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Hypoactive and Hyperactive Catecholamines
In ADHD, the tonic pool is hypothesized to be reduced, which allows for a larger-than-normal phasic release of DA and, hence, disorganized behavior leading to inattention, and hyperactivity
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AMP
- non‐catecholamine, sympathomimetic amines
- -Promote release of catecholamines (primarily dopamine and norepinephrine) from their storage sites in the presynaptic nerve terminals
- -Block the reuptake of catecholamines by competitive inhibition
- -Compete with MAO and reduce breakdown of endogenous biological amines
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MPH
- Mild CNS stimulant related to amphetamine
- Blocks reuptake of DA and NE
- NOT as effective at release or MAO inhibition
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Methylphenidate, SR, LA
- Ritalin, Ritalin SR, Ritalin LA
- MPH
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Methylphenidate ER, CD
- Metadate ER, Metadate CD
- MPH
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Methylphenidate OROS (osmotic-controlled release oral delivery system)
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Methylphenidate Transdermal
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Dexmethylphenidate IR, XR
- Focalin, Focalin XR
- MPH
- Isomer of methylphenidate
- -NET/DAT reuptake inhibitor‐indirect sympathomimetic
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Dextroamphetamine, Spansules
- Dexedrine or Dexedrine Spansules, Dextrostat
- AMP
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Mixed Amphetamine Salts (Dextroamphetamine, amphetamine), XR
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Atomoxetine
- Straterra
- Non-Stimulant
- Selective norepinephrine reuptake inhibitor (NET)
- May be better in psychosis or psych Sx
- DNU w/i 2 weeks of D/C of MAOI
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Atomoxetine ADR
- Cardiovascular
- -Increased blood pressure and heart rate (similar to those seen with conventional psychostimulant)
- GI
- -Anorexia, weight loss, nausea, abdominal pain
- Miscellaneous
- -Fatigue, dry mouth, constipation,urinary hesitancy and erectile dysfunction.
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Clonidine ER
- Kapvay
- Non-Stimulant
- Likely CNS post-synaptic
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Guanfacine ER
- Intuniv
- Non-Stimulant
- Likely CNS post-synaptic
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TCAs
- Secondary/tertiary amines with selectivity for NE reuptake transporter (NET)
- -Imipramine
- -Desipramine
- -Amitriptyline
- -Nortriptyline
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Buproprion
modulate DA reuptake (DAT) by modulating GAT
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Anorexiants-appetite suppressants (Weight reduction)
- Phentermine/topiramate- similar to amphetamine
- -Selectivity for NET > DAT > SERT
- -Reduced hunger perception in hypothalamus
- Fenfluramine‐ similar to amphetamine
- -Withdrawn in 1997
- -Selectivity for SERT in appetite suppression
- Methamphetamine‐ similar to amphetamine
- Phendimetrazine- similar to amphetamine
- Sibutramine‐ NET > SERT > DAT reuptake inhibition
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