Amphetamine Psychosis Research Articles

Characteristics of Amphetamine Psychosis with Respect to the Length of Drug Exposure.

Over the past decade, the number of individuals requiring medical care for amphetamine-related psychosis has increased. This study aims to examine the psychological characteristics of amphetamine psychosis in drug-addicted patients depending on the length of drug exposure and compared to patients diagnosed with paranoid schizophrenia. The study was carried out in psychiatric clinic No. 1 in Kyiv (Ukraine) in 2019, involving 107 patients. Of all the participants, 50 were included in Group 1 (methamphetamine psychosis) and 57 - in Group 2 (paranoid schizophrenia). All patients were treated with medication to relieve exacerbating symptoms. They underwent extensive testing to determine the impairment severity of cognitive function, attention, and task performance during remission. In Group 1, the timing of onset for paranoid symptoms depends on the length of amphetamine exposure (Spearman correlation coefficient = 0.89). The efficacy and dynamics of drug treatment in Group 2 were similar to patients in Group 1. However, the effect of reduction in Group 2 was achieved only in 4 months. Delusions, emotional disturbances, hallucinations in patients of Group 1 occurred 2.3 times more frequently than in Group 2 (p ≤ 0.05). The patients of Group 1 are characterized by the presence of disorders related to the affective and behavioral components. All reported exacerbations are related to amphetamine use. Patients in Group 1 learned a smaller number of words compared to those in Group 2. Besides, a large number of errors and difficulties with shifting focus were recorded.

Revisiting Tulsa: Understanding Amphetamine Addiction in the Early Photography of Larry Clark

Revisiting <i>Tulsa</i>: Understanding Amphetamine Addiction in the Early Photography of Larry Clark

Chronic antipsychotic treatment targets GIRK current suppression, loss of long-term synaptic depression and behavioural sensitization in a mouse model of amphetamine psychosis.

Antipsychotic drugs (APDs) are the mainstay of the pharmacological treatment of psychotic disorders like schizophrenia. While the clinical efficacy of APDs has long since been established, the neurobiological mechanisms underlying their therapeutic benefits are still not well understood. Here, we used an escalating amphetamine regimen to induce a psychosis-like state in mice. To achieve clinically relevant drug concentrations in amphetamine-pretreated mice, the typical APD haloperidol or the atypical APD olanzapine were chronically administered via subcutaneously implanted osmotic mini-pumps. Demonstrating their therapeutic efficacy, both drugs dampened amphetamine-induced hyperlocomotion and restored normal behaviour in the light-induced activity test. Whole-cell recordings from dopaminergic neurons of the ventral tegmental area (VTA) in ex vivo brain slices revealed two pronounced aberrations associated with the psychosis-like state: Strongly enhanced spontaneous firing and a substantial loss of G protein-gated inwardly rectifying potassium (GIRK) current upon activation of GABAB receptors with baclofen. Chronic haloperidol and olanzapine restored normal firing and partially rescued the GIRK current response to baclofen. In ex vivo slices containing the nucleus accumbens, which receives a dopaminergic projection from the VTA, abrogation of long-term synaptic depression (LTD) and enhanced excitatory drive onto medium spiny neurons were identified as synaptic consequences of amphetamine-induced psychosis. Again, both alterations proved amenable to chronic APD treatment. Our data provide evidence for aberrant neuronal function and plasticity in the mesolimbic dopamine system during an induced psychotic state and identify these alterations as targets of chronic APD treatment.

Amphetamine Psychoses and Legal Responsibility

Advances in understanding aspects of the relationship between illicit substance use/abuse and psychiatric syndromes highlight the need for Nations to develop relevant explicit policies or legislation to ensure that Courts deliver judgments on criminal responsibility which match with their national wishes or policies.

Escalating patterns of emergency health care prior to first admission with amphetamine psychosis: A window of opportunity?

AimTo describe health service contact in the two years prior to a first hospital admission with amphetamine-related psychosis, and to identify possible opportunities for early intervention. MethodRoutine health data collections were used to identify 6130 persons aged 16–65 who had a first hospital admission with amphetamine-related psychosis in New South Wales (NSW), Australia, between 2005 and 2016. Health service contacts in the two years prior to first admission were identified, using public hospital, emergency department and community mental health data. Prior care was compared to 41,444 people with first psychosis admissions without amphetamine diagnoses. ResultsTwo thirds of people with amphetamine-related psychosis had health service contact in the two years prior to their first psychosis admission. Of these, 45% had ED contacts and 30% had prior general hospital admissions. The likelihood of contact escalated throughout the two years prior to admission. Prior substance-related conditions, infectious diseases, injuries and accidents were common. Compared to other first psychosis admissions, people with amphetamine-related psychoses were less likely to have prior specialised mental health care (OR 0.84, 95% CI 0.78, 0.89) and more likely to have prior general health care (OR 1.40, 95% CI 1.29, 1.51). ConclusionEmergency departments and units treating people with infectious diseases or injuries should consider strategies to detect amphetamine and other substance use. Early detection and referral to specialist mental health or drug and alcohol care may prevent some amphetamine-related psychoses.

Amphetamines: Potent Recreational Drug of Abuse

Amphetamines are central nervous system (CNS) stimulants and belong to psychoactive drugs that affect chemicals in the brain, nerves and exert a constant contribution to hyperactivity and impulse control. The communal group of amphetamines comprises amphetamine, dextroamphetamine and methamphetamine. Amphetamines show its action on the mesolimbic dopaminergic reward system by inducing release of dopamine and to some extent norepinephrine, in the synaptic clefts of the nucleus accumbens and other terminal areas. They offer not only a sense of euphoric state, but also addiction. Amphetamines are frequently prescribed for the treatment of attention deficit hyperactivity disorder (ADHD) in children, adolescents and adults, narcolepsy and obesity. At therapeutic doses, amphetamine causes emotional and cognitive effects such as euphoria, change in desire for sex, increased wakefulness, improved cognitive control, etc. The balance of benefit/risk is the main challenge for its clinical use. When overused these medications can be highly addictive, are often diverted from the user to be used as recreational drugs. Adverse effects include anxiety, aggression, headache, insomnia, hyperactivity, palpitations, increased breathing rate, increased blood pressure, tachycardia, arrhythmia, dilated pupils, paranoia, etc. However, at large doses, these drugs may impair cognitive function and induce rapid muscle breakdown. Even higher doses may give rise to hallucinations, paranoia, psychosis and potentially lifethreatening conditions such as convulsions, stroke, kidney failure, etc. The furthermost serious health implications of amphetamine resulting from chronic use are dependence, considered by compulsive drug-seeking and drug use and a phenomenon notorious as amphetamine psychosis. Therefore the objective of this study was to explore the functions of the amphetamines as recreation drug of abuse.

Psychosis induced by amphetamines.

The study reviews publications on the use of methamphetamine and amphetamine in relation to psychotic symptoms, substance-induced psychosis, and primary psychosis published between July 2014 and December 2015. The databases MEDLINE, Embase, and PsycINFO were searched using the terms 'amphetamine psychosis' and 'methamphetamine psychosis' for the time period 1 July 2014 to 31 December 2015. There were 37 studies published on the subject during this time period. Risk factors for psychotic symptoms, substance-induced psychosis, and primary psychosis included patterns of drug use, but results also pointed to the importance of nondrug-related vulnerability. Cognitive impairment is associated with both amphetamine use and psychosis, and the impairment among those with amphetamine-induced psychosis resembles that of schizophrenia. At the neuronal level, GABAergic mechanisms may offer some understanding about the association between stimulant use and psychosis. Several different types of antipsychotic medication are effective for treating agitation and psychosis, but drugs with high DRD2 blockade should be used with caution. Some novel treatments are described, but are not sufficiently repeated to be recommended. During the past 18 months, studies have been published that cover risk factors, neuronal mechanisms, and treatment. These recent results do not differ from previous understandings, but the role of cognition and GABAergic dysfunction should be further investigated, and knowledge about resilience factors is still scarce. Also, a clearer evidence base for medical treatment of psychosis with concurrent amphetamine use is warranted. VIDEO ABSTRACT.

A Hypothesis Concerning Schizophrenia

In 1965, Bell noted that amphetamine psychosis mimicked schizophrenia. Later, van Ree and Otte lucidated that amphetamine and alpha-endorphin had similar effects in the Central Nervous System, while Wiegant et al. found increased levels of gamma and alpha-endorphin in the hypothalamic tissue of schizophrenic human cadavers.

Multiple infectious pseudoaneurysms: An autopsy case

A 47-year-old Japanese woman died unexpectedly 11 days after admission due to acute cerebellar infarction. The patient had a history of Sjögren syndrome with long-term steroid therapy, hypertension, thalamic infarction and amphetamine psychosis. Multiple pseudoaneurysms in both the aorta and coronary artery were found at autopsy, and one located in the aortic root had ruptured into the pericardium resulting in sudden unexpected death. The detailed examination suggested that the pseudoaneurysms resulted from microbial infection to the arterial wall via the vasa vasorum. Immunosuppression induced by the long-term steroid therapy and abused drug injection could have influenced the formation of pseudoaneurysms.

Protective Effects of Phytochemical Antioxidants Against Neurotoxin-Induced Degeneration of Dopaminergic Neurons

The specific toxicity to dopaminergic neurons of psychostimulants and neurotoxins has been extensively studied in vivo and in vitro, and findings have been used to establish animal models of amphetamine psychosis or Parkinson’s disease. The multiple mechanisms of neurotoxicity operating in these disorders are known to involve oxidative stress or neuroinflammation, producing the characteristic behavioral and neuropathlogical changes arising from injured dopaminergic neurons and glial cells. A number of studies have shown that glia-targeting antioxidants play important roles in protecting against the neurotoxicity caused by psychostimulants or neurotoxins. Phytochemicals, which are non-nutritive plant chemicals, protect dopaminergic neurons and glial cells from damage caused by psychostimulants or neurotoxins. The objective of this review was to evaluate the involvement of glial cells in dopaminergic neuron–specific toxicity and to explore the neuroprotective activity of phytochemicals in terms of anti-inflammatory and antioxidant action.

Randomized controlled trial of aripiprazole versus risperidone for the treatment of amphetamine-induced psychosis

Background: Lifetime prevalence of amphetamine-induced psychotic disorder is reported as being up to 23% for methamphetamine (MA) abusers. Approximately 25% of those with a baseline DSM-IV diagnosis of substance-induced psychosis are diagnosed with primary psychosis at one-year follow-up. Evidence on the treatment of amphetamine psychosis is very limited. Objectives: To investigate the efficacy of risperidone versus aripiprazole in treatment of amphetamine-induced psychotic symptoms. Methods: In a double-blind study, 45 participants were randomly allocated to either aripiprazole 15 mg or risperidone 4 mg daily over a six-week trial. Positive and negative symptoms of psychosis were assessed using the Scale for Assessment of Negative Symptoms (SANS) and the Scale for Assessment of Positive Symptoms (SAPS) at baseline and completion of the trial. Results: SANS and SAPS scores decreased significantly in both groups. Mean SAPS score reduction in risperidone and aripiprazole group was 16.20 and 10.80, respectively, after trial course (p < 0.001). Mean SANS score reduction in risperidone and aripiprazole group was 9.35 and 11.25, respectively (p = 0.08). Conclusions: Both aripiprazole and risperidone were effective for patients diagnosed with amphetamine-induced psychotic disorder. However, risperidone had the greater effect on positive psychotic symptoms while patients with negative symptoms may respond better to aripiprazole. There is a case for further studies evaluating the efficacy of atypical antipsychotics in this disorder.

Negative priming in amphetamine psychosis

Amphetamine abuse may lead to a psychotic state, its symptomatology being very similar to what is seen in paranoid schizophrenia. Failure of attentional inhibition of irrelevant information is thought to be associated with the psychotic symptoms in schizophrenia. Negative priming (NP) paradigm is believed to measure this impairment. Several studies have shown impaired NP in schizophrenia. In the present study a spatial NP task was used to assess attentional inhibition in a group of amphetamine-induced psychosis patients. Nineteen patients with amphetamine-induced psychotic disorder and 20 healthy subjects participated in this study. Severity of psychotic symptoms was measured prior to testing using the Brief Psychiatric Rating Scale (BPRS). Patients showed no deficit in NP, and the amount of their NP effect was not significantly different from healthy subjects. Besides, we did not find any correlation between the amount of NP effect and severity of symptoms. Our results may indicate that cognitive mechanisms underlying NP might not be affected in amphetamine psychosis.

Amphetamine Versus Non Amphetamine-Related First Episode Psychosis in Saudi Arabian Patients

Background: Amphetamines are illicit psychostimulant drugs that can induce psychotic symptoms. Very few studies have been conducted in Kingdom of Saudi Arabia (SA) on amphetamine abuse and related psychosis. Recently, the pattern of amphetamine abuse in SA showed a significant trend of increased frequency. Objectives: To investigate the extent of amphetamine abuse in a sample of Saudi patients hospitalized for first episode of acute psychosis. Also, to compare in that sample between amphetamine psychosis and other psychoses regarding demographic data, premorbid personality and symptoms profile. Method: 106 patients with acute psychosis were hospitalized and screening of urine for amphetamine was conducted for all. Patients’ psychiatric evaluation included interviewing, and ICD-10 criteria for personality disorders. 30 healthy subjects were also included for comparison with patients. Results: 34/106 of psychotic patients (32%) were positive for amphetamine in urine (≥ 1000 ng/ml). The frequency of personality disorders was significantly higher (P < 0.01) in the patients (54/106; 51%) compared with healthy subjects (6/30; 20%). Also, the incidence of personality disorders was significantly higher (P < 0.01) in amphetamine positive psychosis (25/34; 73.5%) compared with amphetamine negative psychosis (29/72; 40%). Cluster B personality disorders particularly the antisocial and borderline were significantly higher in amphetamine positive psychosis (13/34; 38%) compared with amphetamine negative psychoses (6/72; 8%). The symptom profile showed significant difference between amphetamine positive and amphetamine negative psychosis as regards ideas of reference (50% vs. 14%), suspiciousness (44% vs. 11%), suicidal ideation (38% vs. 23%), paranoid delusions (29% vs. 17%) and increased pulse or blood pressure (29% vs. 7%) respectively. Conclusion: Screening of amphetamine in urine among patients with first episode of acute psychosis can help and support the clinical distinction of amphetamine psychosis from other types of psychosis. This is therapeutically critical since the line of treatment may be different between the two types of psychoses.

Conversation with Michael Kuhar

Conversation with Michael Kuhar

Amphetamine psychosis: a model for studying the onset and course of psychosis

The aetiology of schizophrenia remains complex, although proposed models have identified genetic markers and environmental pathogens as important risk factors. Researchers have found no large-effect or unique genetic elements, and only a small number of putative environmental agents have been identified. Use of amphetamine-type stimulants (ATSs) is an exemplar environmental pathogen, as it is known to trigger schizophrenia-like illness and other psychotic and manic episodes. To date, the ATS model of illness onset has been under-utilised. It has the potential to reveal key neurobiological elements of schizophrenia and related psychoses. The model proposed here has the capacity to inform detection of those at risk of ATS-related psychoses, and therefore help develop early intervention strategies. It is possible that the same approach may be used in young people known to be at risk of schizophrenia and related disorders, by informing models that involve other environmental or genetic risks.

Treatment for amphetamine psychosis

Chronic amphetamine users may have experience of paranoia and hallucination. It has long been believed that dopamine antagonists, such as chlorpromazine, haloperidol, and thioridazine, are effective for the treatment of amphetamine psychosis. To evaluate risks, benefits, costs of treatments for amphetamine psychosis. MEDLINE (1966-2007), EMBASE (1980-2007), CINAHL (1982-2007), PsychINFO (1806-2007), CENTRAL (Cochrane Library 2008 issue 1), references of obtained articles. All randomised controlled and clinical trials (RCTs, CCTs) evaluating treatments (alone or combined) for people with amphetamine psychosis Two authors evaluated and extracted the data independently. Dichotomous data were extracted on an intention-to-treat basis in which the dropouts were assigned as participants with the worst outcomes. The Relative Risk (RR) with the 95% confidence interval (95% CI) was used to assess the dichotomous data. The Weighted Mean Difference (WMD) with 95% CI was used to assess the continuous data. The comprehensive searches found one randomised controlled trial of treatment for amphetamine psychosis meeting the criteria for considering studies. The study involved 58 participants and compared the efficacy and tolerability of two antipsychotic drugs, olanzapine (a newer antipsychotic) and haloperidol (a commonly used antipsychotic medication used as a control condition), in treating amphetamine-induced psychosis. The results show that both olanzapine and haloperidol at clinically relevant doses were efficacious in resolving psychotic symptoms, with the olanzapine condition showing significantly greater safety and tolerability than the haloperidol control as measured by frequency and severity of extrapyramidal symptoms. Only one RCT of treatment for amphetamine psychosis has been published. Outcomes from this trial indicate that antipsychotic medications effectively reduce symptoms of amphetamine psychosis, the newer generation and more expensive antipsychotic medication, olanzapine, demonstrates significantly better tolerability than the more affordable and commonly used medication, haloperidol.There are other two studies that did not meet the inclusion criteria for this review. The results of these two studies show that agitation and some psychotic symptoms may be abated within an hour after antipsychotic injection.Whether this limited evidence can be applied for amphetamine psychotic patients is not yet known.The medications that should be further investigate are conventional antipsychotics, newer antipsychotics and benzodiazepines. However, naturalistic studies of amphetamine psychotic symptoms and the prevalence of relapse to psychosis in the presence of amphetamine, are also crucial for advising the development of study designs appropriate for further treatment studies of amphetamine psychosis.

Reversal of the expression pattern of Aldolase C mRNA in Purkinje cells and Ube 1x mRNA in Golgi cells by a dopamine D1 receptor agonist injections in the methamphetamine sensitized-rat cerebellum

The cerebellum has a parasagittal modular structure, in which Zebrin (Aldolase) positive and negative bands expressed in Purkinje cell layers alternate, and is involved in amphetamine psychosis. Administration of SKF38393, a D1 receptor agonist, reversed the behavioral sensitization of methamphetamine. In the vermis, there were the binding sites of SKF38393. In methamphetamine-sensitized rats the expression of the Aldolase mRNA positive bands move laterally in the rat vermis. We provide here the evidence that the D1 agonist injections also reversed the expression pattern of both the Aldolase mRNA in Purkinje cells and Ube (ubiquitin activating enzyme) 1x mRNA in Golgi interneurons of the sensitized rats. Thus the reverse changes in gene expression pattern in the vermis may be involved in the mechanisms of the behavioral plasticity and suggests the new treatment of drug abuse.

覚醒剤濫用歴を有する顎顔面部蜂窩織炎の１例

Stimulant abuse is a social problem in recent years. We describe a patient with a history of stimulant abuse who had flashback phenomena during hospitalization for the treatment of a maxillofacial phlegmon caused by intraoral self mutilation.The patient was a man in his forties who continued to take stimulants and served a sentence in prison since 1 year before admission to our hospital.He had pain in the left cheek for 1 month before admission to our hospital and was referred to a certain hospital. He was given a diagnosis of maxillofacial phlegmon with intracranial abscess on computed tomography. The patient was referred to the Department of Emergency and Critical Care Medicine in our hospital for further examination and treatments.Because the maxillofacial phlegmon was apparently caused by intraoral infection, he was referred to our department. With the patient under general anaesthesia, we performed drainage of the left fossa infratemporalis, intraorbital region, fossa pterygopalatine, and the submandibular space on the day of admission to our hospital. Incomprehensible speech and self mutilation occurred after the drainage. Amphetamine psychosis with flashback phenomenon was diagnosed by a psychiatrist in our hospital. Antipsychotic drugs and a tranquilizer were prescribed, and his symptoms improved.His prognosis was good. He returned to his original hospital 20 days after surgery.In conclusion, it is very important to recognize the clinical condition of amphetamine psychosis. The treatment of such patients requires close cooperation with a psychiatrist.

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;

Lobeline Attenuates Methamphetamine-induced Stereotypy in Adolescent Mice

In this study, we investigated the effects of lobeline, an alkaloid constituent of Indian tobacco, on methamphetamine (METH)-induced stereotypy in male ICR mice (41-50 days old), an animal model for amphetamine psychosis. After a single administration of METH (10 mg/kg, i.p.), mice showed an initial short-lasting hyperlocomotion and subsequent stereotyped behaviors with a plateau level 25 min after drug challenge. Pretreatment with lobeline (3.0-30 mg/kg, i.p.) 15 min prior to the drug challenge significantly decreased the intensity of stereotypy and increased its latency to onset in a dose-dependent manner, especially 20 min after the drug challenge. In saline challenge groups, the doses of lobeline examined did not affect spontaneous locomotion nor induced any stereotyped behaviors. High-performance liquid chromatography analysis revealed that the range of lobeline doses examined except 30 mg/kg did not affect apparent monoamine turnover in the cerebral cortex, the region of the striatum and nucleus accumbens, and the region of the thalamus and hypothalamus of the mice 20 and 60 min after the drug challenge. These results suggested that the inhibitory effect of lobeline (3.0-10 mg/kg) on METH-induced stereotypy was not attributed to the change in the apparent monoamine turnover.