Understanding the Relationship Between Amphetamines and Psychosis

Abstract

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.

A systematic review of risk factors for methamphetamine-associated psychosis

“…In addition, some studies have not sufficiently accounted for or excluded individuals with primary psychotic disorders. Although there have been three previous narrative reviews focussing on factors associated with MA psychosis (Bramness et al, 2012; Glasner-Edwards and Mooney, 2014; Rognli and Bramness, 2015), these have not utilised systematic methodology and have not attempted to evaluate the quality of studies or potential sources of bias.…”

A Research of Methamphetamine Induced Psychosis in 1,430 Individuals With Methamphetamine Use Disorder: Clinical Features and Possible Risk Factors

“…A recent Norwegian study found no association between the severity of psychotic symptoms and quantitative measures of blood amphetamine concentration ( 16 ). In addition, there have been three narrative reviews focusing on risk factors associated with MIP ( 4 , 17 , 18 ), showed that it was complicated to determine causality for the MIP, and difficult to make clear about the risk factors of psychotic disorders among MA users.…”

A New Look at an Old Drug: Cumulative Effects of Low Ribavirin Doses in Amphetamine-Sensitized Rats

“…Overall, this information could be of clinical importance as it helps to understand variations in both behavioral responses to low doses of AMPH (≤ 0.25 mg/kg/day) and the incidence of behavioral sensitization after intermittent usage of low doses in humans [39,42,43].…”