Increased levels of neurotransmitters such as norepinephrine, serotonin and dopamine can lead to psychomotor agitation which can manifest as a variety of symptoms. Symptoms include talkativeness and nervousness, which can progress to significant anxiety and aggression.
CNS stimulants speed up mental processes and cause increased feelings of wakefulness and alertness. The patient may develop insomnia based on an increase in energy levels and decreased need for sleep. By decreasing the patient's afternoon dose and avoiding medication administration after 4:00PM, the patient may minimize the effect of insomnia.
CNS stimulants mimic the effects of norepinephrine in the blood vessels and cause excessive vasoconstriction that may develop hypertension.
CNS stimulants may overstimulate the heart muscle and cause tachycardia and dysrhythmias. By mimicking the effects of norepinephrine, these medications increase heart rate, AV conduction, and force of contraction.
CNS stimulation may result in new tics or worsening of pre-existing tics. Types of tics include both motor and verbal tics.
CNS stimulants act upon the hypothalamus and cause appetite suppression. Loss of appetite or anorexia will cause weight loss. Weight loss may be desirable in obese patients but is considered an adverse effect in leaner patients. Administering the medication during or after meals will prevent the weight loss effects of anorexia.
Physiological tolerance develops with chronic use of CNS stimulants. As the body adapts to the effects of CNS stimulants, the patient may increase the dosage and frequency of these drugs to yield the desired euphoric effect.
CNS stimulants create feelings of euphoria and increases the risk of abuse and psychological dependence. Regular use of CNS stimulants develops into physical dependence. The patient will experience abstinence syndrome, if the use of CNS stimulants is abruptly stopped. Symptoms of abstinence syndrome include exhaustion, depression, excessive sleeping and eating, and craving the drug.
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