Pemoline

Pemoline, formerly sold under the brand name Cylert among others, is a stimulant medication which was used in the treatment of attention deficit hyperactivity disorder (ADHD) and narcolepsy. It has since been discontinued in most countries due to rare but serious liver toxicity. The medication was taken by mouth.

Common side effects include insomnia, decreased appetite, abdominal pain, irritability, and headaches, while rare cases of serious liver damage requiring liver transplantation or causing death have been reported. As a stimulant, pemoline acts as a selective dopamine reuptake inhibitor and releasing agent via indirect agonism of dopamine receptors. In addition, it shows little activity with respect to norepinephrine, thus minimal to no cardiovascular or sympathomimetic effects in comparison to many other stimulants.

Pemoline was first synthesized in 1913, but its stimulant activity was not discovered until the 1930s, nor used for ADHD until 1975. Between 1997 and 2005, many countries, including the United States, withdrew the drug due to liver toxicity. However, it remains available in Japan for the treatment of narcolepsy at lower doses than those used for ADHD. Pemoline is a schedule IV controlled substance in the United States due to structural and functional similarity to other stimulants, and potential for misuse. However, it is noted to have less misuse potential than other stimulant drugs.