Psychosis amphetamine

Stimulants induce both tolerance and sensitization to their behavioral effects. Tolerance develops to the anorectic and euphoric effects of stimulants (Schuster 1981) however, chronic intermittent use of low doses of stimulants delays the development of tolerance. With the doses commonly used in clinical practice, patients treated for narcolepsy or for depressive or apathetic states find that the stimulant properties usually persist without development of tolerance however, the persistence of antidepressant effects remains a matter of controversy. Sensitization has been linked to the development of amphetamine-induced psychosis (Yui et al. 1999). Sensitization to the induction of psychosis is suggested because psychosis is induced by progressively lower doses and shorter periods of consumption of amphetamine following repeated use over time (Sato 1986). Sensitization for amphetamine-induced psychosis may persist despite long periods of abstinence. 

The development of psychosis is the most striking clinical characteristic of high-dose stimulant abuse. The amphetamines, methylphenidate, and phen-metrazine all produce psychosis (Ellinwood et al. 1973 Harris and Batki 2000 Iversen et al. 1978 Lucas and Weiss 1971 McCormick and McNeil 1962). 

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Martin WR, Sloan JW, Sapira JD, et al Physiologic, subjective, and behavioral effects of amphetamine, methamphetamine, ephedrine, phenmetrazine, and methylphenidate in man. Clin Pharmacol Ther 12 245-258, 1971 McCormick TC Jr, McNeil TW Acute psychosis and Ritalin abuse. Tex State J Med... 

Ellinwood, E.H. Amphetamine psychosis Individuals, settings, and sequences. In Ellinwood, E.H., and Cohen, S., eds. Current Conceprs on Amphetamine Abuse. Rockville, MD National Institute on Mental Health, 1972. pp. 143-157. 

Robinson, T.E., and Becker, J.B. Enduring changes in brain and behavior produced by chronic amphetamine administration A review and evaluation of animal models of amphetamine psychosis. Brain Res 11 157-198, 1986. 

Jonsson, L., and Gunne, L. Clinical studies of amphetamine psychosis. In Costa, E., and Garattini, S., eds. Amphetamines and Related Compounds. New York Raven Press, 1970. ppi. 929-936. 

The treatment goals for acute intoxication of ethanol, cocaine/amphetamines, and opioids include (1) management of psychological manifestations of intoxication, such as aggression, hostility, or psychosis, and (2) management of medical manifestations of intoxication such as respiratory depression, hyperthermia, hypertension, cardiac arrhythmias, or stroke. 

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. 

Psychosis, often clinically indistinguishable from schizophrenia (a mental disorder)—this is the most serious sign of amphetamine addiction. 

Toxic psychosis Several monoamine stimulants including cocaine are known to produce a temporary or even a lasting psychotic state after heavy use. Reviews of numerous clinical case reports have shown amphetamine to produce a chronic psychotic state, sometimes persisting for months after cessation. There appears to be a sensitization effect in this regard, because after recovery, psychotic states may recur with minimal use of amphetamine or alcohol. When compared to schizophrenic patients, people with amphetamine-induced psychosis demonstrate fewer negative symptoms (Boutros and Bowers 1996). 

As would be expected, khat overuse produces symptoms similar to those of other monoamine stimulants, such as cocaine or amphetamine, including signs of sympathetic overarousal. In the extreme this can involve a toxic psychosis. Disorders more frequently associated with chronic khat use in males are headaches, anorexia, insomnia, constipation, and respiratory illnesses (Kennedy et al. 1983). Females report higher incidences of acute gastritis, jaundice, bronchitis and hepatic diseases. Also, cathinone has toxic reproductive effects in humans and experimental animals (Islam et al. 1990). It decreases sperm count and motility, and increases the number of abnormal sperm cells. It also decreases plasma testosterone in rats. 

In addition to the acute ingestion of these hallucinogenic drugs, the chronic use of alcohol, amphetamines, or cocaine can lead to paranoia that in many respects resembles the psychosis of schizophrenia. In these cases, the psychotic symptoms may persist long after the substance use has been stopped. 

In the aftermath of World War II, problems with amphetamine abuse began to arise. An epidemic of amphetamine abuse and related cases of amphetamine-induced psychosis arose first in Japan and later in the United States. Since that time, use of amphetamines and other stimulants has been greatly curtailed and as a class are more tightly regulated than virtually any other psychotropic agents, with the exception of narcotic analgesics. 

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. 

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