Amphetamines

ByGerald F. O’Malley, DO, Grand Strand Regional Medical Center;
Rika O’Malley, MD, Grand Strand Medical Center
Reviewed/Revised Dec 2022
VIEW PROFESSIONAL VERSION

Amphetamines are stimulant drugs that are used to treat certain medical conditions but are also subject to abuse.

  • Amphetamines increase alertness, enhance physical performance, and produce euphoria and a sense of well-being.

  • Amphetamines suppress appetite and some people misuse amphetamines to lose weight.

  • An overdose can cause extreme agitation, delirium, and a life-threatening high body temperature, heart attack, or stroke.

  • Urine tests can detect most amphetamines.

  • For an overdose, treatment involves sedatives, blood pressure–lowering medications, and sometimes cooling treatments.

(See also Drug Use and Abuse.)

Amphetamines include the drug amphetamine and its many variants such as methamphetamine (speed or crystal meth) and methylenedioxymethamphetamine (MDMA, Ecstasy, or Adam). Methamphetamine is the most commonly used amphetamine in the United States. Use of MDMA is growing in popularity. Amphetamines are usually taken by mouth but can be snorted, smoked, or injected.

Because some amphetamines are widely used as treatment for attention-deficit/hyperactivity disorder, obesity, and narcolepsy, there is a ready supply that can be diverted to illegal use. Some amphetamines are not approved for medical use and are manufactured and used illegally.

Some amphetamine users are depressed and seek the mood-elevating effects of these stimulants to temporarily relieve the depression. Others use them during high-energy activities. Amphetamines cause more dopamine to be released in the brain. (Dopamine is a neurotransmitter, a substance that helps nerve cells communicate.) This effect is the likely cause of mood elevation. MDMA differs from other amphetamines in that it also interferes with the reuptake of serotonin (another neurotransmitter) in the brain. Amphetamine users frequently develop dependence, often referred to as a substance use disorder.

Did You Know...

  • High doses of amphetamines may raise body temperature to dangerous levels.

Amphetamines use causes both immediate and long-term symptoms.

Immediate effects

  • Increased alertness

  • Reduced fatigue

  • Heightened concentration

  • Decreased appetite

  • Enhanced physical performance

Amphetamines may produce a feeling of well-being, euphoria, and loss of inhibitions. Also, people sweat profusely, and their pupils are dilated.

Binge usage (perhaps over several days) eventually causes extreme exhaustion and a need for sleep.

Overdose

High doses (overdose) increase blood pressure and heart rate. These increases may be life threatening. People may become extremely paranoid, violent, and out of control.

People may become delirious. Heart attacks have occurred, even in healthy young athletes. Blood pressure may become so high that a blood vessel in the brain ruptures, causing a stroke. Other effects include dizziness, nausea, vomiting, diarrhea, seizures, and a life-threatening high body temperature (hyperthermia).

Long-term effects

People who habitually use amphetamines rapidly develop tolerance as part of dependence. They need to use more and more to get the same effect. The amount ultimately used may be more than several times the original dose. Most people using very high doses over several days or weeks become confused and psychotic because amphetamines can cause severe anxiety, paranoia, and a distorted sense of reality.

Psychotic reactions include hearing and seeing things that are not there (auditory and visual hallucinations) and false beliefs (delusions), such as a feeling of having unlimited power (omnipotence) or of being persecuted (paranoia). Memory may be affected. Confusion, memory loss, and delusions may last for months. Although these effects can occur in any user, people with a mental health disorder, such as schizophrenia, are more vulnerable to them.

Withdrawal symptoms

When an amphetamine is suddenly stopped, symptoms vary. People dependent on amphetamines become tired or sleepy—an effect that may last for 2 or 3 days after stopping the drug. As a result, they are more likely to be injured.

Some people are extremely anxious and restless, and some, especially those with a tendency toward depression, become depressed when they stop. They may become suicidal but may lack the energy to attempt suicide for several days.

  • A doctor's evaluation

Other tests, such as electrocardiography, computed tomography, and blood tests, may be done to check for complications.

After an overdose, treatment may include

  • Observation and monitoring until the person is sober

  • Sedatives

  • Blood pressure–lowering medications

  • Cooling for hyperthermia (dangerously high body temperature)

  • Treatment for depression and suicidal tendencies during withdrawal period

  • Cognitive-behavioral therapy to prevent relapse

Benzodiazepines

Medications for high blood pressure

Cooling treatments, such as wetting and blowing air over the person's skin or using special cooling blankets, may be needed for hyperthermia.

During drug withdrawal, long-term users may need to be hospitalized so that they can be observed for suicidal behavior. Antidepressants may be given if depression persists. Otherwise, no treatment is generally needed for people experiencing withdrawal.

Cognitive-behavioral therapy (a form of psychotherapy) helps some people stay free of amphetamines.

More Information

The following English-language resources may be useful. Please note that THE MANUAL is not responsible for the content of these resources. 

  1. National Institute on Drug Abuse (NIDA):

  2. Substance Abuse and Mental Health Services Administration (SAMHSA): US Department of Health agency that leads public health efforts to improve behavioral health and provides resources, including treatment locators, toll-free helplines, practitioner training tools, statistics, and publications on a variety of substance-related topics.

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