Ever since discovering the over-the-counter stimulant ephedrine nearly six years ago, I have used it -- the cheesily packaged convenience store/truck stop variety -- on an almost daily basis. My dosage has slowly decreased over the years, and I now find that 12.5 or 25 mg of ephedrine is plenty. Still, I depend on it for school and work, the way that some depend on their morning cup of coffee. I've heard sensational stories about ephedrine's effects: that it increases the risk of stroke, heart attacks and kidney damage and even accelerates the aging process! So, I'm wondering what has been substantiated? Should I be concerned about my routine use?
You're asking a great question, because the world is being flooded with all sorts of dietary aids and supplements, including ephedrine. And unfortunately, there's a dearth of reliable information about these products.
What we know about ephedrine is this: It is a powerful stimulant of the sympathetic nervous system -- it gets you ready for "fight or flight." Like all stimulants, it increases your heart rate and blood pressure to better supply the body with nutrients and oxygen. It also raises the amount of glucose in the blood, and dilates the bronchioles of the lungs to allow you to breathe better -- just what you need to go into battle or run like hell. (It has been used to treat asthma in Asia for thousands of years.)
This drug is very much like cocaine, amphetamines and other stimulants. But it does not affect the brain as much, nor does it release the "addicting" chemical dopamine in the brain's reward circuitry. So the buzz you get from ephedrine is mostly the jittery feeling of having your heart rate and blood pressure rise. This "buzz" is why athletes take it when they work out. It also fools some people into thinking they are working harder than they really are; but they aren't gaining that much from it.
The real benefit of ephedrine may be in a completely different area: attention and focus. Some research studies show that ephedrine allows sustained attention and focus during boring experiences and may even improve learning. It probably also helps one to stay awake. Our bet is that you're experiencing these benefits, and that's why you like the drug. Also, from what you say, you're using the drug as it should be used, at a low dose. (Recently the Food and Drug Administration suggested that ephedrine tablets should not contain more than 8 milligrams of ephedrine and that no more than 24 milligrams should be consumed per day. It also recommended using it for no more than one week at a time.)
At high doses, people can experience anxiety, nervousness, heart palpitations, insomnia and tremors. These are signs of overstimulation of the sympathetic nervous system, and continued use at these levels can result in heart damage or stroke. We know it's hard to believe, but even young, healthy athletes are having strokes and heart attacks from too much of this drug. The FDA is in the process of gathering the data to determine if it can regulate its marketing. (While the agency requires all pharmaceutical drugs to be deemed as "safe" and "effective" before they go on the market, that is not true for dietary supplements and herbal products, which means that many such products are being sold without any type of oversight. The FDA can intervene in the sale of a dietary supplement, however, if it can definitively show from scientific studies or other evidence that the product is causing serious harm.)
In your case, we don't think you have much to worry about unless you have heart disease or hypertension, in which case you should never use stimulants of any kind without consulting your physician first. Also, you are taking ephedrine but not caffeine; this also protects you from the most adverse effects of high doses. The ephedrine-caffeine combination is most effective for weight loss, but also the most likely to cause problems.
Buzzed appears every week in Salon Health. Do you have a question? E-mail us at firstname.lastname@example.org.