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Methamphetamine

Medical Uses and Contraindications: – Methamphetamine hydrochloride (Desoxyn) FDA-approved for ADHD and obesity treatment. – Off-label use for narcolepsy and idiopathic hypersomnia. – Contraindications: History […]

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Medical Uses and Contraindications:
– Methamphetamine hydrochloride (Desoxyn) FDA-approved for ADHD and obesity treatment.
– Off-label use for narcolepsy and idiopathic hypersomnia.
– Contraindications: History of substance use disorder, heart disease, severe agitation/anxiety.
– FDA advises against use in arteriosclerosis, glaucoma, hyperthyroidism, severe hypertension.
– Monitoring recommended for bipolar disorder, depression, elevated blood pressure, etc.

Adverse Effects and Risks:
– High harm potential, mood swings, stimulant psychosis, violent behavior.
– Potential for compulsive drug use, neurotoxicity impacting brain structure and function.
– Reductions in grey matter volume, metabolic integrity markers.
– Withdrawal symptoms may persist for months after heavy use.

Production, Distribution, and Chemistry:
– Methamphetamine production restricted in many countries.
– Illicit production common due to ease of synthesis.
– Trafficked and sold for recreational use in Asia, Oceania, and the US.
– Belongs to substituted phenethylamine and substituted amphetamine classes.
– High addiction liability, mood elevation, energy increase, appetite reduction.

Physical, Sexual, and Psychological Effects:
– Physical effects: Loss of appetite, hyperactivity, dilated pupils.
– Sexual health effects: Linked to higher frequencies of unprotected sex, increased STI risk.
– Psychological effects: Euphoria, alertness, irritability, violent behaviors.
– Association with anxiety, depression, psychosis.

Overdose, Psychosis, and Emergency Treatment:
– Wide range of overdose symptoms, including confusion and high body temperature.
– Stimulant psychosis symptoms: Paranoia, hallucinations, delirium.
– Deaths from methamphetamine overdose reported by CDC.
– Emergency treatment includes managing symptoms, antipsychotics, and beta blockers.

Methamphetamine (Wikipedia)

Methamphetamine (contracted from N-methylamphetamine) is a potent central nervous system (CNS) stimulant that is mainly used as a recreational drug and less commonly as a second-line treatment for attention deficit hyperactivity disorder and obesity. Methamphetamine was discovered in 1893 and exists as two enantiomers: levo-methamphetamine and dextro-methamphetamine. Methamphetamine properly refers to a specific chemical substance, the racemic free base, which is an equal mixture of levomethamphetamine and dextromethamphetamine in their pure amine forms, but the hydrochloride salt, commonly called crystal meth, is widely used. Methamphetamine is rarely prescribed over concerns involving human neurotoxicity and potential for recreational use as an aphrodisiac and euphoriant, among other concerns, as well as the availability of safer substitute drugs with comparable treatment efficacy such as Adderall and Vyvanse. Dextromethamphetamine is a stronger CNS stimulant than levomethamphetamine.

Methamphetamine
INN: Metamfetamine
A racemic image of the methamphetamine compound
A 3d image of the levo-methamphetamine compound A 3d image of the dextro-methamphetamine compound
Clinical data
Pronunciation/ˌmɛθæmˈfɛtəmn/
(METH-am-FET-ə-meen), /ˌmɛθəmˈfɛtəmn/
(METH-əm-FET-ə-meen), /ˌmɛθəmˈfɛtəmən/
(METH-əm-FET-ə-mən)
Trade namesDesoxyn, Methedrine
Other namesN-methylamphetamine, N,α-dimethylphenethylamine, desoxyephedrine
AHFS/Drugs.comMonograph
License data
Dependence
liability
Physical: None; Psychological: Very High
Addiction
liability
Very High
Routes of
administration
Medical: oral (ingestion)
Recreational: oral, intravenous, intramuscular, subcutaneous, vapour inhalation, insufflation, rectal, vaginal
ATC code
Legal status
Legal status
Pharmacokinetic data
BioavailabilityOral: 67%
Intranasal: 79%
Inhalation: 67–90%
Intravenous: 100%
Protein bindingVaries widely
MetabolismCYP2D6 and FMO3
MetabolitesAmphetamine
Pholedrine
N-Hydroxymethamphetamine
Onset of actionOral: 3 hours (peak)
Intranasal: <15 minutes
Inhalation: <18 minutes
Intravenous: <15 minutes
Elimination half-life9–12 hours (range 5–30 hours) (irrespective of route)
Duration of action8–12 hours
ExcretionPrimarily kidney
Identifiers
  • (RS)-N-methyl-1-phenylpropan-2-amine
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
PDB ligand
CompTox Dashboard (EPA)
ECHA InfoCard100.007.882 Edit this at Wikidata
Chemical and physical data
FormulaC10H15N
Molar mass149.237 g·mol−1
3D model (JSmol)
ChiralityRacemic mixture
Melting point170 °C (338 °F)
Boiling point212 °C (414 °F) at 760 mmHg
  • CNC(C)Cc1ccccc1
  • InChI=1S/C10H15N/c1-9(11-2)8-10-6-4-3-5-7-10/h3-7,9,11H,8H2,1-2H3 checkY
  • Key:MYWUZJCMWCOHBA-UHFFFAOYSA-N checkY
  (verify)

Both racemic methamphetamine and dextromethamphetamine are illicitly trafficked and sold owing to their potential for recreational use. The highest prevalence of illegal methamphetamine use occurs in parts of Asia and Oceania, and in the United States, where racemic methamphetamine and dextromethamphetamine are classified as schedule II controlled substances. Levomethamphetamine is available as an over-the-counter (OTC) drug for use as an inhaled nasal decongestant in the United States. Internationally, the production, distribution, sale, and possession of methamphetamine is restricted or banned in many countries, owing to its placement in schedule II of the United Nations Convention on Psychotropic Substances treaty. While dextromethamphetamine is a more potent drug, racemic methamphetamine is illicitly produced more often, owing to the relative ease of synthesis and regulatory limits of chemical precursor availability.

In low to moderate doses, methamphetamine can elevate mood, increase alertness, concentration and energy in fatigued individuals, reduce appetite, and promote weight loss. At very high doses, it can induce psychosis, breakdown of skeletal muscle, seizures and bleeding in the brain. Chronic high-dose use can precipitate unpredictable and rapid mood swings, stimulant psychosis (e.g., paranoia, hallucinations, delirium, and delusions) and violent behavior. Recreationally, methamphetamine's ability to increase energy has been reported to lift mood and increase sexual desire to such an extent that users are able to engage in sexual activity continuously for several days while binging the drug. Methamphetamine is known to possess a high addiction liability (i.e., a high likelihood that long-term or high dose use will lead to compulsive drug use) and high dependence liability (i.e. a high likelihood that withdrawal symptoms will occur when methamphetamine use ceases). Withdrawal from methamphetamine after heavy use may lead to a post-acute-withdrawal syndrome, which can persist for months beyond the typical withdrawal period. Methamphetamine is neurotoxic to human midbrain dopaminergic neurons and, to a lesser extent, serotonergic neurons at high doses. Methamphetamine neurotoxicity causes adverse changes in brain structure and function, such as reductions in grey matter volume in several brain regions, as well as adverse changes in markers of metabolic integrity.

Methamphetamine belongs to the substituted phenethylamine and substituted amphetamine chemical classes. It is related to the other dimethylphenethylamines as a positional isomer of these compounds, which share the common chemical formula C10H15N.


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