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Therapeutic PO doses of L and D amphetamine do not pose any significant long term risks if taken as directed for the appropriate condition in terms of the literature I have read in peer reviewed studies from academic journals:Potential Adverse Effects of Amphetamine Treatment on Brain and Behavior: A Review==========================================================I have been on methylphenidate, Adderral, Dexedrine and lisdexamphetamine for over twenty years. (separately) and while my experience is entirely anecdotal with a pretty small sample size and no control………The benefits of being able to function outweigh any potential long term risks for me.My concern when I was put on both methylphenidate and Mirapex (a dopamine agonist) together whether the increase in dopamine activity might trigger Parkinson’s or some other horrible issue. 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Serial behavior and motor responses.[Psychopharmacology (Berl). 1979]Review Therapeutic advances in narcolepsy.[Sleep Med. 2007]Review Drugs of abuse and the aging brain.[Neuropsychopharmacology. 2008]Substance abuse treatment need among older adults in 2020: the impact of the aging baby-boom cohort.[Drug Alcohol Depend. 2003]Review Current research on methamphetamine-induced neurotoxicity: animal models of monoamine disruption.[J Pharmacol Sci. 2003]Amphetamine sensitization alters dendritic morphology in prefrontal cortical pyramidal neurons in the non-human primate.[Neuropsychopharmacology. 2007]Review Interactions between methamphetamine and environmental stress: role of oxidative stress, glutamate and mitochondrial dysfunction.[Addiction. 2007]Escalating dose-binge treatment with methylphenidate: role of serotonin in the emergent behavioral profile.[J Pharmacol Exp Ther. 1999]Methylphenidate and brain dopamine neurotoxicity.[Brain Res. 1997]Hippocampus norepinephrine, caudate dopamine and serotonin, and behavioral responses to the stereoisomers of amphetamine and methamphetamine.[J Neurosci. 1995]Chemical release of dopamine from striatal homogenates: evidence for an exchange diffusion model.[J Pharmacol Exp Ther. 1979]Repeated binge exposures to amphetamine and methamphetamine: behavioral and neurochemical characterization.[J Pharmacol Exp Ther. 1997]Recovery of striatal dopamine function after acute amphetamine- and methamphetamine-induced neurotoxicity in the vervet monkey.[Brain Res. 1997]Early methylphenidate administration to young rats causes a persistent reduction in the density of striatal dopamine transporters.[J Child Adolesc Psychopharmacol. 2001]Repeated binge exposures to amphetamine and methamphetamine: behavioral and neurochemical characterization.[J Pharmacol Exp Ther. 1997]Amphetamine treatment similar to that used in the treatment of adult attention-deficit/hyperactivity disorder damages dopaminergic nerve endings in the striatum of adult nonhuman primates.[J Pharmacol Exp Ther. 2005]Differential effects of methylphenidate and dextroamphetamine on the motor activity level of hyperactive children.[Neuropsychopharmacology. 1989]Pharmacokinetics of SLI381 (ADDERALL XR), an extended-release formulation of Adderall.[J Am Acad Child Adolesc Psychiatry. 2003]Amphetamine treatment similar to that used in the treatment of adult attention-deficit/hyperactivity disorder damages dopaminergic nerve endings in the striatum of adult nonhuman primates.[J Pharmacol Exp Ther. 2005]Pharmacokinetics of SLI381 (ADDERALL XR), an extended-release formulation of Adderall.[J Am Acad Child Adolesc Psychiatry. 2003]A pharmacokinetic/pharmacodynamic study comparing a single morning dose of adderall to twice-daily dosing in children with ADHD.[J Am Acad Child Adolesc Psychiatry. 2003]Repeated binge exposures to amphetamine and methamphetamine: behavioral and neurochemical characterization.[J Pharmacol Exp Ther. 1997]Review Interactions between methamphetamine and environmental stress: role of oxidative stress, glutamate and mitochondrial dysfunction.[Addiction. 2007]Effects of neonatal and prepubertal hormonal manipulations upon estrogen neuroprotection of the nigrostriatal dopaminergic system within female and male mice.[Neuroscience. 2005]Effects of a cold environment or age on methamphetamine-induced dopamine release in the caudate putamen of female rats.[Pharmacol Biochem Behav. 1993]Age-related toxicity in prefrontal cortex and caudate-putamen complex of gerbils (Meriones unguiculatus) after a single dose of methamphetamine.[Neuropharmacology. 1991]3H-amphetamine concentrations in the brains of young and aged rats: implications for assessment of drug effects in aged animals.[Neurobiol Aging. 1980]Escalating dose pretreatment induces pharmacodynamic and not pharmacokinetic tolerance to a subsequent high-dose methamphetamine binge.[Synapse. 2006]Escalating dose methamphetamine pretreatment alters the behavioral and neurochemical profiles associated with exposure to a high-dose methamphetamine binge.[Neuropsychopharmacology. 2003]Escalating dose pretreatment induces pharmacodynamic and not pharmacokinetic tolerance to a subsequent high-dose methamphetamine binge.[Synapse. 2006]Influence of age and time interval between death and autopsy on dopamine and 3-methoxytyramine levels in human basal ganglia.[J Neural Transm. 1976]Review Update on amphetamine neurotoxicity and its relevance to the treatment of ADHD.[J Atten Disord. 2007]Repeated binge exposures to amphetamine and methamphetamine: behavioral and neurochemical characterization.[J Pharmacol Exp Ther. 1997]Recovery of striatal dopamine function after acute amphetamine- and methamphetamine-induced neurotoxicity in the vervet monkey.[Brain Res. 1997]Review NTP-CERHR monograph on the potential human reproductive and developmental effects of amphetamines.[NTP CERHR MON. 2005]Review Growth on stimulant medication; clarifying the confusion: a review.[Arch Dis Child. 2005]Comparative effects of methylphenidate and mixed salts amphetamine on height and weight in children with attention-deficit/hyperactivity disorder.[J Am Acad Child Adolesc Psychiatry. 2006]Does prolonged therapy with a long-acting stimulant suppress growth in children with ADHD?[J Am Acad Child Adolesc Psychiatry. 2006]Effects of stimulant medication on growth rates across 3 years in the MTA follow-up.[J Am Acad Child Adolesc Psychiatry. 2007]Comparative effects of methylphenidate and mixed salts amphetamine on height and weight in children with attention-deficit/hyperactivity disorder.[J Am Acad Child Adolesc Psychiatry. 2006]Stimulant treatment over 5 years: effects on growth.[J Am Acad Child Adolesc Psychiatry. 2006]Effects of stimulant medication on growth rates across 3 years in the MTA follow-up.[J Am Acad Child Adolesc Psychiatry. 2007]Does prolonged therapy with a long-acting stimulant suppress growth in children with ADHD?[J Am Acad Child Adolesc Psychiatry. 2006]Stimulant-related reductions of growth rates in the PATS.[J Am Acad Child Adolesc Psychiatry. 2006]Review NTP-CERHR monograph on the potential human reproductive and developmental effects of amphetamines.[NTP CERHR MON. 2005]Review Treatment for amphetamine dependence and abuse.[Cochrane Database Syst Rev. 2001]Review Biological treatments for amfetamine dependence : recent progress.[CNS Drugs. 2007]Use of d-amphetamine and related central nervous system stimulants in children.[Pediatrics. 1973]Why do we need an Addiction supplement focused on methamphetamine?[Addiction. 2007]Review NTP-CERHR monograph on the potential human reproductive and developmental effects of amphetamines.[NTP CERHR MON. 2005]Analysis of pyrolysis products of methamphetamine.[J Anal Toxicol. 2004]Stimulant use and the potential for abuse in Wisconsin as reported by school administrators and longitudinally followed children.[J Dev Behav Pediatr. 1998]The use, misuse and diversion of prescription stimulants among middle and high school students.[Subst Use Misuse. 2004]Medical use, illicit use and diversion of prescription stimulant medication.[J Psychoactive Drugs. 2006]Medical use, illicit use, and diversion of abusable prescription drugs.[J Am Coll Health. 2006]Medical and nonmedical stimulant use among adolescents: from sanctioned to unsanctioned use.[CMAJ. 2001]Issues of medication administration and control in Iowa schools.[J Sch Health. 2003]Parents report on stimulant-treated children in the Netherlands: initiation of treatment and follow-up care.[J Child Adolesc Psychopharmacol. 2006]Review Therapeutic advances in narcolepsy.[Sleep Med. 2007]Review Narcolepsy.[Neurol Clin. 1996]Reinforcing, subject-rated, performance and physiological effects of methylphenidate and d-amphetamine in stimulant abusing humans.[J Psychopharmacol. 2004]Review Comparing the abuse potential of methylphenidate versus other stimulants: a review of available evidence and relevance to the ADHD patient.[J Clin Psychiatry. 2003]Discriminative stimulus and self-reported effects of methylphenidate, d-amphetamine, and triazolam in methylphenidate-trained humans.[Exp Clin Psychopharmacol. 2005]PET study examining pharmacokinetics, detection and likeability, and dopamine transporter receptor occupancy of short- and long-acting oral methylphenidate.[Am J Psychiatry. 2006]Review When ADHD and substance use disorders intersect: relationship and treatment implications.[Curr Psychiatry Rep. 2007]Do individuals with ADHD self-medicate with cigarettes and substances of abuse? 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striatum.[Brain Res Dev Brain Res. 1993]Age-dependent differential responses of monoaminergic systems to high doses of methamphetamine.[J Neurochem. 2000]Tolerance to the neurotoxic effects of methamphetamine in young rats.[Eur J Pharmacol. 2002]Stimulant therapy and risk for subsequent substance use disorders in male adults with ADHD: a naturalistic controlled 10-year follow-up study.[Am J Psychiatry. 2008]Age of methylphenidate treatment initiation in children with ADHD and later substance abuse: prospective follow-up into adulthood.[Am J Psychiatry. 2008]Review Abuse of amphetamines and structural abnormalities in the brain.[Ann N Y Acad Sci. 2008]Psychiatric comorbidity of methamphetamine dependence in a forensic sample.[J Neuropsychiatry Clin Neurosci. 2000]Association of dopamine transporter reduction with psychomotor impairment in methamphetamine abusers.[Am J Psychiatry. 2001]Methamphetamine blood concentrations in human abusers: application to pharmacokinetic modeling.[Synapse. 2007]Review Structural and metabolic brain changes in the striatum associated with methamphetamine abuse.[Addiction. 2007]Review Current research on methamphetamine-induced neurotoxicity: animal models of monoamine disruption.[J Pharmacol Sci. 2003]Why is parkinsonism not a feature of human methamphetamine users?[Brain. 2004]Striatal dopamine nerve terminal markers in human, chronic methamphetamine users.[Nat Med. 1996]Reduced striatal vesicular monoamine transporters after neurotoxic but not after behaviorally-sensitizing doses of methamphetamine.[Eur J Pharmacol. 1997]Analysis of VMAT2 binding after methamphetamine or MPTP treatment: disparity between homogenates and vesicle preparations.[J Neurochem. 2000]Effects of dopaminergic drug treatments on in vivo radioligand binding to brain vesicular monoamine transporters.[Nucl Med Biol. 1996]The vesicular monoamine transporter is not regulated by dopaminergic drug treatments.[Eur J Pharmacol. 1995]Review Structural and metabolic brain changes in the striatum associated with methamphetamine abuse.[Addiction. 2007]Mood disturbances and regional cerebral metabolic abnormalities in recently abstinent methamphetamine abusers.[Arch Gen Psychiatry. 2004]Changes in cerebral glucose metabolism during early abstinence from chronic methamphetamine abuse.[Mol Psychiatry. 2008]Higher cortical and lower subcortical metabolism in detoxified methamphetamine abusers.[Am J Psychiatry. 2001]Partial recovery of brain metabolism in methamphetamine abusers after protracted abstinence.[Am J Psychiatry. 2004]Structural abnormalities in the brains of human subjects who use methamphetamine.[J Neurosci. 2004]Enlarged striatum in abstinent methamphetamine abusers: a possible compensatory response.[Biol Psychiatry. 2005]Effects of methamphetamine dependence and HIV infection on cerebral morphology.[Am J Psychiatry. 2005]Review Abuse of amphetamines and structural abnormalities in the brain.[Ann N Y Acad Sci. 2008]Evidence for long-term neurotoxicity associated with methamphetamine abuse: A 1H MRS study.[Neurology. 2000]Association of dopamine transporter reduction with psychomotor impairment in methamphetamine abusers.[Am J Psychiatry. 2001]Low level of brain dopamine D2 receptors in methamphetamine abusers: association with metabolism in the orbitofrontal cortex.[Am J Psychiatry. 2001]Changes in cerebral glucose metabolism during early abstinence from chronic methamphetamine abuse.[Mol Psychiatry. 2008]Higher cortical and lower subcortical metabolism in detoxified methamphetamine abusers.[Am J Psychiatry. 2001]Mood disturbances and regional cerebral metabolic abnormalities in recently abstinent methamphetamine abusers.[Arch Gen Psychiatry. 2004]Cerebral metabolic dysfunction and impaired vigilance in recently abstinent methamphetamine abusers.[Biol Psychiatry. 2005]Enlarged striatum in abstinent methamphetamine abusers: a possible compensatory response.[Biol Psychiatry. 2005]Decreased cerebral blood flow of the right anterior cingulate cortex in long-term and short-term abstinent methamphetamine users.[Drug Alcohol Depend. 2006]Loss of dopamine transporters in methamphetamine abusers recovers with protracted abstinence.[J Neurosci. 2001]Partial recovery of brain metabolism in methamphetamine abusers after protracted abstinence.[Am J Psychiatry. 2004]Changes in cerebral glucose metabolism during early abstinence from chronic methamphetamine abuse.[Mol Psychiatry. 2008]The nature, time course and severity of methamphetamine withdrawal.[Addiction. 2005]Methamphetamine abstinence syndrome: preliminary findings.[Am J Addict. 2004]Review Brain injury: prolonged induction of transcription factors.[Acta Neurobiol Exp (Wars). 2000]Review Decision making, the P3, and the locus coeruleus-norepinephrine system.[Psychol Bull. 2005]Review Neuropsychology and neuropharmacology of P3a and P3b.[Int J Psychophysiol. 2006]Effects of repeated administration of methamphetamine on P3-like potentials in rats.[Int J Psychophysiol. 1999]Review NTP-CERHR monograph on the potential human reproductive and developmental effects of amphetamines.[NTP CERHR MON. 2005]Amphetamine treatment similar to that used in the treatment of adult attention-deficit/hyperactivity disorder damages dopaminergic nerve endings in the striatum of adult nonhuman primates.[J Pharmacol Exp Ther. 2005]Review Drugs of abuse and the aging brain.[Neuropsychopharmacology. 2008]Association between decline in brain dopamine activity with age and cognitive and motor impairment in healthy individuals.[Am J Psychiatry. 1998]Association between age-related decline in brain dopamine activity and impairment in frontal and cingulate metabolism.[Am J Psychiatry. 2000]Decreased dopamine D2 receptor availability is associated with reduced frontal metabolism in cocaine abusers.[Synapse. 1993]Review A neurologist's reflections on boxing. 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glutathione adduct formation.[Toxicol Appl Pharmacol. 2006]Psychotic side effects of psychostimulants: a 5-year review.[Can J Psychiatry. 1999]Adderall-induced psychosis in an adolescent.[J Am Board Fam Pract. 2002]Psychotic and manic-like symptoms during stimulant treatment of attention deficit hyperactivity disorder.[Am J Psychiatry. 2006]Nine- or fewer repeat alleles in VNTR polymorphism of the dopamine transporter gene is a strong risk factor for prolonged methamphetamine psychosis.[Pharmacogenomics J. 2003]Review [Japanese Genetics Initiative for Drug Abuse (JGIDA)].[Nihon Shinkei Seishin Yakurigaku Zasshi. 2004]Risks of high-dose stimulants in the treatment of disorders of excessive somnolence: a case-control study.[Sleep. 2005]Psychiatric morbidity in narcoleptics on chronic high dose methylphenidate therapy.[J Nerv Ment Dis. 1995]Genetic influences on DSM-III-R drug abuse and dependence: a study of 3,372 twin pairs.[Am J Med Genet. 1996]Genetic and environmental influences on drug use and abuse/dependence in male and female twins.[Drug Alcohol Depend. 1998]Review [Japanese Genetics Initiative for Drug Abuse (JGIDA)].[Nihon Shinkei Seishin Yakurigaku Zasshi. 2004]Nine- or fewer repeat alleles in VNTR polymorphism of the dopamine transporter gene is a strong risk factor for prolonged methamphetamine psychosis.[Pharmacogenomics J. 2003]An association study between catechol-O-methyl transferase gene polymorphism and methamphetamine psychotic disorder.[Psychiatr Genet. 2006]Identification of functional polymorphisms in the promoter region of the human PICK1 gene and their association with methamphetamine psychosis.[Am J Psychiatry. 2007]Dopamine transporter-dependent induction of C-Fos in HEK cells.[Synapse. 2002]Review [Japanese Genetics Initiative for Drug Abuse (JGIDA)].[Nihon Shinkei Seishin Yakurigaku Zasshi. 2004]Review Lithium and valproate protect against dextro-amphetamine induced brain choline concentration changes in bipolar disorder patients.[World J Biol Psychiatry. 2004]Nomifensine attenuates d-amphetamine-induced dopamine terminal neurotoxicity in the striatum of rats.[Chin J Physiol. 2000]Methyllycaconitine prevents methamphetamine-induced effects in mouse striatum: involvement of alpha7 nicotinic receptors.[J Pharmacol Exp Ther. 2005]Attenuation of cocaine and methamphetamine neurotoxicity by coenzyme Q10.[Neurochem Res. 2006]Baicalein attenuates methamphetamine-induced loss of dopamine transporter in mouse striatum.[Toxicology. 2006]Melatonin protects SK-N-SH neuroblastoma cells from amphetamine-induced neurotoxicity.[J Pineal Res. 2007]Impairment in consolidation of learned place preference following dopaminergic neurotoxicity in mice is ameliorated by N-acetylcysteine but not D1 and D2 dopamine receptor agonists.[Neuropsychopharmacology. 2007]Review Combining structural and functional neuroimaging data for studying brain connectivity: a review.[Psychophysiology. 2008]Review Brain mapping as a tool to study 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