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Sudafed: A weak amphetamine

Posted by mtdewcmu on April 30, 2011, at 13:21:36

In reply to Pseudoephedrine (sudafed), posted by blueboy on April 9, 2010, at 9:52:55

> But anyway, I am taking 4x30mg pseudoephedrine daily (I weigh 255 pounds) with the blessing of a good psychiatric team, and so far it has been startlingly effective to treat on a wide range of mental problems, including Axis I diagnosis of bipolar II.

This is an old zombie-thread, but I would be curious to know if the benefits were sustained. It's not hard to believe that PSE would have an up-front benefit, but I would be surprised if it lasted. In college I noticed that it was somewhat easier to get my homework done if I took some pseudoephedrine. The benefit was not very robust.

Pseudoephedrine (PE) has an identical structure to methamphetamine with the addition of a hydroxyl group. The effect of the hydroxyl group is to make the molecule more hydrophilic, and therefore less of it can cross the blood-brain barrier. If you eliminate the hydroxyl by reduction, you get methamphetamine (MA). If you eliminate the hydroxyl by oxidation, you get methcathinone (MC), which is a potent CNS stimulant similar to MA. Again, the reason MC is a more potent CNS stimulant than PE is that MC is less hydrophilic due to less opportunity to form hydrogen bonds. To the extent that some small amount of PE crosses the blood-brain barrier and gets into the CNS, it probably has effects very similar to MA. The only thing preventing PE from being as potent a stimulant as MA is its relative inability to get into the CNS. So, when looking at psychoactive effects, it makes sense to think of pseudoephedrine as being a very weak methamphetamine, with dosages being limited by its tendency to cause peripheral stimulant effects that become dangerous well before the CNS effects become intense.

So, I don't think pseudoephedrine is something new to psychiatry. I think a propensity to respond to PE is probably an indicator that you would do well if given amphetamines. (Meth)amphetamine has a long-established place in psychiatry, and it is an all-around cleaner stimulant than pseudoephedrine, with a greater degree of headroom to play with dose.


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