What is Amphetamine Psychosis?
The use of amphetamine and methamphetamine is widespread in the general population and common among patients with psychiatric disorders. Amphetamines may induce symptoms of psychosis very similar to those of acute schizophrenia spectrum psychosis. This has been an argument for using amphetamine-induced psychosis as a model for primary psychotic disorders. To distinguish the two types of psychosis on the basis of acute symptoms is difficult. However, acute psychosis induced by amphetamines seems to have a faster recovery and appears to resolve more completely compared to schizophrenic psychosis.
The increased vulnerability for acute amphetamine psychosis seen among those with schizophrenia, schizotypal personality, and, to a certain degree other psychiatric disorders, is also shared by non-psychiatric individuals who previously have experienced amphetamine-induced psychosis. Schizophrenia spectrum disorder and amphetamine-induced psychosis are further linked together by the finding of several susceptibility genes common to both conditions. These genes probably lower the threshold for becoming psychotic and increase the risk for a poorer clinical course of the disease.
What Stimulants Cause Psychosis?
There are different kinds of street amphetamines. Common ones and some of their slang terms are:
- Amphetamine: goey, louee, speed, uppers, whiz
- Dextroamphetamine (ADHD medicine used illegally): dexies, kiddie-speed, pep pills, uppers; black beauty (when combined with amphetamine)
- Methamphetamine (crystal solid form): base, crystal, d-meth, fast, glass, ice, meth, speed, whiz, pure, wax
- Methamphetamine (liquid form): leopard’s blood, liquid red, ox blood, red speed
Illegal amphetamines come in different forms:
- Pills and capsules
- Powder and paste
- Crystal
- Liquid
They can be used in different ways:
- Swallowed
- Dabbed onto the gums
- Inhaled through the nose (snorted)
- Injected into a vein (shooting up)
- Smoked
Symptoms of Amphetamine Psychosis
The symptoms of psychosis induced by amphetamines are very similar to those of acute schizophrenia spectrum psychosis and include lack of concentration, delusions of persecution, increased motor activity, disorganization of thoughts, lack of insight, anxiety, suspicion, and auditory hallucinations. [1]
Some studies have suggested differences with more pronounced grandiosity and visual hallucinations. The thought disorders that occur in schizophrenia are characterized by splitting and loosening of associations, a concreteness of abstract thought, and impairment in goal-directed thought may be less prominent in amphetamine psychosis. However, distinguishing the two types of psychosis on the basis of acute symptoms is probably very difficult. The similarities between the two conditions are, in fact, so pronounced that this has been used as an argument for using amphetamine-induced psychosis as a model for primary psychotic disorders.
In contrast to schizophrenic psychosis, acute psychosis induced by amphetamines seems to have a faster recovery and appears to resolve with abstinence, although the recovery may be incomplete. Japanese researchers have argued that psychosis induced by amphetamines could, in fact, be of much longer duration, up to several years. This research describes spontaneous psychotic relapses in the long term after remittance of psychosis (“flashbacks”), a phenomenon acknowledged in the popular folk culture in the USA and Europe but much less researched.
Stressful situations seem to trigger such flashbacks in susceptible individuals and several vulnerability factors have been identified, e.g. a family history of psychosis. It is difficult to distinguish the Japanese chronic amphetamine psychosis from a primary psychosis triggered by the use of amphetamines, although it has been claimed that they constitute separate entities.
f you’re dependent on amphetamines, you may:
- Miss work or school
- Not complete or perform tasks as well
- Not eat and lose a lot of weight
- Have severe dental problems
- Find it difficult to stop using amphetamines
- Experience withdrawal symptoms if you don’t use amphetamines
- Have episodes of violence and mood disturbances
- Have anxiety, insomnia, or paranoia
- Feel confused
- Have visual or auditory hallucinations
- Have delusions, such as the sensation that something is crawling under your skin
Risk Factors and Acute vs. Chronic Psychosis
The use of amphetamines is common among patients with psychiatric disorders, especially in the United States. In animal models, there is sensitization to the rewarding effects of amphetamines. Sensitization is also seen in human subjects. There is reason to believe that an earlier psychosis involves a risk of future psychotic episodes due to this sensitization, or possibly to the development of dopaminergic supersensitivity.
Psychosis may be precipitated acutely by amphetamine due to its effects on dopaminergic activity in the CNS. In the longer term, the neurotoxic effects of the drugs on serotonin and dopamine neurons and dopamine transporters may play a role. Amphetamine sensitization seems to cause dysregulation of dopamine by the ventral subiculum. There is an over-expression of the dopamine receptor, subtype 2 (DRD2), and a higher sensitivity of DRD2 to the effects of amphetamines in vulnerable individuals. [2]
In addition to the increased risk of psychosis following the use of amphetamines in people who have experienced amphetamine-induced psychosis previously, patients with schizophrenia and schizotypal personality traits may more readily become psychotic after the use of amphetamines. Other risk factors for psychosis may include amphetamine use disorders (abuse and dependence), the presence of other psychiatric disorders (primarily attenuated psychosis syndrome, personality disorders, and affective disorders), early cognitive dysfunction (such as those found in the prodromal states of schizophrenia), family history of mental disorder and the use of other drugs like opiates, benzodiazepines, cannabis, and alcoholism.
Amphetamine psychosis may be purely related to high drug usage, or high drug usage may trigger an underlying vulnerability to schizophrenia. There is some evidence that vulnerability to amphetamine psychosis and schizophrenia may be genetically related.
The similarities between acute schizophrenic psychosis and psychosis following the use of amphetamines are so pronounced that the latter has been suggested as a model for schizophrenia. However, it remains unresolved whether the relationship between amphetamines and psychosis is explained by drug exposure (amphetamine-induced psychosis), amphetamines use triggering a primary psychotic disorder, or both. Although psychosis may be induced by amphetamine in healthy individuals, not all subjects become psychotic by the doses of amphetamines allowed in the experiments.
Some, but not all, individuals using amphetamines have experienced psychotic episodes, and a few have experienced psychosis as an adverse event during stimulant treatment. Is this a result of differences in amphetamine exposure or differences in vulnerability? Furthermore, psychosis is precipitated by a lower dose of amphetamines in individuals with primary psychosis and may be blocked by the use of anti-psychotics. Finally, there seem to be many genetic and physiological similarities between amphetamine-induced psychosis and acute schizophrenic psychosis, suggesting that vulnerability may play a significant role in the occurrence of amphetamines-induced psychosis.
Amphetamine Psychosis Recovery
Treatments for amphetamine use disorder may include a combination of the following:
Hospitalization
If you experience strong drug cravings, you may find it easier to go through amphetamine withdrawal in a hospital setting. Hospitalization may also help if you have negative mood changes, including aggression and suicidal behavior.
Therapy
Individual counseling, family therapy, and group therapy can help you:
- Identify the feelings associated with amphetamine use
- Develop different coping mechanisms
- Repair relationships with your family
- Develop strategies to avoid amphetamine use
- Discover activities you enjoy in place of amphetamine use
- Get support from others with use disorder as they understand what you’re going through, sometimes in a 12-step treatment program [3]
Medication
Your doctor may prescribe medication to ease severe symptoms of withdrawal. Some doctors may prescribe naltrexone to help with your cravings. Your doctor may also prescribe other medications to help relieve symptoms of anxiety, depression, and aggression.
Amphetamine Induced Psychosis Treatment
Treatment begins with recognizing there is a problem. Once you decide you want to do something about your drug use, the next step is to get help and support.
Treatment programs use behavior change techniques through counseling (talk therapy). The goal is to help you understand your behaviors and why you use amphetamines. Involving family and friends during counseling can help support you and keep you from going back to using (relapsing). [4]
If you have severe withdrawal symptoms, you may need to stay at an inpatient treatment program. There, your health and safety can be monitored as you recover. At this time, there is no medicine that can help reduce the use of amphetamines by blocking their effects. But, scientists are researching such medicines.
Inpatient drug rehab provides a drug-free place away from obstacles that could trigger your cravings. You typically stay in a treatment center for several weeks and participate in individual and group therapies. If you or a loved one is struggling with amphetamine psychosis and addiction, We Level Up TX addiction specialists are standing by to help. Contact us today, there’s no obligation and calls are 100% confidential.
Sources:
[1-2] Amphetamine-induced psychosis – a separate diagnostic entity or primary psychosis triggered in the vulnerable? – National Center for Biotechnology Information, U.S. National Library of Medicine
[3] Amphetamine Dependence – https://www.healthline.com/health/amphetamine-dependence
[4] Substance use – Amphetamines – U.S. Department of Health and Human Services National Institutes of Health
