ADHD - An Illustrated historical overview

Psychostimulants P sychostimulants, drugs employed to elevate mood, are regarded as useful tools in managing a range of disorders, including depression and the akinesia of Parkinson’s disease. Pharmacological agents have been used with this aim for centuries; in the 19 th century they were known as “nerve tonics”, and included a num- ber of plant-derived agents, including strychnine and cocaine. A traditionally, well-known agent to stimulate and to enhance concentra- tion was ephedrine, a salt that was iso- lated from the plant Ephedra vulgaris in 1885 by the Japanese chemist Na- gayoshi Nagai. Similar in structure to the synthetic derivatives amphetamine and methamphetamine, ephedrine is still used in kampo, the traditional Chi- nese herbal medicine practiced in Ja- pan, and is still very popular in China as ma-huang. Nagai later synthesized methamphetamine from ephedrine, and his compatriot Akira Ogata (1887– 1978) succeeded in crystallizing it in 1919. Amphetamine was first synthesized in 1887 by the Romanian chemist Lazar Edeleanu at the Humboldt Universi ty in Berlin, but was largely unknown un- til the Philadelphia-based company Smith, Kline and French introduced an inhaler and bronchodilator in 1932 under the trade name “Benzedrine”. It was freely available through the 1930s, when its stimulant properties were first recognized, leading to its widespread use by troops during the Second World War . Although it might seem counter-intui- tive, psychostimulants have proved to be particularly effective in the manage- ment of ADHD and a panel of drugs has been researched and used to treat ADHD, particularly amphetamine and methylphenidate. While other medications are pre- scribed to manage symptoms of the disorder as well as co-existing symp- toms of mood disorder or anxiety, a non-stimulant substance used to treat ADHD is atomoxetine. By Paul Foley, Sydney, Australia.