Drug-induced psychosis associated with crystalline methamphetamine.
ABSTRACT A case of drug-induced psychosis related to crystalline methamphetamine is described, highlighting the phenomenology and relevant treatment.
A 44-year-old woman with borderline personality traits and severe drug dependence developed a protracted drug-induced psychosis related to chronic high-dose crystalline methamphetamine use. Complete resolution of symptoms occurred with antipsychotic medication and abstinence from methamphetamine. Rapid recurrence of symptoms occurred at a time of high stress associated with minimal methamphetamine use and cessation of low-dose quetiapine. Symptoms rapidly resolved with abstinence, quetiapine and reduction of stressors.
A drug-induced psychosis resembling paranoid schizophrenia can occur with repeated or high-dose use of methamphetamine. While this generally resolves rapidly with cessation of stimulant use, some cases of protracted drug-induced psychosis in vulnerable individuals have been documented. Behavioural sensitization can also occur, and neuroleptics may prevent the recurrence of further psychosis triggered by ongoing low-dose methamphetamine use.
- SourceAvailable from: Mohamad Hussain Habil[Show abstract] [Hide abstract]
ABSTRACT: Amaç: Bu çalışmada metamfetamin bağımlılığı olan hastalardaki psikozun tedavisinde aripiprazol'ün tera-pötik etkisini ve tolerabilitesini değerlendirmek amaç-lanmıştır. Yöntem: Bu prospektif tek kollu açık çalışma Malaya Üniversitesi Tıp Merkezi'nde [University Malaya Medical Centre (UMMC)] yürütülmüştür. Çalışmaya DSM-IV'e göre metamfetamin bağımlılığı ile birlikte akut psiko-tik semptomları bulunan hiç tedavi almamış hastalar alındı. Çalışmaya alınan hastalara başlangıçta 5-10 mg, sonraki 2-14 günde esnek dozda (5-15 mg/gün) aripip-razol verildi. Bulgular: Çalışmaya katılan 49 hastadan 41' i (%83.7) çalışmayı tamamladı. Başlangıç PANSS toplam puanı ortalaması 79.2±13.7 ve CGI-S puanı ortalaması 4.3±0.5 idi. Çalışma sonunda PANNS-toplam ve CGI-S puanların-da istatistiksel olarak anlamlı ölçüde azalma gözlendi. Başlangıca göre 14'üncü günde PANSS puanında orta-lama 27.6±21.4 puan [p<0.05, 95% CI (-34.8, -20.4)] ve CGI-S puanında ortalama 2.0±1.2 puan [p<0.05, 95% CI (-2.4, -1.6)] saptandı. Çalışma süresince aripiprazol genel olarak iyi tolere edildi. On (%20.4) hastada yan etki rapor edildi. Hareket ile ilişkili yan etkiler bakımın-dan istatistiksel olarak anlamlı bir farklılık saptanmadı. Sonuç: Bu çalışmada metamfetamin kullanımıyla ilişkili psikotik semptomların aripiprazol tedavisiyle düzeldi-ği saptandı. Aripiprazol hafif-orta düzeydeki yan etki profili ile genel olarak iyi tolere edildi. Bu bulgular ışığında aripiprazol metamfetamin ile ilişkili psikozun tedavisinde etkili ve güvenli bir tedavi seçeneği olarak düşünülebilir. Anahtar sözcükler: Metamfetamin bağımlılığı, psikoz, aripiprazol, açık çalışma, güvenlik, etkililik Kli nik Psikofarmakoloji Bülteni 2012;22(2):121-9 ABS TRACT: An open-label study of aripiprazole for methamphetamine induced psychosis Objective: This study aimed to explore the therapeutic effects and tolerability of aripiprazole in the treatment of psychosis among methamphetamine dependent patients. Methods: This was an open label single arm prospective study conducted at the University Malaya Medical Centre (UMMC). The study subjects included treatment naive patients with a current diagnosis of methamphetamine dependence with co-occurring acute psychotic symptoms based on the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). Eligible patients were treated with an initial dose of 5-10 mg aripiprazole followed by flexible doses (5-15mg/day) from day 2 to 14. Results: Out of 49 patients enrolled, 41 patients (83.7%) completed the study. At baseline the mean PANSS total score was 79.2±13.7 and the mean CGI-S score was 4.3±0.5. There was a statistically significant decline in the mean PANSS-total and CGI-S scores over the course of the study. The mean reduction was 27.6±21.4 point (p<0.05, 95% CI (-34.8, -20.4)) from baseline on day 14 for total PANSS score and 2.0±1.2 point (p<0.05, 95% CI (-2.4, -1.6) for CGI-S. Aripiprazole was generally well tolerated during the study. Adverse events were reported in 10 (20.4%) patients. No statistically significant changes were noted with respect to movement-related adverse events. Conclusions: This study found that aripiprazole improved the psychotic symptoms associated with methamphetamine use. It was generally well tolerated with mild to moderate adverse events. Based on these results aripiprazole might be an effective and safe option for the treatment of methamphetamine induced psychosis.Bulletin of Clinical Psychopharmacology 06/2012; 22(2). · 0.37 Impact Factor
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ABSTRACT: Background. Methamphetamine-induced psychosis (MIP) in Iran has turned into a serious issue in terms of health and treatment, lacking any obvious treatment methods for its resistant cases. Aims of Case Report. In the present study, a number of two cases of treatment of MIP with clozapine, which were resistant to the treatment with other antipsychotics, have been reported. Both cases completely responded to the treatment in only 2 weeks and no signs of psychosis relapse were seen in an 8-9 follow-up. Conclusion. Because of its particular pharmacologic features, clozapine may be effective in treating MIP.Case Reports in Psychiatry. 01/2015; 2014.
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ABSTRACT: It was previously suggested that the malic enzyme 2 (ME2) as the candidate gene for psychosis in fine mapping of chromosome 18q21. Chromosome 18q21 is also one of the possible regions that can contribute to addiction.Clinical Psychopharmacology and Neuroscience 04/2014; 12(1):54-64.