DHEA: What Is It?

Dehydroepiandrosterone or DHEA is made from cholesterol by the adrenal glands, which sit on top of each kidney. Production of this substance peaks in the mid-20s, and gradually declines with age in most people. What this drop means or how it affects the aging process, if at all, is unclear. In fact, scientists are somewhat mystified by DHEA and have not fully sorted out what it does in the body. However, researchers do know that the body converts DHEA into two hormones that are known to affect us in many ways: estrogen and testosterone.

Supplements of DHEA can be bought without a prescription and are sold as anti-aging remedies. Some proponents of these products claim that DHEA supplements improve energy, strength, and immunity. DHEA is also said to increase muscle and decrease fat. Right now there is no conclusive evidence that DHEA supplements do any of these things in people, and there is little scientific evidence to support the use of DHEA as a “rejuvenating” hormone. Although the long-term (over 1 year) effects of DHEA supplements have not been studied, there are early signs that these supplements, even when taken briefly, may have several detrimental effects on the body, including liver damage.

In addition, some people’s bodies make more estrogen and testosterone from DHEA than others. There is no way to predict who will make more and who will make less. Researchers are concerned that DHEA supplements may cause high levels of estrogen or testosterone in some people. This is important because testosterone may play a role in prostate cancer, and higher levels of estrogen are associated with an increased risk of breast cancer. It is not yet known for certain if supplements of estrogen and testosterone, or supplements of DHEA, also increase the risk of developing these types of cancer. In women, high testosterone levels can cause acne and growth of facial hair.

Overall, research on DHEA to date does not provide a clear picture of the risks and benefits. Two short-term studies showed no harmful effects of DHEA supplementation on blood, prostate, or liver function. However, the studies were small in size, and no conclusions about the safety or efficacy of DHEA supplementation could be made based on their results.

Researchers are working to find more definite answers about DHEA’s effects on aging, muscles, and the immune system. In the meantime, people who are thinking about taking supplements of this hormone should understand that its effects are not fully known. Some of these unknown effects might turn out to be harmful.

http://www.niapublications.org/tipsheets/pills.asp

Buyer Beware: Can a Nutritional Supplement Reverse Aging?

Some hormone-like products are available over the counter and can be used without consulting a physician. The Institute discourages people from self-medicating with these products for a number of reasons.

• First, these products are marketed as dietary supplements, and therefore are not regulated by the FDA in the same way as drugs. This is an important distinction because the requirements for marketing a dietary supplement are very different from those that apply to hormones marketed as drugs. Unlike drug manufacturers, a firm selling dietary supplements doesn’t need FDA approval of its products and doesn’t need to prove that its products are safe and effective before marketing.
• Also, there is no specific guarantee that the substance in the container is authentic or that the indicated dosage is accurate. Because of these differing standards, hormone-like substances that are sold as dietary supplements may not be as thoroughly studied as drug products, and, therefore, the potential consequences of their use are not well understood or defined.
• In addition, these over-the-counter products may interfere with other medications you are taking.

Therefore, the NIA (National Institute on Aging) does not recommend taking any supplement, including DHEA and melatonin, that is touted as an “anti-aging” remedy because no supplement has been proven to serve this purpose. The influence of these supplements on a person’s health is unknown, particularly when taken over a long period of time.

http://www.niapublications.org/tipsheets/pills.asp

CNS Depressants: Are They Addictive?

Discontinuing prolonged use of high doses of CNS depressants can lead to withdrawal. Because they work by slowing the brain’s activity, a potential consequence of abuse is that when one stops taking a CNS depressant, the brain’s activity can rebound to the point that seizures can occur. Someone thinking about ending their use of a CNS depressant, or who has stopped and is suffering withdrawal, should speak with a physician and seek medical treatment.

In addition to medical supervision, counseling in an in-patient or out-patient setting can help people who are overcoming addiction to CNS depressants. For example, cognitive-behavioral therapy has been used successfully to help individuals in treatment for abuse of benzodiazepines. This type of therapy focuses on modifying a patient’s thinking, expectations, and behaviors while simultaneously increasing their skills for coping with various life stressors.

Often the abuse of CNS depressants occurs in conjunction with the abuse of another substance or drug, such as alcohol or cocaine. In these cases of polydrug abuse, the treatment approach should address the multiple addictions.

http://www.drugabuse.gov/infofacts/PainMed.html

CNS Depressants: What Are They?

CNS depressants slow normal brain function. In higher doses, some CNS depressants can become general anesthetics. Tranquilizers and sedatives are examples of CNS depressants. CNS depressants can be divided into two groups, based on their chemistry and pharmacology:
Barbiturates, such as mephobarbital (Mebaral) and pentobarbitalsodium (Nembutal), which are used to treat anxiety, tension, and sleep disorders.

• Benzodiazepines, such as diazepam (Valium), chlordiazepoxide HCl (Librium), and alprazolam (Xanax), which can be prescribed to treat anxiety, acute stress reactions, and panic attacks.
• Benzodiazepines that have a more sedating effect, such as estazolam (ProSom), can be prescribed for short-term treatment of sleep disorders.

There are many CNS depressants, and most act on the brain similarly—they affect the neurotransmitter gamma-aminobutyric acid (GABA). Neurotransmitters are brain chemicals that facilitate communication between brain cells. GABA works by decreasing brain activity. Although different classes of CNS depressants work in unique ways, ultimately it is their ability to increase GABA activity that produces a drowsy or calming effect. Despite these beneficial effects for people suffering from anxiety or sleep disorders, barbiturates and benzodiazepines can be addictive and should be used only as prescribed.

CNS depressants should not be combined with any medication or substance that causes drowsiness, including prescription pain medicines, certain OTC cold and allergy medications, or alcohol. If combined, they can slow breathing, or slow both the heart and respiration, which can be fatal.

http://www.drugabuse.gov/infofacts/PainMed.html

Are Opiates Addictive?

Long-term use also can lead to physical dependence—the body adapts to the presence of the substance and withdrawal symptoms occur if use is reduced abruptly. This can also include tolerance, which means that higher doses of a medication must be taken to obtain the same initial effects. Note that physical dependence is not the same as addiction—physical dependence can occur even with appropriate long-term use of opioid and other medications. Addiction, as noted earlier, is defined as compulsive, often uncontrollable drug use in spite of negative consequences.

Individuals taking prescribed opioid medications should not only be given these medications under appropriate medical supervision, but also should be medically supervised when stopping use in order to reduce or avoid withdrawal symptoms. Symptoms of withdrawal can include restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, cold flashes with goose bumps ("cold turkey"), and involuntary leg movements.

Individuals who become addicted to prescription medications can be treated. Options for effectively treating addiction to prescription opioids are drawn from research on treating heroin addiction. Some pharmacological examples of available treatments follow:

• Methadone, a synthetic opioid that blocks the effects of heroin and other opioids, eliminates withdrawal symptoms and relieves craving. It has been used for over 30 years to successfully treat people addicted to opioids.
• Buprenorphine, another synthetic opioid, is a recent addition to the arsenal of medications for treating addiction to heroin and other opiates.
• Naltrexone is a long-acting opioid blocker often used with highly motivated individuals in treatment programs promoting complete abstinence. Naltrexone also is used to prevent relapse. Naloxone counteracts the effects of opioids and is used to treat overdoses.

http://www.drugabuse.gov/infofacts/PainMed.html

Opiates: What Are They?

Opioids are commonly prescribed because of their effective analgesic, or pain relieving, properties. Studies have shown that properly managed medical use of opioid analgesic compounds is safe and rarely causes addiction. Taken exactly as prescribed, opioids can be used to manage pain effectively.

Among the compounds that fall within this class—sometimes referred to as narcotics—are morphine, codeine, and related medications. Morphine is often used before or after surgery to alleviate severe pain. Codeine is used for milder pain. Other examples of opioids that can be prescribed to alleviate pain include oxycodone (OxyContin—an oral, controlled release form of the drug); propoxyphene (Darvon); hydrocodone (Vicodin); hydromorphone (Dilaudid); and meperidine (Demerol), which is used less often because of its side effects. In addition to their effective pain relieving properties, some of these medications can be used to relieve severe diarrhea (Lomotil, for example, which is diphenoxylate) or severe coughs (codeine).

Opioids act by attaching to specific proteins called opioid receptors, which are found in the brain, spinal cord, and gastrointestinal tract. When these compounds attach to certain opioid receptors in the brain and spinal cord, they can effectively change the way a person experiences pain. In addition, opioid medications can affect regions of the brain that mediate what we perceive as pleasure, resulting in the initial euphoria that many opioids produce. They can also produce drowsiness, cause constipation, and, depending upon the amount taken, depress breathing. Taking a large single dose could cause severe respiratory depression or death.

Opioids may interact with other medications and are only safe to use with other medications under a physician's supervision. Typically, they should not be used with substances such as alcohol, antihistamines, barbiturates, or benzodiazepines. Since these substances slow breathing, their combined effects could lead to life-threatening respiratory depression.

http://www.drugabuse.gov/infofacts/PainMed.html

Stimulants: Q & A

Q: What are stimulants?
A: As the name suggests, stimulants increase alertness, attention, and energy, as well as elevate blood pressure and increase heart rate and respiration. Stimulants historically were used to treat asthma and other respiratory problems, obesity, neurological disorders, and a variety of other ailments. But as their potential for abuse and addiction became apparent, the medical use of stimulants began to wane. Now, stimulants are prescribed for the treatment of only a few health conditions, including narcolepsy, ADHD, and depression that has not responded to other treatments.

Q: How do stimulants effect the brain and body?
A: Stimulants, such as dextroamphetamine (Dexedrine and Adderall) and methylphenidate (Ritalin and Concerta), have chemical structures similar to a family of key brain neurotransmitters called monoamines, which include norepinephrine and dopamine. Stimulants enhance the effects of these chemicals in the brain. Stimulants also increase blood pressure and heart rate, constrict blood vessels, increase blood glucose, and open up the pathways of the respiratory system. The increase in dopamine is associated with a sense of euphoria that can accompany the use of these drugs.

Q: What are the possible consequences of stimulant use and abuse?
A: As with other drugs of abuse, it is possible for individuals to become dependent upon or addicted to many stimulants. Withdrawal symptoms associated with discontinuing stimulant use include fatigue, depression, and disturbance of sleep patterns. Repeated use of some stimulants over a short period can lead to feelings of hostility or paranoia. Further, taking high doses of a stimulant may result in dangerously high body temperature and an irregular heartbeat. There is also the potential for cardiovascular failure or lethal seizures.

Q: Is it safe to use stimulants with other medications?
A: Stimulants should be used in combination with other medications only under a physician's supervision. Patients also should be aware of the dangers associated with mixing stimulants and OTC cold medicines that contain decongestants; combining these substances may cause blood pressure to become dangerously high or lead to irregular heart rhythms.

http://www.drugabuse.gov/ResearchReports/Prescription/prescription4.html#Stimulants