Psychosis paranoid

Wills S Drugs of Abuse. London, Pharmaceutical Press, 1997 Winstock AR Chronic paranoid psychosis after misuse of MDMA. BMJ 302 1150-1151, 1991... 

Winstock AR Chronic paranoid psychosis after misuse of MDMA. BMJ 302 6785,... 

Todd J. 1954. Trichloroethylene poisoning with paranoid psychosis and Lilliputian halucination. Br Med J 1 439-440. 

Chronic cocaine use can cause a syndrome of insomnia, hallucinations, delusions, and apathy. This syndrome develops around the time when the euphoria turns to a paranoid psychosis, which resembles paranoid schizophrenia. Further, after cessation of cocaine use, the hallucinations may stop, but the delusions can persist. Still, the incidence of a persistent cocaine-induced psychosis appears to be rare. One study found only 4 out of 298 chronic cocaine users receiving a diagnosis of psychotic disorder (Rounsaville et al. 1991). This incidence is approximately the... 

As noted above, large doses of amphetamine, cocaine, and other sympathomimetics can cause acute paranoid reactions, either spontaneously in abusers or experimentally in normal volunteers. An injection of a large amphetamine dose, for example, often produces a paranoid psychosis within hours. Frequent smaller doses over several days can also produce a paranoid psychotic reaction. An episode s duration usually parallels the length of time the drug remains in the body. 

The most common MAOl behavioral toxicity is the precipitation of a hypomanic or manic episode, but restlessness, hyperactivity, agitation, irritability, and confusion can also occur. Rare cases of paranoid psychosis have been reported. 

The metabolism of amphetamine has been studied in those presenting with amphetamine psychosis. In the presence of acidified urine, the renal elimination of amphetamine increased significantly. The intensity of the psychosis was found to correlate with the amount of basic polar metabolites excreted in the urine, such as norephedrine and p-hydroxyamphetamine, and not with the plasma amphetamine concentration. This suggests that these metabolites may play an important role in the development of paranoid psychosis in chronic amphetamine users.6... 

Repeated cocaine use can lead to reverse tolerance, such as acute paranoid psychosis. 

FIGURE 13—5. Production of reverse tolerance in a cocaine abuser. Repeated intoxication with cocaine may produce complex adaptations of the dopamine neuronal system, such as sensitization or reverse tolerance. Thus, in repeat users, cocaine releases more and more dopamine. In such cases doses of cocaine that previously only induced euphoria can create an acute paranoid psychosis virtually indistinguishable from paranoid schizophrenia. 

The clinical effects of amphetamine and its derivatives are very similar to those of cocaine, although the euphoria they produces may be less intense but last longer than that due to cocaine. Signs of amphetamine intoxication, toxicity, overdose, sensitization by production of an acute paranoid psychosis, and withdrawal syndrome are all similar to those described above for cocaine. 

Paranoid psychosis is characterized by severe retardation, apathy and anxious self-punishment and blame. True or False. 

Chronic abuse of MPH can lead to marked tolerance and psychological dependence. According to the DEA, chronic MPH intoxication is identical to the paranoid psychosis of amphetamine intoxication. Studies indicate that 5-15% of the amphetamine users who become psychotic fail to make a complete recovery. 

Besides the paranoid psychosis associated with chronic use of amphetamines, a specific lesion associated with chronic amphetamine use is necrotizing arteritis, which may involve many small and medium-sized arteries and lead to fatal brain hemorrhage or renal failure. Overdoses of amphetamines are rarely fatal they can usually be managed by sedating the patient with benzodiazepines. 

MDMA and MDA abuse has been associated with panic disorder, depression and chronic paranoid psychosis. As these conditions may also occur independently of these drugs, it is difficult to prove causality but it seems reasonable to conclude that some individuals are more vulnerable to such psychiatric disorders which are exacerbated by these drugs. In... 

In the March 1986 safety review of the NDA (Kapit, 1986b), the FDA psychiatrist summarized five serious clinical events in the first 77 patients given Prozac, including 1 with paranoid psychosis and 1 with manic psychosis. There was also evidence in Eli Lilly s files—presented in my testimony—that some of the first human subjects responded very adversely to Prozac. In his deposition, Eli Lilly s top scientist, Ray Fuller (1994), confirmed the existence of an early in-house memo, in which he wrote ... 

A 79-year-old man developed a paranoid psychosis with auditory hallucinations during treatment with... 

Paranoid psychosis has also been described in a 64-year-old man who had first begun to use crack cocaine 6 months before. The paranoid symptoms continued for 3 weeks after he stopped using crack. 

First-onset paranoid psychosis has also been reported (216). 

A 28-year-old man, without a psychiatric history, developed a paranoid psychosis. He had been taking levamisole twice a week in an unspecified dose for 2 years for a stage 4 melanoma and metastatic lymph nodes in the axilla. Physical examination, a CT scan, an electroencephalogram, and standard laboratory tests were all normal. He was treated with perphenazine, with partial success, but after tapering of the dose his symptoms reappeared. It was thought likely that the psychosis had been caused by levamisole, which was discontinued. Three weeks later he had recovered completely. Levamisole was not reintroduced. 

Maitai CK, Dhadphale M. khat-induced paranoid psychosis. Br J Psychiatry 1988 152 294. 

Kruis R, Barger R. Paranoid psychosis with sulindac. JAMA 1980 243(14) 1420. 

A 79-year-old man developed a paranoid psychosis with auditory hallucinations during treatment with amfebutamone (100 mg tds) (10). The symptoms remitted with reduction of the dose of amfebutamone and the introduction of haloperidol 5 mg/day. 

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