One presenting with symptoms typically arising from chronic use/abuse of all SM amines might be treated using some of the experimental methods mentioned above, if one elects to treat a condition deemed untreatable with anything other than the usual symptomatic approaches, as is almost always the case...however, the 'condition' itself will rarely be considered to be a 'syndrome' of neurotoxicity from abuse, but will be considered, instead, as someone pointed out, to be post stim. sequelae and will be attributed to the usual belief that stimulant abuse leads to prolonged phys. and psych. impairment lasting from months to years [to paraphrase a thousand 'standard' manuals clinicans go by]. Neurotox. will be mentioined out loud only when chronic abuse leads to onset of psychoses indistinguashable from schizophrenia, and only in that case will all the newer treatments be tried, in the inpatient setting. This is to say, i don't see why there is a distinction between the post stimulant abuse 'prolonged' refractory period and the not yet official post stim abuse syndrome of some sort, since it is impossible to tell the two apart [save from some imaging pointing to drastic neural degeneration among other things] and thus, why we should even try to discern between the two, at this point, if diagnostic criteria do not exist. As a preventative measure, wouldn't the ethical clinical response be to go the way of 'regeneration' by whichever means possible, considering that both conditions are serious impediments to the patient, while also taking the symptom based approach of treatment which does not at all interfere with the former 'experimental' one? No, because usually the patient presenting the post stim. 'withdrawal' is often treated like a junkie who deserves what he gets, if I might be so bold as to make such a declaration.....I realize this is not an ethics argument, so forgive me for straying.
I was just making a point pertaining to the theory which dismisses any sort of complex series of disorders arising from stim. abuse as a rarity, and accepts a ten year episode of psychosocial impairment as a withdrawal symptom.....outrageous.
About reduction of tox. during use of stimulants - it's typically not done by those who are looking to get high, because as a rule, most agents which are believed to reduce damage usually always take away from the desired high, with the exception of the high dose antioxidants someone mentioned. The hardcore users will avoid everything 'protective', and will often experience a diminished high from agents administered which do not actually interact with the stimulant taken, as placebo effect. This is not common knowledge in non psych. clinical circles, unless they happen to have arisen from a generation exposed to the club circuit of the major cities, wherein the pillhead on the floor 5 times a week will be unable to recall his name and address but will never forget what to mix and what not to mix with his e. Neuroprotective to him is anathema. Just like it is to the average clinician.
There are all these nootropics springing up and/or coming back in fourth world countries, like Russia, where brain degeneration and neurotoxicity is more common from daily binge drinking and less glamorous than pretty pill stims substances like industrial agents of all sorts and over the counter bromide preparations which are popularly thought to be safe 'traditional' panaceas for everything.....but these nootropics themselves have abuse potential. I will try to find a text and paraphrase it in translation..regarding the 'nootropics'. It's a big deal in Europe, but is commonly dismissed in the US. What is not dismissed is administration of aricept to the ex pillheads of the club scene by the 'progressive' new york city medical community [all I can vouch for, since I don't know about the other communities]. Ergoloids I understand....but aricept and reminyl, and rivastigmine to non-alzh. patients is just ridiculous.
A.A.M.
