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view · edit Frequently asked questions Q1: Lisdexamfetamine is mentioned in the article along with levoamphetamine and dextroamphetamine. Is lisdexamfetamine (brand name: Vyvanse) a form of amphetamine? A1: No. At the molecular level, lisdexamfetamine has the molecular structure of amphetamine coupled with the amino acid lysine, making it chemically distinct from the amphetamine enantiomers (i.e., levoamphetamine and dextroamphetamine). Lisdexamfetamine has the chemical formula C15H25N3O; however, amphetamine, dextroamphetamine, and levoamphetamine have the formula C9H13N. Consequently, lisdexamfetamine is not an optical isomer of amphetamine like dextroamphetamine and levoamphetamine. As an inactive prodrug, it simply has no effect on the human body until enzymes metabolize it into dextroamphetamine. This is why it is covered in the article along with the enantiomers. References ^ "Identification". Lisdexamfetamine. University of Alberta. 16 September 2013. Retrieved 28 September 2014. {{cite encyclopedia}}: |work= ignored (help) "Identification". Amphetamine. University of Alberta. 8 February 2013. Retrieved 28 September 2014. {{cite encyclopedia}}: |work= ignored (help)

This article is written in American English, which has its own spelling conventions (color, defense, traveled) and some terms that are used in it may be different or absent from other varieties of English. According to the relevant style guide, this should not be changed without broad consensus.

	Amphetamine is a featured article; it (or a previous version of it) has been identified as one of the best articles produced by the Misplaced Pages community. Even so, if you can update or improve it, please do so.
	This article appeared on Misplaced Pages's Main Page as Today's featured article on April 3, 2015.
Article milestones Date Process Result October 19, 2013 Peer review Reviewed November 30, 2013 Good article nominee Listed January 22, 2014 Featured article candidate Not promoted April 21, 2014 Featured article candidate Not promoted August 1, 2014 Featured article candidate Not promoted October 8, 2014 Featured article candidate Not promoted January 14, 2015 Featured article candidate Promoted Current status: Featured article

Ideal sources for Misplaced Pages's health content are defined in the guideline Misplaced Pages:Identifying reliable sources (medicine) and are typically review articles. Here are links to possibly useful sources of information about Amphetamine. PubMed provides review articles from the past five years (limit to free review articles) The TRIP database provides clinical publications about evidence-based medicine. Other potential sources include: Centre for Reviews and Dissemination and CDC

Revisions succeeding this version of this article is substantially duplicated by a piece in an external publication. Since the external publication copied Misplaced Pages rather than the reverse, please do not flag this article as a copyright violation of the following source: Amphetamines: Potent Recreational Drug of Abuse (PDF), Journal of Addiction Research & Therapy, 21 July 2017 Additional comments At least half of this "review article" is composed of copy/pasted article text with superficial revision, tables (2 total), and diagrams (2 total) from Amphetamine and Adderall#Mechanism of action without attribution to these articles.

Section sizes Section size for Amphetamine (44 sections) Section name Byte count Section total (Top) 20,107 20,107 Uses 10 77,346 Medical 629 50,467 ADHD 19,441 19,441 Binge eating disorder 16,689 16,689 Narcolepsy 13,708 13,708 Enhancing performance 29 18,590 Cognitive performance 9,628 9,628 Physical performance 8,933 8,933 Recreational 8,279 8,279 Contraindications 4,747 4,747 Adverse effects 708 53,679 Physical 7,943 7,943 Psychological 5,237 5,237 Reinforcement disorders 31 39,791 Addiction 5,631 5,631 Biomolecular mechanisms 15,530 30,647 Pharmacological treatments 7,542 7,542 Behavioral treatments 7,575 7,575 Dependence and withdrawal 3,482 3,482 Overdose 5,375 11,376 Toxicity 4,838 4,838 Psychosis 1,163 1,163 Drug interactions 9,952 9,952 Pharmacology 18 59,617 Pharmacodynamics 18,435 35,272 Dopamine 6,279 6,279 Norepinephrine 806 806 Serotonin 1,213 1,213 Other neurotransmitters, peptides, hormones, and enzymes 8,539 8,539 Pharmacokinetics 12,392 12,392 Pharmacomicrobiomics 7,460 7,460 Related endogenous compounds 4,475 4,475 Chemistry 4,872 25,264 Substituted derivatives 2,641 2,641 Synthesis 9,875 9,875 Detection in body fluids 7,876 7,876 History, society, and culture 7,427 22,276 Legal status 6,269 6,269 Pharmaceutical products 8,580 8,580 Notes 98 98 Reference notes 49 49 References 28 28 External links 1,751 1,751 Total 286,290 286,290

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Removal of lack of neurotoxicity in humans statement due to serious misinterpretation of the sources

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Please either remove "There is no evidence that amphetamine is directly neurotoxic in humans" or change to "The neurotoxicity in humans under therapeutic doses is currently not understood" as there is no basis to sustain the current sentence using current citations.

"Amphetamine". United States National Library of Medicine – Toxicology Data Network. Hazardous Substances Data Bank. Archived from the original on 2 October 2017. Retrieved 2 October 2017. Direct toxic damage to vessels seems unlikely because of the dilution that occurs before the drug reaches the cerebral circulation.

This citation is talking about vascular toxicity in the brain, rather than neurotransmitter toxicity (neurotoxicity), thus can't sustain the above statement.

Malenka RC, Nestler EJ, Hyman SE (2009). "Chapter 15: Reinforcement and addictive disorders". In Sydor A, Brown RY (eds.). Molecular Neuropharmacology: A Foundation for Clinical Neuroscience (2nd ed.). New York, USA: McGraw-Hill Medical. p. 370. ISBN 9780071481274. Unlike cocaine and amphetamine, methamphetamine is directly toxic to midbrain dopamine neurons.

This citation is a secondary source with no basis on research.

Throughout my search for alternative sources, I have not found any concrete research into neurotoxic effects in humans rather than lab animals at all. Review of the existing literature links to effects in humans being not understood

Thus I believe that the sentence as it is currently written in the article leads readers to false conclusions that it's safe to take amphetamines in therapeutic doses as there is research with no evidence, rather than that there is no research at all. Ritave (talk) 16:30, 24 April 2023 (UTC)

@Ritave: The Toxnet source does indeed talk about neurovascular damage. It's still a form neurotoxicity. The molecular neuropharmacology textbook is a graduate-level text written by three researchers who read, perform, write, and synthesize research in this field. In fact, one of them is heavily cited throughout this article. In any event, it is a WP:MEDRS-compliant source.

That being said, Amphetamine has been a pharmaceutical drug with an ongoing medical use for 80 years; in spite of the large population size of active medical amphetamine users, researchers have not identified neurotoxicity in the brains of individuals who take amphetamine pharmaceuticals at therapeutic doses and published a paper about it. You can't "prove" a negative finding with the vast majority of statistical hypothesis tests employed in statistical models; that's just not how statistical inference works. Hence, why nobody publishes papers saying "hey, we did all these brain scans and found that amphetamine is not neurotoxic". What you can say is, "we failed to detect evidence of neurotoxicity", but literally no one publishes research papers with a negative result like that because it's not a research finding (seriously, I challenge you to find one); rather, it's a lack of one. If you expect a stronger statement to be made based on more research, you'll be waiting a while because that will never happen. Seppi333 (Insert 2¢) 04:50, 7 May 2023 (UTC)

Thank you for the explanation, it helped me understand a different view.

Regarding the first citation, I'd say using data showing no dangers in a subset of a category by extending it to a whole category is misleading. Especially when the main mechanism of action of the drug is based on a nervous system rather than the vascular system.

I understand that Amphetamine was not found to be neurotoxic and I don't expect research stating negative result to exist. I tried to find one before asking for a change.

The sentence I'm asking to change is making deductions rather than inductions from the data to a general audience, creating a sense of security about a topic. That sense of security might be well based from unwritten experience of doctors over the world, but as a layman, I could not find more data outside of this single book that would either confirm or deny such statement.

Rather than strengthening the statement on more data, I'm asking to relax the statement to a more ambiguous one, more in line of the intent of "it should be safe to administer based on previous experience" rather than "it's safe to administer and here's proof of such". Ritave (talk) 20:39, 21 May 2023 (UTC)

@Seppi333: I've dug into this subject a bit (131 MEDRS refs in the last decade) and found a few interesting ones which I suggest you check out. A 2020 review states that the neurotoxicity of amphetamine increases the risk of Parkinon's severalfold after exposure, but is silent about dose. Some of the cited sources in the review apply this to therapeutic doses as well. Anything of substance in your opinion? Wretchskull (talk) 17:18, 16 July 2023 (UTC)

@Wretchskull: Really busy off-wiki right now, so I'll follow up on this by Friday. There's a lot to unpack on this topic, so I'll probably give you a more comprehensive/detailed response on the concordant and inconsistent evidence of direct neurotoxicity by amphetamine vs certain substituted amphetamines (meth & MDMA) in humans of which I am aware; I wrote/cited virtually all the pharmacology and neurotoxicity-related content in these articles, so I'm familiar with the similarities and differences between them. FWIW, that review makes a fairly weak assertion about the strength of the association with PD relative to the relationship mentioned in methamphetamine#Neurotoxic_and_neuroimmunological. Seppi333 (Insert 2¢) 06:26, 19 July 2023 (UTC)

@Wretchskull: Just read through the review you linked. I think the only thing really worth adding to an article from that paper is the involvement of α-synuclein as a mechanism of methamphetamine-induced direct neurotoxicity within the nigrostriatal pathway.

This statement - The molecular studies show that amphetamine upregulates α-syn in substantia nigra which accumulates leading to aggregation, which in turn damages neurons contributing to the Parkinson’s-like behavior . - seemed like a bombshell until I looked at the citations and realized the authors are discussing evidence involving methamphetamine; I'm not sure how the authors and peer reviewers missed this. The only evidence they actually provided about amphetamine from a research paper is that amphetamine and methamphetamine both bind to N-terminus of intrinsically unstructured α-synuclein, which induces a folded conformation; in turn, this increases the likelihood of protein misfolding and aggregation. The fact that amphetamine and methamphetamine have similar effects on body temperature and similar mechanisms for causing it would seem to suggest that amphetamine would also increase α-synuclein expression through cerebral hyperpyrexia. Taken together, it seems plausible that amphetamine neurotoxicity could increase PD risk. The relationship between methamphetamine and PD is well-established in humans, but, the evidence supporting this relationship for amphetamine is entirely based on in vitro evidence of α-synuclein protein binding and its shared mechanisms of neurotoxicity with methamphetamine. So, there's basically no evidence in humans from a retrospective study to support that claim; it's just a well-founded suspicion at this point. Seppi333 (Insert 2¢) 15:12, 20 July 2023 (UTC)

I appreciate the thorough reply! Makes a lot of sense now. By the way, I've also discovered a review stating that ADHD may be neuroprotective later in life due to the effects of stimulation-seeking behavior, and that amphetamine may strip that. Would you consider this notable in any way? Wretchskull (talk) 22:55, 20 July 2023 (UTC)

Interesting hypothesis. I don't think it's worth covering research topics that are under investigation on Misplaced Pages, though. Better to wait until there are published research findings, as it avoids misleading readers whenever results differ from expectations and precludes the need to update the information later on when findings are published. Seppi333 (Insert 2¢) 00:33, 22 July 2023 (UTC)

Seppi I have been waiting for another amphetamine infodump from you for literal YEARS. Like, holy shit. Reading the archives of this talk page and the FA reviews back in the day taught me a ridiculous amount and happened to benefit my own Dexedrine treatment plan overall. Why don't you start a blog or something? It'd be great to read your insight on a number of things in greater detail regarding this compound without it being necessarily an exercise in improving the composition of this article. I know I don't just speak for myself on this. Like, you're the man, man! 103.51.113.44 (talk) 16:09, 22 July 2023 (UTC)

Hahaha, I appreciate the sentiment. I've been a bit preoccupied with work at my company since mid-2020, so I've been much less active on Misplaced Pages for the past 3 years compared to the preceding 7-ish. For the same reason, I haven't really have much time available for other activities like blogging either. That being said, my workload recently decreased, and I'll likely be reasonably active on Misplaced Pages at least until the end of the year. Seppi333 (Insert 2¢) 06:49, 23 July 2023 (UTC)

Amine

Shouldn’t “amine”, located in the very first paragraph, be transformed into a link?

Is there a reason it hasn’t? HockeyCowboy (talk) 09:31, 28 April 2023 (UTC)

I did. Hope that’s ok. HockeyCowboy (talk) 05:54, 30 April 2023 (UTC)

Lead content

@Dexedream: I apologize for undoing what you wrote, but a lot of the content you introduced to the lead section is way too technical per MOS:INTRO. Also, the article originally had a 4-paragraph, 20-sentence lead section, which was already above average for a featured article, per MOS:LEADLENGTH. The lead looks to be about ~50% longer (24 vs 16 line breaks) on my screen with your changes relative to the original version, which pushes it well outside the guidelines.

I don't see a problem with introducing this content with citations in the body of the article, though. Seppi333 (Insert 2¢) 00:27, 22 July 2023 (UTC)

Semi-protected edit request on 11 September 2023

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Change dependance/abuse liability from "moderate" to "high" as per the cited reference (Stahl) P3nt0th41 (talk) 04:59, 11 September 2023 (UTC)

@P3nt0th41: I am able to access a copy of the source - it doesn't seem to state that the dependence liability is high. The source states:

•High abuse potential, Schedule II drug
•Patients may develop tolerance, psychological dependence

While I agree it clearly states that abuse potential is high, dependence liability is not listed in the same way. Is there some reason to interpret "may" as a high rather than moderate risk? I've closed the edit request to get it out of the queue but am completely open to discussion. Tollens (talk) 02:12, 14 September 2023 (UTC)

The text does not indicate the abuse liability is "moderate" either? That is your interpretation.

The prescribing information for amphetamine explicitly states the same fact.

The dependence liability of amphetamine is widely known with a plethora of literature supporting the fact - including any prescribing information published after 1980.

T

The fact that it's listed as moderate on the page is discrediting the veracity of the article.

Furthermore, it is baffling as to why methylphenidate is listed as "high", and yet amphetamine is listed as "moderate". Anyone with a basic understanding of psychostimulant pharmacology would be dismayed by how ridiculous this is.

I assumed this would have been obvious edit and not something that required discussion. P3nt0th41 (talk) 05:01, 14 September 2023 (UTC)

Re: Furthermore, it is baffling as to why methylphenidate is listed as "high", and yet amphetamine is listed as "moderate". Anyone with a basic understanding of psychostimulant pharmacology would be dismayed by how ridiculous this is.

Thanks for pointing this out. I've gone ahead and addressed that on the current revision of the methylphenidate article so that it's on par with this article.

For context, addiction/dependence liability parameters on drug infoboxes on Misplaced Pages are largely relative to other drugs that have a rating on their respective infoboxes. Without standardised reinforcement schedules for each drug that assess self-administration, the parameters are instead set based clinical evidence, the pharmacology of each drug, as well as the usage patterns and doses administered amongst the population. IMO it makes no sense to place methylphenidate and amphetamine at the same rating (i.e., "high") as heroin, cocaine, and methamphetamine because all three of those drugs are the most widely used recreational "hard drugs" globally, whereas methylphenidate and amphetamine administered at clinically relevant doses are not associated with an increased likelihood of developing substance use disorder, even though tens of millions of prescriptions are dispensed each year in the United States, Australia, and other countries where these medications are used as first-line treatments for ADHD. Professional Crastination (talk) 06:41, 25 September 2024 (UTC)

Multiple Effect Citations Needed

Why does this page list increased cognitive performance and increased muscle strength as effects? There have been no specifically conclusive, academically acceptable or even scientifically reasonable studies done to show that either of these effects occur in a significant enough portion of the general population to include them as "effects". There have, however, been studies to the contrary. 74.140.151.89 (talk) 20:43, 16 January 2024 (UTC)

Those sections are cited by systematic reviews with meta-analysis of high-quality controlled trials, albeit with varying statistical designs. I don’t know what you consider to be a more scientifically rigorous methodology than meta-analysis for estimating effect sizes, but there’s no “better” scientific methodology than that to establish a drug effect, provided the inclusion of studies is unbiased/systematic and the included studies have adequate statistical designs (i.e., meta-analysis of RCTs with sufficient sample sizes and consistent, minimally-biased estimators is ideal).

If you’ve read different meta-analyses than the ones cited and they happen to have divergent/inconsistent conclusions, please link them here and I’ll edit the section(s) accordingly. Otherwise, the article isn’t going to change based on your opinion. Seppi333 (Insert 2¢) 00:27, 25 September 2024 (UTC)

Addressing the edit for lisdexamphetamine & CDS

In this edit, I included cognitive disengagement syndrome as a condition treatable by amphetamine. It was redacted here on the basis of an absent secondary source and it being lisdexamphetamine.

First, contrary to the statement, I believe I have cited a secondary source: the International Consensus Statement on CDS. It is a scientific consensus, analysis and evaluation/review of the scientific literature including the primary evidence of lisdexamphetamine as a treatment. As the WP:Secondary states: "A secondary source provides thought and reflection based on primary sources, generally at least one step removed from an event. It contains analysis, evaluation, interpretation, or synthesis of the facts, evidence, concepts, and ideas taken from primary sources".

Second, lisdexamphetamine is a valid derivative of amphetamine. As stated in the article: "currently, pharmaceutical amphetamine is prescribed as racemic amphetamine, Adderall, dextroamphetamine, or the inactive prodrug lisdexamfetamine".

Thus I fail to see the issue here. Please discuss. Thanks. Димитрий Улянов Иванов (talk) 01:25, 18 February 2024 (UTC)

WP:LEAD summarizes the body. There is no mention of cognitive disengagement syndrome in the body and it isn't prominent enough (see WP:UNDUE) to be added to the lead.I know lisdexamphetamine formulation will be converted to dexamphetamine but the sources should mention amphetamine. Besides, the very source you cited is a proposal/study asking to recognize CDS as a distinct syndrome (which means it still hasn't been recognized). This is primary source, a clinical trial. And this doesn't even mention amphetamine and still is WP:UNDUE. --WikiLinuz (talk) 04:36, 18 February 2024 (UTC)

No, it is not a proposal for it to be recognised. It’s a consensus in changing terms. They concluded: “it is evident that CDS has reached the threshold of recognition as a distinct syndrome”. While the clinical trial itself does not mention the term CDS, it is cited as part of the international consensus and refers to the same syndrome as they make plain. Димитрий Улянов Иванов (talk) 10:55, 18 February 2024 (UTC)

CDS is not recognized yet. You can come back once standardized diagnostic manuals recognize it. Your source is a study and not a prominent one either. See what WP:WEIGHT says. --WikiLinuz (talk) 17:41, 18 February 2024 (UTC)

You also didn't address the fact the neither of your sources mention "amphetamine" at all, besides them being poor sources to be used here. You cannot add UNDUE material into lead when there is no mention of it in the body. --WikiLinuz (talk) 17:49, 18 February 2024 (UTC)

Not true! I have to reiterate, as the international consensus states: "it is evident that CDS has reached the threshold of recognition as a distinct syndrome". This is the consensus of all the world's leading experts. Since you are directly disagreeing with their robust conclusion, then I look forward to you citing a peer-reviewed rebuttal.

By the way, diagnostic manuals are not leading the research, but follows it and often a decade or two behind where the research is at the time. And the decisions made by the APA are also political, not just scientifically-based so its hard to know where this will go in the subsequent DSM version. Thus the condition not being recognised in diagnostic manuals does not preclude it from being a distinct syndrome and to claim otherwise is to contradict the scientific consensus. Plus, it objectively is prominent despite what you claim; all documented research since it's publication uses the CDS term on the basis of this consensus that I can locate. And, again, it is a scientific consensus which means it is prominent; consensus means the view is held by the majority of scientists in the field which therefore (from what I can read) does not violate WP:WEIGHT in the slightest. To imply otherwise here is to permeate a falsehood.

And on what basis are you suggesting sources cannot specify a derivative of amphetamine? The article states: "pharmaceutical amphetamine is prescribed as racemic amphetamine, Adderall, dextroamphetamine, or the inactive prodrug lisdexamfetamine". Please can you demonstrate that a source cannot be specifying an amphetamine derivative?

On a last note, contrary to your reversive edit on the lisdexamfetamine page, It is not an "advocacy study". The fact that CDS has reached the recognition and evidence threshold is not a promotive idea, it's a statement of fact, as the international scientific consensus makes plain. Димитрий Улянов Иванов (talk) 19:31, 18 February 2024 (UTC)

By the way, diagnostic manuals are not leading the research, but follows it and often a decade or two behind - WP:CRYSTAL, Misplaced Pages does not lead either. Misplaced Pages reports it if only it is recognized by mainstream standardized diagnostic manuals. You cannot use ongoing research as a fact, even if a group of researchers agree on a consensus. Until it is established, by that I mean, recognized by standardized diagnostic manuals, it cannot be included on Misplaced Pages as a distinct medical condition (like CRYSTAL says, Misplaced Pages does not predict future so you cannot write it in Misplaced Pages's voice).Your own source states, Much work remains to further clarify its nature (e.g., transdiagnostic factor, separate disorder, diagnostic specifier) .the condition not being recognised in diagnostic manuals does not preclude it from being a distinct syndrome - Yes it does, at least here.since it's publication uses the CDS term on the basis of this consensus that I can locate - Anyone can go to Google Scholar and type in "cognitive disengagement syndrome" to get all. That's not the point.does not violate WP:WEIGHT in the slightest - Did you even read the WP:LEAD I linked? UNDUE and WEIGHT I mentioned is related to this.And on what basis are you suggesting sources cannot specify a derivative of amphetamine? - WP:SYNTH, you cannot combine one source and another and write a novel synthesis. The source must state amphetamines. I say this because the source itself is primarily dependent on the clinical trial source (it merely reports lisdexamphetamine trials).I think you misunderstood by what I mean by advocacy. I meant, it is a conclusion of a working group proposing to replace the "SCT" with "CDS". Like I said, just because they say "it meets threshold of recognition as a distinct syndrome" does not mean it is yet a distinct syndrome (which your source states in the very next sentence). --WikiLinuz (talk) 22:07, 18 February 2024 (UTC)

"Misplaced Pages reports it if only it is recognized by mainstream standardized diagnostic manuals"

- May you please provide the relevant references or indicate precisely where this is stated? I do not see this specification in the WP:CRYSTAL you linked. Moreover, I can find a variety of conclusions maintained in related articles that contradict the standardised diagnostic manual (e.g. DSM). For example, emotional dysregulation being a core symptom of ADHD. Yet, per DSM diagnostic standards, it is not.

"Anyone can go to Google Scholar and type in "cognitive disengagement syndrome" to get all. That's not the point."

- Well, I was primarily contesting your point that it is "not prominent" and a "poor study". It's a scientific consensus, therefore it does not violate WP:WEIGHT that you referenced from what I can read. A scientific consensus objectively means it is prominent. To address your latter claim, no, it is not a poor study. It's a peer-reviewed international scientific consensus elucidating the mountain of research on CDS. There is nothing "poor" about it.

"Your own source states, Much work remains to further clarify its nature (e.g., transdiagnostic factor, separate disorder, diagnostic specifier) ." + "Like I said, just because they say "it meets threshold of recognition as a distinct syndrome" does not mean it is yet a distinct syndrome (which your source states in the very next sentence)"

- You are conflating the terms syndrome and disorder, and contextually, in extension. First, any notion that experts are self-refuting their own conclusion (specifying it is a distinct syndrome then not) is an absurd proposition at any surface-glance. It is also wrong, as they do not follow up by stating it is not a distinct syndrome as you claim; they're referring to differentiating it from ADHD in the context of certain organisations (e.g. APA). That's why the term syndrome was selected as "disorder" implies unanimous establishment by organisations. Yet, CDS is simultanously a distinct condition - hence their conclusion and terminology of syndrome.

"WP:SYNTH, you cannot combine one source and another and write a novel synthesis. The source must state amphetamines. I say this because the source itself is primarily dependent on the clinical trial source (it merely reports lisdexamphetamine trials)."

Ok, accepted. Still, a) this article maintains that amphetamine can be prescribed as lisdexamfetamine, an actual derivative (but I shan't belabour this point further but would appreciate any better clarification on that); b) this does not stand in the lisdexamfetamine article.

"I think you misunderstood by what I mean by advocacy. I meant, it is a conclusion of a working group proposing to replace the "SCT" with "CDS". Like I said, just because they say "it meets threshold of recognition as a distinct syndrome" does not mean it is yet a distinct syndrome..."

- No, it's an international scientific consensus, which the report group merely reports, nor is it a "proposition" or an "advocacy". This fact is evident by their conclusion which states; "To experts in the field, it is evident that CDS has reached the threshold of recognition as a distinct syndrome. Still, there is much more work to be done in further clarifying its nature, etiologies, demographic factors, relations to other psychopathologies, and linkages to specific domains of functional impairment". Proposition would imply it has not yet reached the threshold of recognition as a distinct syndrome, but instead are suggesting it should. That is not what was concluded.

CDS meets validity as a distinct syndrome as established by said scientific consensus. The syndrome is considered valid because: 1) well-trained professionals in a variety of settings and cultures agree on its distinction plus presence or absence using well-defined methods and scientific findings and 2) the diagnosis is useful for predicting a) additional problems the patient may have (e.g., difficulties learning in school); b) future patient outcomes (e.g., risk for unemployment; c) unique pattern of response rates to treatment (e.g., medications and psychological treatments); and d) features that indicate a consistent set of causes for the condition (e.g., findings from genetics, twins or brain imaging). They also concluded: ". This constellation of symptom dimensions is considered to be a syndrome because of the higher co-occurrence (inter-correlation) or coherence of these symptoms with each other and inter-relatedness of its dimensions relative to their relationship with symptoms/dimensions of other psychopathologies (ie, internal validity) and unique association and prediction with functional outcomes when covarying other psychopathologies (ie, external validity)". Димитрий Улянов Иванов (talk) 22:02, 19 February 2024 (UTC)

The working group conclusion/consensus citation isn't apt here. Neither is a clinical trial. If you cannot find a secondary, high-quality, peer-reviewed WP:MEDRS review articles, medical textbooks, or meta-analysis that states amphetamines (or their derivates) is indicated or can be used to treat/manage "cognitive disengagement syndrome," you cannot add it here.And the sources in question do not meet this criteria. --WikiLinuz (talk) 22:53, 19 February 2024 (UTC)

Semi-protected edit request on 6 June 2024

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This section “ The oral bioavailability of amphetamine varies with gastrointestinal pH; it is well absorbed from the gut, and bioavailability is typically 90%. Amphetamine is a weak base with a pKa of 9.9; consequently, when the pH is basic, more of the drug is in its lipid soluble free base form, and more is absorbed through the lipid-rich cell membranes of the gut epithelium. Conversely, an acidic pH means the drug is predominantly in a water-soluble cationic (salt) form, and less is absorbed.” under the sub heading “Pharmacokinetics” is not relevant to Lisdexamphetamine. The pro drug is almost completely absorbed from the gastro system into the blood stream, and the majority of conversion from Lisdexamphetamine to Dextroamphetamine + Lysine happens in the blood stream. The pH is therefore not a factor in bioavailability for this drug. Please see here for evidence:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2873712/

The section in Jimmymozzer (talk) 15:09, 6 June 2024 (UTC)

 Not done: it's not clear what changes you want to be made. Please mention the specific changes in a "change X to Y" format and provide a reliable source if appropriate. Lightoil (talk) 17:09, 11 June 2024 (UTC)

@Jimmymozzer Re: "The oral bioavailability of amphetamine " under the sub heading “Pharmacokinetics” is not relevant to Lisdexamphetamine.

This wiki article is on amphetamine, which "is about mixtures of levoamphetamine and dextroamphetamine", per the italicised text in the first line of the article. Additionally, the top of this talk page has a "frequently asked questions" banner that solely covers whether LDX is covered an amphetamine, in which the answer that LDX is "chemically distinct from the amphetamine enantiomers (i.e., levoamphetamine and dextroamphetamine)" is provided. So, the content covered in the pharmacokinectics section of this article (i.e., the bioavaliability of amphetamine and its enantiomers) is entirely appropriate given that this is the amphetamine article and not the LDX article.

In any event, your concern regarding the coverage of LDX's unique conversion to dextroamphetamine by a rate-limiting enzyme in blood is actually addressed both in the first paragraph of the pharmacology section of the LDX article and in the third paragraph of the PK section in this very article (i.e., amphetamine). Despite the heavy reliance on transcluding content from this article (i.e., amphetamine), all of the wiki articles covering different pharmaceutical amphetamines/dose-formulations (e.g., Adderall, dextroamphetamine, lisdexamfetamine) have unique content added to address notable characteristics where applicable; case in point: when I wrote the binge eating disorder section for the LDX article, I purposefully wrote the source code in a way that only allows the coverage of that content to be rendered in the medical uses section of the LDX article - and not, say, the Adderall article - if only because LDX is the only amphetamine-dosage formulation to have its clinical use and efficacy in BED covered in systematic reviews and meta-analysis'.

With all that said, I do agree that it's a bit odd that the PK section of the LDX article has the passage about oral absoprtion and gastrointestinal pH included in the transclusion from this article. Though, I suppose that may just be a limitation of wikipedia's source code. In any event, I'll take a look the source code when I have some free time later today and see if there's anything that can be done about it. If it can be removed without breaking the other articles that use the same transclusion, then I'll likely see to it. Professional Crastination (talk) 08:42, 16 July 2024 (UTC)

Protected page edit request

Hello. Requesting that the following category be added to this semi-protected page:

]

See the monoaminergic activity enhancer page for details and sources. Thank you. 98.191.202.231 (talk) 19:57, 25 July 2024 (UTC)

 Done Professional Crastination (talk) 06:46, 25 September 2024 (UTC)

Schedule II revert.

@Irruptive Creditor,

Firstly, I'd like to apologise for the edit summary in my first revert. I mistakingly referred to WP:MEDRS because the Rx label happens to be MEDRS-compliant when I meant to refer to WP:AGE MATTERS; you're correct that a drug's DEA schedule in the United States isn't necessarily a biomedical claim.

In any event, the reason why I've reverted your revisions are for two reasons. 1. The citation you've added was published well over five decades ago (see WP:AGE MATTERS). 2. We already had a more recent (i.e., May 2024) citation that meets WP:V and states the following outright:

"Adderall® contains amphetamine, a Schedule II controlled substance."

The above quote is from USFDA-approved prescribing information (which a prescribing physician would have to read before issuing an associated Rx); the revision currently hosted by DailyMed was updated ~6 months ago and directly supports the statement about amphetamine's schedule II status in the United States, so there's no issue with verifiability. Acknowledging that, I'm not sure how replacing an up-to-date citation with a federal register from 1971 improves this article. It's not as if the claim that amphetamine is a schedule II drug is remotely controversial or has raised any verifiability concerns on this talk page.

This also applies to the changes reverted in the methamphetamine article because that case is virtually identical to what I've raised here. Professional Crastination (talk) 10:32, 1 December 2024 (UTC)

The issue is that a product label is not a legal source useful for making legal claims such as legal status, legal sources are. Your arguments of recency hold little support for using a product label over the actual law as in the legal status section, when discussing other countries like Australia, the article cites the actual laws(Poison Standard), and not a product label. So then, upon what grounds is the United States or an Adderall product label so meritorious as to be the exception to this general trend of citing law when discussing law?

Among other reasons, linking to the law is preferable when considering there have been cases were the propriety of the move to Schedule II has been questioned and thus having a link to the actual scheduling order is helpful to practitioners and the public (see U.S. v Kendall (1989), U.S. v Kinder (1991), and such).

Considering no other editors in the four days since my edit are bothered or expressed seeing merit in using a product label, I will shortly upon making this comment, revert to the prior edition so as to not irritate others with this dispute. If we come to some contrary agreement or others are to chime in as to favor the product label, then so wills it. Pleasant editing, Irruptive Creditor (talk) 15:34, 1 December 2024 (UTC)

Fair enough. You make an excellent point regarding the uniformity of using legislation as corroborating sources for other jurisdictions (e.g., Australia). For that reason, I'm happy to accept your revert. Professional Crastination (talk) 03:02, 2 December 2024 (UTC)

Changes to how the medical section is transcluded to other articles

I'm just putting it out to other editors that I changed the mechanism used to selectively transclude content to amphetamine's child articles (i.e., Adderall and dextroamphetamine). Those articles now use labelled selection transclusion. In a nuthsell, this post is just asking everyone to be mindful of new "section begin" and "section end" tags above and below the three disorders covered in Amphetamine#Medical

This is how the source code appears on the amphetamine article:

<!-- Section begin: ADHD --> 
==== ADHD ==== 
<!-- Section end: ADHD --> 
<!-- Section begin: BED --> 
==== Binge eating disorder ==== 
<!-- Section end: BED --> 
<!-- Section begin: Narcolepsy --> 
==== Narcolepsy ==== 
<!-- Section end: Narcolepsy -->

This is how the source code appears on articles with the medical section transcluded:

(NB: ''each template renders its own section without headings, so headings have been added to the transcluded articles'')
=== Medical uses ===
====ADHD====
{{#lsth:Amphetamine|ADHD}}
====Binge Eating Disorder====
{{#lsth:Amphetamine|BED}}
====Narcolepsy====
{{#lsth:Amphetamine|Narcolepsy}}

No other selective transclusions from this article have been altered.

For context, when I wrote the Binge Eating Disorder section a few months ago, I originally intended for it to only transclude to the lisdexamfetamine article. This is because the current literature only covers amphetamine's treatment efficacy for BED when it's administered as LDX, as opposed to adderall and dextroamphetamine, which have notable differences compared to LDX (e.g., the immediate-release forms of the latter drugs confer treatment effects for approximately 3–4 hours, whereas LDX persists for about 12–14 hours).

As the amphetamine wiki article is the parent article of LDX, the BED content also appears here because this article receives much , much more traffic and consequently it's beneficial for readers to have this content available here. However, due to the way transclusions were previously coded in this article's source, I had to add an "ifpagename=" exception to render the BED content to LDX sans adderall & d-amph. As another editor pointed out in their edit notes, this template resulted in the BED section being treated as a subset of the ADHD section in the source code, even though BED had its own subheading. To address this, I've made changes to the source code. Moreover, I've appended invisible comments below the relevant headings on each transcluded article to let editors know that they will need to make edits on this article for their desired changes to render in the article they're currently editing.

The latter collapsed tab above has only been applied to adderall and dextroamphetamine. I haven't bothered to make the above changes to lisdexamfetamine largely because I'm lazy af (see: professional crastination ) and the page renders just fine ATM because it transcludes virtually all of the medical section. I might change the source code on LDX to mirror the other articles in the coming days, though. FWIW, I was planning on originally excluding narcolepsy from being transcluded to the LDX when I wrote that section for the amph article, but after discussing it with Seppi333 I agree that it's probably worthwhile to have content included there because narcolepsy is an example of a legitimate off-label use for LDX. Professional Crastination (talk) 08:54, 4 December 2024 (UTC)

Contra TAAR1 agonism as the mediator of amphetamine actions

Requesting input on this topic here at WikiProject Pharmacology. Thanks. – AlyInWikiWonderland (talk, contribs) 15:59, 13 December 2024 (UTC)

RfC about TAAR1 agonism as the mediator of amphetamine monoamine release

Please consider joining the feedback request service. An editor has requested comments from other editors for this discussion. This page has been added to the following list: Maths, science, and technology When discussion has ended, remove this tag and it will be removed from the list. If this page is on additional lists, they will be noted below.

Do amphetamine and related drugs mediate their monoamine release via TAAR1 agonism and is this scientific consensus?

(See here at the WikiProject Pharmacology talk page for the extensive existing discussion.)

– AlyInWikiWonderland (talk, contribs) 01:40, 7 January 2025 (UTC)

Listed at: WT:WikiProject Medicine. Mathglot (talk) 03:52, 7 January 2025 (UTC)

Talk page copyvio banner

In this edit of 16:03, 1 September 2017 by Seppi333 (talk · contribs), the talk page template {{Backwardscopyvio}} was added among the templates at the top of this Talk page, focusing attention on unattributed copying of content into this article, and naming "Amphetamine and Adderall#Mechanism of action" as the source articles of the copying. As this article is entitled "Amphetamine", I assume that formerly another, related article was involved in the copying, as well as the Adderall article. Seppi333, do you recall anything about this situation? Misplaced Pages's licensing requires all copying from other articles to be attributed, and there is no statue of limitations, so if they are still unattributed, then WP:RIA applies. Mathglot (talk) 04:32, 7 January 2025 (UTC)

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