Clinical Drug Experience Knowledgebase

Pipradrol (Meratran) is a psychoactive agent and a central nervous system stimulant useful in the field of psychiatry. In vitro study has shown that pipradrol inhibits the reuptake of and stimulates the release of dopamine and norepinephrine. In these pharmacodynamic actions it is less potent than d-amphetamine. It was shown that pipradrol conditioned place preference (CPP) was blocked by selective D1 dopamine antagonist SCH23390 suggesting that a rewarding effect of pipradrol establishment of a CPP may involve activation of D1 dopamine receptors. Pipradrol was initially used as an adjunct in the dietary management of obesity as well as for the treatment of dementia. There have been a number of reports on the properties of pipradrol showing its favorable effects in the treatment of depression and fatigue status as well as a variety of other conditions including narcolepsy, spasmodic torticollis, schizophrenia and in geriatric practice. Pipradrol has a definite cerebral stimulating effect without affecting the blood pressure or respiration and has been used to counteract post-anasthetic and chlorpromazine depression in man. Structurally related to -phenylmethylamphetamine, a potent stimulant with a long half-life, pipradrol differs from amphetamine in that its action is more intense at higher centres, it lacks pressor activity, there is no post-excitement depression, and it does not depress the desire for food as occurs with amphetamine. The drug however is enhancing the existing pathologic behavior such as exacerbating pre-existing anxiety and is considered the drug of abuse. Meratran has certain indications and contraindications. Indications are schizophrenics without delusions having restriction of interest and activity and with depressant features, psycho-motor retardation and/or blocking of communication, long-term hospitalized schizophrenics with severe deterioration while contraindications are patients with delusions, anxiety, disturbed patients with cerebral arteriosclerosis. Pipradrol was made illegal in many countries in 1970s due to its abuse potential. It is classified under the Misuse of Drugs Act as a Class C substance. The combination of pipradrol with multivitamins and minerals marketed as Alertonic Elixir is used as adjunctive therapy in combating fatigue resulting from emotional or nutritional causes.   ^NCATS