Schizophrenia paranoid

Amphetamine Clinically used for narcolepsy (sudden day-time onset sleep) and Attention Deficit Hyperactivity Disorder (ADHD) formerly used as a short-term slimming agent, as an antidepressant and to boost athletic performance recreational use widespread tolerance develops readily highly addictive regular users suffer many health problems and a reduced life expectancy amphetamine psychosis may develop, with similar symptoms to acute paranoid schizophrenia. 

Adverse events include ulceration of nasal mucosa and nasal septal collapse, tachycardia, heart failure, hyperthermia, shock, seizures, psychosis (similar to paranoid schizophrenia), and sudden death. 

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... 

Casanova MF. (1997). The temporolimbic system theory of paranoid schizophrenia. Schizophr Bull. 23(3) 513-15. 

As drugs of mixed action, amphetamines activate adrenergic receptors and simultaneously release endogenic catecholamines (norepinephrine and dopamine) from neurons of the brain and periphery. Sympathomimetic effects on the periphery are very similar to those of ephedrine. Amphetamine elevates systolic and diastolic blood pressure and has weakly expressed, broncholytic action. These effects are more prolonged, yet less expressed, than with epinephrine. The distinctive feature of amphetamines is their psychostimulatory activity. Larger doses can cause hallucinations and mental conditions similar to paranoid schizophrenia. As a sympathomimetic, amphetamine is sometimes used for uterine inertia. Synonyms of amphetamine are phenamine and benzedrine. 

Drug abuse and dependence Prolonged abuse of ephedrine can lead to symptoms of paranoid schizophrenia. Patients exhibit such signs as tachycardia, poor nutrition and hygiene, fever, cold sweat, and dilated pupils. Some measure of tolerance develops, but addiction does not occur. 

Manifestations of chronic intoxication Severe dermatoses, marked insomnia, irritability, hyperactivity, and personality changes have occurred. Disorganization of thoughts, poor concentration, visual hallucinations, and compulsive behavior often occur. The most severe manifestation of chronic intoxication is psychosis, often clinically indistinguishable from paranoid schizophrenia. This is rare with oral amphetamines. 

Anisette Doe, a 28-year old woman, went to the emergency department with abdominal bloating and inability to void her bladder she had been unable to urinate for 16 hours. A urinary catheter was inserted and 2.5 L of urine was withdrawn. Subsequent testing revealed no calculi or masses in the bladder, urethra, ureters, or kidneys. Ms. Doe s medical records indicated that she was being treated with clozapine for paranoid schizophrenia. She reported no signihcant side effects as a result of this treatment. For 2 days prior to admission to the hospital, Ms. Doe complained of a cold and was taking diphenhydramine Benadryl)... 

It is used in manifestation of psychotic disorders, acute and chronic paranoid schizophrenia. 

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. 

Bipolar affective (manic-depressive) disorder is a frequently diagnosed and very serious psychiatric disorder. Patients with cyclic attacks of mania have many symptoms of paranoid schizophrenia (grandiosity, bellicosity, paranoid thoughts, and overactivity). The gratifying response to lithium therapy of patients with bipolar disorder has made such diagnostic distinctions important. 

Similar effects have been reported after abuse of the amphetamines which, in addition, may be associated with increasing stereotyped behaviour and a full psychotic episode (auditory, visual and tactile hallucinations often unassociated with cardiovascular symptoms) which may be difficult to differentiate from paranoid schizophrenia. This is the basis for using amphetamine as a model for schizophrenia, in both animals and human volunteers. The central effects of high doses of cocaine and the amphetamines may be suppressed by the administration of neuroleptics. 

Most studies of HG volume in schizophrenia used mainly or exclusively male subjects. One study, at least, found similar volume reductions in both male and female subjects with schizophrenia (Takahashi et al., 2006). In contrast, a study of paranoid schizophrenia patients by Rojas et al. (1997) found reduced HG in males but not in females. 

Rojas DC, Teale P, Sheeder J, Simon J, Reite M. 1997. Sex-specific expression of Heschl s gyrus functional and structural abnormalities in paranoid schizophrenia. Am J Psychiatry 154(12) 1655-1662. 

J, NAA/Cr ratio in left medial TL of patients subjects with family history of schizophrenia showed greater deficit than subjects without history J, NAA/Cr ratio in left medial TL of patients J, NAA/Cr and Cho/Cr ratios in patients with disorganized and undifferentiated types of schizophrenia than with paranoid schizophrenia... 

A 21-year-old man with paranoid schizophrenia was treated with zuclopentixol, which was withdrawn because of extrapyramidal adverse effects, He was given clozapine 300 mg/day, and from day 43 developed breathlessness and complained of pain in his shoulders on deep inspiration. A chest X-ray showed an enlarged cardiac silhouette and bilateral pleural effusions. An echocardiogram showed pericardial and pleural effusions with no compromise of cardiac function. Clozapine was withdrawn and all the symptoms resolved within 2 weeks. 

A 37-year-old man with paranoid schizophrenia had ejaculatory difficulty during sexual intercourse with his wife, compatible with retrograde ejaculation, 1-2 weeks after starting to take risperidone (201). He reported complete failure to emit semen but a normal desire, erection, and sense of orgasm. Semen was seen in postcoital urine. The dosage of risperidone was reduced to 3 mg/day and anterograde ejaculation was partially restored. 

A 17-year-old man, with a history of paranoid schizophrenia and irregular abuse of cannabis and alcohol, took risperidone (202). Starting at 0.5 mg/day, the dose was titrated up to 4 mg/day over 3 weeks. In a few weeks, he stopped taking risperidone because of a recurrent inability to ejaculate, despite normal libido, erection, and sense of orgasm he also had difficulty in urinating. These effects disappeared after drug withdrawal. However, risperidone was restarted because of relapse of schizophrenia, and the ejaculatory disturbance recurred within a few days. 

A woman with paranoid schizophrenia developed catatonia 5 days after the abrupt withdrawal of olanzapine and alprazolam (26). The catatonic symptoms included mutism, prostration, waxy flexibility, oculogyric movements, and an inability to swallow. Her symptoms disappeared after administration of alprazolam and haloperidol, and there was no recurrence. 

Amphetamines release monoamines from the brain and thereby stimulate noradrenergic, serotonergic, and particularly dopaminergic receptors. Under certain circumstances this leads to psychosis and compulsive behavior, as well as auditory hallucinations similar to those experienced in paranoid schizophrenia. In addition, amphetamines cause an acute toxic psychosis with visual hallucinations, usually after one or two extremely large doses (54). 

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