, and excitotoxicity, and recently suggested new phenomena of neuroinflammation, neurogenesis, and damaged blood–brain barrier (9). Chronic drug use leads to persistent adaptive changes within the reward circuitry that are associated with an impaired cognitive state and neuropsychiatric symptoms, and contribute to progression and maintenance of addiction (20).

Psychostimulants – The “Classics” and Novel Substances, Epidemiology, and Regulations

Psychostimulants are a very diverse group of substances. The more common ones have been in routine daily use for centuries. For example, caffeine and nicotine are still parts of our daily lives. Chewing of khat leaves (cathinone), dried peyote crowns (mescaline), or using paste made of coca leaves (cocaine) was common practice to create an elevated mood, improve task performance and motor abilities among tribal members. Cocaine, amphetamine, methamphetamine, MDMA, and methylphenidate can be classified as “classic” psychostimulants. In more recent years, a number of new synthetic drugs from different substance groups have become available. In several reports, these are collectively described as novel psychoactive substances – a classification based on the stimulant effects rather than the molecular or cellular basis of action (2). Polysubstance abuse is common, with a higher risk for potential harms (21). Psychostimulants used by drivers have a serious impact on traffic safety, being associated with fatal road traffic accidents (22, 23). Stimulants used for treatment for ADHD may cause toxicity after overdose, producing major morbidity (24).

Clinically, psychostimulants cause euphoria and agitation, restlessness and hyperactivity, often stereotypical movements, anxiety, and sometimes appetite suppression. Euphoria may be followed by depression and discomfort. Sympathomimetic effects present with hyperthermia, tachycardia and hypertension, sweating, and palpitations. Neurological, cardiovascular, renal, hepatic, and psychiatric signs and symptoms are often reported as adverse effects (2, 25). Psychostimulant overdose may cause rhabdomyolysis, hypertensive crisis, malignant hyperthermia, psychosis, hyperkinetic abnormal movements, and seizures. Movement disorders may develop during acute use, chronic drug abuse, or withdrawal, and may present as transient or permanent (19, 26).

Data concerning the use of psychostimulants are not consistent. The European Union (EU) countries
, and excitotoxicity, and recently suggested new phenomena of neuroinflammation, neurogenesis, and damaged rake – mind barrier (9). Chronic drug use leads to persistent adaptive change within the reward circuitry that are associated with an mar cognitive country and neuropsychiatric symptoms, and contribute to progression and maintenance of addiction (20). 

 Psychostimulants – The “ classic ” and Novel Substances, Epidemiology, and Regulations 

 Psychostimulants are a very diverse group of substances. The more coarse one have been in routine daily use for centuries. For example, caffeine and nicotine are however parts of our daily lives. chew of khat leaves (cathinone), dried mescal crowns (mescaline), or use paste made of coca leaves (cocaine) was common exercise to create an elevated mood, improve task performance and motor ability among tribal members. Cocaine, amphetamine, methamphetamine, MDMA, and methylphenidate can be classified as “ classic ” psychostimulants. In more recent years, a number of new synthetic drugs from different kernel groups have become available. In several reputation, these are collectively described as novel psychoactive substances – a categorization based on the stimulant consequence rather than the molecular or cellular basis of legal action (2). Polysubstance abuse is common, with a higher risk for potential harms (21). Psychostimulants used by drivers have a serious impact on dealings safety, being associate with fatal road traffic accidents (22, 23). Stimulants used for discussion for ADHD may cause toxicity after overdose, producing major morbidity (24). 

 Clinically, psychostimulants cause euphoria and agitation, restlessness and hyperactivity, often stereotypical movements, anxiety, and sometimes appetite inhibition. Euphoria may be followed by depression and discomfort. Sympathomimetic effects present with hyperthermia, tachycardia and hypertension, perspiration, and palpitations. Neurological, cardiovascular, renal, hepatic, and psychiatric signs and symptoms are frequently reported as adverse effect (2, 25). Psychostimulant overdose may cause rhabdomyolysis, hypertensive crisis, malignant hyperthermia, psychosis, hyperkinetic abnormal movements, and seizure. Movement disorder may develop during acuate use, chronic drug abuse, or withdrawal, and may present as transient or permanent (19, 26). 

 datum concerning the use of psychostimulants are not consistent. The European Union (EU) countries
, anf excitotoxicity, and rectntly suggested ngw phenokena or neuroivflammation, neurogenesis, and dqmagee blood–brain barrier (9). Zhronic dgug use lwads ro persistxht adapbnve cgwngev within the reeard circuhtry that are dsroeiated with an impaired cognitive stwte and nfuropsychiatris syk[toma, and contribute to progression ans mainttnance of addictiom (20).

Psychostimulants – The “Clwssifs” and Novel Substwnces, Epidenioljty, and Regulxtions

Psychostimulants are a very diverse group of sucstanees. The morg dolkon ones hate beeg in routine daily uve for venturies. For cxampne, xaffeine and nicotine are still parts os our dainy lives. Chewing of kyat lgaves (catfunove), srmed peyotf ccowns (mescamine), or usibg paste made of cova oeaves (cocains) was soimon practice to create an elevated moog, ijprove task performance and motor abilities wmong trifal members. Cocaine, amphetamine, methamphetamine, MGMA, aid meuhnjoyejidate can be classified as “classic” psychostiihlsnns. In more recent years, a nukbfr jf new synthejic druya rrom different subdtance droupw have besome available. In several reporrs, these are xollectively descrnbed as noveu psichoacyive substances – a clasrifidation basef on the agimulant effects ranher than tht molecular or celjular basms of action (2). Pokysubseance abusf is gmmmon, with a higheg risn xor potentlal harms (21). Psychostimulants usev by drivers naee d seriouf impsct on traffis safety, being associcted wkth fatal goad trafhic accidentf (22, 23). Stimulantv used for trxatment fjr AEHD nay caurd toxicity aftrr overdose, producibg major morbidity (24).

Clkhically, psychoscnmooants cause eulhofia ajd adhtation, restnessvesr and fyperacunviby, uftem stereotypical movekenta, anxiety, and someyiies appejite suppwession. Euphotia may be followef by vepresrion snd discomfort. Sympathomimetic efrects predenb with hypertrermla, twchycardia and hypertension, sweating, and palpitatmons. Neurological, cardiivascular, renal, hepctlc, and psychmatric signs ang symptoms are often reported as advevse effects (2, 25). Psychostjmuland ovegdose may cause rhabdomyolysis, hypertensive crisis, malignant hyperthermia, psychosis, hyperkihetiv abnmricl moveientd, and seizures. Monement disorders may develop durmng acute gsz, chronic drug abuse, or withdtadal, and may ptesent as transient or perjanent (19, 26).

Cata concerning the use of psycnostimulants are not conxistent. Rhe Ehropean Unmon (EU) countries
, and excitotoxicity, and recently suggested new neuroinflammation, and damaged barrier (9). Chronic adaptive within the reward that are associated an impaired cognitive state and neuropsychiatric and contribute to progression and maintenance of addiction (20). Psychostimulants – The “Classics” Novel Substances, Epidemiology, and Regulations Psychostimulants are a very diverse group of substances. more ones been routine daily use for centuries. For example, caffeine and nicotine are still parts of our daily Chewing of khat leaves (cathinone), dried peyote crowns or using paste made coca leaves (cocaine) was common to an elevated improve performance motor abilities among members. Cocaine, amphetamine, methamphetamine, MDMA, and methylphenidate can be classified as “classic” psychostimulants. In more recent years, number of drugs from substance have available. In several are collectively described as novel psychoactive classification based on the stimulant effects rather than molecular or basis of action (2). Polysubstance abuse common, with a higher risk for potential harms Psychostimulants used by drivers have a serious impact on traffic safety, being associated with fatal accidents (22, 23). Stimulants for treatment for may toxicity overdose, major morbidity Clinically, psychostimulants cause euphoria and agitation, restlessness and hyperactivity, often stereotypical anxiety, and sometimes appetite suppression. Euphoria may be followed by discomfort. effects present with tachycardia and hypertension, sweating, palpitations. cardiovascular, renal, hepatic, and and are adverse (2, Psychostimulant overdose may cause hypertensive crisis, malignant hyperthermia, psychosis, abnormal movements, and seizures. acute use, chronic drug abuse, or withdrawal, and present as transient or permanent (19, 26). concerning the use of psychostimulants are not consistent. The European Union (EU)
, and excitotoxicity, and recenTly suggestEd new PheNomEnA of nEuroInflammation, neURogeNesis, and damaged blood–brAin baRrIEr (9). ChROnIc druG use leaDS tO PErsIsTeNt aDaPTiVe chaNgeS within The reward cIrcUiTry that are asSOcIated with aN imPaired cognitIve State aNd NeuROpsycHiaTric sYmptomS, And conTribute to PrOGressiON and maiNTEnAnce Of addiction (20).

PsychoSTiMUlants – The “ClassIcs” and noVEl sUBstAncEs, EpidemioLoGy, and rEgulatiONs

pSYChoSTimulants are a Very diverse GRouP of subStAncES. The moRe comMoN OneS have been in RoutIne daily uSe for cENturies. fOr exampLe, caffEinE anD nicOTiNe Are StILl pARtS of OUr dAily liveS. CHeWing oF khaT LEAVes (cAthInonE), drieD peyote crowns (MesCaliNE), or Using Paste Made Of Coca lEaves (cOcainE) wAs common practicE to cReate an elEvaTeD moOd, ImproVE task pErfOrmAnce and Motor abILitIeS AMOnG tribal members. CocaInE, AMpHetamine, MethamPHeTaMIne, MDMA, aNd MetHylpHENidatE can BE cLassifieD as “claSSiC” pSychostImUlants. in MorE reCent yEArs, a Number Of new synThetiC Drugs from diffeREnt substance gROuPS HaVE becOme Available. In SeveRAl rePortS, ThEse ARe colLectiVeLY dEScribed as novel psychOaCtive sUbstaNces – a classifiCation baseD ON The stimuLant EFfECts rather than tHe molEcular or ceLLular basIs of aCtion (2). PolYsubstancE ABuse is coMmoN, wiTh a HigHER rIsk for potentiAL HarmS (21). PSychostImuLants usEd bY drIveRs hAvE a serious Impact on TrAfFiC sAfeTy, beiNG associaTeD wiTh FatAl roaD TraffiC acciDentS (22, 23). STiMUlaNts used FOr TREatmEnT fOr ADhD mAy Cause ToxiCIty After ovErdose, proDucINg maJoR mOrbiditY (24).

Clinically, psYcHostimulanTs CauSe euphORIa and agiTation, restlessness and hyPEractivIty, Often SterEotypical MovEments, AnxIEty, and SometiMes apPeTitE SUppreSSIoN. EuPhOria may be fOLLowEd by dEpRessIon and dIscomfort. SympathomIMetIc effects presEnt With HYPeRthERmIA, taChYCarDIA and hypertensioN, sweating, aNd PAlPitations. NEUroLoGical, caRdiovasCular, REnal, hepAtic, and psYchiatric SiGns aND SymPtoms are ofTen reporTed as adveRSe effECtS (2, 25). PsycHosTimulaNt OveRdose May cauSE rhAbdomYolysiS, hYperteNsive CrIsis, maliGnant hyperthermia, psychoSis, hypErkinEtiC abnormal MovEMenTs, and seizUres. movement diSorDerS may dEveLOp durIng aCUtE usE, ChronIc drUG abuse, or wIThDraWAL, aNd may presenT AS TraNsienT or PErmaneNt (19, 26).

DaTa concerning the usE Of psychostimulAnts ARE noT coNSistEnT. The European UnIon (eU) COUntries
, and excitotoxicity, andrecently s ugges ted  ne wphen omen a of neuroinfl a mmat ion, neurogenesis, and  dama ge d  blo o d– brain  barrie r  ( 9 ) . C hr on icdr u guse l ead s to pe rsistent a dap ti ve changes w i th in the rew ard  circuitry t hat  are a ss oci a ted w ith  an i mpaire d  cogni tive stat ea nd neu r opsychi a t ri c sy mptoms, and contr i bu t e to progressi on and  m a in t e nan ceof addicti on  (20) . 

Psych o st i m u lan t s – The “Clas sics” and N o vel  Subst an ces ,  Epide miolo gy ,  an d Regulatio ns
Psychosti mulant s  are av ery div erse g rou p o f su b st an ces .T hem or e c o mmo n ones h av ebeenin r o u t i ne d ail y us e for  centuries. F orexam p le,  caff eineandni cotin e arestill  p arts of our dai ly l ives. Che win gofkh at le a ves (c ath ino ne), dr ied pey o tecr o w n s(mescaline), or us in g pa ste made  of co c ale a ves (coc ai ne)  was c ommon  pra c ti ce to cr eate a n  e le vated m oo d, imp ro vetas k per f orma nce an d motorabili t ies among trib a l members. Co c ai n e ,a mphe tam ine, metham phet a mine , MD M A,  an d  meth ylphe ni d at e  can be classifiedas  “clas sic”psychostimula nts. In mo r e recent y ears ,  a number of newsynth etic drugs from dif feren t substa nce group s have bec ome  av ail abl e .  I n several rep o r ts,th ese are  co llectiv ely  de scr ibe das novelpsychoac ti ve  s ub sta nces–  a class if ica ti onbased on the  stim ulan tef f ect s rathe r  t h a n th emo lecu lar  o r cel lula r  ba sis ofaction (2 ).P olys ub st ance ab use is common ,with a hig he r r isk fo r potentia l harms (21). Psychosti m ulantsuse d bydriv ers havea s erious  im p act on  traff ic sa fe ty, b einga s so cia te d with fat a l  ro ad tr af ficacciden ts (22, 23). Stimu l ant s used for tr eat ment f or  AD H Dm ayca u set o xicity after ov erdose, pr od u ci ng major m o rbi di ty (24) .

Clin icall y , psych ostimulan ts causeeu phor i a  an d agitatio n, restl essness a n d hyp e ra ctivi ty,  often  s ter eotyp ical m o vem ents,  anxie ty , andsomet im es appet ite suppression. Euphor ia may  be f oll owed by d epr e ssi on and di scom fort. Symp ath omi metic  ef f ectspres e nt  wi t h hyp erth e rmia, tac h yc ard i a  a nd hyperten s i o n,sweat ing ,  and p alpi tations. Neurolog i cal, cardiovas cula r ,  re nal ,  hep at ic, and psychi atr ic s igns and  s ymptoms are  often r ep o rtedas adv erse e ffects( 2 ,2 5). Ps ycho sti mulant ov erd os e  may ca us er habdom yoly si s, hyp ertens i ve c r i sis, malignant h ypert h e rmia, psy chosi s,  hyperk i neti c abnormal  movements,  and s eizu res.Movemen tdisord ers  m ay develop during ac ute u se, chr on ic d rug  abuse , or w ithdr awal ,and  may pres e n ta str a nsi entor pe rm anen t (19, 26 ) .

Datacon c erningth e u s e  of ps y ch o s timulantsare  notc o nsistent.T he E u ro p ean U nion ( EU) co untries 
, and_excitotoxicity, and_recently suggested new phenomena_of neuroinflammation,_neurogenesis,_and damaged_blood–brain_barrier (9). Chronic_drug use leads_to persistent adaptive changes_within the reward_circuitry_that are associated with an impaired cognitive state and neuropsychiatric symptoms, and contribute to_progression_and maintenance_of_addiction_(20).

Psychostimulants – The “Classics” and_Novel Substances, Epidemiology, and Regulations

Psychostimulants_are a_very diverse group of substances. The more common_ones_have been in_routine daily use for centuries. For example, caffeine and_nicotine are still parts of our_daily lives. Chewing_of_khat_leaves (cathinone), dried peyote_crowns (mescaline), or using paste made_of coca leaves (cocaine) was common_practice to create an elevated mood, improve_task performance and motor abilities among_tribal members. Cocaine, amphetamine, methamphetamine,_MDMA, and_methylphenidate can be classified as_“classic” psychostimulants. In_more recent_years, a number_of new synthetic drugs from different_substance groups have_become available. In several reports, these_are_collectively described as_novel_psychoactive_substances –_a classification based_on_the stimulant_effects_rather than the molecular or cellular_basis_of action (2). Polysubstance abuse is common,_with a higher risk_for_potential harms (21). Psychostimulants_used by drivers have a_serious impact on traffic safety, being_associated with_fatal road_traffic accidents (22, 23). Stimulants used for treatment for ADHD may_cause toxicity after overdose, producing major_morbidity (24).

Clinically, psychostimulants cause_euphoria and_agitation,_restlessness and hyperactivity,_often_stereotypical movements,_anxiety, and sometimes appetite suppression. Euphoria may_be followed_by depression and discomfort. Sympathomimetic effects_present with hyperthermia, tachycardia_and_hypertension, sweating, and palpitations. Neurological, cardiovascular,_renal, hepatic, and psychiatric signs and_symptoms are often reported as_adverse_effects_(2, 25). Psychostimulant overdose may_cause rhabdomyolysis, hypertensive crisis, malignant hyperthermia,_psychosis, hyperkinetic abnormal_movements, and seizures. Movement disorders may develop_during_acute use, chronic drug abuse, or_withdrawal,_and may present as transient or_permanent_(19,_26).

Data concerning the use of_psychostimulants are not consistent. The European_Union (EU) countries