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Stimulants have been found to have detrimental effects on muscle control and can lead to deterioration of the heart muscle. The abuse of central nervous system stimulants can affect the heart and compromise the functioning of the cardiovascular system, leading to significant damage to the muscular system. Powerful stimulants such as cocaine and methamphetamine can produce brain damage, which can further compromise the musculoskeletal system. Additionally, certain stimulant medications can cause severe muscle pain, stiffness, and cramping. ADHD medications, for example, enhance the effect of dopamine in the body, increasing motor activity and muscular endurance. However, an excess of these stimulant-type drugs may increase the occurrence of tremors and myoclonus in muscle tissue, thereby increasing the risk of injury during movement.
| Characteristics | Values |
|---|---|
| Effect on muscle control | Tremors and impaired movement |
| Effect on the heart | Cardiomyopathy, high blood pressure, and heartbeat irregularities |
| Effect on brain | Brain damage |
| Effect on muscle pain and stiffness | Severe muscle pain and stiffness |
| Effect on muscle endurance | Increased muscular endurance |
| Effect on muscle fatigue | Increased tolerance to fatigue |
| Effect on tics | Trigger or worsen tics |
| Effect on core temperature | Increased core temperature |
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What You'll Learn
Dexmethylphenidate and methylphenidates
Dexmethylphenidate is the D-threo-enantiomer of methylphenidate, a medication used to treat attention deficit hyperactivity disorder (ADHD). It has a specific binding to a dopamine transporter in the basal ganglia, resulting in a longer duration of efficacy compared to methylphenidate. Dexmethylphenidate is considered effective in treating ADHD, with improvements in symptoms observed in children. However, it is associated with certain side effects, including abdominal pain, loss of appetite, and fever. More severe side effects may include psychosis, sudden cardiac death, mania, anaphylaxis, seizures, and priapism.
In terms of muscular effects, dexmethylphenidate and other methylphenidates have been linked to severe muscle pain and stiffness in some individuals with ADHD. This can lead to a decreased range of motion and impact physical activities. Additionally, stimulant medications, including dexmethylphenidate, may affect muscle control and contribute to psychomotor control deficits, as seen in heavy stimulant users.
It is important to note that the impact of dexmethylphenidate on muscle deterioration is not extensively studied, and the available literature primarily focuses on muscle pain and stiffness rather than deterioration. However, stimulant drugs, in general, can affect the heart muscle and compromise the functioning of the cardiovascular system, leading to serious conditions such as cardiomyopathy, high blood pressure, and arrhythmias.
Methylphenidate, the parent compound of dexmethylphenidate, has been studied more extensively. It is considered safe during pregnancy, with no conclusive evidence of adverse effects on fetal development. Methylphenidate has a side-effect profile similar to dexmethylphenidate, and its effects on muscle deterioration are not widely reported. However, it is known to cause muscle pain and stiffness in some cases.
In summary, while dexmethylphenidate and methylphenidates may not directly cause muscle deterioration, they can lead to muscle pain, stiffness, and control issues. The impact of these medications on muscle health warrants further investigation, especially regarding long-term use.
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Lisdexamfetamine and dextroamphetamine-amphetamine
Lisdexamfetamine is a prodrug of dextroamphetamine, a central nervous system stimulant. It is a Class B controlled substance in the United Kingdom, a Schedule 8 controlled drug in Australia, and a Schedule II controlled substance in the United States. Lisdexamfetamine is used primarily as a treatment for attention deficit hyperactivity disorder (ADHD) and binge eating disorder. It is also used off-label to treat narcolepsy. Lisdexamfetamine is available as oral capsules and chewable tablets.
Lisdexamfetamine has been reported to cause muscle pain, cramping, and stiffness. These side effects have been most widely reported with lisdexamfetamine, but there is also data suggesting that the combination medication dextroamphetamine-amphetamine may cause similar symptoms. Muscle pain, cramping, and stiffness have not been reported for non-amphetamine stimulant medications used in the treatment of ADHD.
Dextroamphetamine is the active metabolite of lisdexamfetamine and is available under the brand name Vyvanse. It is also available as a generic drug. Dextroamphetamine is sometimes prescribed as the inactive prodrug lisdexamfetamine. Side effects of dextroamphetamine at therapeutic doses include elevated mood, decreased appetite, dry mouth, excessive grinding of the teeth, headache, increased heart rate, increased wakefulness or insomnia, anxiety, and irritability, among others. At excessively high doses, dextroamphetamine can cause psychosis, addiction, and rapid muscle breakdown. However, for individuals with pre-existing psychotic disorders, there may be a risk of psychosis even at therapeutic doses.
In healthy people at oral therapeutic doses, amphetamine has been shown to increase muscle strength, acceleration, athletic performance, and endurance. Amphetamine improves endurance and reaction time primarily through reuptake inhibition and release of dopamine in the central nervous system. However, at much higher doses, amphetamine can induce effects that severely impair performance, such as rapid muscle breakdown and elevated body temperature.
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Stimulants and muscle control
The musculoskeletal system includes muscles, tendons, ligaments, and bones and is responsible for nearly every movement in the body. It is primarily controlled by the central nervous system, and damage to the latter can lead to issues with the former.
Stimulants such as cocaine and methamphetamine can damage important areas in the brain, which can lead to movement problems. Chronic use of these stimulants can produce brain damage, which can further compromise the musculoskeletal system. Abuse of central nervous system stimulants can also affect the heart (cardiac muscle) and compromise the functioning of the cardiovascular system, which can lead to significant damage to the muscular system.
Stimulants may also have detrimental effects on muscle control. Researchers have found that current or past use of methamphetamine or other stimulants may lead to psychomotor control deficits, or a reduced ability to control physical movement. Heavy stimulant users may experience tremors and arm-droop, with tremors persisting for at least 18 months following withdrawal from stimulant use.
Dexmethylphenidate, and potentially other methylphenidates used to treat ADHD, may cause severe muscle pain and stiffness. Lisdexamfetamine, an amphetamine stimulant, is also known to cause muscle pain, cramping, and stiffness. However, non-amphetamine stimulant medications used to treat ADHD, such as methylphenidate, have not been implicated in causing significant muscle pain and stiffness without other serotonin-related symptoms.
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Stimulants and the cardiovascular system
Stimulants can have a range of adverse effects on the cardiovascular system. These effects can be particularly harmful to older adults or those with pre-existing cardiovascular conditions.
Stimulants are commonly prescribed to treat attention deficit hyperactivity disorder (ADHD) in children. However, prescriptions for stimulants have increased in recent years, with these drugs now being given more frequently to older adults. Stimulants can cause the heart to beat faster and with more force, which can lead to an increase in blood pressure. This can be particularly dangerous for those who are already at risk of heart disease.
Research has found that stimulant use may lead to a short-term spike in the risk of heart attacks, strokes, and heart rhythm disorders (arrhythmias). A study published in JAMA Network Open in 2021 found that, on average, stimulant users aged 66 and older were 40% more likely to end up in the emergency room or hospital with a serious heart complication within 30 days of starting the drug. However, over a longer time period of six to twelve months, people taking stimulants did not experience a higher risk of heart-related issues compared to non-users.
Stimulants have also been linked to other cardiovascular issues, such as hypertension, tachycardia, palpitations, and ECG abnormalities. These issues can be seen in both adults and children taking stimulants. In rare cases, sudden death has been associated with stimulant treatment in children and adolescents with structural cardiac abnormalities or other serious heart problems.
Additionally, certain stimulants, such as lisdexamfetamine, have been known to cause muscle pain, cramping, and stiffness. This can further impact an individual's quality of life and physical capabilities.
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Stimulants and tics
The relationship between stimulants and tics has been a subject of research and debate. While some studies have suggested an association between stimulant use and the emergence or exacerbation of tics, others have found no causal link. The concern regarding the use of stimulants in individuals with tic disorders, particularly in the context of Attention-Deficit Hyperactivity Disorder (ADHD), has been a clinical challenge.
Historically, there has been hesitation among clinicians to prescribe stimulants to children with ADHD who also have tic disorders due to the fear of worsening tics. However, recent studies and meta-analyses have provided conflicting results. Some research suggests that stimulant medications can indeed bring out or intensify tics in individuals with underlying tic disorders. In certain cases, the discontinuation of stimulant medication has been associated with an improvement or disappearance of tics.
On the other hand, several studies have found no significant association between stimulant use and the onset or worsening of tics. A meta-analysis by Friedland and Walkup (2015) concluded that psychostimulants were not the cause of tic exacerbation in children with ADHD. Additionally, a study by Law and Schachar (1999) found that at lower doses, stimulants did not worsen tics in children with ADHD, and there was no difference in tic severity between different stimulants.
The impact of tic disorders on ADHD symptoms is considered limited in comparison. Therefore, the treatment of ADHD symptoms often takes priority. When addressing the management of tics and ADHD, a common approach is to first consider non-stimulant medications for ADHD. If this is ineffective, a combination of anti-tic medications and low-dose stimulant therapy may be explored.
It is important to note that the presence of tics should not be a barrier to receiving treatment for ADHD. The benefits of stimulant medications for ADHD can be significant, and there are alternative treatment options available if tics emerge or worsen. Close collaboration with a physician is crucial to determine the most appropriate treatment approach for individuals with ADHD and tic disorders.
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Frequently asked questions
Stimulants can have detrimental effects on muscle control, causing psychomotor control deficits and a reduced ability to control physical movement. They can also cause muscle pain, cramping, and stiffness.
No, only certain stimulants have been found to cause muscle deterioration. For example, dexmethylphenidate, lisdexamfetamine, and dextroamphetamine-amphetamine have been reported to cause muscle pain and stiffness.
Yes, stimulants can enhance muscular endurance and reduce the feeling of fatigue while exercising. However, they can also increase the risk of heat injury, as they increase core body temperature and mask signs of fatigue.
Chronic use of powerful stimulants can produce brain damage, which can compromise the musculoskeletal system and lead to movement problems. Tremors caused by stimulant use can persist for at least 18 months after discontinuing the drug.
