Treatment of toxicity from amphetamines, related derivatives, and analogues: A systematic clinical review

Richards, John R.; Albertson, Timothy E; Derlet, Robert W.; Lange, Richard A.; Olson, Kent R.; Horowitz, B. Zane

doi:10.1016/j.drugalcdep.2015.01.040

Cited by 84 publications

(54 citation statements)

References 125 publications

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“…In the immediate acute phase, the use of benzodiazepines will be a good alternative [39] and is recommended in guidelines [40,41]. However, the updated review identified only one case series and one case report using benzodiazepines, leading to the conclusion that benzodiazepines may be adequate for controlling agitation, but less evidence is available for their use in treating psychosis [34].…”

Section: Drug Treatmentmentioning

confidence: 98%

“…The review also identified one case report using a a 2 -adrenergic agonist [34] and we found one study from Iran that used ECT on treatment resistant methamphetamine psychosis [42]. None of these treatments can be recommended as evidence-based treatments for amphetamine-induced psychosis or psychosis with concurrent amphetamine use, but should inspire further research to provide more evidence.…”

Section: Drug Treatmentmentioning

confidence: 99%

“…Haloperidol may be less recommended owing to higher levels of extrapyramidal side-effects, dystonia, and prolonged QT interval, and also because of the possibility of GABAergic cell death [19 & ]. In summary, the literature suggests that risperidone is more effective in treating positive symptoms than aripiprazole, but may be less tolerated because of its purer DRD2 profile [34].…”

Section: Drug Treatmentmentioning

confidence: 99%

“…The study, and thus the Cochrane review, showed that both olanzapine and haloperidol in clinically relevant doses were effective in treating psychotic symptoms. A new review identified five randomized controlled trials, two prospective controlled studies, four case series, and 10 case reports on the use of antipsychotics for the treatment of psychosis following use of amphetamines [34]. One of the studies included in this updated review was also picked up by the literature search for this study [35 & ].…”

Section: Drug Treatmentmentioning

confidence: 99%

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Psychosis induced by amphetamines

Bramness

Rognli

2016

Current Opinion in Psychiatry

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During the past 18 months, studies have been published that cover risk factors, neuronal mechanisms, and treatment. These recent results do not differ from previous understandings, but the role of cognition and GABAergic dysfunction should be further investigated, and knowledge about resilience factors is still scarce. Also, a clearer evidence base for medical treatment of psychosis with concurrent amphetamine use is warranted. VIDEO ABSTRACT.

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Section: Drug Treatmentmentioning

confidence: 98%

Section: Drug Treatmentmentioning

confidence: 99%

Section: Drug Treatmentmentioning

confidence: 99%

Section: Drug Treatmentmentioning

confidence: 99%

See 2 more Smart Citations

Psychosis induced by amphetamines

Bramness

Rognli

2016

Current Opinion in Psychiatry

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“…A recent review on treatment of toxicity of amphetamine recommended the use of antipsychotics, benzodiazepines, and beta-blockers to control psychosis, agitation, and hyper-adrenergic symptoms [78]. The Australian guidelines for the treatment of acute methamphetamine-induced psychosis recommend only the use of benzodiazepines in the initial and most acute phase [79].…”

Section: Treatment Of Amphetamine-induced Psychosismentioning

confidence: 99%

Understanding the Relationship Between Amphetamines and Psychosis

Rognli

Bramness

2015

Curr Addict Rep

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Use of amphetamine and methamphetamine (hereafter amphetamines) can cause acute psychotic symptoms and may also contribute to persistent psychotic conditions such as schizophrenia. Still, much remains uncertain about the mechanisms and nature of this relationship. In this paper, we review certain aspects of this relationship, with particular emphasis on papers published during the past 3 years. A review of the literature reveals that, in addition to the established knowledge that amphetamines can cause acute psychotic symptoms, more evidence has emerged that amphetamines may play a role also in the pathogenesis of schizophrenia. Determining causality for the amphetamine-psychosis association has, however, proven complicated. Reversed causality may be the case, as may be the notion that both use of amphetamines and psychosis reciprocally affect each other with deteriorating effects on both conditions. Clinical features like sensitization to amphetamines precipitating psychosis, that even amphetamineinduced psychosis may persist, and diagnostic transition from amphetamine-induced to primary psychosis suggest a continuous and mutual interaction between individual vulnerability, amphetamine exposure, and psychosis. The high transition rates also point to amphetamine-induced psychosis as a major risk factor for primary psychosis. Mortality rates are high for both psychosis and use of amphetamines, and we lack highquality treatment guidelines to apply when these two conditions occur together. Amphetamine-induced psychosis may be more affiliated with primary psychosis than previously assumed. Some clinical implications are suggested.

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Association of Stimulant Medication Use With Bone Mass in Children and Adolescents With Attention-Deficit/Hyperactivity Disorder

et al. 2016

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IMPORTANCE Murine studies reveal that sympathetic nervous system activation leads to decreased bone mass. Stimulant medications used to treat attention-deficit/hyperactivity disorder (ADHD) increase sympathetic tone and may affect bone remodeling. Because bone mass accrual is completed by young adulthood, assessing stimulant effects on bone density in growing children is of critical importance. OBJECTIVE To investigate associations between stimulant use and bone mass in children and adolescents. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional analysis used data collected from January 1, 2005, to December 31, 2010, from the National Health and Nutrition Examination Survey (NHANES) database. NHANES is a series of cross-sectional, nationally representative health and nutrition surveys of the US population. All children, adolescents, and young adults aged 8 to 20 years with dual-energy x-ray absorptiometry (DXA), anthropometric, demographic, and prescription medication use data were eligible for participation. Of the 6489 respondents included in the multivariable linear regression analysis, 159 were stimulant users and 6330 were nonusers. Data were analyzed from October 8, 2015, to December 31, 2016. EXPOSURES Stimulant use, determined by questionnaires administered via interview. MAIN OUTCOMES AND MEASURES The association between stimulant use and total femur, femoral neck, and lumbar spine bone mineral content (BMC) and bone mineral density (BMD) was assessed using DXA. RESULTS Study participants included 6489 NHANES participants with a mean (SD) age of 13.6 (3.6) years. Stimulant use was associated with lower bone mass after adjustment for covariates. Mean lumbar spine BMC was significantly lower in stimulant users vs nonusers (12.76 g; 95% CI, 12.28-13.27 g vs 13.38 g; 95% CI, 13.26-13.51 g; P = .02), as was mean lumbar spine BMD (0.90 g/cm 2 ; 95% CI, 0.87-0.94 g/cm 2 vs 0.94 g/cm 2 ; 95% CI, 0.94-0.94 g/cm 2 ; P = .03) and mean femoral neck BMC (4.34 g; 95% CI, 4.13-4.57 g vs 4.59 g; 95% CI, 4.56-4.62 g; P = .03). Mean BMD of the femoral neck (0.88 g/cm 2 ; 95% CI, 0.84-0.91 g/cm 2 vs 0.91 g/cm 2 ; 95% CI, 0.90-0.91 g/cm 2 ; P = .08) and total femur (0.94 g/cm 2 ; 95% CI, 0.90-0.99 g/cm 2 vs 0.99 g/cm 2 ; 95% CI, 0.98-0.99 g/cm 2 ; P = .05) were also lower in stimulant users vs nonusers. Participants treated with stimulants for 3 months or longer had significantly lower lumbar spine BMD (0.89 g/cm 2 ; 95% CI, 0.85-0.93 g/cm 2 vs 0.94 g/cm 2 ; 95% CI, 0.94-0.94 g/cm 2 ; P = .02) and BMC (12.71 g; 95% CI, 12.14-13.32 g vs 13.38 g; 95% CI, 13.25-13.51 g; P = .03) and femoral neck BMD (0.87 g/cm 2 ; 95% CI, 0.74-0.83 g/cm 2 vs 0.91 g/cm 2 ; 95% CI, 0.83-0.84 g/cm 2 ; P = .048) than nonusers. CONCLUSIONS AND RELEVANCE Children and adolescents reporting stimulant use had lower DXA measurements of the lumbar spine and femur compared with nonusers. These findings support the need for future prospective studies to examine the effects of stimulant use on bone mass in children.

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Treatment of toxicity from amphetamines, related derivatives, and analogues: A systematic clinical review

Cited by 84 publications

References 125 publications

Psychosis induced by amphetamines

Psychosis induced by amphetamines

Understanding the Relationship Between Amphetamines and Psychosis

Association of Stimulant Medication Use With Bone Mass in Children and Adolescents With Attention-Deficit/Hyperactivity Disorder

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