]

### Lisdexamfetamine

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Main article: Lisdexamfetamine

Lisdexamfetamine (Vyvanse, etc.) is an amphetamine-type medication, sold for use in treating ADHD.[160] Its effects typically last around 14 hours.[161] Lisdexamfetamine is inactive on its own and is metabolized into dextroamphetamine in the body.[60] Consequently, it has a lower abuse potential.[60]

### Pseudoephedrine

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Main article: Pseudoephedrine

Pseudoephedrine is a sympathomimetic drug of the phenethylamine and amphetamine chemical classes. It may be used as a nasal/sinus decongestant, as a stimulant,[162] or as a wakefulness-promoting agent.[163]

The salts pseudoephedrine hydrochloride and pseudoephedrine sulfate are found in many over-the-counter preparations, either as a single ingredient or (more commonly) in combination with antihistamines, guaifenesin, dextromethorphan, and/or paracetamol (acetaminophen) or another NSAID (such as aspirin or ibuprofen). It is also used as a precursor chemical in the illegal production of methamphetamine.

### Catha edulis (Khat)

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Main article: Khat

Catha edulis

Khat is a flowering plant native to the Horn of Africa and the Arabian Peninsula.[164][165]

Khat contains a monoamine alkaloid called cathinone, a "keto-amphetamine". This alkaloid causes excitement, loss of appetite, and euphoria. In 1980, the World Health Organization (WHO) classified it as a drug of abuse that can produce mild to moderate psychological dependence (less than tobacco or alcohol),[166] although the WHO does not consider khat to be seriously addictive.[165] It is banned in some countries, such as the United States, Canada, and Germany, while its production, sale, and consumption are legal in other countries, including Djibouti, Ethiopia, Somalia, Kenya and Yemen.[167]

### Modafinil

[edit]

Main article: Modafinil

Modafinil is an eugeroic medication, which means that it promotes wakefulness and alertness. Modafinil is sold under the brand name Provigil among others. Modafinil is used to treat excessive daytime sleepiness due to narcolepsy, shift work sleep disorder, or obstructive sleep apnea. While it has seen off-label use as a purported cognitive enhancer, the research on its effectiveness for this use is not conclusive.[168] Despite being a CNS stimulant, the addiction and dependence liabilities of modafinil are considered very low.[169][170][171] Although modafinil shares biochemical mechanisms with stimulant drugs, it is less likely to have mood-elevating properties.[170] The similarities in effects with caffeine are not clearly established.[172][173] Unlike other stimulants, modafinil does not induce a subjective feeling of pleasure or reward, which is commonly associated with euphoria, an intense feeling of well-being. Euphoria is a potential indicator of drug abuse, which is the compulsive and excessive use of a substance despite adverse consequences. In clinical trials, modafinil has shown no evidence of abuse potential, that is why modafinil is considered to have a low risk of addiction and dependence, however, caution is advised.[174][175]

### Pitolisant

[edit]

Main article: Pitolisant

Pitolisant is an inverse agonist (antagonist) of the histamine 3 (H3) autoreceptor. As such, pitolisant is an antihistamine medication that also belongs to the class of CNS stimulants.[176][177][178][179] Pitolisant is also considered a medication of eugeroic class, which means that it promotes wakefulness and alertness. Pitolisant is the first wakefulness-promoting agent that acts by blocking the H3 autoreceptor.[180][181][182]

Pitolisant has been shown to be effective and well-tolerated for the treatment of narcolepsy with or without cataplexy.[182][181][180]

Pitolisant is the only non-controlled anti-narcoleptic drug in the US.[180] It has shown minimal abuse risk in studies.[180][183]

Blocking the histamine 3 (H3) autoreceptor increases the activity of histamine neurons in the brain. The H3 autoreceptors regulate histaminergic activity in the central nervous system (and to a lesser extent, the peripheral nervous system) by inhibiting histamine biosynthesis and release upon binding to endogenous histamine.[184] By preventing the binding of endogenous histamine at the H3, as well as producing a response opposite to that of endogenous histamine at the receptor (inverse agonism), pitolisant enhances histaminergic activity in the brain.[185]

### 5-HT2A receptor agonists

[edit]

Certain serotonergic psychedelics and related non-hallucinogenic drugs, acting as serotonin 5-HT2A receptor agonists, have been reported to have mild stimulant and/or "psychic energizing" (i.e., acute antidepressant) effects, both in animals and humans.[186][187][188] These effects are often present at low or sub-hallucinogenic doses.[188][187] Psychedelics are also known to promote wakefulness[189][190] or cause insomnia.[188]

Psychedelic and related drugs that have been reported to produce stimulant effects include the phenethylamines 2,5-DMA (DOH),[188] DOM,[188][187] DOET,[188][187] DOPR,[191] MTFEM,[192] Ariadne (4C-DOM),[193] and ASR-2001 (2CB-5PrO),[194][195] among others.[188] The lysergamide LSD has also been reported to have mild stimulant effects.[186] Conversely, psilocybin does not seem to produce the same stimulant effects.[186] The non-hallucinogenic Ariadne was under development as a potential pharmaceutical drug to take advantage of such effects in the treatment of conditions like depression in the 1970s, and reached phase 3 clinical trials, but was shelved for strategic economic reasons.[193][196][197][188] ASR-2001, which is likewise non-hallucinogenic, is under development for use as a stimulant-like medication for treatment of psychiatric disorders.[194][195]

Serotonin 5-HT2A receptor agonists have been found to increase dopamine levels in brain areas like the frontal cortex, striatum, and nucleus accumbens in animal studies.[198][199][200][201] Relatedly, serotonin 5-HT2A receptor agonists are known to produce stimulant-like effects in animals such as hyperlocomotion (increased locomotor activity)[202] and pro-motivational effects.[188][191] The serotonin 5-HT2C receptor, which most psychedelics additionally activate to varying degrees, is known to have opposing effects on dopamine release and stimulant-related behavior, which may contribute to inverted U-shaped dose–response relationships as well as divergent stimulant-like effects between different psychedelics.[203][202]

## Recreational use and issues of abuse

[edit]

Main article: Recreational drug use § Stimulants

See also: Substance abuse

Stimulants enhance the activity of the central and peripheral nervous systems. Common effects may include increased alertness, awareness, wakefulness, endurance, productivity, and motivation, arousal, locomotion, heart rate, and blood pressure, and a diminished desire for food and sleep. Use of stimulants may cause the body to reduce significantly its production of natural body chemicals that fulfill similar functions. Until the body reestablishes its normal state, once the effect of the ingested stimulant has worn off the user may feel depressed, lethargic, confused, and miserable. This is referred to as a "crash", and may provoke reuse of the stimulant.

Abuse of central nervous system (CNS) stimulants is common. Addiction to some CNS stimulants can quickly lead to medical, psychiatric, and psychosocial deterioration. Drug tolerance, dependence, and sensitization as well as a withdrawal syndrome can occur.[204] Stimulants may be screened for in animal discrimination and self-administration models which have high sensitivity albeit low specificity.[205] Research on a progressive ratio self-administration protocol has found amphetamine, methylphenidate, modafinil, cocaine, and nicotine to all have a higher break point than placebo that scales with dose indicating reinforcing effects.[206] A progressive ratio self-administration protocol is a way of testing how much an animal or a human wants a drug by making them do a certain action (like pressing a lever or poking a nose device) to get the drug. The number of actions needed to get the drug increases every time, so it becomes harder and harder to get the drug. The highest number of actions that the animal or human is willing to do to get the drug is called the break point. The higher the break point, the more the animal or human wants the drug. In contrast to the classical stimulants such as amphetamine, the effects of modafinil depend on what the animals or humans have to do after getting the drug. If they have to do a performance task, like solving a puzzle or remembering something, modafinil makes them work harder for it than placebo, and the subjects wanted to self-administer modafinil. But if they had to do a relaxation task, like listening to music or watching a video, the subjects did not want to self-administer modafinil. This suggests that modafinil is more rewarding when it helps the animals or humans do something better or faster, especially considering that modafinil is not commonly abused or depended on by people, unlike other stimulants.[206]

Dependence potentials of common stimulants[166]

Drug | Mean | Pleasure | Psychological dependence | Physical dependence
Cocaine | 2.39 | 3.0 | 2.8 | 1.3
Tobacco | 2.21 | 2.3 | 2.6 | 1.8
Amphetamine | 1.67 | 2.0 | 1.9 | 1.1
Ecstasy | 1.13 | 1.5 | 1.2 | 0.7

## Treatment for misuse

[edit]

Psychosocial treatments, such as contingency management, have demonstrated improved effectiveness when added to treatment as usual consisting of counseling and/or case-management. This is demonstrated with a decrease in dropout rates and a lengthening of periods of abstinence.[207]

## Testing

[edit]

The presence of stimulants in the body may be tested by a variety of procedures. Serum and urine are the common sources of testing material although saliva is sometimes used. Commonly used tests include chromatography, immunologic assay, and mass spectrometry.[208]

## See also

[edit]

* Antidepressants
* Depressants
* Hallucinogens
* Nootropics
* Psychoanaleptics

## Notes

[edit]

1. ^ The active ingredient in some OTC inhalers in the United States is listed as levmetamfetamine, the INN and USAN of levomethamphetamine.[147][148]

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[Figure 4](b) Examples of synthetic, pharmaceutically important substituted amphetamines."
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184. ^ West RE, Zweig A, Shih NY, Siegel MI, Egan RW, Clark MA (November 1990). "Identification of two H3-histamine receptor subtypes". Molecular Pharmacology. 38 (5): 610–613\. doi:10.1016/S0026-895X(25)09479-9. PMID 2172771. Archived from the original on 10 December 2023. Retrieved 22 January 2024.
185. ^ Sarfraz N, Okuampa D, Hansen H, Alvarez M, Cornett EM, Kakazu J, et al. (30 May 2022). "pitolisant, a novel histamine-3 receptor competitive antagonist, and inverse agonist, in the treatment of excessive daytime sleepiness in adult patients with narcolepsy". Health Psychology Research. 10 (3): 34222. doi:10.52965/001c.34222 (inactive 15 July 2025). PMC 9239364. PMID 35774905.`{{cite journal}}`: CS1 maint: DOI inactive as of July 2025 (link)
186. ^ a b c Kuypers KP (2024). "Microdosing Psychedelics as a Promising New Pharmacotherapeutic". Modern CNS Drug Discovery. Cham: Springer Nature Switzerland. pp. 407–436\. doi:10.1007/978-3-031-61992-2_26. ISBN 978-3-031-61991-5. Retrieved 28 May 2025. "Interestingly, users sometimes attribute other effects to different psychedelics, in which LSD is more associated with cognitive and/or stimulant effects and psilocybin with emotional or well-being effects (Anderson et al. 2019b; Johnstad 2018). This stronger stimulant character of LSD compared to psilocybin was seen by some as an advantage while others experienced it as uncomfortable (Johnstad 2018). [...] Additionally, McGlothlin et al. (1967) showed that LSD (25 mcg) indeed induces stimulant effects, as the effects were similar to those of amphetamine (20 mg) (McGlothlin et al. 1967). Notwithstanding this does not confirm that psilocybin and LSD would have dissimilar effects; it rather supports the claims by users that LSD in low doses has stimulant effects (Johnstad 2018; Anderson et al. 2019a). [...] Decades earlier, Albert Hofmann, the "discoverer" of LSD and its hallucinogenic effects, mentioned that "very small doses, perhaps 25 micrograms," could be useful as an antidepressant (Ghose 2015; Horowitz 1976) or as a substitute for Ritalin (Fadiman 2017; Horowitz 1976)."
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196. ^ Shulgin A, Manning T, Daley PF (2011). "#7. ARIADNE". The Shulgin Index, Volume One: Psychedelic Phenethylamines and Related Compounds. Vol. 1\. Berkeley, CA: Transform Press. pp. 7–9\. ISBN 978-0-9630096-3-0. OCLC 709667010.
197. ^ Cunningham MJ, Bock HA, Serrano IC, Bechand B, Vidyadhara DJ, Bonniwell EM, Lankri D, Duggan P, Nazarova AL, Cao AB, Calkins MM, Khirsariya P, Hwu C, Katritch V, Chandra SS, McCorvy JD, Sames D (January 2023). "Pharmacological Mechanism of the Non-hallucinogenic 5-HT2A Agonist Ariadne and Analogs". ACS Chemical Neuroscience. 14 (1): 119–135\. doi:10.1021/acschemneuro.2c00597. PMC 10147382. PMID 36521179.
198. ^ Nichols DE (February 2004). "Hallucinogens". Pharmacol Ther. 101 (2): 131–181\. doi:10.1016/j.pharmthera.2003.11.002. PMID 14761703.
199. ^ Hatzipantelis CJ, Olson DE (February 2024). "The Effects of Psychedelics on Neuronal Physiology". Annu Rev Physiol. 86: 27–47\. doi:10.1146/annurev-physiol-042022-020923. PMC 10922499. PMID 37931171. "Systemic administration of psilocybin in rats rapidly increased dopamine release in the PFC (78), suggesting that psilocin regulates a known top-down neurocircuit involving 5-HT2ARexpressing pyramidal neurons that project to and activate mesocortical dopaminergic VTA neurons. Indeed, activation of 5-HT2ARs in the PFC by DOI increases mesocortical dopaminergic signaling (134), and 25I-NBOMe dose-dependently increases dopamine in the frontal cortex (129). DOI and psilocin also activate mesolimbic dopaminergic VTA neurons, increasing dopamine release in the nucleus accumbens (135, 136)."
200. ^ Wojtas A, Gołembiowska K (December 2023). "Molecular and Medical Aspects of Psychedelics". Int J Mol Sci. 25 (1): 241. doi:10.3390/ijms25010241. PMC 10778977. PMID 38203411.
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203. ^ Canal CE, Murnane KS (January 2017). "The serotonin 5-HT2C receptor and the non-addictive nature of classic hallucinogens". J Psychopharmacol. 31 (1): 127–143\. doi:10.1177/0269881116677104. PMC 5445387. PMID 27903793.
204. ^ Dackis CA, Gold MS (1990). "Addictiveness of central stimulants". Advances in Alcohol & Substance Abuse. 9 (1–2): 9–26\. doi:10.1300/J251v09n01_02. PMID 1974121.1–2&rft.pages=9-26&rft.date=1990&rft_id=info:doi/10.1300/J251v09n01_02&rft_id=info:pmid/1974121&rft.aulast=Dackis&rft.aufirst=CA&rft.au=Gold,+MS&rfr_id=info:sid/en.wikipedia.org:Stimulant" class="Z3988">
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## External links

[edit]

Look up stimulant or upper in Wiktionary, the free dictionary.

Wikimedia Commons has media related to Stimulants.

* v
* t
* e

Stimulants

Adamantanes|

* Adapromine
* Amantadine
* Bromantane
* Memantine
* Rimantadine

Adenosine antagonists|

* 8-Chlorotheophylline
* 8-Cyclopentyltheophylline
* 8-Phenyltheophylline
* Aminophylline
* Caffeine
* CGS-15943
* Dimethazan
* Istradefylline
* Paraxanthine
* SCH-58261
* Theobromine
* Theophylline

Alkylamines|

* Cyclopentamine
* Cypenamine
* Cyprodenate
* Heptaminol
* Isometheptene
* Methylhexaneamine
* Octodrine
* Propylhexedrine
* Tuaminoheptane

Ampakines|

* CX-516
* CX-546
* CX-614
* CX-691
* CX-717
* IDRA-21
* LY-404,187
* LY-503,430
* Nooglutyl
* Org 26576
* PEPA
* S-18986
* Sunifiram
* Unifiram

Arylcyclohexylamines|

* Benocyclidine
* Dieticyclidine
* Esketamine
* Eticyclidine
* Gacyclidine
* Ketamine
* Phencyclamine
* Phencyclidine
* Rolicyclidine
* Tenocyclidine
* Tiletamine

Benzazepines|

* 6-Br-APB
* SKF-77434
* SKF-81297
* SKF-82958

Cathinones|

* 3-FMC
* 3-MMC
* 3,4-DMMC
* 4-BMC
* 4-CMC
* 4-Methylbuphedrone
* 4-Methylcathinone
* 4-MEAP
* 4-Methylpentedrone
* Amfepramone
* Benzedrone
* Buphedrone
* Bupropion
* Butylone
* Cathinone
* Dimethylcathinone
* Ethcathinone
* Ethylone
* Flephedrone
* Hexedrone
* Isoethcathinone
* Mephedrone
* Methcathinone
* Methedrone
* Methylenedioxycathinone
* Methylone
* Mexedrone
* N-Ethylbuphedrone
* N-Ethylhexedrone
* Pentedrone
* Pentylone
* Phthalimidopropiophenone

Cholinergics|

* A-84,543
* A-366,833
* ABT-202
* ABT-418
* AR-R17779
* Altinicline
* Anabasine
* Arecoline
* Bradanicline
* Cotinine
* Cytisine
* Dianicline
* Epibatidine
* Epiboxidine
* GTS-21
* Ispronicline
* Nicotine
* PHA-543,613
* PNU-120,596
* PNU-282,987
* Pozanicline
* Rivanicline
* Sazetidine A
* SIB-1553A
* SSR-180,711
* TC-1698
* TC-1827
* TC-2216
* Tebanicline
* UB-165
* Varenicline
* WAY-317,538

Convulsants|

* Anatoxin-a
* Bicuculline
* DMCM
* Flurothyl
* Gabazine
* Pentetrazol
* Picrotoxin
* Strychnine
* Thujone

Eugeroics|

* Adrafinil
* Armodafinil
* CRL-40,940
* CRL-40,941
* Fluorenol
* Modafinil

Oxazolines|

* 4-Methylaminorex
* Aminorex
* Clominorex
* Cyclazodone
* Fenozolone
* Fluminorex
* Pemoline
* Thozalinone

Phenethylamines|

* 1-(4-Methylphenyl)-2-aminobutane
* 1-Methylamino-1-(3,4-methylenedioxyphenyl)propane
* 2-Fluoroamphetamine
* 2-Fluoromethamphetamine
* 2-OH-PEA
* 2-Phenyl-3-aminobutane
* 2,3-MDA
* 3-Fluoroamphetamine
* 3-Fluoroethamphetamine
* 3-Methoxyamphetamine
* 3-Methylamphetamine
* 4-Fluoroamphetamine
* 4-Fluoromethamphetamine
* 4-MA
* 4-MMA
* 4-MTA
* 6-FNE
* AL-1095
* Alfetamine
* a-Ethylphenethylamine
* Amfecloral
* Amfepentorex
* Amidephrine
* 2-Amino-1,2-dihydronaphthalene
* 2-Aminoindane
* 5-(2-Aminopropyl)indole
* 2-Aminotetralin
* Acridorex
* Amphetamine (Dextroamphetamine, Levoamphetamine)
* Amphetaminil
* Arbutamine
* β-Methylphenethylamine
* β-Phenylmethamphetamine
* Benfluorex
* Benzphetamine
* BDB
* BOH
* 3-Benzhydrylmorpholine
* BPAP
* Camfetamine
* Cathine
* Chlorphentermine
* Cilobamine
* Cinnamedrine
* Clenbuterol
* Clobenzorex
* Cloforex
* Clortermine
* Cypenamine
* D-Deprenyl
* Denopamine
* Dimethoxyamphetamine
* Dimethylamphetamine
* Dobutamine
* DOPA (Dextrodopa, Levodopa)
* Dopamine
* Dopexamine
* Droxidopa
* EBDB
* Ephedrine
* Epinephrine
* Epinine
* Etafedrine
* Ethylnorepinephrine
* Etilamfetamine
* Etilefrine
* Famprofazone
* Fencamfamin
* Fencamine
* Fenethylline
* Fenfluramine (Dexfenfluramine, Levofenfluramine)
* Fenproporex
* Feprosidnine
* Fludorex
* Formetorex
* Furfenorex
* Gepefrine
* Hexapradol
* HMMA
* Hordenine
* 4-Hydroxyamphetamine
* 5-Iodo-2-aminoindane
* Ibopamine
* Indanylamphetamine
* Iofetamine
* Isoetarine
* Isoprenaline
* L-Deprenyl (Selegiline)
* Lefetamine
* Lisdexamfetamine
* Lophophine
* MBDB
* MDA (tenamfetamine)
* MDBU
* MDEA
* MDMA (midomafetamine)
* MDMPEA
* MDOH
* MDPR
* MDPEA
* Mefenorex
* Mephentermine
* Metanephrine
* Metaraminol
* Mesocarb
* Methamphetamine (Dextromethamphetamine, Levomethamphetamine)
* Methoxamine
* Methoxyphenamine
* MMA
* Methoxyphenamine
* MMDA
* MMDMA
* MMMA
* Morforex
* N,alpha-Diethylphenylethylamine
* N,N-Dimethylphenethylamine
* Naphthylamphetamine
* Nisoxetine
* Norepinephrine
* Norfenefrine
* Norfenfluramine
* Normetanephrine
* L-Norpseudoephedrine
* Octopamine
* Orciprenaline
* Ortetamine
* Oxifentorex
* Oxilofrine
* PBA
* PCA
* PCMA
* PHA
* Pentorex
* Phenatine
* Phenpromethamine
* Phentermine
* Phenylalanine
* Phenylephrine
* Phenylpropanolamine
* Pholedrine
* PIA
* PMA
* PMEA
* PMMA
* PPAP
* Prenylamine
* Propylamphetamine
* Pseudoephedrine
* Ropinirole
* Salbutamol (Levosalbutamol)
* Sibutramine
* Solriamfetol
* Synephrine
* Theodrenaline
* Tiflorex
* Tranylcypromine
* Tyramine
* Tyrosine
* Xylopropamine
* Zylofuramine

Phenylmorpholines|

* 3-Fluorophenmetrazine
* Fenbutrazate
* Fenmetramide
* G-130
* Manifaxine
* Morazone
* Morforex
* Oxaflozane
* PD-128,907
* Phendimetrazine
* Phenmetrazine
* 2-Phenyl-3,6-dimethylmorpholine
* Pseudophenmetrazine
* Radafaxine

Piperazines|

* 2C-B-BZP
* 3C-PEP
* BZP
* CM156
* DBL-583
* GBR-12783
* GBR-12935
* GBR-13069
* GBR-13098
* GBR-13119
* JJC8-088
* MeOPP
* MBZP
* oMPP
* Vanoxerine

Piperidines|

* 1-Benzyl-4-(2-(diphenylmethoxy)ethyl)piperidine
* 2-Benzylpiperidine
* 2-Methyl-3-phenylpiperidine
* 3,4-Dichloromethylphenidate
* 4-Benzylpiperidine
* 4-Fluoromethylphenidate
* 4-Methylmethylphenidate
* Desoxypipradrol
* Difemetorex
* Diphenylpyraline
* Ethylnaphthidate
* Ethylphenidate
* Methylnaphthidate
* Isopropylphenidate
* JZ-IV-10
* Methylphenidate (Dexmethylphenidate)
* Nocaine
* Phacetoperane
* Pipradrol
* Propylphenidate
* Serdexmethylphenidate
* SCH-5472

Pyrrolidines|

* 2-Diphenylmethylpyrrolidine
* 4-Cl-PVP
* 5-DBFPV
* α-PPP
* α-PBP
* α-PCYP
* α-PHiP
* α-PHP
* α-PHPP
* α-PVP
* α-PVT
* Diphenylprolinol
* DMPVP
* FPOP
* FPVP
* MDPPP
* MDPBP
* MPBP
* MPHP
* MPPP
* MOPVP
* MOPPP
* Indapyrophenidone
* MDPV
* Naphyrone
* PEP
* Picilorex
* Prolintane
* Pyrovalerone

Racetams|

* Oxiracetam
* Phenylpiracetam
* Phenylpiracetam hydrazide

Tropanes|

* 4-fluorotropacocaine
* 4'-Fluorococaine
* Altropane (IACFT)
* Brasofensine
* CFT (WIN 35,428)
* β-CIT (RTI-55)
* Cocaethylene
* Cocaine
* Dichloropane (RTI-111)
* Difluoropine
* FE-β-CPPIT
* FP-β-CPPIT
* Ioflupane (123I)
* Norcocaine
* PIT
* PTT
* RTI-31
* RTI-32
* RTI-51
* RTI-112
* RTI-113
* RTI-120
* RTI-121 (IPCIT)
* RTI-126
* RTI-150
* RTI-177
* RTI-229
* RTI-336
* RTI-354
* RTI-371
* RTI-386
* Salicylmethylecgonine
* Tesofensine
* Troparil (β-CPT, WIN 35,065-2)
* Tropoxane
* WF-23
* WF-33

Tryptamines|

* 4-HO-αMT
* 4-Methyl-αET
* 4-Methyl-αMT
* 5-Chloro-αMT
* 5-Fluoro-αMT
* 5-MeO-αET
* 5-MeO-αMT
* 5-MeO-DIPT
* 6-Fluoro-αMT
* 7-Methyl-αET
* αET
* αMT

Others|

* 2-MDP
* 3,3-Diphenylcyclobutanamine
* Amfonelic acid
* Amineptine
* Amiphenazole
* Atipamezole
* Atomoxetine
* Bemegride
* Benzydamine
* BTQ
* BTS 74,398
* Centanafadine
* Ciclazindol
* Clofenciclan
* Cropropamide
* Crotetamide
* D-161
* Desipramine
* Diclofensine
* Dimethocaine
* Efaroxan
* Etamivan
* Fenisorex
* Fenpentadiol
* Gamfexine
* Gilutensin
* GSK1360707F
* GYKI-52895
* Hexacyclonate
* Idazoxan
* Indanorex
* Indatraline
* JNJ-7925476
* Lazabemide
* Leptacline
* Lomevactone
* LR-5182
* Mazindol
* Meclofenoxate
* Medifoxamine
* Mefexamide
* Methamnetamine
* Methastyridone
* Methiopropamine
* Naphthylaminopropane
* Nefopam
* Nikethamide
* Nomifensine
* O-2172
* Oxaprotiline
* PNU-99,194
* PRC200-SS
* Rasagiline
* Rauwolscine
* Rubidium chloride
* Setazindol
* Tametraline
* Tandamine
* Thiopropamine
* Thiothinone
* Trazium
* UH-232
* Yohimbine

ATC code: N06B

* v
* t
* e

Major chemical drug groups – based upon the Anatomical Therapeutic Chemical Classification System

gastrointestinal tract
/ metabolism (A)|

* stomach acid
* Antacids
* H2 antagonists
* Proton-pump inhibitors
* Antiemetics
* Laxatives
* Antidiarrhoeals / Antipropulsives
* Anti-obesity drugs
* Diabetes medication
* Vitamins
* Dietary minerals

blood and blood
forming organs (B)|

* Antithrombotics
* Antiplatelets
* Anticoagulants
* Thrombolytics / fibrinolytics
* Antihemorrhagics
* Platelets
* Coagulants
* Antifibrinolytics

cardiovascular
system (C)|

* cardiac therapy / antianginals
* Cardiac glycosides
* Antiarrhythmics
* Cardiac stimulants
* Antihypertensives
* Diuretics
* Vasodilators
* Beta blockers
* Calcium channel blockers
* renin–angiotensin system
* ACE inhibitors
* Angiotensin II receptor antagonists
* Renin inhibitors
* Antihyperlipidemics
* Statins
* Fibrates
* Bile acid sequestrants

skin (D)|

* Emollients
* Cicatrizants
* Antipruritics
* Antipsoriatics
* Medicated dressings

genitourinary
system (G)|

* Hormonal contraception
* Fertility agents
* Selective estrogen receptor modulators
* Sex hormones

endocrine
system (H)|

* Hypothalamic–pituitary hormones
* Corticosteroids
* Glucocorticoids
* Mineralocorticoids
* Sex hormones
* Thyroid hormones / Antithyroid agents

infections and
infestations (J, P, QI)|

* Antimicrobials: Antibacterials (Antimycobacterials)
* Antifungals
* Antivirals
* Antiparasitics
* Antiprotozoals
* Anthelmintics
* Ectoparasiticides
* Intravenous immunoglobulin
* Vaccines

malignant disease
(L01–L02)|

* Anticancer agents
* Antimetabolites
* Alkylating
* Spindle poisons
* Antineoplastic
* Topoisomerase inhibitors

immune disease
(L03–L04)|

* Immunomodulators
* Immunostimulants
* Immunosuppressants

muscles, bones,
and joints (M)|

* Anabolic steroids
* Anti-inflammatories
* Non-steroidal anti-inflammatory drugs
* Antirheumatics
* Corticosteroids
* Muscle relaxants
* Bisphosphonates

brain and
nervous system (N)|

* Analgesics
* Anesthetics
* General
* Local
* Anorectics
* Anti-ADHD agents
* Antiaddictives
* Anticonvulsants
* Antidementia agents
* Antidepressants
* Antimigraine agents
* Antiparkinson agents
* Antipsychotics
* Anxiolytics
* Aphrodisiacs
* Depressants
* Entactogens
* Entheogens
* Euphoriants
* Hallucinogens
* Psychedelics
* Dissociatives
* Deliriants
* Hypnotics / Sedatives
* Mood stabilizers
* Motivation-enhancing drug
* Neuroprotectives
* Nootropics
* Neurotoxins
* Orexigenics
* Serenics
* Stimulants
* Wakefulness-promoting agents

respiratory
system (R)|

* Decongestants
* Bronchodilators
* Cough medicines
* H1 antagonists

sensory organs (S)|

* Ophthalmologicals
* Otologicals

other ATC (V)|

* Antidotes
* Contrast media
* Radiopharmaceuticals
* Dressings
* Senotherapeutics

*  Drugs
* Pharmacological classification systems
* ATC codes
*  Medicine portal

* v
* t
* e

Chemical classes of psychoactive drugs

Stimulants|

* Amphetamine-type/dopamine releasing agents: Alkylamines
* Cycloalkylaminopropanes
* Arylpiperazines
* Benzylpiperazines
* Phenylpiperazines
* Phenethylamines
* Aminorexes/phenyloxazolamines
* Amphetamines/α-methylphenethylamines
* Cathinones/β-ketoamphetamines
* β-Hydroxyamphetamines/cathinols
* Naphthylaminopropanes
* Phentermines
* Phenylisobutylamines/α-ethylphenethylamines
* α-Propylphenethylamines
* Phenylmorpholines/phenmetrazines
* Thiopropamines/thienylaminopropanes

* Cocaine-type/typical dopamine reuptake inhibitors: Phenethylamines
* Phenidates/benzylpiperidines
* Phenylethylpyrrolidines
* Pyrrolidinophenones
* Phenyltropanes/cocaine analogues

* Modafinil-type/atypical dopamine reuptake inhibitors: Modafinil analogues
* Phenylpiracetams

* Caffeine-type/adenosine receptor antagonists: Xanthines/methylxanthines

* Nicotine-type/nicotinic acetylcholine receptor agonists: Nicotine analogues

Depressants|

* GABAA receptor positive allosteric modulators: Alcohols/ethanol analogues
* Barbiturates
* Benzodiazepines
* Pyrrolobenzodiazepines
* Thienobenzodiazepines
* Thienodiazepines
* Thienotriazolodiazepines
* Triazolobenzodiazepines
* Carbamates
* Ethers
* Neuroactive steroids
* Nonbenzodiazepines
* β-Carbolines
* Cyclopyrrolones
* Imidazopyridines
* Pyrazolopyrimidines
* Phenols
* Piperidinediones
* Quinazolinones

* GABAA receptor agonists: Isoxazoles

* GHB receptor agonists: 1,4-Butanediols

* α2δ subunit-containing voltage-gated calcium channel blockers: Gabapentinoids

* Opioids/μ-opioid receptor agonists: Benzimidazoles
* Nitazenes
* Fentanyl analogues/phenylpiperidines
* Mitragyna alkaloids
* Morphinans/phenanthrenes
* Opiates/opium alkaloids
* Utopioids

* Antihistamines/H1 receptor antagonists: Benzimidazoles
* Diarylmethanes
* Ethylenediamines
* Tricyclics
* Dibenzocycloheptenes

Hallucinogens|

* Serotonergic psychedelics/serotonin 5-HT2A receptor agonists: Arylpiperazines
* Phenylpiperazines
* Quinolinylpiperazines
* Cyclized tryptamines
* Azepinoindoles
* Ibogalogs
* Iboga alkaloids
* β-Carbolines
* Harmala alkaloids
* Ergolines
* Lysergamides
* Simplified/partial lysergamides
* Phenethylamines (methoxyphenethylamines)
* 2Cs
* 25-NB/NBOMes
* 2C-Os
* 2C-Ts
* HOT-x
* TWEETIOs
* Amphetamines/α-methylphenethylamines
* 3Cs
* Dimethoxyamphetamines/DMAs
* DOx
* Alephs
* Methylenedioxyamphetamines/MDxx
* Trimethoxyamphetamines/TMAs
* BOx
* FLYs/benzofurans
* Phenylisobutylamines/α-ethylphenethylamines
* 4Cs
* Scalines
* Tryptamines
* α-Alkyltryptamines
* α-Alkyl-β-ketotryptamines
* 4-Hydroxytryptamines
* 5-Hydroxytryptamines
* 5-Methoxytryptamines
* Miscellaneous

* Dissociatives/NMDA receptor antagonists: Adamantanes
* Arylcyclohexylamines
* Diarylethylamines
* Morphinans

* κ-Opioid receptor agonists: Benzomorphans
* Salvinorins

* GABAA receptor agonists: Isoxazoles

* Deliriants/anticholinergics/muscarinic acetylcholine receptor antagonists: Diarylmethanes
* Tropanes

* Others: Cyclized tryptamines
* Azepinoindoles
* Iboga alkaloids
* (Phyto)cannabinoids

Entactogens|

* Serotonin releasing agents: Phenethylamines
* Aminoindanes
* Aminotetralins
* Amphetamines
* Benzofuranylaminopropanes
* Benzothiophenylaminopropanes
* Ethylenedioxyamphetamines
* Indanylaminopropanes
* Indolylaminopropanes
* Methylenedioxyamphetamine/MDxx
* Tetralinylaminopropanes
* Tryptamines
* α-Alkyltryptamines
* Miscellaneous

Psychiatric drugs|

* Anxiolytics: Azapirones
* Benzodiazepines
* Pyrrolobenzodiazepines
* Thienobenzodiazepines
* Thienodiazepines
* Thienotriazolodiazepines
* Triazolobenzodiazepines

* Antidepressants: Tricyclic antidepressants
* Dibenzazepines
* Dibenzocycloheptenes
* Dibenzothiepins
* Dibenzoxazepines
* Dibenzoxepins
* Tetracyclic antidepressants

* Antipsychotics/dopamine D2 receptor antagonists or partial agonists: Benzamides
* Benzimidazoles
* Benzisothiazoles
* Benzisoxazoles
* Butyrophenones
* Diphenylbutylpiperidines
* Phenylpiperazines
* Tricyclics
* Dibenzazepines
* Dibenzodiazepines
* Dibenzothiazepines
* Dibenzothiepins
* Dibenzoxazepines
* Phenothiazines
* Thienobenzodiazepines

* Mood stabilizers/anticonvulsants: Gabapentinoids
* Tricyclics
* Dibenzazepines
* Valproates

Others|

* Nootropics: Racetams
* Phenylpiracetams

* Miscellaneous: Adamantanes
* Catecholamines
* Tetrahydroisoquinolines
* Yohimbans

* v
* t
* e

Recreational drug use

Major recreational drugs

| Depressants|

* Barbiturates
* Benzodiazepines
* Carbamates
* Ethanol (alcohol)
* Alcoholic beverage
* Beer
* Wine
* Gabapentinoids
* GHB
* Inhalants
* Medical
* Nitrous oxide (recreational use)
* Hazardous solvents
* contact adhesives
* Gasoline
* nail polish remover
* Paint thinner
* Other
* Freon
* Kava
* Nonbenzodiazepines
* Quinazolinones
* Quaaludes

|

Opioids|

* Buprenorphine
* Suboxone
* Subutex
* Codeine
* Lean
* Desomorphine
* Krokodil
* Dextropropoxyphene
* Darvocet
* Darvon
* Fentanyl
* Diamorphine
* Heroin
* Hydrocodone
* Hydromorphone
* Dilaudid
* Methadone
* Mitragyna speciosa
* Kratom
* Morphine
* Opium
* Oxycodone
* /paracetamol
* Tramadol

Stimulants|

* Amphetamine
* Arecoline
* Areca
* Betel
* Caffeine
* Coffee
* Energy drinks
* Tea
* Cathinone
* Khat
* Cocaine
* Coca
* Cocaine paste
* Crack
* Ephedrine
* Ephedra
* MDPV
* Mephedrone
* Methamphetamine
* Methylone
* Methylphenidate
* Modafinil
* Nicotine
* Polacrilex
* Salt
* Tobacco
* Theobromine
* Cocoa
* Chocolate

Entactogens|

* 2C series
* 6-APB
* Benzofury
* AMT
* MDA
* MDMA
* Ecstasy
* Molly

Hallucinogens|

| Psychedelics|

* 2C-B
* 25I-NBOMe
* 4-AcO-DMT
* 5-MeO-DMT
* Psychoactive toads
* Bufotenin
* Vilca
* Yopo
* DMT
* Ayahuasca
* LSA and iso-LSA
* Morning glory
* Ergot
* LSD
* Mescaline
* Peruvian torch
* Peyote
* San Pedro
* Psilocybin and psilocin
* Psilocybin mushrooms

|

Dissociatives|

* DXM (recreational use)
* Inhalants
* Nitrous oxide (recreational use)
* Ketamine
* MXE
* PCP

Deliriants|

* Atropine and Scopolamine
* Atropa belladonna
* Datura
* Hyoscyamus niger
* Mandragora officinarum
* Dimenhydrinate
* Diphenhydramine

Cannabinoids|

* THC
* Cannabis (Marijuana)
* Hashish
* Hash oil
* Synthetic cannabinoids
* JWH-018
* APICA
* APINACA
* Spice

Others|

* Ibogaine
* Tabernanthe iboga
* Muscimol
* Amanita muscaria
* Oneirogens
* Calea zacatechichi
* Silene capensis
* Salvinorin A
* Salvia divinorum

Drug culture

| Cannabis culture|

* 420
* Cannabis consumption
* Cannabis cultivation
* Cannabis edible
* Cannabis rights
* Cannabis rights leaders
* List of cannabis rights organizations
* Cannabis smoking
* Cannabis Social Club
* Cannabis tea
* Cannabis vaping
* Head shop
* Legal history of cannabis in the United States
* Legality of cannabis
* Marijuana Policy Project
* Medical cannabis
* NORML
* Cannabis and religion
* Stoner film

|

Coffee culture|

* Coffee break
* Coffeehouse
* Latte art
* Teahouse

Drinking culture|

* Bartending
* Beer culture
* Beer festival
* Binge drinking
* Diethyl ether
* Drinking games
* Drinking song
* Happy hour
* Hip flask
* Nightclub
* Oktoberfest
* Pub
* Pub crawl
* Sommelier
* Sports bar
* Tailgate party
* Wine bar
* Wine tasting

Psychedelia|

* Psychonautics
* Art
* Drug
* Era
* Experience
* Literature
* Music
* Microdosing
* Smart shop
* Therapy
* Trip report

Smoking culture|

* Cigarette card
* Fashion cigarettes
* Cloud-chasing
* Loosie
* Smokeasy
* Smoking fetishism
* Tobacco smoking

Other|

* Chasing the dragon
* Club drug
* Counterculture of the 1960s
* Dance party
* Drug paraphernalia
* Drug tourism
* Entheogen
* Hippie
* Needle sharing
* Nootropic
* Party and play
* Poly drug use
* Rave
* Religion and drugs
* Self-medication
* Sex and drugs
* Urban legends about drugs
* Whoonga

Legality of drug use

| International|

* International drug control conventions
* 1961 Narcotic Drugs
* 1971 Psychotropic Substances
* 1988 Drug Trafficking
* Other treaties addressing drugs
* Law of the Sea Convention
* Convention Against Doping
* Council of the European Union decisions on designer drugs

|

State level|

* Drug policy
* Decriminalization
* Legalization
* Prohibition
* Regulation
* Supply reduction
* Policy reform
* Demand reduction
* Drug Policy Alliance
* Harm reduction
* Law Enforcement Action Partnership
* Liberalization
* Latin America
* Students for Sensible Drug Policy

Drug policy
by country|

* Australia
* Canada
* China
* Czech Republic
* Germany
* India
* Laos
* Netherlands
* Philippines
* Poland
* Portugal
* Romania
* Slovakia
* South Korea
* Soviet Union
* Sweden
* Switzerland
* United States
* Just Say No
* Office of National Drug Control Policy
* School district drug policies
* California
* Colorado
* Maryland
* Oregon
* Virginia
* United Kingdom

Drug legality|

* Alcohol legality
* Anabolic steroid legality
* Cannabis legality
* Cocaine legality
* Methamphetamine legality
* Psilocybin decriminalization in the U.S.
* Psilocybin mushrooms legality
* Salvia legality

Other|

* Arguments for and against drug prohibition
* Cannabis rights
* Capital punishment for drug trafficking
* Cognitive liberty
* Designer drug
* Drug court
* Drug possession
* Drug test
* Narc
* Politics of drug abuse
* War on drugs
* Mexican drug war
* Plan Colombia
* Philippine drug war
* Zero tolerance

Other

| Drug
production
and trade|

| Drug
production|

* Coca production in Colombia
* Drug precursors
* Opium production in Afghanistan
* Rolling meth lab

|

Drug trade|

* Illegal drug trade
* Afghanistan
* Aruba
* Australia
* Bangladesh
* Belize
* Benin
* Bhutan
* Bolivia
* Brazil
* Burma
* Cambodia
* Chile
* China
* Colombia
* Costa Rica
* Cuba
* Cyprus
* Dominican Republic
* El Salvador
* Estonia
* Finland
* Germany
* Haiti
* Honduras
* India
* Indian Ocean region
* Iran
* Italy
* Japan
* Kenya
* Kosovo
* Kyrgyzstan
* Laos
* Latin America
* Latvia
* Malaysia
* Mauritius
* Moldova
* Nigeria
* Norway
* Oman
* Panama
* Papua New Guinea
* Paraguay
* Philippines
* Poland
* Portugal
* Puerto Rico
* Russia
* Saint Kitts and Nevis
* Seychelles
* Slovakia
* South Africa
* South Korea
* Spain
* Suriname
* Switzerland
* Taiwan
* Thailand
* Turkey
* Turks and Caicos Islands
* United Arab Emirates
* United States
* Venezuela
* Darknet market
* Pharmaceutical distribution
* Beer shop
* Cannabis shop
* Liquor store
* Liquor license

Issues with
drug use|

* Abuse
* Addiction
* Date rape drug
* Dependence
* Driving impaired
* Drug harmfulness
* Effects of cannabis
* Drug-related crime
* Fetal alcohol spectrum disorder
* Long-term effects of cannabis
* Neurotoxicity
* Overdose
* Passive smoking
* of tobacco or other substances

Harm reduction|

* Drug checking
* Drug legalization
* Drug rehabilitation
* Needle and syringe programmes
* Opioid replacement therapy
* Pharmacovigilance
* Reagent testing
* Regulation of therapeutic goods
* Responsible drug use
* Substance abuse prevention
* Supervised injection site
* Trip killer

Countries by
drug use|

* Alcohol consumption
* Cocaine use
* Cannabis
* Annual use
* Lifetime use
* Opiates use
* Tobacco consumption

Authority control databases

National|

* United States
* France
* BnF data
* Japan
* Czech Republic
* Israel

Other|

* Yale LUX

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