Talk:Methamphetamine/Archive 7

Archive 1

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Archive 6

Archive 7

Structure

The structure shown here has an explicit terminal CH3 group, while the structure on the levo- page ends with the carbon, and has the hydrogens implied. I'm not a chemist, but I'm fairly certain the later is more typical (though both are correct), and the explicit CH3 made me do a double take. Can someone who knows more (chemistry and or wiki style conventions) confirm if there's a preferred style? It would be nice for the structure to be harmonized between the enantiomers. Kackola (talk) 14:42, 14 December 2021 (UTC)

Bupropion and Naltrexone COMBINED for Treatment of Meth Use disorder

Article mentions use of both Bupropion and Naltrexone independently for treatment of Meth use disorder, but does not include a paper published January 2021 (DOI: 10.1056/NEJMoa2020214) that shows a significantly stronger effect when these drugs are used in combination. I saw this mentioned by a previous user on this Talk page, but no edit has been made. I am not able to edit the article, so if you are able to and see this, please take the time to edit.

Thanks — Preceding unsigned comment added by ReadOx (talk • contribs) 19:24, 18 December 2021 (UTC)

Help for the Readers - Suggestion

Please add to the Adverse Effects - Sexually Transmitted Infections title Safety Information regarding HIV transmission that there are programs to protect people whom may be at risk. The programs is called PrEP and PEP which stand for Pre-Exposure Prophylaxis (PrEP) and Post Exposure Prophylaxis for treatment and prevention of HIV transmission regarding all sexually active adults be they different or same gender intimacy (heterosexual or Homosexual or (LGBTIQ)). It allows people to take better care of each other and reduce transmission if following a PrEP program. Alagrexa (talk) 08:05, 6 February 2022 (UTC)

Help for the Readers - Suggestion #2 Safety Info: Usage

Please add a section called Drug Use - Safety Information

Please provide a section that discusses safe usage amounts recreationally and habitually so that people may find out how to not abuse the substance. Keep it simple for all readers or link to a site.

Please provide a link to, or, discuss how to practice hygiene when using needles. Hygiene for smoking too. and COVID-19. With regard to the usage hygiene section could you please refer to medications to treat HIV and Hepatitis C. Alagrexa (talk) 08:12, 6 February 2022 (UTC)

Fatal dose section should probably be revised

The text "Doses of 200 mg or more of methamphetamine are considered fatal.[40]" which refers to the study "Methamphetamine overdose and fatality : 2 cases report" in the Journal of the Medical Association of Thailand, claims the doses of 200mg are lethal. Yet the study "A Comparison of Patterns of Methamphetamine and Cocaine Use" describes addicts routinely taking up to 830mg a day. Alongside the former study, the study "Acute Methamphetamine Intoxication: Brain Hyperthermia, Blood-Brain Barrier and Brain Edema" shows the LD50 in rats to be "55 and 57 mg/kg", referring to (Davis et al., 1987; Yamamoto, 1963). although toxicity seems to change drastically based around temperature, at 29c 80% of rats died after injection of just 9mg/kg (Brown and Kiyatkin, 2005).

It seems that revising the section to include the complete view would be ideal. — Preceding unsigned comment added by MHg1RjM3NTlERiAg (talk • contribs) 21:25, 9 April 2022 (UTC)

Yes I agree the “source” originally cited seems to mention only that two people died after taking an uncertain amount of

unknown pills. As far as I can tell it assumes its an established fact 200 mg of meth kills. A a wide range of factors, from size, heart health, tolerance, and treatment makes listing a fatal dose pointless.  CanGodForgiveUs (talk) 08:15, 9 September 2022 (UTC)

Stop writing a false information while using sources that are not even closely affiliated with medical files.

It is time to address this issue. Right of to a good start, most accent is being pointed to adverse effects of the medication. The only truth in that first paragraph is that, indeed it is very rare for methamphetamine to be prescribed. After that is where insanity starts. Author does not differentiate between what is being prescribed and it’s street analogs, while hurling terms such as dextroMETHamphetamine, levomethamphetamine. while not even mentioning that methamphetamine converts into dextroamphetamine.Moving forward -neurotoxicity. Agree- it can be, and is neurotoxic, but why? At which doses?Coming onto end and of that bird excrement of a first paragraph author states that , agdextroMETHamphetamine is more potent than levoMETHamphetamine. anyone who is closely related to a topic of stimulants would be just saying that amphetamine’s right molecule- dextroamphetamine promotes better stimulation of a CNS, and it’s useless left molecule-levoamphetamine mostly responsible for not desired overstimulation of the peripheral system-as in you sweating.Now, comparing something like methamphetamine and adderall in their effectivity... who reviewed all of this? Why the very first paragraph doesn’t clearly distinguishes between Desoxyn, a hydrochloride form of methamphetamine, approved by the FDA as a last line of treatment of ADHD l, morbid obesity and severe forms of narcolepsy, and crystal methamphetamine.where are specifics? All of that comes out being biased to say the leas. While Desoxyn is most definitely not being prescribed often, it saved a lot of lives. It is authors like you, who made it even more harder to get. 2601:281:D082:2160:99FA:FAD1:98AF:1A4B (talk) 19:17, 6 May 2022 (UTC)

Methamphetamine is a neurotoxin, in that it is directly neurotoxic (i.e., positive statistical correlation without a threshold effect). This is as opposed to compounds that aren't inherently neurotoxic, such as amphetamine (the compound, not the class), which doesn't start producing a toxic effect until some nontrivial dose is reached to begin a neurotoxic cascade.

Methamphetamine has a multi-modal neurotoxic mechanism which arises through hyperpyrexia, dopamine autoxidation, sigma-1 receptor activation, the inhibition of EAAT2 (EAAT2 is responsible for >90% of glutamate clearance in the brain) which leads to a marked elevation of synaptic glutamate, increased ROS+RNS generation (and possibly other mechanisms). In combination, these effects cause oxidative stress, promote excitotoxicity, trigger a neuroimmune response (i.e., microglial activation), and induce apoptotic signaling cascades in neurons. This is all outlined in the article, specifically in the neurotoxic and neuroimmunological section.

Furthermore, sources cited for claims made regarding methamphetamine use and neurotoxicity in humans follow WP:MEDRS guidelines.

As for the comment about editors of this article having an influence declining methamphetamine prescriptions, I don't understand why you entertain that as truth. 2403:4800:3403:E000:C5A3:D674:AAD2:8EC3 (talk) 14:21, 28 July 2022 (UTC)

200mg fatal dosage section should be removed

This section should be removed as it detracts from the legitimacy of the article. There a plethora of case reports where dosages far exceed 200mg.

Also this is a snippet from https://www.ncbi.nlm.nih.gov/books/NBK507808/ regarding Dexamphetamine (which is a good yard stick to measure by given that there seems to be little clarity on the actual lethal dosage of methamphetamine):

"Twenty to 25 mg/kg is reportedly the lethal dose in the adult population, but the dose-response is variable between the patients. Chronic amphetamine abusers may develop tolerance to up to 15,000 mg/day without lethal results"

Now unless there is some proven pathway that makes methamphetamine roughly 10x more potent in terms of its potential lethality (assuming the average adult weights 80kg), then we should probably remove this until we can verify it with more research, I've tried to access the full article that the 200mg number was pulled from to see if there is more information to be gleaned. — Preceding unsigned comment added by 121.200.5.24 (talk) 23:10, 26 May 2022 (UTC)

• My guess is that 200mg is considered the LD50, meaning that half the people will die with a dose of 200mg. That means the other half won't, but that is still considered a lethal dose...for half the population. Dennis Brown - 2¢ 11:26, 9 September 2022 (UTC)

Semi-protected edit request on 10 October 2022

I request to change an error 122.161.51.154 (talk) 14:34, 10 October 2022 (UTC)

 Not done This is not the right page to request additional user rights.
If you want to suggest a change, please request this in the form "Please replace XXX with YYY" or "Please add ZZZ between PPP and QQQ".
Please also cite reliable sources to back up your request, without which no information should be added to, or changed in, any article. - Arjayay (talk) 15:59, 10 October 2022 (UTC)

Semi-protected edit request on 12 November 2022

I would please to can you allow me change like to let me change. There are several grammar mistakes in this article. This is only gramatically correct as of july 2022 but the dictionary for drugs has been officialy updated. The correct term is "memphatamatine" not "methamphetamine". Would you kindly allow us to change it? If not we would be happy for someone to assist us in editing the article. F15Dude (talk) 09:44, 12 November 2022 (UTC)

 Not done: please provide reliable sources that support the change you want to be made. Please ensure that your requests are written in a clear and concise way. Actualcpscm (talk) 10:04, 12 November 2022 (UTC)

Semi-protected edit request

This text from the third paragraph should be changed or given a propper source. Beeing able to engage in sexual activity continuously for several days is not mentioned in the source article. Secondly the source article in by no means a scientific source.

"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."

source ariticle: https://web.archive.org/web/20130812083225/http://www.nbcnews.com/id/6646180/ns/health-addictions/t/meths-aphrodisiac-effect-adds-drugs-allure/

Muskimolen (talk) 19:10, 25 December 2022 (UTC)

Mention of dextroamphetamine instead of D-meth

The last sentence of the first paragraph mentions "Dextroamphetamine is a stronger CNS stimulant than levomethamphetamine."

Comparing D-amph to L-meth here is odd, because no reason has been introduced to suddenly compare an enantiomer of amphetamine to an enantiomer of METHamphetamine. There is also no source given. It should probably be dextro*METH*amphetamine.

Would someone be so kind to correct this?

Also, source [124] measured CNS stimulant activity of both enantiomers, through blood pressure, heart rate, respiratory rate and "intoxication/drug effect" ratings. D-meth scored higher on systolic blood pressure and effect duration. The enantiomers scored equally on all other measures.

So, I'm not sure the following under Pharmacology -> Pharmacodynamics -> 2nd-to-last sentence is accurate: "Dextromethamphetamine is a stronger psychostimulant, but levomethamphetamine has stronger peripheral effects, (...) and longer perceived effects among addicts."

Additionally, source [122] is unrelated to this sentence - it measures whether the caudate-putamen dopamine response after deprenyl administration can be attributed exclusively to its metabolite L-meth, or also to L-meth metabolites and/or deprenyl itself.

The same goes for [123], which exclusively measured and compared intra- and extracellular levels of dopamine, serotonine and norepinephrine. The only conclusion drawn about the (psycho)stimulant properties of both enantiomers is that the enantiomer response profiles of these neurotransmitters don't have simple relationships with the enantiomer behavior profiles. 82.170.165.135 (talk) 11:12, 23 January 2023 (UTC)

error

Dextroamphetamine is a stronger CNS stimulant than levomethamphetamine.

Dextroamphetamine is a stronger CNS stimulant than dextromethamphetamine.

Or is that "racemic" methamphetamine? All CNS stimulants are stronger than levo because it isn't one, so the original text is either incorrect or erroneous. Angierockstheplanet (talk) 00:02, 20 April 2023 (UTC)

Semi-protected edit request on 15 January 2023

Dextroamphetamine is a stronger CNS stimulant than levomethamphetamine.

Dextroamphetamine needs to be changed to dextromethamphetamine as this sentence was originally stating the stronger CNS stimulation of the dextro enantiomer of methamphetamine, not amphetamine. 76.8.183.219 (talk) 16:55, 15 January 2023 (UTC)

 Not done: please provide reliable sources that support the change you want to be made. ~ Eejit43 (talk) 01:30, 18 January 2023 (UTC)

There is no source here supporting this comparison of D-amph to L-meth.

Source [124] sort-of-supports changing this, although I personally think "stronger" is a vague term to use here. 82.170.165.135 (talk) 11:21, 23 January 2023 (UTC)

Where's the dextromethamphetamine page?

We have a levometh page but not for dextrometh? And why is the dextrometh link, which is supposed to be non-existent because the page hasn't been created, link back to the racemic methamphetamine page? Someone kinda needs to fix that and add an actual dextromethamphetamine page. Doxylamine (talk) 21:58, 22 May 2023 (UTC)

Semi-protected edit request on 7 July 2023

Change A: Methamphetamine < Uses < Medical

"In the United States, methamphetamine hydrochloride, under the trade name Desoxyn, has been approved by the FDA for treating ADHD and obesity in both adults and children;[24][25] however, the FDA also indicates that the limited therapeutic usefulness of methamphetamine should be weighed against the inherent risks associated with its use.[24] To avoid toxicity, FDA guidelines recommend methamphetamine at doses 25mg/day for ADHD in adults and children over six years of age.[5] Methamphetamine is sometimes prescribed off label for narcolepsy and idiopathic hypersomnia.[26][27] In the United States, methamphetamine's levorotary form is available in some over-the-counter (OTC) nasal decongestant products.[note 3]"

To Change B: Methamphetamine < Uses < Medical

"In the United States, methamphetamine hydrochloride, under the trade name Desoxyn, has been approved by the FDA for treating ADHD and obesity in both adults and children;[24][25] however, the FDA also indicates that the limited therapeutic usefulness of methamphetamine should be weighed against the inherent risks associated with its use.[24] To avoid toxicity and a risk of side effects, FDA guidelines recommend the initial dose of methamphetamine at doses 5-10mg/day for the treatment of ADHD in adults, and for the treatment of ADHD and obesity in children over six years of age. If a patient's therapeutic dose has not been reached, the dose may be increased by 5mg in weekly intervals until the optimum clinical response is found. The usual effective dose is around 20-25mg, however some people may find lower doses to be more therapeutic. "Methamphetamine should be administered at the lowest effective dosage, and dosage should be individually adjusted."[5] If required, a daily dose may be divided into 2 effective doses. Methamphetamine is sometimes prescribed off label for narcolepsy and idiopathic hypersomnia in doses up to 60mg.[5][26][27] In the United States, methamphetamine's levorotary form is available in some over-the-counter (OTC) nasal decongestant products.[note 3]

References

The explanation for my edit request:

Contained within the "Uses" and "Medical" section for methamphetamine, there is a distressing error that claims, "To avoid toxicity, FDA guidelines recommend methamphetamine at doses 25mg/day for ADHD in adults and children over six years of age."

This is misleading, considering that a beginning dose, 25mg of methamphetamine, is NOT recommended by the FDA for the treatment of ADHD in adults, as well as the treatment of ADHD and obesity in children over six years of age without an observed clinical trial. A dose of 25mg is only "recommended" in the treatment of ADHD (Or a child's obesity) after testing a patient's dose-responsive relationship.

Reference [5] states that, "Methamphetamine is used as a secondary treatment for attention deficit hyperactivity disorder (ADHD) in children over the age of six and for the short-term management of exogenous obesity. Used in this context, the FDA has approved the administration of methamphetamine at doses of up to 25 mg/day."

Stated within the Desoxyn Prescribing Information PDF, reference 24, and according to "[Dailymed]",

"For treatment of children 6 years or older with a behavioral syndrome characterized by moderate to severe distractibility, short attention span, hyperactivity, emotional lability and impulsivity: an initial dose of 5 mg DESOXYN once or twice a day is recommended. Daily dosage may be raised in increments of 5 mg at weekly intervals until an optimum clinical response is achieved. The usual effective dose is 20 to 25 mg daily. The total daily dose may be given in two divided doses daily."

I suggest that we revise the Medical section of methamphetamine to become more informative and to ensure maximum risk prevention. Seventeenyearoldchemist (talk) 22:44, 7 July 2023 (UTC)

 Done --WikiLinuz {talk} 01:06, 8 July 2023 (UTC)

I appreciate the quick fix. Thanks for updating my talk page as well!

I also like how you improved the readability of the edit through the use of semicolons.

I was debating whether I should've included that Desoxyn can be prescribed for Narcolepsy at up to 60mg, but I later realized that it was unnecessary to include the maximum dosages because the clinical period is probably the same for somebody being prescribed methamphetamine for narcolepsy. Thanks for catching that and shortening up the edit! Seventeenyearoldchemist (talk) 07:25, 8 July 2023 (UTC)

Semi-protected edit request on 18 July 2023

Reason for edit: Small grammatical error.

Change A: In the United States, methamphetamine hydrochloride, under the trade name Desoxyn, has been approved by the FDA for treating ADHD and obesity in both adults and children;[24][25] however, the FDA also indicates that the limited therapeutic usefulness of methamphetamine should be weighed against the inherent risks associated with its use.[24] To avoid toxicity and risk of side effects, FDA guidelines recommend initial dose of methamphetamine at doses 5-10mg/day for ADHD in adults and children over six years of age, and may be increased at weekly intervals of 5mg, up to 25mg/day, until optimum clinical response is found; the usual effective dose is around 20-25mg/day.[5][24] Methamphetamine is sometimes prescribed off label for narcolepsy and idiopathic hypersomnia.[26][27] In the United States, methamphetamine's levorotary form is available in some over-the-counter (OTC) nasal decongestant products.[note 3]

Change B: In the United States, methamphetamine hydrochloride, under the trade name Desoxyn, has been approved by the FDA for treating ADHD and obesity in both adults and children;[24][25] however, the FDA also indicates that the limited therapeutic usefulness of methamphetamine should be weighed against the inherent risks associated with its use.[24] To avoid toxicity and risk of side effects, FDA guidelines recommend an initial dose of methamphetamine at doses 5-10mg/day for ADHD in adults and children over six years of age, and may be increased at weekly intervals of 5mg, up to 25mg/day, until optimum clinical response is found; the usual effective dose is around 20-25mg/day.[5][24] Methamphetamine is sometimes prescribed off label for narcolepsy and idiopathic hypersomnia.[26][27] In the United States, methamphetamine's levorotary form is available in some over-the-counter (OTC) nasal decongestant products.[note 3] Seventeenyearoldchemist (talk) 02:55, 18 July 2023 (UTC)

 Done - FlightTime (open channel) 03:00, 18 July 2023 (UTC)