General practice & prim · UKMLA & AKT
Stimulant use disorder
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise stimulant use disorder — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Principal stimulants: amphetamines/methamphetamine (Class B), cocaine and MDMA/ecstasy (Class A) under Misuse of Drugs Act 1971
- All act by causing synaptic dopamine excess - amphetamines/MDMA reverse DAT to flood synapse; cocaine blocks DAT preventing reuptake
- MDMA additionally causes serotonin surge (empathogenic effects) and stimulates ADH release → dilutional hyponatraemia with excess water intake
- Chronic use down-regulates dopamine receptors → tolerance and withdrawal syndrome (dopamine tone below baseline when drug absent)
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