Drilldown: Medicines

Artemisia absinthium (1) · Atomoxetine (1) · Atropa belladonna (1) · Banisteriopsis caapi (1) · Betel (1) · Black Drink (1) · Brugmansia (1) · Chocolate (1) · Clonidine (1) · Coca (1) · Coffee (1) · Guanfacine (1) · Guarana (1) · Hyoscyamus niger (1) · Khat (1) · Kola (1) · Lisdexamfetamine (dimesylate) (1) · Mandragora officinarum (1) · Mescal Bean (1) · Mimosa hostilis (1) · Phalaris arundinaceae (1) · Tea (1) · Yerba mate (1)

''Areca catechu'' (the nut); ''Piper betle'' (the leaf) (1) · ''Brugmansia'' spp., Angel's trumpet, ''borrachero'', ''toé'' (1) · ''Camellia sinensis'' (formerly ''Thea sinensis'') (1) · ''Catha edulis''. Chat, qat, the Flower of Paradise (1) · ''Coffea arabica'', ''Coffea canephora'' (robusta) (1) · ''Cola nitida'', ''Cola acuminata'' (1) · ''Erythroxylum coca'', ''E. novogranatense'' (1) · ''Ilex paraguariensis'' (1) · ''Ilex vomitoria'' (1) · ''Mimosa tenuiflora''. Jurema preta, tepescohuite (1) · ''Paullinia cupana'' (1) · ''Sophora secundiflora''. Texas mountain laurel, frijolillo (1) · ''Theobroma cacao'' (1) · Deadly nightshade (1) · Henbane, black henbane (1) · Intuniv (extended-release), Tenex (immediate-release) (1) · Kapvay (ER, ADHD), Catapres (IR, antihypertensive), Catapres-TTS (transdermal patch), Duraclon (epidural injection) (1) · Mandrake (1) · Reed canary grass (1) · Strattera (1) · The ayahuasca vine, ''yagé'', ''caapi'', ''mariri'' (1) · Vyvanse, Elvanse (EU) (1) · Wormwood, absinthe, la Fée Verte, the Green Muse (1)

Research material · Classic Psychedelic · Stimulant · Opioid · Sedative-Hypnotic · Phenethylamine · Tryptamine · Benzodiazepine · Botanical · [[:Category:Antihypertensives|Antihypertensive]] · Dissociative · Anticonvulsant · Antidepressant · Plant Medicine · Analgesic · Antipsychotic · Antiparkinsonian · Empathogen · Neuroleptic · Cathinone

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None (2) · Active alkaloid is cytisine, a nicotinic acetylcholine receptor agonist. NOT a classical 5-HT2A psychedelic. (1) · Active principle is thujone, a GABA-A antagonist (the opposite of most CNS depressants). Also present in cooking sage (''Salvia officinalis''), tansy, and ''Thuja'' cedars. (1) · Caffeine (1.5–2%) + theobromine + kolanin (a glycoside). (1) · Caffeine (highest of the ''Ilex'' genus) plus saponins that produce ritual vomiting at high doses. (1) · Caffeine (sometimes called 'mateine' historically, though chemically identical), theobromine, theophylline, plus polyphenols. (1) · Caffeine + theophylline + L-theanine. L-theanine (an amino acid unique to tea) modulates glutamate and produces an 'alpha-wave' calming overlay on caffeine's stimulation, hence tea's reputation as a 'cleaner' stimulant than coffee. (1) · Caffeine is a non-selective adenosine A1/A2A receptor antagonist; also weak PDE inhibition. Beans contain theobromine (3,7-DMX) and theophylline (1,3-DMX) in smaller amounts. (1) · Contains the β-carboline alkaloids harmine, harmaline, and tetrahydroharmine, reversible monoamine oxidase inhibitors (RIMAs) that allow oral DMT to reach the brain. (1) · Contains varying amounts of DMT, 5-MeO-DMT, bufotenine, and gramine depending on strain and growing conditions. (1) · Highest natural caffeine content of any plant (2–7% by dry weight, ~2–4× coffee). Caffeine is bound to tannins, producing a slower release than pure coffee caffeine. (1) · Primary alkaloid is (S)-(-)-cathinone, a phenylpropanolamine close kin to amphetamine. Releases dopamine and norepinephrine. Also contains cathine (=norpseudoephedrine) and norephedrine. (1) · Primary alkaloid is arecoline, a muscarinic agonist (M1, M2, M3, M4) and partial agonist at nicotinic receptors. Produces alertness, salivation, sweating, mild euphoria. (1) · Primary alkaloid is cocaine, a tropane that blocks reuptake of dopamine and norepinephrine (and serotonin). At low oral doses from leaf chewing, the slow release favors NE-mediated alertness over DA-mediated euphoria. (1) · Primary alkaloid is theobromine (3,7-dimethylxanthine), with minor caffeine. Also contains phenethylamine, anandamide (an endogenous cannabinoid), tryptophan (serotonin precursor), and flavanols. The combined effect is mild stimulation + mood elevation. (1) · Root bark contains ~1% N,N-dimethyltryptamine (DMT) and related tryptamines. Oral activity requires MAOI co-administration. (1) · Tropane alkaloids: hyoscyamine (dominant; the racemic form is atropine), scopolamine. Competitive muscarinic antagonism. (1) · Tropane alkaloids: hyoscyamine, scopolamine, atropine, apoatropine. (1) · Tropane alkaloids: hyoscyamine, scopolamine, in higher seed concentrations than belladonna or datura. (1) · Tropane alkaloids: scopolamine (dominant), hyoscyamine, atropine. Competitive antagonism at muscarinic acetylcholine receptors. (1) · '"`UNIQ--vote-00000013-QINU`"' Once converted, dextroamphetamine acts by displacing dopamine and norepinephrine from presynaptic vesicles via VMAT-2 and reversing DAT and NET transport, the shared mechanism of all amphetamine-class agents'"`UNIQ--ref-00000014-QINU`"'. (1) · '"`UNIQ--vote-00000019-QINU`"' Sedation and hypotension are the dose-limiting effects; gradual titration and bedtime or split dosing mitigate both. Abrupt discontinuation can precipitate rebound hypertension, particularly with long-standing use'"`UNIQ--ref-0000001A-QINU`"'. (1)

'"`UNIQ--vote-00000006-QINU`"' (3) · '"`UNIQ--vote-00000008-QINU`"', '"`UNIQ--vote-00000009-QINU`"' (8) · '"`UNIQ--vote-0000000C-QINU`"', '"`UNIQ--vote-0000000D-QINU`"', '"`UNIQ--vote-0000000E-QINU`"', '"`UNIQ--vote-0000000F-QINU`"' (1) · '"`UNIQ--vote-00000013-QINU`"' (1) · '"`UNIQ--vote-00000015-QINU`"', '"`UNIQ--vote-00000016-QINU`"' (1) · '"`UNIQ--vote-0000001B-QINU`"', '"`UNIQ--vote-0000001C-QINU`"', '"`UNIQ--vote-0000001D-QINU`"', '"`UNIQ--vote-0000001E-QINU`"', '"`UNIQ--vote-0000001F-QINU`"' (1) · '"`UNIQ--vote-0000001F-QINU`"', '"`UNIQ--vote-00000020-QINU`"', '"`UNIQ--vote-00000021-QINU`"', '"`UNIQ--vote-00000022-QINU`"', '"`UNIQ--vote-00000023-QINU`"', '"`UNIQ--vote-00000024-QINU`"', '"`UNIQ--vote-00000025-QINU`"' (1) · '"`UNIQ--vote-00000065-QINU`"' (1) · '"`UNIQ--vote-000000AD-QINU`"', '"`UNIQ--vote-000000AE-QINU`"' (1) · '"`UNIQ--vote-000000CF-QINU`"', '"`UNIQ--vote-000000D0-QINU`"', '"`UNIQ--vote-000000D1-QINU`"' (1) · '"`UNIQ--vote-000003A0-QINU`"', '"`UNIQ--vote-000003A1-QINU`"' (1) · '"`UNIQ--vote-0000069B-QINU`"', '"`UNIQ--vote-0000069C-QINU`"' (1) · '"`UNIQ--vote-00000747-QINU`"', '"`UNIQ--vote-00000748-QINU`"' (1) · '"`UNIQ--vote-0000081E-QINU`"' (1)

None (15) · A ''marduuf'' bundle (~50 g fresh leaves) chewed over a couple of hours (1) · A measured pour of absinthe diluted 5:1 with cold water over sugar (the louche ritual) (1) · ADHD (Kapvay ER): 0.1 mg PO at bedtime, titrate weekly to 0.4 mg/day divided BID. HTN (IR): 0.1 mg PO BID, titrate by 0.1 mg increments (1) · ADHD: 30 mg PO once daily in the morning; titrate by 10-20 mg weekly to clinical effect. Binge-eating disorder: 30 mg/day, titrate to 50-70 mg/day (1) · Children ≤70 kg: 0.5 mg/kg/day, titrate to 1.2 mg/kg/day after 3 days. Adults and children >70 kg: 40 mg PO once daily for 3 days, then 80 mg/day, then if needed 100 mg/day after 2-4 weeks (1) · Intuniv ER 1 mg PO once daily; titrate by 1 mg/week as tolerated to clinical response (1) · One cup (~40–60 mg caffeine; about half of brewed coffee) (1) · One cup (~80–145 mg caffeine for brewed; 60–100 mg for instant) (1)

A ''betel quid'': areca nut slice + betel leaf + slaked lime (calcium hydroxide) ± tobacco ± spices, chewed (1) · Acid/base extraction of fresh young grass for tryptamines; combined with an MAOI (1) · Bark/woody stem decocted with a DMT-source plant (''Psychotria viridis'', ''Diplopterys cabrerana'') to make ayahuasca (1) · Bright red seeds, traditionally ingested or smoked. Highly toxic, narrow margin between active and lethal (1) · Capsules 10, 18, 25, 40, 60, 80, 100 mg (1) · Capsules 10, 20, 30, 40, 50, 60, 70 mg; chewable tablets 10, 20, 30, 40, 50, 60 mg (1) · Dried leaves and twigs, infused in a gourd (''mate'') and drunk through a metal straw (''bombilla'') (1) · Dried leaves, infused. Six major processings: white, green, yellow, oolong, black, pu-erh (1) · Dried leaves; absinthe liqueur (120–160 proof, with hyssop, lemon balm, fennel, anise, sometimes Acorus calamus) (1) · Extended-release tablets 1, 2, 3, 4 mg (Intuniv); immediate-release tablets 1, 2 mg (Tenex) (1) · Fermented and roasted seeds, ground. Mexican tradition: drunk with chili, cornmeal, achiote. European tradition: with sugar and milk (1) · Flowers or leaves infused or smoked. Highly variable potency; narrow toxic margin (1) · Fresh leaves and tender twigs chewed; degrades on drying (1) · Fresh nuts chewed; also dried and powdered (1) · IR tablets 0.1, 0.2, 0.3 mg; ER tablets 0.1, 0.2 mg (Kapvay); transdermal patches 0.1, 0.2, 0.3 mg/24h (TTS-1/2/3, weekly); epidural injection (Duraclon) (1) · Leaves and seeds, traditionally smoked or infused. Possibly the original Pythia oracle plant (1) · Leaves chewed with a pinch of slaked lime (the lime converts cocaine HCl to freebase for buccal absorption); also drunk as tea (''mate de coca'') (1) · Leaves, berries, root. Historically: belladonna cigarettes ("Asthmador") OTC in US until the 1970s (1) · Roasted beans, ground; brewed (drip, French press, espresso, cold brew, percolated) (1) · Roasted seeds ground to powder, mixed with water; commercial syrups and energy drinks (1) · Root bark acid/base-extracted for DMT; or as the resurrected ''jurema preta'' brew (decocted with an MAOI such as ''Peganum harmala'') (1) · Root, traditionally carved into ''mannikens'' or infused into wine (1) · Toasted leaves and twigs decocted to a near-black concentrate (1)

None (19) · 100 mg/day (adult); 1.4 mg/kg/day or 100 mg total (pediatric, whichever lower) (1) · 2.4 mg/day (HTN, IR); 0.4 mg/day (ADHD, Kapvay) (1) · 7 mg/day in children and adolescents; weight-based ceiling (~0.12 mg/kg/day) applies in smaller patients (1) · 70 mg/day (1)

buccal); refined cocaine has its own profile (1) · epidural injection (1) · inhalation (2) · Oral (18) · Oral (buccal absorption) (1) · Oral (buccal) (1) · Oral (leaf (1) · Oral (with MAOI) (2) · smoked (extracted DMT) (1) · topical (1) · transdermal (1)

None (16) · 1-2 hours (slower than immediate-release amphetamine because activation requires enzymatic cleavage in red blood cells) (1) · 15–30 min (2) · 30-60 min (IR oral); 2-3 days to steady state (transdermal patch) (1) · ADHD effect emerges over 1-2 weeks (slower than psychostimulants); full effect 4-6 weeks (1) · Gradual; full clinical effect over 2-4 weeks of titration (1) · ~15–30 min (1)

None (16) · 10-12 hours (smoother profile than immediate-release amphetamine salts) (1) · 24 hours (once-daily or split BID dosing) (1) · 2–4 h (1) · 3–4 h (1) · 3–5 h (subjective) (1) · 8-12 hours (IR); ~7 days (transdermal patch) (1) · ~24 hours (ER formulation supports once-daily dosing) (1)

None (17) · 12-16 hours'"`UNIQ--ref-00000026-QINU`"' (1) · Parent lisdexamfetamine <1 hour; dextroamphetamine 10-12 hours after release'"`UNIQ--ref-00000017-QINU`"' (1) · ~17-18 hours (Intuniv ER); ~17 hours (immediate-release)'"`UNIQ--ref-00000020-QINU`"' (1) · ~5 h (caffeine) (2) · ~5 hours in extensive CYP2D6 metabolizers; ~21 hours in CYP2D6 poor metabolizers'"`UNIQ--ref-00000014-QINU`"' (1)

None (18) · ~58% (extended-release); ~80% (immediate-release)'"`UNIQ--ref-00000021-QINU`"' (1) · ~63% (oral; extensive first-pass)'"`UNIQ--ref-00000015-QINU`"' (1) · ~75-85% (oral); ~60% (transdermal at steady state)'"`UNIQ--ref-00000027-QINU`"' (1) · ~96% after red blood cell hydrolytic cleavage releases dextroamphetamine'"`UNIQ--ref-00000018-QINU`"' (1) · ~99% (caffeine) (1)

None (18) · Limit to <200 mg/d (~2 cups brewed) (1) · Limited human data. Animal studies show fetal effects at maternally toxic doses; use only if benefits justify the potential risk.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Limited human data.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Limited human data; the amphetamine class is associated with intrauterine growth restriction and neonatal withdrawal symptoms.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1) · Older agent with substantial use experience but limited controlled data; case reports of neonatal sedation and transient hypertension with maternal use near term.<sup class="pcp-cn" title="This claim needs a citation.">&#91;[[Pharmacopedia:Citation needed|citation&nbsp;needed]]&#93;</sup> (1)

None (14) · Currently legal in most jurisdictions with thujone limits (1) · Leaves legal in Bolivia, Peru, Colombia; cocaine internationally controlled (1) · Plant unrestricted; pharmaceutical atropine Rx-only (1) · Schedule I in US since 1993 (despite traditional use elsewhere); legal in Ethiopia, Kenya, Yemen, Somalia, Djibouti (1) · Unrestricted (food) (1) · [[USLegal:Prescription only|Rx-only]] in US. '''Not a controlled substance''', the principal clinical selling point versus psychostimulant ADHD options. Carries the antidepressant-class '''Boxed Warning''' for suicidal ideation in pediatric patients'"`UNIQ--ref-00000016-QINU`"' (1) · [[USLegal:Prescription only|Rx-only]] in US. Not a controlled substance, like guanfacine and unlike the psychostimulant alternatives for ADHD'"`UNIQ--ref-00000028-QINU`"' (1) · [[USLegal:Prescription only|Rx-only]] in US. Not a controlled substance, which is a meaningful contrast to the psychostimulant alternatives for ADHD'"`UNIQ--ref-00000022-QINU`"' (1) · [[USLegal:Schedule II|Schedule II controlled substance]] in US'"`UNIQ--ref-00000019-QINU`"' (1)