Amphetamine Dependent Patients Research Articles

Co-abuse of amphetamine and alcohol harms kidney and liver.

The prevalence of alcohol use disorder was found 75% higher among amphetamine dependent patients. Alcohol and amphetamine alone have nephrotoxicity and hepatoxicity. But, the degree of risk with coabuse of alcohol and amphetamine is unknown. The objective of this study was to assess toxic effects of amphetamine-alcohol co-abuse on the liver and kidney. he present study was a cross-sectional study conducted et al. Amal Hospital for Mental Health, Qassim region, KSA and include one hundred participants. Seventy-five participants were patients hospitalized for the treatment of abuse, and twenty-five participants, were healthy voluntaries, have no history of abuse. An experienced psychiatrist conducted patient interviews and assessed the patients using the DSM-5 criteria. The data from healthy participants were considered as a control. The abuse group was paired with the control group by age and lifestyle. Participants were split into: Group I: Control group (n = 25); Group II: Amphetamine (AMP) abuser group (n = 25); Group III: Alcohol abuser group (n = 25) and Group IV: Combined drug abuser group (AMP and alcohol) (n = 25). The socio-demographic data was collected. Complete medical examination, Body Mass Index and samples of blood and urine were collected from all participants for analytical tests; determination of alcohol and AMP levels, kidney functions and liver functions. The mean BMI values in groups II, III, and IV showed no significant change from the control group. The serum level of albumin and alkaline phosphatase showed significant decrease in all abuser groups. While, alanine transaminase (ALT), Aspartate transaminase (AST) and osteopontin levels showed significant increase in all abuser groups. Fasting blood sugar values showed significant increase in alcohol abusers. On the other hand, it revealed no significant change in AMP and combined groups. The mean values of urea showed no significant change in AMP and alcohol abusers and significant increase in combined drug abuser group. The serum creatinine and all abuser groups showed significant increase in Cystatin C. The alteration in the most of studied biochemical parameters were more than two folds in combined group compared with that of AMP or alcohol groups. Study reveals synergistic liver and kidney toxicity. Amphetamine-alcohol co-abuse significantly heightens kidney and liver toxicity.

The occurrence and severity of obsessive-compulsive disorder in the opium and amphetamine users

ABSTRACT Objective Simultaneous occurrence of psychological disorders such as obsessive-compulsive disorder (OCD) has been reported in patients with a history of substance abuse. We evaluated the occurrence and severity of OCD in opium and amphetamine users. Methods In this cross-sectional study, patients with a history of opium use (n = 100) or with a history of amphetamine use (n = 100) were studied. The diagnosis of OCD was based on the Yale-Brown Obsessive Compulsive questionnaire. Results Regarding the prevalence of OCD in the two groups of opium and amphetamine users, 36% and 22% suffered from very mild OCD, 48% and 36% from mild OCD, 13% and 27% from moderate OCD and 3% and 15% from severe OCD. The severity of OCD was independent of gender and marital status in both groups. In amphetamine users’ group, OCD severity was linked to patients’ age and time for drug usage. Conclusion The severity of OCD is much more severe in amphetamine-dependent patients than in opium-dependent patients. In opioid-dependent patients, the severity of OCD is independent of gender, age, marital status, or duration of drug use, but in amphetamine-dependent patients, the severity of disorder is directly related to age and duration of amphetamine use.

Circadian melatonin profile in opium and amphetamine dependent patients: A preliminary study

AimThe aim of this study was to investigate the relationship between opium and amphetamine dependency with the serum melatonin levels in the presence of circadian rhythm sleep disorders (CRSD). ParticipantsForty four male amphetamine-dependent and opium-dependent patients with CRSD and with more than one year substance dependency were enrolled in this study. Control group consisted of twelve healthy male subjects. DesignThe diagnoses of sleep disorders were established by a psychiatrist and were made on the basis of the criteria of ICSD-II using the patients’ sleep logs. Blood samples were drawn every 4 h through an intravenous catheter. Serum melatonin levels were assayed using an enzyme-linked immunosorbent assay (ELISA) kit. Repeated Measures Analysis of variance (ANOVA) was used to assess differences between the melatonin levels at six separate times. FindingThe serum melatonin levels of the control subjects were significantly higher than both opium-dependent and amphetamine-dependent patients at 24:00, 4:00 and 8:00. The serum melatonin level of the opium-dependent patients were significantly lower than the amphetamine-dependent patients at 24:00 (26.9 ± 11.4 vs. 41 ± 19.4, respectively; p = 0.006) and were significantly higher than the amphetamine-dependent patients at 16:00 (12.7 ± 5.1 vs. 8.9 ± 4.1, respectively; p = 0.011). ConclusionThis is an evidence of negative effects of substance dependence on circadian cycle of melatonin secretion among opium and amphetamine dependent patients.

Does abstinence resolve poor sleep quality in former methamphetamine dependents?

Background and objectiveAmong substances that have a significant effect on sleep are stimulants, including amphetamines. As there are few studies assessing sleep quality in methamphetamine withdrawal this study aims to evaluate changes in sleep quality of methamphetamine dependent patients during early remission period by controlling depression and anxiety as confounding variables. MethodsThis study was conducted in Mashhad, Iran. Ninety amphetamine dependent patients, who were admitted in residential centers during 2012–2014 and met our inclusion criteria, were chosen by purposive nonprobability sampling method. Sleep quality was assessed by Pittsburg sleep questionnaire, in the first, second, and after the fourth week of abstinence. Additionally all participants were assessed by Beck Depression Inventory-2 and Beck Anxiety Inventory for controlling depressive and anxiety symptoms. ResultsThe prevalence of improper quality of sleep was very high (97.8%) within the first week of withdrawal, but it reduced considerably four weeks after abstinence (52.2%), which was statistically significant (P=0.00). The variations of depression and anxiety levels within four weeks after quitting methamphetamine, have low impact on variation of patients' sleep quality (adjusted R2<0.5). Furthermore, the effectiveness of these two intervening variables on patients' quality of sleep was dwindled over time after abstinence. ConclusionsThis study showed that the patients' quality of sleep improved significantly four weeks after abstinence and its variation was independent from variations in anxiety and depressive symptoms.

Role of Cognitive Rehabilitation in Patients Suffering From Schizophrenia with a Comorbid Addiction to Amphetamine and Cannabis

Introduction An important element of the rehabilitation in schizophrenia is cognitive rehabilitation, aimed at the greatest possible reduction in deficits. Objective The aim of this study was to examine cognitive functioning in schizophrenic patients with a comorbid addiction to psychoactive substances participating in a cognitive rehabilitation program. Methods All recruited patients were men, aged between 20 and 45 years. They were examined in the initial period of the stay at the treatment center and after 4-7 weeks of hospitalization, after the stabilization of acute psychotic symptoms. During this time patients participated in the cognitive rehabilitation program. Cognitive function were assessed: Trail Making Test (TMT A & B), Stroop Test, and Verbal Fluency Test. Patients were divided into two groups according to abused substances: a) amphetamine users (n = 15), b) cannabis users (n = 11). As for the medication – 25 of 26 patients were treated with second generation antipsychotics. Results After the process of rehabilitation of cognitive functions of all gained patients gained a significant improvement. The type of abused psychoactive substance did not significantly affect cognitive functioning. However, amphetamine-dependent patients achieved better results in some of the cognitive tests. Cognitive rehabilitation does not affect the reduction of psychopathological symptoms. However, in patients addicted to amphetamines a decrease in the severity of these symptoms was found. Conclusions Cognitive rehabilitation exerts a positive effect on cognitive functioning of schizophrenic patients with concomitant dependence on psychoactive substances.

Amphetamine Dependence and Co-Morbid Alcohol Abuse: Associations to Brain Cortical Thickness

BackgroundLong-term amphetamine and methamphetamine dependence has been linked to cerebral blood perfusion, metabolic, and white matter abnormalities. Several studies have linked methamphetamine abuse to cortical grey matter reduction, though with divergent findings. Few publications investigate unmethylated amphetamine's potential effects on cortical grey matter. This work investigated if amphetamine dependent patients showed reduced cortical grey matter thickness. Subjects were 40 amphetamine dependent subjects and 40 healthy controls. While all subjects were recruited to be free of alcohol dependence, structured clinical interviews revealed significant patterns of alcohol use in the patients. Structural magnetic resonance brain images were obtained from the subjects using a 1.5 Tesla GE Signa machine. Brain cortical thickness was measured with submillimeter precision at multiple finely spaced cortical locations using semi-automated post-processing (FreeSurfer). Contrast analysis of a general linear model was used to test for differences between the two groups at each cortical location. In addition to contrasting patients with controls, a number of analyses sought to identify possible confounding effects from alcohol.ResultsNo significant cortical thickness differences were observed between the full patient group and controls, nor between non-drinking patients and controls. Patients with a history of co-morbid heavy alcohol use (n = 29) showed reductions in the superior-frontal right hemisphere and pre-central left hemisphere when compared to healthy controls (n = 40).ConclusionsAmphetamine usage was associated with reduced cortical thickness only in patients co-morbid for heavy alcohol use. Since cortical thickness is but one measure of brain structure and does not capture brain function, further studies of brain structure and function in amphetamine dependence are warranted.

Sustained release methylphenidate for the treatment of ADHD in amphetamine abusers: A pilot study

The efficacy of stimulant treatment in patients with substance use disorders and comorbid attention deficit hyperactivity disorder (ADHD) has been tested for cocaine and alcohol dependence but so far no studies have been conducted in amphetamine dependent individuals. The present trial was a pilot study aiming to test the feasibility of treating amphetamine dependent patients with comorbid ADHD with central stimulant medication. The study was a double-blind, placebo controlled trial with parallel groups design comparing the efficacy of a fixed dose (72 mg) of OROS methylphenidate (MPH) with placebo (PL) in reducing ADHD symptoms in currently abstinent adults with amphetamine dependence and ADHD. Twenty-four treatment seeking patients who met the DSM IV criteria for amphetamine dependence and ADHD were randomized to MPH/PL. The trial was conducted at an outpatient facility with twice weekly visits, measuring ADHD symptoms and drug use. Patients rated their ADHD symptoms on a weekly basis and provided supervised urine specimens for drug toxicology twice weekly. All patients participated in weekly sessions of a skills training programme. Both the groups significantly reduced their self-rated ADHD symptoms during the 12-week treatment but there was no difference between the two treatment arms. Drug use, both measured by urine toxicology and self-report did not differ between the groups. No difference was found between the two groups with regards to craving for amphetamine or in retention in treatment. Larger studies with higher doses combined with individual dosage and longer follow-up periods are warranted.

`ADHD patient' or `illicit drug user'? Managing medico-moral membership categories in drug dependence services

Amphetamine-dependent patients seeking treatment are diagnosed with ADHD at a significantly higher rate than members of the general population. To study this relationship as it is constructed in everyday life, we draw on membership categorization analysis to examine how individuals account for their candidate memberships in two social categories — `illicit amphetamine user' and `ADHD patient'. We analyse interviews with four drug-dependent individuals, diagnosed with adult ADHD, undergoing detoxification treatment in Perth, Western Australia. Participants formulated their problematic behaviour via membership in the morally neutral category `ADHD patient' and methodically constructed symptoms as predicates of this category, despite the availability of the equally valid alternative category `illicit amphetamine user'. The category `ADHD patient' is shown to be functional: it absolves drug users from responsibility for troublesome conduct, and provides continued access to amphetamines as `medication'. In such cases, the diagnosis of ADHD arguably affords the conditions of possibility for an iatrogenic disorder in that the prescription of ATS medication provides for a morally and legally sanctioned form of drug dependence.

Naltrexone Attenuates the Subjective Effects of Amphetamine in Patients with Amphetamine Dependence

Amphetamine abuse and dependence is a global health concern with a collateral increase in medical and social problems. Although some of the neurobiological mechanisms underlying amphetamine dependence and its devastating effects in humans are known, the development of rational and evidence-based treatment is lagging. There is evidence from preclinical studies suggesting that the endogenous opioid system plays a role in mediating some of the behavioral and neurochemical effects of amphetamine in a variety of controlled settings. In the present study we assessed the effects of naltrexone, an opioid antagonist (50 mg) on the subjective physiological and biochemical response to dexamphetamine (30 mg) in 20 amphetamine-dependent patients. Patients received naltrexone/amphetamine followed by placebo/amphetamine, 1 week apart in a randomized double-blind placebo-controlled design. The primary objective of the study was to evaluate the effect of pretreatment with naltrexone on the subjective response to amphetamine, using a Visual Analog Scale. The secondary objective was to investigate the effects of naltrexone on physiological and biochemical responses to amphetamine, as measured by changes in blood pressure, heart rate, skin conductance, and cortisol. Naltrexone significantly attenuated the subjective effects produced by dexamphetamine in dependent patients (p<0.001). Pretreatment with naltrexone also significantly blocked the craving for dexamphetamine (p<0.001). There was no difference between the groups on the physiological measures. The results suggest that the subjective effects of amphetamine could be modulated via the endogenous opioid system. The potential of naltrexone as an adjunct pharmaceutical for amphetamine dependence is promising.

10th International Conference on Philosophy, Psychiatry and Psychology, Sun City

&lt;p&gt;In the last few years much data in the gulf region indicate that amphetamine psychosis has become more common and more prolonged.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim.&lt;/strong&gt; This study was done to: 1) assess clinical features related to amphetamine withdrawal, 2) assess if there are changes in these features in comparison to other previous studies or not, 3) study the relation between amphetamine and chronicity of psychotic symptoms, 4) find a reason for such suspected changes if present.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods.&lt;/strong&gt; A total of 150 male amphetamine dependent inpatients were selected according to ICD-10 research diagnostic criteria. Patients were subjected to the following procedures: 1) Oral informed consent. 2) Full psychiatric interview. 3) Urine test for common addictive substances on admission 4) Symptoms checklist which have been designed by the authors to assess Clinical features associated with amphetamine 5) Symptom Checklist–90–Revised (Derogates 1994).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results.&lt;/strong&gt; Generally the present study shows that the psychotic symptoms were very common with Amphetamine dependent patients and the severity of all symptoms decreased significantly during the different phases of treatment. Delusions and hallucinations were very common during 2nd week (54% and 51% respectively) and persisted for more than 8 weeks in 24% and 10% of patients respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion.&lt;/strong&gt; Some of the results are similar to previous studies as Dalmau et al. 1999 and Koyama et al. 1991 but still the duration of psychosis is much longer.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion.&lt;/strong&gt; There is increased risk of psychosis with use of amphetamine and a lot of reasons may play role as starting abuse at early age, sensitization process that may lead to chronic psychosis, and adulterating substances like ephedrine that may be dangerous and can lead to permanent damage of brain serotonin nerve endings.&lt;/p&gt;

Hyperbolic discounting may be reduced to electrical coupling in dopaminergic neural circuits

Loss of self-control in drug addicts (e.g. cocaine and amphetamine dependent patients) has been associated with hyperbolic discounting of delayed rewards (i.e., inconsistency in intertemporal choice). Neurobiophysical mechanisms underlying hyperbolic discounting are still unknown in spite of recent extensive work in neuroeconomics. Understanding of neuronal mechanisms of hyperbolic discounting is important for establishing neuropharmacological treatment of addiction. At the cognitive level, previous studies have indicated that psychophysics of time-estimation (i.e., Weber-Fechner law and Steven's power law of time-perception) may explain inconsistency in intertemporal choice. Regarding neuronal substrates of time-estimation, drugs of abuse dramatically change time-estimation, indicating that dopaminergic activities may mediate time-estimation. With respect to neuronal changes induced by drugs of abuse, recent studies have revealed that gap junction proteins (e.g., connexin 36) in dopamine neurons are increased by an self-administration of dopaminergic drugs such as cocaine and amphetamine. However, it has been yet to be examined how the enhanced electrical coupling due to substance administration induces addiction. Furthermore, a recent biophysical modelling study has demonstrated that the effect of the psychophysical laws are potentiated by non-synaptic electrical coupling between neurons via gap junctions. Based on these current findings, we hypothesized that hyperbolic discounting may be reduced to biophysical characteristics of dopamine neural circuits, that is, electrical coupling between time-encoding dopaminergic neurons via gap junctions. The present hypothesis states that drugs of abuse may induce addiction by exacerbating subject's impulsivity (a discount rate) and inconsistency (hyperbolicity) in intertemporal choice partly due to enhanced expression of gap junction proteins in dopaminergic neurons. Possible psychopharmacological treatments of impulsivity in drug addicts implied by our present hypothesis, e.g., administration of a gap junction blocker, are discussed.

An open clinical trial of naltrexone for amphetamine dependence: Compliance and tolerability

The aim of the study was to assess the feasibility of naltrexone as a potential pharmacotherapy for amphetamine dependence. The study design was an open-label clinical trial with 20 amphetamine-dependent patients receiving 12 weeks of treatment comprised of naltrexone (50 mg) along with relapse prevention therapy. Patients were assessed weekly for adverse events and compliance to medication. Tolerability to naltrexone was measured by patient's self-report and observed adverse effects along with plasma markers of hepatotoxicity. Compliance to treatment was measured by number of treatment days attended and by the presence of naltrexone's metabolite, 6-β-naltrexol in urine. Majority of the patients tolerated the medication well, also during relapse. Mild headache, nausea and abdominal pain were reported (n=3) but subsided within 2 weeks. Plasma levels of hepatic markers did not reveal any significant increase from baseline. Eleven out of 20 patients complied with the treatment and there was a significantly higher proportion of positive tests of 6-β-naltrexol in urine among patients completing 12 weeks of treatment compared to those who did not (77% vs. 22%). The frequency and amount of amphetamine consumed was significantly lower during treatment compared with pre-treatment consumption (P<0.01). In conclusion, naltrexone was well tolerated with moderate rates of compliance, supporting the feasibility of investigating this compound in a larger placebo-controlled trial as a potential pharmacotherapy for amphetamine dependence.

Self detoxication by amphetamine dependent patients: a pilot study

Fifty current or past amphetamine dependent clients attending a Community Drug and Alcohol Team service took part in structured interviews about their previous attempts to stop using amphetamine. Thirty three had made a total of 47 attempts at self detoxication; 15 had undergone enforced withdrawal and ten had previously sought medical treatment. A total of 86% of subjects described significant withdrawal symptoms on stopping use of amphetamines. Increased use of other drugs was commonly reported as a means of coping with withdrawal, psycho-social techniques being used less systematically. The implications for the provision of attractive, effective treatments are discussed.

Pharmacological blockade of amphetamine effects in amphetamine dependent subjects

Pharmacological blockade of the euphoric effect of amphetamine was studied in amphetamine dependent patients. An eleven grade self-rating scale was used for registration of the subjective feeling of euphoria after intravenous administration of 200 mg d,l-amphetamine. Three neuroleptic drugs, chlorpromazine, thioridazine, pimozide, the α-receptor-blocking agent phenoxybenzamine and the β-receptor-blocking agent propranolol were tested for possible anti-amphetamine effect. — The euphoric effect of amphetamine was significantly reduced after a single dose of 50 mg of chlorpromazine and after 7 and 13 days of chlorpromazine treatment, 50 mg every 8 h. Single doses of chlorpromazine 25 mg or thioridazine 25 and 50 mg, respectively, had no effect. Pimozide significantly reduced euphoria after single doses of 5, 10 and 20 mg, but there was no dose-response relationship. The amphetamine-induced euphoria was also reduced by 7 and 13 days of treatment with pimozide 5 mg daily. Pretreatment for 6 days with phenoxybenzamine had no effect on the response to amphetamine and, propranolol, too both in single doses and after 5 days administration also had no amphetamine blocking effect. — Blood pressure, pulse rate, respiratory rate and body temperature were measured after administration of amphetamine before and after pretreatment with these blocking agents.