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Cited by 266Substance Abuse Treatment and OutcomesSchizophrenia research and treatmentForensic Toxicology and Drug Analysis

Methamphetamine Psychosis: Epidemiology and Management

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Glasner-Edwards, Suzette, Mooney, Larissa J.·2014·CNS Drugs
DOI 10.1007/s40263-014-0209-8PMC PMC5027896
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Abstract

Psychotic symptoms and syndromes are frequently experienced among individuals who use methamphetamine, with recent estimates of up to approximately 40 % of users affected. Although transient in a large proportion of users, acute symptoms can include agitation, violence, and delusions, and may require management in an inpatient psychiatric or other crisis intervention setting. In a subset of individuals, psychosis can recur and persist and may be difficult to distinguish from a primary psychotic disorder such as schizophrenia. Differential diagnosis of primary vs. substance-induced psychotic disorders among methamphetamine users is challenging; nevertheless, with careful assessment of the temporal relationship of symptoms to methamphetamine use, aided by state-of-the art psychodiagnostic assessment instruments and use of objective indicators of recent substance use (i.e., urine toxicology assays), coupled with collateral clinical data gathered from the family or others close to the individual, diagnostic accuracy can be optimized and the individual can be appropriately matched to a plan of treatment. The pharmacological treatment of acute methamphetamine-induced psychosis may include the use of antipsychotic medications as well as benzodiazepines, although symptoms may resolve without pharmacological treatment if the user is able to achieve a period of abstinence from methamphetamine. Importantly, psychosocial treatment for methamphetamine dependence has a strong evidence base and is the optimal first-line treatment approach to reducing rates of psychosis among individuals who use methamphetamines. Prevention of methamphetamine relapse is the most direct means of preventing recurrence of psychotic symptoms and syndromes. Long-term management of individuals presenting with recurrent and persistent psychosis, even in the absence of methamphetamine use, may include both behavioral treatment to prevent resumption of methamphetamine use and pharmacological treatment targeting psychotic symptoms. In addition, treatment of co-occurring psychiatric disorders including depression and anxiety is important as a means of preventing relapse to methamphetamine use, which is often triggered by associated symptoms.

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Crossref · 10.1007/s40263-014-0209-8

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97 of 97 references verified0 citation errors · 0 not checkable

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  • For psychostimulant-induced psychosis, psychotic symptoms resolve with abstinence by about 1 week.

    “For psychostimulant-induced psychosis, psychotic symptoms resolve with abstinence by about 1 week”

    From Clinical management of psychostimulant withdrawal: review of the evidence (2023) · cites this paper as [80]

    Section 5.1 reports remission within one week of methamphetamine abstinence for a large majority of people with psychotic symptoms. The claim broadens this to psychostimulants generally and implies that symptoms resolve in all cases; Section 3.2 describes a subset with persistent psychosis. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Primary psychosis requires continued care with antipsychotic medication.

    “whereas primary psychosis will require continued care with antipsychotic medication (80).”

    From Clinical management of psychostimulant withdrawal: review of the evidence (2023) · cites this paper as [80]

  • The standard of care for adolescent and young adult SUD treatment is to use interventions specifically tailored or designed for their unique developmental stage.

    “the standard of care for adolescent-and young adult SUD treatment is to use interventions that are specifically tailored or designed for their unique developmental stage.177,178,179”

    From The ASAM/AAAP Clinical Practice Guideline on the Management of Stimulant Use Disorder (2024) · cites this paper as [178]

    Section 5.1 discusses extra caution when prescribing antipsychotics to children and adolescents with methamphetamine-induced psychosis; it does not describe developmentally tailored SUD interventions. Sections 5.2–5.3 discuss psychosocial treatments for methamphetamine use without identifying such tailoring as the standard of care for adolescents and young adults. Searches for developmental-stage and age-appropriate treatment found no passage addressing that claim. (LLM, conf=0.76)

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Research works printed but not linked: 4

  1. [26]Connell PH Amphetamine psychosis Maudsley Monograph No. 5 London Oxford University Press 1958
  2. [28]Griffith JD Cavanaugh JH Oates JA Psychosis induced by the administration of d-amphetamine to human volunteers Efron DH Psychomimetic drugs: proceedings of a workshop organised by the Pharmacology Section, Psychopharmacology Research Branch, National Institute of Mental Health, held at the University of California Irvine Jan. 25, 1969 New York Raven Press 1970
  3. [52]Connell PH Amphetamine psychosis Maudsley Monograph No. 5 London Oxford University Press 1958
  4. [70]First MB Spitzer RL Williams JEW Structured Clinical Interview for DSM-IV-Clinician Version (SCID-CV) (User’s guide and interview) Washington, DC American Psychiatric Press 1997

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Authors
Glasner-Edwards, S., & Mooney, L. J.
Affiliations
University of California, Los Angeles (US)
ORCID
Mooney, Larissa J.
Venue
CNS Drugs
Publisher
Springer Science and Business Media LLC
Published
2014-11-06
Volume
28
Issue
12
Pages
1115-1126
ISSN
  • 1172-7047 (ISSN-L)
  • 1179-1934
DOI
10.1007/s40263-014-0209-8
PMC
PMC5027896
OpenAlex
W2035893127
Cited by
266
References
97
Citations by year
2026: 26 · 2025: 28 · 2024: 29 · 2023: 34 · 2022: 31 · 2021: 31 · 2020: 18 · 2019: 19 · 2018: 26 · 2017: 9 · 2016: 12 · 2015: 2 · 2014: 1
FWCI
6.04
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (tdm)
Locations
  • CNS Drugs (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute on Drug Abuse (K23DA020085)
Topics
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Forensic Toxicology and Drug Analysis
Keywords
methamphetamine psychosis, drug-induced psychosis, differential diagnosis, schizophrenia, antipsychotic drugs, benzodiazepines, methamphetamine dependence, psychosocial interventions, relapse prevention, urine toxicology, crisis intervention
MeSH terms
Central Nervous System Stimulants, Humans, Methamphetamine, Psychoses, Substance-Induced

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