Dextromethamphetamine is one of the most selective releasers of dopamine over norepinephrine, but it is still fairly balanced as an NDRA.[9] Another of the most specific dopamine releasers is recreational stimulant 4-methylaminorex, but it also has considerable activity as a norepinephrine releaser and hence is likewise not a selective DRA.[citation needed]Pemoline, which is structurally related to the aminorex drugs, is a stimulant used to treat ADHD which acts as a selective DRI and DRA, but only weakly stimulates dopamine release.[10][11][12] There is some albeit mixed in-vitro evidence that the antidepressant and modestly selective DRI amineptine may in addition to inhibiting the reuptake of dopamine selectively induce the presynaptic release of dopamine without affecting that of norepinephrine or serotonin.[13][14][15]
The lack of selective DRAs as of present is related to the fact that it has proven extremely difficult to separate dopamine transporter (DAT) affinity from norepinephrine transporter (NET) affinity and retain releasing capability at the same time.[16]
Although no definite selective DRAs have been described, one possible exception is 2-fluoromethcathinone (2-FMC).[5] It has an EC50Tooltip half-maximal effective concentration for dopamine release of 48.7nM and induces 85% release of norepinephrine at a concentration of 10μM.[5] For comparison, the EC50 values of methcathinone are 49.9nM for dopamine release and 22.4nM for norepinephrine release and it induces 100% release of norepinephrine at a concentration of 10μM.[5][1] Hence, compared to methcathinone, 2-FMC appears to be relatively more selective or efficacious for induction of dopamine release over norepinephrine release.[5][1] In any case, the EC50 of 2-FMC for induction of norepinephrine release does not seem to be available.[5]
^Negus SS, Mello NK, Blough BE, Baumann MH, Rothman RB (February 2007). "Monoamine releasers with varying selectivity for dopamine/norepinephrine versus serotonin release as candidate "agonist" medications for cocaine dependence: studies in assays of cocaine discrimination and cocaine self-administration in rhesus monkeys". J Pharmacol Exp Ther. 320 (2): 627–36. doi:10.1124/jpet.106.107383. PMID17071819. As is commonly true for existing monoamine releasers, the potency of these compounds to release norepinephrine was similar to or higher than potency to release dopamine, and compounds with exclusive selectivity for dopamine or norepinephrine release are not yet available (Rothman et al., 2001). [...] Second, the present study documented optimal effects with releasers selective for dopamine/norepinephrine versus serotonin release; however, the degree to which the dopaminergic and/or noradrenergic effects of these drugs contributes to their profiles of behavioral effects remains to be determined. Releasers with selectivity for dopamine versus both norepinephrine and serotonin would help address this issue.
^ abHeal DJ, Smith SL, Findling RL (2012). "ADHD: current and future therapeutics". Curr Top Behav Neurosci. 9: 361–90. doi:10.1007/7854_2011_125. PMID21487953. When predicting the likely efficacy and safety of new therapeutic approaches in ADHD, the knowledge gained from existing drugs can be helpful. The pharmacological characteristics of the most effective drugs for treating ADHD, the stimulants, are summarised below and in Table 3: 1. These drugs produce large and rapid increases in the synaptic concentration of catecholamines in the PFC. 2. There is no obvious ceiling on the magnitude of their effect on catecholamine efflux. 3. The most efficacious ADHD drugs also enhance dopaminergic neurotransmission in sub-cortical brain regions. However, some caveats have to be taken into consideration. For example, lack of information in the public domain indicates that drugs that are selective dopamine releasing agents, or noradrenaline reuptake inhibitors with the pharmacological characteristics of methylphenidate, have not been evaluated as potential ADHD therapies. Hence, it is impossible to know whether sub-cortical dopamine efflux is a critical component of maximal efficacy in an ADHD medication, or alternatively, whether a drug with a selective noradrenergic mechanism that is as powerful as methylphenidate or amphetamine could rival the efficacy of the stimulants.
^Bonnet JJ, Benmansour S, Costentin J, Parker EM, Cubeddu LX (June 1990). "Thermodynamic analyses of the binding of substrates and uptake inhibitors on the neuronal carrier of dopamine labeled with [3H]GBR 12783 or [3H]mazindol". The Journal of Pharmacology and Experimental Therapeutics. 253 (3): 1206–14. PMID2141637.
^Bonnet JJ, Chagraoui A, Protais P, Costentin J (1987). "Interactions of amineptine with the neuronal dopamine uptake system: Neurochemicalin vitro and in vivo studies". Journal of Neural Transmission. 69 (3–4): 211–220. doi:10.1007/BF01244342. ISSN0300-9564. PMID3625193. S2CID9886698.