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Thread: On Amphetamine Psychosis

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    On Amphetamine Psychosis

    .

    What is amphetamine psychosis?

    http://www.paihdelinkki.fi/english/f...aineet_02e.htm

    Amphetamine psychosis is a psychotic mental health disorder that is caused by the use of amphetamines and is therefore traditionally classified as a so-called organic psychosis. The term psychosis usually refers to a mental disorder where the patient’s sense of reality is distorted due to delusions or hallucinations (auditory, visual or olfactory) and possibly due to fluctuations in consciousness. Amphetamines may cause psychotic symptoms in various ways, but usually the term ‘amphetamine psychosis’ is refers to a delusional state, brought on by the use of amphetamines that do not involve clear hallucinations or changes in one’s state of consciousness. It is caused by high-scale, long-term use of amphetamines. Risks are increased by aging, mixed use of substances and physical illnesses. It may also become chronic and more serious if the use of amphetamines continues.

    Typical symptoms of amphetamine psychosis include paranoid delusions where the patient feels he/she is threatened or under persecution, even though in reality exists no grounds for these feelings. The patient keeps glancing nervously around and is excessively sensitive to perceptions of others. Quite possibly one doesn’t suffer from hallucinations. Amphetamine psychosis may be difficult to distinguish from psychosis typical of schizophrenia, but under professional supervision patients recover quicker and with greater ease as long as they stop using amphetamines.

    Patients who suffer from schizophrenia and use amphetamines have psychotic states that are characterised by problems unique to them. In these cases it may be difficult to estimate which symptom is caused by which factor. Amphetamine psychosis, like other psychoses, is usually treated with antipsychotic medication and other psychiatric care. Treatment can take place at a psychiatric hospital although milder psychoses can also be treated in outpatient care.

    Sami Pirkola, Lic. Med.
    Senior research scientist, National Public Health Institute


    http://en.wikipedia.org/wiki/Amphetamine_psychosis

    From Wikipedia, the free encyclopedia

    What is amphetamine psychosis?
    http://www.paihdelinkki.fi/english/f...aineet_02e.htm

    Amphetamine psychosis is a form of psychosis which can result from amphetamine or methamphetamine use. Typically it appears after large doses or chronic use, although in rare cases some people may become psychotic after relatively small doses. Other chemicals or drugs which similarly increase dopamine function (such as cocaine and L-DOPA) can produce similar psychotic states. Because of this, the term stimulant psychosis is sometimes used in preference.

    Amphetamine psychosis can include delusions, hallucinations and thought disorder. This is thought to be largely due to the increase in dopamine activity in the mesolimbic pathway of the brain caused by amphetamine-like drugs, although other factors such as chronic sleep deprivation may also play a part. The link between amphetamine and psychosis is one of the major sources of evidence for the dopamine hypothesis of psychosis.

    The link between amphetamine and psychosis was first made by Young and Scoville in 19381 and was originally considered to be a rare condition. As amphetamine use increased after World War II, largely due to the widespread use of amphetamine compounds in nasal decongestant and dieting preparations, it became clear that chronic amphetamine use often led to psychotic symptoms.

    Hallucinations are frequently reported in chronic amphetamine users, with over 80% of users reporting the presence of hallucinatory experiences2, typically as visual or auditory experiences. Delusions, paranoia, fears about persecution, hyperactivity and panic are also reported as the most common features3

    Concurrent to having delusions and hallucinations, chronic amphetamine users may also display stereotyped, repetitive and seemingly purposeless movements, known as 'motor stereotypies' or more commonly as 'knick knacking', 'tweeking' or being 'hung-up'. These may include examining, sorting, disassembling, and cleaning. The article on punding gives a more conclusive description of this behavior.

    One particular manifestation of psychosis associated with amphetamine use is delusional parasitosis or Ekbom's syndrome, where a person falsely believes themselves to be infested with parasites. However, related behaviour may occur in non-psychotic conditions, where users will realise they are not infested by parasites but will pick at their skin anyway. This more closely resembles obsessive-compulsive disorder.



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    Sv: On amphetamine psychosis

    speed has been hyped up in popular culture

    bands singing about how cool it is - well it doesent sound too cool anymore

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    Re: On amphetamine psychosis

    done it 3 times. The third time I was in some sort of psychotic state I think after hadn't slept for like 48 hours. The world suddenly became like hell on earth, all negative thoughts. No more speed for me ...

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    Exclamation Amphetamine-Related Psychiatric Disorders

    Amphetamine-Related Psychiatric Disorders

    by Michael Larson, DO

    The whole article here

    1. Amphetamine-induced anxiety disorder

    2. Amphetamine-induced mood disorder

    3. Amphetamine-induced psychotic disorder with delusions

    4. Amphetamine-induced psychotic disorder with hallucinations

    5. Amphetamine-induced sexual dysfunction

    6. Amphetamine-induced sleep disorder

    7. Amphetamine intoxication

    8. Amphetamine intoxication delirium

    9. Amphetamine withdrawal

    10.Amphetamine-related disorder not otherwise specified


    Either prescription or illegally manufactured amphetamines can induce these disorders. Prescription amphetamines are used frequently in children and adolescents to treat attention-deficit/hyperactivity disorder (ADHD), and they are the most commonly prescribed medications in children. The dose of Adderall(XR) (dextroamphetamine sulfate, dextroamphetamine saccharate, amphetamine aspartate monohydrate, amphetamine sulfate) needed to produce toxicity and psychiatric symptoms in a child is as low as 2 mg. A typical dose is 2.5-40 mg/d. In adults, narcolepsy, ADHD of the adult type, weight loss, and some depression can be treated with amphetamines. However, because of their addicting potential, these drugs are no longer used for weight loss. Although they are controlled substances, abuse is possible, especially in persons with alcoholism or substance abuse.

    The substance 3,4-methylenedioxymethamphetamine (MDMA) is a popular recreational stimulant commonly referred to as ecstasy, which was manufactured legally in the 1980s. MDMA has the desired effects of euphoria, high energy, and social disinhibition lasting 3-6 hours. The drug is often consumed in dance clubs, where users dance vigorously for long periods. The drug sometimes causes toxicity and dehydration, as well as severe hyperthermia. Several other amphetamine derivatives are para-methoxyamphetamine (PMA), 2,5-dimethoxy-4-bromo-amphetamine (DOB), methamphetamine (crystal methamphetamine, crystal meth, or "Tina"), and 3,4-methylenedioxyamphetamine (MDA). Crystal meth is the pure form of methamphetamine, and, because of its low melting point, it can be injected.

    Khat (Catha edulis Forsk) is the only known organically derived amphetamine. It is produced from the leaves of the Qat tree located throughout East Africa and the Arabian Peninsula. The leaves of the tree are chewed, extracting the active ingredient, cathinone, and producing the desired effects of euphoria and, unlike other amphetamines, anesthesia.

    In the midwestern United States, methcathinone, the synthetic form of cathinone, has been produced illegally since 1989, after a student at the University of Michigan stole research documents and began to illegally manufacture the drug. Methcathinone is relatively easy to produce and contains the same chemicals found in over-the-counter (OTC) asthma and cold medicines, paint solvents and thinners, and drain openers (eg, Drano). Its addiction potential is similar to that of crack cocaine.

    Amphetamine-related psychiatric disorders are conditions resulting from intoxication or long-term use of amphetamines or amphetamine derivatives. The disorders are often self-limiting after cessation, though, in some patients, psychiatric symptoms may last several weeks after discontinuation. Some individuals experience paranoia during withdrawal as well as during sustained use. Amphetamine use may elicit or be associated with the recurrence of other psychiatric disorders. People addicted to amphetamines sometimes decrease their use after experiencing paranoia and auditory and visual hallucinations. Furthermore, amphetamines can be psychologically but not physically addictive.

    The symptoms of amphetamine-induced psychiatric disorders can be differentiated from those of related primary psychiatric disorders by time. If symptoms do not resolve within 2 weeks after the amphetamines are discontinued, a primary psychiatric disorder should be suspected. Depending on the severity of symptoms, symptomatic treatment can be delayed to clarify the etiology.

    Amphetamine-induced psychosis (delusions and hallucinations) can be differentiated from psychotic disorders when symptoms resolve after amphetamines are discontinued. Absence of first-rank Schneiderian symptoms, including anhedonia, avolition, amotivation, and flat affect, further suggests amphetamine-induced psychosis. Symptoms of amphetamine use may be indistinguishable from those associated with the cocaine use. Amphetamines, unlike cocaine, do not cause local anesthesia and have a longer psychoactive duration.

    Amphetamine-induced delirium follows a reversible course similar to other causes of delirium, and it is identified by its relationship to amphetamine intoxication. After the delirium subsides, little to no impairment is observed. Delirium is not a condition observed during amphetamine withdrawal.

    Mood disorders similar to hypomania and mania can be elicited during intoxication with amphetamines. Depression can occur during withdrawal, and repeated use of amphetamines can produce antidepressant-resistant amphetamine-induced depression. Of interest, low-dose amphetamines can be used as an adjunct in the treatment of depression, especially in patients with medical compromise, lethargy, hypersomnia, low energy, or decreased attention.

    Sleep disturbances appear in a fashion similar to mood disorders. During intoxication, sleep can be decreased markedly. In withdrawal, sleep often increases. A disrupted circadian rhythm can result from late or high doses of prescription amphetamines or from chronic or intermittent abuse of amphetamines. Individuals who use prescription amphetamines can easily correct their sleep disturbance by lowering the dose or taking their medication earlier in the day than they have been. Insomnia is the most common adverse effect of prescription amphetamines.

    Amphetamine-related disorder not otherwise specified is a diagnosis assigned to those who have several psychiatric symptoms associated with amphetamine use but who do not meet the criteria for a specific amphetamine-related psychiatric disorder.


    Pathophysiology: The pathophysiology of amphetamine-related psychiatric disorders is difficult to establish, because amphetamines influence multiple neural systems. In general, chronic amphetamine abuse may cause psychiatric symptoms due to dopamine depletion in 3 areas of the brain: the orbitofrontal cortex, the dorsolateral prefrontal cortex, and the amygdala.

    Amphetamine-induced psychosis often results after increased or large use of amphetamines, as observed in binge use or after protracted use. Prescription amphetamines induce the release of dopamine in a dose-dependent manner; low doses of amphetamines deplete large storage vesicles, and high doses deplete small storage vesicles. This increase in dopaminergic activity may be causally related to psychotic symptoms because the use of D2-blocking agents (eg, haloperidol) often ameliorates these symptoms. Amphetamine-induced psychosis has been used as a model to support the dopamine hypothesis of schizophrenia, in which overactivity of dopamine in the limbic system and striatum is associated with psychosis. However, negative symptoms commonly observed in schizophrenia are relatively rare in amphetamine psychosis.

    MDMA causes the acute release of serotonin and dopamine and inhibits the reuptake of serotonin into the neuron. MDMA has neurotoxic properties in animals and, potentially, in humans. Reports suggest that MDMA use is associated with cognitive, neurologic, and behavioral abnormalities, as well as hyperthermia, but these reports are confounded by the association with other factors (eg, heat, exertion, poor diet, other drug use). Serotonergic damage has been suggested to lead to cognitive impairment.

    Delirium caused by amphetamines may be related to the anticholinergic activity, as observed in different classes of drugs, such as tricyclic antidepressants, benzodiazepines, sedatives, and dopamine-activating drugs. Rapid eye movement during the first phase is decreased during intoxication, and a rebound elevation of rapid eye movement occurs during withdrawal; this effect eventually alters the circadian rhythm and results in sleep disturbances.


    Frequency:
    In the US: Psychosis, delirium, mood symptoms, anxiety, insomnia, and sexual dysfunction are considered rare adverse effects of therapeutic doses of prescription amphetamines. Dextroamphetamine has a slightly increased rate of these adverse effects because of its increased CNS stimulation.

    Data from the 1998 National Household Survey on Drug Abuse showed that 4.4% of people aged 12 years and older report use during their lifetime, 0.7% reported use in the year before the survey, and 0.3% reported use in the month before the survey.

    Data about the frequency of amphetamine-related psychiatric disorders are unreliable because of comorbid primary psychiatric illnesses.

    Intravenous (IV) use occurs more frequently in people of low socioeconomic status than in those of high socioeconomic status.
    Internationally: The first amphetamine epidemic occurred after World War II in Japan, when leftover supplies intended to counteract fatigue in pilots were made available to the general public. This even resulted in many cases of amphetamine psychosis. Of interest, both German and American troops used these preparations during World War II, as did Japanese kamikaze pilots.

    Khat, which is primarily used in Ethiopia for cultural and religious purposes, has been well studied. A house-to-house survey of 10,468 adults showed a lifetime prevalence of khat use of 55.7%. Daily use occurred among 17.4%, and 80% indicated they used khat to increase concentration during prayer. Khat dependency has been associated with people of Muslim religion and with people of low socioeconomic status.

    Mortality/Morbidity: The Drug Abuse Warning Network (DAWN) Annual Medical Examiner Data for 1998 showed 5% of all drug-related deaths were due to methamphetamines. DAWN data indicated 26% of all drug-related deaths in Oklahoma City were due to methamphetamine, making it the city's most frequent drug-related cause of death in 1998.
    In high doses, prescription amphetamines can produce cardiovascular collapse, myocardial infarction, stroke, seizures, renal failure, ischemic colitis, and hepatotoxicity. Death related to MDMA can occur from malignant hyperthermia that leads to kidney failure and cardiovascular collapse. Heart attacks, seizures, subarachnoid and intracranial hemorrhage, and strokes may also result in death. The rate of suicide and accidents can increase during periods of toxicity and withdrawal.
    In high doses, prescription amphetamines and amphetamine derivatives increase sexual arousal and disinhibition, increasing the risk of exposure to sexually transmitted diseases.
    Memory impairment can result after long-term use of high doses of amphetamines because of damage to serotonin-releasing neurons. In the emergency department patients with amphetamine-related disorders are one third more likely than patients with cocaine-related disorders to be transferred to an inpatient psychiatric ward. This difference may partly be because amphetamine withdrawal lasts longer then cocaine withdrawal, and amphetamines are more psychogenic than cocaine.

    Race: Amphetamine-related psychiatric disorders most commonly occur in white individuals.

    Sex:
    With IV use, amphetamine-related psychiatric disorders most commonly occur in men, with a male-to-female ratio of 3-4:1.
    With non-IV use, amphetamine-related psychiatric disorders occur equally in men and women.

    Age:
    Amphetamine-related psychiatric disorders most frequently occur in people aged 20-39 years who are inclined to abuse amphetamine derivatives at rave parties and dance clubs.
    Adolescents have developed a method for abusing prescription amphetamines in which prescription tablets are crushed into a powder and inhaled nasally.
    .

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