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The highest prevalence of illegal methamphetamine use occurs in parts of Asia, Oceania, and in the United States, where racemic methamphetamine, levomethamphetamine, 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.The FDA also advises individuals with bipolar disorder, depression, elevated blood pressure, liver or kidney problems, mania, psychosis, Raynaud's phenomenon, seizures, thyroid problems, tics, or Tourette syndrome to monitor their symptoms while taking methamphetamine.The physical effects of methamphetamine can include loss of appetite; hyperactivity; dilated pupils; excessive sweating; increased movement; dry mouth and teeth grinding (leading to "meth mouth"); headache; irregular heartbeat (usually as accelerated heartbeat or slowed heartbeat); rapid breathing; high blood pressure or low blood pressure; high body temperature; diarrhea or constipation; blurred vision; dizziness; twitching; muscle cramps, spasms, pain or stiffness; numbness; tremors; dry skin; acne; and pale appearance or flushed skin.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: C Methamphetamine is contraindicated in individuals with a history of substance use disorder, heart disease, or severe agitation or anxiety, or in individuals currently experiencing arteriosclerosis, glaucoma, hyperthyroidism, or severe hypertension.
Moreover, evidence suggests that adverse changes in the level of biomarkers of metabolic integrity and synthesis occur in recreational users, such as a reduction in N-acetylaspartate and creatine levels and elevated levels of choline and myoinositol.
Following presynaptic dopamine and glutamate co-release by such psychostimulants, ΔFos B functions as "one of the master control proteins" that produces addiction-related structural changes in the brain, and upon sufficient accumulation, with the help of its downstream targets (e.g., nuclear factor kappa B), it induces an addictive state.
Sufficiently overexpressing ΔJun D in the nucleus accumbens with viral vectors can completely block many of the neural and behavioral alterations seen in chronic drug abuse (i.e., the alterations mediated by ΔFos B).
An extremely large overdose may produce symptoms such as adrenergic storm, methamphetamine psychosis, substantially reduced or no urine output, cardiogenic shock, bleeding in the brain, circulatory collapse, hyperpyrexia (i.e., dangerously high body temperature), pulmonary hypertension, kidney failure, rapid muscle breakdown, serotonin syndrome, and a form of stereotypy ("tweaking").
This diagram depicts the signaling events in the brain's reward center that are induced by chronic high-dose exposure to psychostimulants that increase the concentration of synaptic dopamine, like amphetamine, methamphetamine, and phenethylamine.