User:Rakshya Khatri/sandbox

Topic of wikipedia page : Stimulant psychosis

Sub topic I am going to edit : Stimulants known to cause psychosis - Amphetamine

Introduction : Amphetamine and its derivatives are well known to induce psychosis, typically when abused chronically or in high doses.[1] In an Australian study of 309 active amphetamine users, 18% had experienced a clinical level psychosis in the past year.[2] The generic term "Amphetamines" describes both amphetamine proper, as well as the substituted amphetamines. The amphetamine molecule consists of a phenethylamine core with a methyl group attached to the alpha carbon. The substituted amphetamines consist of the same structure with one or more substitutions; prevalent examples include cathinone, DOM, ephedrine, MDMA, methamphetamine, methcathinone, and methylphenidate, though a large number of such compounds have been synthesized.

Symptoms : The symptoms of amphetamine psychosis include auditory and visual hallucinations, persecutory delusions and delusions of reference concurrent with both clear consciousness and prominent extreme agitation.[3][4] The symptoms of acute amphetamine psychosis are very similar to that of the acute phase of schizophrenia[1], however in amphetamine psychosis visual hallucinations are more common and thought disorder is rare.[5] Ampthetamine psychosis may be purely to do with high drug usage or high drug usage may trigger an underlying vulnerability to schizophrenia.[1] There is some evidence that vulnerability to amphetamine psychosis and schizophrenia may be genetically related. Relatives of methamphetamine users with a history of amphetamine psychosis are five times more likely to have been diagnosed with schizophrenia than relatives of methamphetamine users without a history of amphetamine psychosis.[6] The disorders are often distinguished by a rapid resolution of symptoms in amphetamine psychosis, while schizophrenia is more likely to follow a chronic course.[7]

Psychosis : A Japanese study of recovery from the psychosis reported a 64% recovery rate within 10 days rising to a 82% recovery rate at 30 days after amphetamine cessation.[8] However it has been suggested that about 5-15% of users fail to make a complete recovery from the psychosis in the long term.[9] Furthermore the psychosis can be quickly reestablished with further use, even of a small dose.[8] Psychosocial stress has been found to be an independent risk factor for psychosis relapse, even without further amphetamine use in certain cases.[10]

Behavioral Changes : When rats were exposed to AMPH, their responses were multiphasic. They would go on a stereotypy phase with no movement except occasional biting and licking and then a sudden post stereotypy locomotion phase making sudden darting movements. As they are progressively exposed to higher dosage over a longer time, it is observed that stereotypy phase increases with intensity and duration while locomotion phase is diminished. [11]

Neuro-chemical Changes : Progressive decline of extracellular dopamine and serotonin in caudate-putamen and nucleus acumbens. Relationship of this to behavioral changes. Decline was persistent even after 3 weeks of last dosage on rats. In humans, it has been found that irritability introduced with interrupted stereotypy at the beginning of usage of drugs. This slowly led to anxiety upon heavier usage. The anxiety appears to intensify progressively during the course of a binge before individuals experience paranoid delusions. [11]

1. ^ a b c d Shoptaw SJ, Kao U, Ling W. Treatment for amphetamine psychosis (Review). Cochrane Database of Systematic Reviews 2009 Issue 1.

2. ^ McKetin R, McLaren J, Lubman DI, Hides L. The prevalence of psychotic symptoms among methamphetamine users. Addiction 2006;101(10):1473–8.

3. ^ Dore G, Sweeting M. Drug-induced psychosis associated with crystalline methamphetamine. Australasian Psychiatry 2006;14(1):86–9.

4. ^ Srisurapanont M, Ali R, Marsden J, Sunga A, Wada K,Monteiro M. Psychotic symptoms in methamphetamine psychotic in-patients. International Journal of Neuropsychopharmacology 2003;6(4):347–52.

5. ^ Alan F. Schatzberg, Charles B. Nemeroff (2009). The American Psychiatric Publishing Textbook of Psychopharmacology. The American Psychiatric Publishing. pp. 847–48. ISBN 978-1-58562-309-9.

6. ^ Chen CK, Lin SK, Pak CS, Ball D, Loh EW, Murray RM. Morbid risk for psychiatric disorder among the relatives of methamphetamine users with and without psychosis. American Journal of Medical Genetics. Part B, Neuropsychiatric Genetics 2005;136(1):87–91.

7. ^ McIver C, McGregor C, Baigent M, Spain D, Newcombe D, Ali R. Guidelines for the medical management of patients with methamphetamine-induced psychosis. Drug and Alcohol Services: South Australia 2006.

8. ^ a b Sato M, Numachi Y, Hamamura T. Relapse of paranoid psychotic state in methamphetamine model of schizophrenia. Schizophrenia Bulletin 1992;18(1):115–22.

9. ^ Hofmann FG. A handbook on drug and alcohol abuse: the biomedical aspects. 2nd Edition. New York: Oxford University Press, 1983.

10. ^ Yui K, Ikemoto S, Goto K. Factors for susceptibility to episode recurrence in spontaneous recurrence of methamphetamine psychosis. Annals of the New York Academy of Sciences 2002;965:292–304.

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