Psychosis during Methylphenidate Abuse

Spensley, James; Rockwell, Don A.

doi:10.1056/nejm197204202861607

Cited by 65 publications

(23 citation statements)

References 12 publications

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“…There is in fact an increasing body o f evidence linking central dopaminergic hyperactivity with animal stereotypy and some forms o f human psychoses (Connell, 1958: Glowinski et a l, 1966: Ellinwood, 1967Randrup and Munkvad, 1967, \910\Nyback and Sedvall, 1969: Rylander, 1969Willner et a l, 1970;Snyder et al. 1970;Anden, 1970: Angrist and Gershon, 1970, 1972Ho et a l, 1971: Spensley andRockwell, 1972;Strian et a l, 1972: Scheel-Kruger. 1972Angrist et a l, 1973).…”

Section: Discussionmentioning

confidence: 99%

Rebound Phenomena in Manic Patients following Physostigmine

Shopsin

Janowsky

Davis³

et al. 1975

Neuropsychobiology

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The authors have administered physostigmine intravenously to three hospitalized manic patients on a double-blind basis. All three individuals showed clinical change both during and after the physostigmine period, which can be clearly delineated into three distinct phases. The behavioral modifications occurring during the physostigmine run did not qualitatively alter the underlying mania. The authors focus on ‘rebound’ phenomena, or post-physostigmine changes, as a possible clinical index with which chemically to characterize the initial state of amine imbalance responsible for a given affective illness. The data are considered consistent with an adrenergic-dopaminergic-cholinergic balance hypothesis of affective disorders, and may provide a relevant link in understanding the interface or crossover between manic and schizo-affective illness.

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Section: Discussionmentioning

confidence: 99%

Rebound Phenomena in Manic Patients following Physostigmine

Shopsin

Janowsky

Davis³

et al. 1975

Neuropsychobiology

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“…Several lines of evidence suggest that dopaminergic neurotransmission plays the most important role in the etiology of DI, as with other disorders in the spectrum of psychotic and delusional disorders. This is because DI can be secondary to drugs such as cocaine, amphetamine, pemoline, or methylphenidate, which increase synaptic dopamine levels by blocking presynaptic dopamine reuptake at the dopamine transporter (118,141,142,164,303). Furthermore, antidopaminergic substances, such as antipsychotics, are helpful in the majority of patients with DI (99,178).…”

Section: Pathophysiology Of DImentioning

confidence: 99%

Delusional Infestation

Freudenmann

Lepping²

2009

Clin Microbiol Rev

230

367

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SUMMARY This papers aims at familiarizing psychiatric and nonpsychiatric readers with delusional infestation (DI), also known as delusional parasitosis. It is characterized by the fixed belief of being infested with pathogens against all medical evidence. DI is no single disorder but can occur as a delusional disorder of the somatic type (primary DI) or secondary to numerous other conditions. A set of minimal diagnostic criteria and a classification are provided. Patients with DI pose a truly interdisciplinary problem to the medical system. They avoid psychiatrists and consult dermatologists, microbiologists, or general practitioners but often lose faith in professional medicine. Epidemiology and history suggest that the imaginary pathogens change constantly, while the delusional theme “infestation” is stable and ubiquitous. Patients with self-diagnosed “Morgellons disease” can be seen as a variation of this delusional theme. For clinicians, clinical pathways for efficient diagnostics and etiology-specific treatment are provided. Specialized outpatient clinics in dermatology with a liaison psychiatrist are theoretically best placed to provide care. The most intricate problem is to engage patients in psychiatric therapy. In primary DI, antipsychotics are the treatment of choice, according to limited but sufficient evidence. Pimozide is no longer the treatment of choice for reasons of drug safety. Future research should focus on pathophysiology and the neural basis of DI, as well as on conclusive clinical trials, which are widely lacking. Innovative approaches will be needed, since otherwise patients are unlikely to adhere to any study protocol.

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“…[9][10][11][12] On these grounds methylphenidate has been abused as a recreational drug since the 1960s and more recently as a "neuroenhancing" "smart drug". [12,13] Possible side effects related to methylphenidate overdoses include tachycardia, hallucinations and psychosis. [11,13] Since methylphenidate is a widely regulated pharmaceutical, structurally diverse and often more potent NPS of the phenidate class have entered the drug market.…”

Section: Introductionmentioning

confidence: 99%