Can ephedrine cause euphoria?

Ephedrine Can Cause Euphoria and Has Potential for Abuse

Yes, ephedrine can cause euphoria, particularly at high doses, due to its amphetamine-like properties and effects on the central nervous system. 1

Mechanism of Action and Effects

• Ephedrine acts as both a direct and indirect adrenergic agonist, with its most potent action being as a substrate of the norepinephrine transporter (EC50 values around 50 nM), followed by activity at the dopamine transporter 2
• At high doses, ephedrine exhibits amphetamine-like properties that can cause mood enhancement and euphoric effects 1
• The drug increases the release of epinephrine and norepinephrine, increasing activity at postsynaptic α and β receptors, which contributes to its stimulant effects 3

Evidence of Euphoric Effects and Abuse Potential

• Ephedrine-containing products have been marketed to adolescents and young adults with explicit pledges of "mood enhancing and aphrodisiac properties" 1
• Products containing ephedrine have been sold under names like "Herbal Ecstasy," "Cloud 9," and "Ultimate Xphoria," specifically targeting those seeking euphoric effects 1
• In a study of 27 adults with no history of drug dependence, ephedrine increased ratings of "high" and scores on the "euphoria" scale of the Addiction Research Center Inventory 4
• Among female weightlifters who used ephedrine, 19% displayed frank ephedrine dependence, indicating its potential for abuse 5

Health Risks and Concerns

• High-dose ephedrine use can lead to serious adverse effects including:
  • Nervousness and anxiety 1
  • Tachycardia and hypertension 1
  • Seizures 1
  • Psychosis 6
• A case report documented a woman who increased her ephedrine dose from therapeutic levels to 500-1000 mg daily and developed paranoid psychosis with delusions of persecution and auditory hallucinations 6
• The FDA has issued warnings about ephedrine-containing products due to serious cardiovascular side effects 1

Regulatory Status and Concerns

• Multiple states and localities have banned the sale of botanical ephedra due to safety concerns 1
• The FDA banned supplements with ephedra after the herb was linked to serious cardiovascular side effects 1
• Fifteen deaths among young people in the US have been attributed to the herbal stimulant ephedra (containing ephedrine) 1

Risk Factors for Euphoric Response

• Males appear to be more susceptible to the reinforcing effects of ephedrine than females 4
• Current marijuana use, lower baseline anxiety, and certain personality traits (lower harm avoidance) were associated with greater likelihood of choosing ephedrine in experimental settings 4
• Individuals with eating disorders and body image concerns may be at higher risk for ephedrine abuse 5

Clinical Implications

• Healthcare providers should be aware of ephedrine's potential to cause euphoria and be misused, especially in high-risk populations 1
• Patients with a history of substance use disorders may be at increased risk for misusing ephedrine-containing products 4, 5
• Monitoring for signs of dependence is important when prescribing medications containing ephedrine 6