Disturbance of Consciousness Due to Methamphetamine Abuse

Nakatani, Yoji; Hara, Takashi

doi:10.1159/000066236

Cited by 20 publications

(4 citation statements)

References 16 publications

(16 reference statements)

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“…19 In addition, the use of METH also leads to clinical symptoms such as rapid and irregular heartbeat, delirium, psychosis and heart failure. 20, 21 METH has been shown to exacerbate HIV-associated neurotoxicity in the CNS. 22 Previous studies have proved that METH and gp120 work synergistically to increase the level of proinflammatory cytokine IL-6 and induce oxidative stress, which lead to apoptosis in astrocytes.…”

mentioning

confidence: 99%

Methamphetamine potentiates HIV-1 gp120-mediated autophagy via Beclin-1 and Atg5/7 as a pro-survival response in astrocytes

Cao

Kumar

et al. 2016

Cell Death Dis

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Methamphetamine (METH), a commonly used controlled substance, is known to exacerbate neuropathological dysfunction in HIV-infected individuals. The neuropathological manifestation results from cell death or dysfunction in the central nervous system (CNS) wherein autophagy is expected to have an important role. Autophagy is generally considered protective during deprivation/stress. However, excessive autophagy can be destructive, leading to autophagic cell death. This study was designed to investigate if METH and HIV-1 gp120 interact to induce autophagy in SVGA astrocytes, and whether autophagy is epiphenomenal or it has a role in METH- and gp120-induced cytotoxicity. We found that METH and gp120 IIIb caused an increase in LC3II level in astrocytes in a dose- and time-dependent manner, and the level of LC3II was further increased when the cells were treated with METH and gp120 IIIb in combination. Next, we sought to explore the mechanism by which METH and gp120 induce the autophagic response. We found that METH induces autophagy via opioid and metabotropic glutamate receptor type 5 (mGluR5) receptors. Other than that, signaling proteins Akt, mammalian target of rapamycin (mTOR), Beclin-1, Atg5 and Atg7 were involved in METH and gp120-mediated autophagy. In addition, long-term treatment of METH and gp120 IIIb resulted in cell death, which was exacerbated by inhibition of autophagy. This suggests that autophagy functions as a protective response against apoptosis caused by METH and gp120. This study is novel and clinically relevant because METH abuse among HIV-infected populations is highly prevalent and is known to cause exacerbated neuroAIDS.

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mentioning

confidence: 99%

Methamphetamine potentiates HIV-1 gp120-mediated autophagy via Beclin-1 and Atg5/7 as a pro-survival response in astrocytes

Cao

Kumar

et al. 2016

Cell Death Dis

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“…Numerous substances, for instance methamphetamine, cocaine, hallucinogens, inhalants, opioids and bath salts may be a cause of delirium (Nakatani and Hara, 1998, Maldonado, 2008a, Fadel and Serra, 2009, Kasick et al, 2012Burapakajornpong et al, 2012).…”

Section: Substance Abusementioning

confidence: 99%

Management of Delirium

Maneeton¹,

Maneeton²

2013

Mental Disorders - Theoretical and Empirical Perspectives

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Delirium is categorized in the cognitive disorders, characterized by acute onset, global impairment in cognitive, emotional, mental, and behavioral functioning, fluctuating level of consciousness, attention impairment, decreased or increased psychomotor activity and the disturbance of sleep-wake cycle. Emotional and behavioral abnormalities are common presented with some neurological manifestations, e.g., tremor, asterixis, nystagmus, incoordination, urinary incontinence. Delirium is a behavioral disturbance and serious complication commonly found in consultation-liaison psychiatry. Its prevalence and incidence rates are varied, possibly depend on severity of illness, patient population, the method of assessment and the diagnostic criteria. Prevalence of delirium ranges from 10% to 30% and its incidence is between 3% and 29% for patients admitted in general hospitals (Siddiqi et al., 2006, Maneeton et al., 2007a, Praditsuwan et al., 2012). High prevalence and incidence are noted in elderly and severely ill patients. For instance, the prevalence of delirium in elderly and ICU patients are up to 40% and 80%, respectively (Bledowski and Trutia, 2012, Praditsuwan et al., 2012). An occurrence of delirium is associated with miserable clinical outcomes. It often increases morbidity, mortality, length of hospitalization, institutionalization, and poor functional outcome (Siddiqi et al., 2006, Cole et al., 2009, Fong et al., 2012). The mortality rate is higher in patients with hypoactive subtype of delirium (Yang et al., 2009). Delirium is often under recognized by health professionals. There are many faces for the clinical presentation of delirium. It can be caused by a variety of etiology. To prevent and minimize the consequences of delirium, physician should prompt intervenes for this condition (Attard et al., 2008).

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“…Darke et al (2008) reviewed both physical and psychological problems associated with crystal amphetamine abuse, drawing special attention to propensities toward depression, anxiety, and suicidal behavior. These are beyond the well-documented phenomenon of crystal methamphetamine-induced psychosis, characterized by Nakatani (1998) as passing through three distinct stages: restlessness and insomnia, hallucinatory/paranoid state, and disturbance of consciousness. Each of these phases was observed in DK, and the last stage seemed to offer a glimpse into his unconscious preoccupations, including death and shame or regret over substance abuse.…”

mentioning

confidence: 90%

Crystal Methamphetamine, Body Dysmorphia, and Shame: A Psychodynamic Case Report from the Trainee Perspective

Jiménez

McAfee

2010

Journal of Gay & Lesbian Mental Health

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Shame is an affect common to many pathological as well as nonpathological states. It is rarely described in academic psychiatry, and the reasons are probably more sociocultural than physiologic or scientific. Whether identified as shame or termed something else altogether, it is often the target of effective therapies addressing anxiety, depression, substance abuse, personality conflicts, and even delusions. It is particularly common within lesbian, gay, bisexual, and transgender (LGBT) populations given the difficulties of confronting and accepting the self. Using a clinical case experienced by a psychiatry resident trainee as a framework, this paper explores the phenomenon of shame as a common pathway to several psychiatric diagnoses within the same patient. Psychodynamic aspects of the patient's relationships with family members, his interactions with the resident, and the resident's countertransferential reactions are explored as well.

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Disturbance of Consciousness Due to Methamphetamine Abuse

Cited by 20 publications

References 16 publications

Methamphetamine potentiates HIV-1 gp120-mediated autophagy via Beclin-1 and Atg5/7 as a pro-survival response in astrocytes

Methamphetamine potentiates HIV-1 gp120-mediated autophagy via Beclin-1 and Atg5/7 as a pro-survival response in astrocytes

Management of Delirium

Crystal Methamphetamine, Body Dysmorphia, and Shame: A Psychodynamic Case Report from the Trainee Perspective

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