The Pharmacokinetics and Pharmacogenomics of Psychostimulants

Child Adolesc Psychiatr Clin N Am. 2022 Jul;31(3):393-416. doi: 10.1016/j.chc.2022.03.003. Epub 2022 May 11.

Abstract

The psychostimulants-amphetamine and methylphenidate-have been in clinical use for well more than 60 years. In general, both stimulants are rapidly absorbed with relatively poor bioavailability and short half-lives. The pharmacokinetics of both stimulants are generally linear and dose proportional although substantial interindividual variability in pharmacokinetics is in evidence. Amphetamine (AMP) is highly metabolized by several oxidative enzymes forming multiple metabolites while methylphenidate (MPH) is primarily metabolized by hydrolysis to the inactive metabolite ritalinic acid. At present, pharmacogenomic testing as an aid to guide dosing and personalized treatment cannot be recommended for either agent. Few pharmacokinetically based drug-drug interactions (DDIs) have been documented for either stimulant.

Keywords: Amphetamine; Methylphenidate; Pharmacodynamics; Pharmacogenomics; Pharmacokinetics; Psychostimulants.

Publication types

  • Review

MeSH terms

  • Attention Deficit Disorder with Hyperactivity* / drug therapy
  • Central Nervous System Stimulants*
  • Humans
  • Methylphenidate* / pharmacokinetics
  • Pharmacogenetics

Substances

  • Central Nervous System Stimulants
  • Methylphenidate