What is Amphetamine Psychosis?
Amphetamine psychosis differs from primary psychosis and alcohol-induced psychosis, not only due to its causes but also its symptoms and their development. Amphetamines are a group of psychoactive drugs that have different physical and psychological effects on the body. They are being used either as recreational drugs or as prescription drugs. In both cases, they have a wide range of possible amphetamine effects. One of the most serious is amphetamine psychosis. This is a mental disorder derived from the use of these drugs.
Because amphetamine psychosis is related to drug use, it’s different from other conditions, such as delirium or schizophrenia. However, amphetamine psychosis symptoms are similar to schizophrenia and can happen even in healthy people. Amphetamine psychosis typically arises in one of two forms: amphetamine-induced psychosis and amphetamine withdrawal psychosis.
What Stimulants Cause Psychosis?
Stimulants are drugs that increase the body’s functions by increasing the speed of activity in the central nervous system (brain and spinal column). These drugs increase the amount of dopamine in the brain, resulting in an increase in heart rate, alertness, and energy. Stimulants can be beneficial in treating medical conditions such as attention deficit hyperactivity disorder, narcolepsy, obesity, and depression.
Familiar examples of stimulants include caffeine, cocaine, amphetamines, methamphetamines, and nicotine. All of these substances share common side effects due to their similar influence on the CNS. These include, but are not limited to, appetite suppression, sleep disturbances, increased blood pressure, agitation and psychosis. It should be noted that numerous studies have proven a co-morbidity of mental illness with stimulant-induced psychosis .
According to the National Center for Biotechnology Information (NCBI) , psychosis resulting from stimulant abuse is commonly observed in clinical practices today. This is in large part due to the significant increase in attention-deficit hyperactive disorder (ADHD) diagnoses in recent years, the increase in methamphetamine trafficking, and the prevalence of stimulant use in the day-to-day activities by many of those living in today’s fast-paced society.
Acute psychosis induced by stimulants occurs within a period of four to five days after intoxication. The symptoms typically resolve with abstinence. However, recovery may be incomplete. The current inability to predict those users who will experience stimulant-induced psychosis from those users who will not need further investigation. However, if the general population is made more aware of the risk factors associated with psychosis, it may help prevent those vulnerable from abusing stimulants.
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Amphetamine and Methamphetamine
The most common cause of stimulant-induced psychosis is amphetamine and methamphetamine use. They inhibit dopamine reuptake into neurons by binding to dopamine transporters (DAT), resulting in an increase in the concentration of dopamine in the synaptic cleft. They also utilize the vesicular monoamine transporter 2 (VMAT2) to enter neurosecretory vesicles within the neuron.
The amphetamine displaces the dopamine within the vesicles, resulting in dopamine release into the cleft. This prevention of dopamine reuptake with the additional release of dopamine results in an increase in the concentration of dopamine in the mesolimbic and mesocortical pathways. The mesocortical pathway projects from the ventral tegmental area (VTA) to numerous areas of the prefrontal cortex. Projections to the dorsolateral prefrontal cortex regulate cognition and executive functioning.
The second most common cause of stimulant-induced psychosis is cocaine. Like amphetamines, cocaine prevents the reuptake of monoamines from the synapse causing an increase in the concentration of monoamines.
Two common stimulants that do not affect the dopamine pathways directly are caffeine and nicotine. Caffeine is the most widely used drug in the world. It exerts its effects by antagonizing adenosine A1 and A2A receptors, which are drivers of sleep and drowsiness. Caffeine releases the inhibitory effect of adenosine receptors on dopamine receptors, allowing an enhancement of dopamine signaling in the striatum, resulting in wakefulness and alertness. This indirect relation with the mesolimbic pathway explains the numerous case studies linked to excessive caffeine intake and psychosis.
Nicotine is an active chemical in tobacco products. It acts as an agonist on the nicotinic acetylcholine receptor, triggering multiple downstream effects including the increase of activity in the dopaminergic pathways. Individuals that encountered acute psychosis for the first time had either smoked for some years prior to the onset or had an excess amount of tobacco ingestion when presenting the symptoms. They were more likely to have smoked than aged-matched controls
Symptoms of Amphetamine Psychosis
Symptoms of amphetamine-induced psychosis can be similar to those of schizophrenia and other disorders. However, it’s important to differentiate between an amphetamine-induced psychosis and a common one. Because misdiagnoses can lead to incorrect treatments. The most common symptoms are the following:
- Delusions. In this case, paranoid and persecutory delusions frequently occur. For example, patients may claim that people are following them in order to do them harm. They also might experience referential thinking, when they believe that certain events are connected with them, even if there’s no evidence of this.
- Hallucinations. The most frequent are auditory and visual. However, they can also be olfactory, kinesthetic, or tactile.
- Obsessive-compulsive behaviors. Some people may develop certain compulsive habits such as excessive cleaning or the pulling out of their hair (trichotillomania).
The most important difference between common and amphetamine-induced psychosis is the presence of negative symptoms. We speak of negative symptoms when the person can’t perform certain processes normally when they should be able to. For example, not being able to have a coherent conversation or to follow a train of thought.
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Forms of Amphetamine Psychosis
There are two forms of psychosis that arise as a result of amphetamine use. The more common form is amphetamine psychosis. This condition comes about after a person has ingested a significant amount of amphetamines. However, it is short-lived and the symptoms subside after the person stops taking amphetamines. However, an amphetamine overdose can cause symptoms to persist even after the drug is flushed out of the person’s system. The second form is known as amphetamine withdrawal psychosis. Generally, people who were long-term users experience this symptom.
Risk Factors and Acute vs. Chronic Amphetamine Psychosis
Though amphetamine-induced psychosis usually is eliminated by the cessation of drug use or by treating psychotic symptoms, occasionally such psychosis can last for weeks, months, or even years beyond its initial onset. When amphetamine-induced psychosis does persist beyond treatment or stopping amphetamine use, several potential situations must be considered. The presence of any of the following conditions can increase the risk of amphetamine-induced psychosis becoming permanent:
- Meeting criteria for severe stimulant use disorder in the DSM-V makes it far more likely that a person will develop psychosis when taking any amphetamines and have worse long-term behavioral outcomes.
- At least seven genes are associated with the potential for amphetamine use to trigger psychosis; moreover, when psychosis does develop, the presence of these genes predicts poorer outcomes.
- Using amphetamine or other substances has the potential to “unlock” a person’s genetic predisposition for organic psychotic disorders, like bipolar disorder or schizophrenia—this is also referred to by the terms sensitization, priming effect, and reverse tolerance.
- The DSM-5 outlines criteria for considering psychotic symptoms to be part of a primary psychotic disorder, even if psychosis develops while using methamphetamine: (1) symptoms are substantially in excess of what would be expected given the type or amount of substance used or the duration of use; (2) there is a history of psychotic episodes that are not substance-related; (3) psychotic symptom onset precedes the onset of substance use; (4) psychotic symptoms persist for at least one month after the cessation of intoxication or acute withdrawal.
- Those with a previous history of primary psychotic symptoms (as a result of schizophrenia, bipolar disorder, or related conditions) before ever using amphetamine display a greater likelihood of experiencing persistent psychotic symptoms.
- Research based on studies of psychosis development in users of methamphetamine suggests that at least two types of amphetamine-induced psychosis exist, including a more severe “delayed lasting type” with symptoms that persist a month or more after stopping amphetamine use. This form is associated with using methamphetamine for five years or longer.
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Adderall Withdrawal Psychosis
Adderall, an amphetamine, is often thought of as a safe or harmless drug but it has been linked with mental health conditions like psychosis and schizophrenia. When people who do not have ADHD take Adderall to do better in school, concentrate, or lose weight, they put themselves at a higher risk for developing abusive behaviors and dangerous side effects . People with ADHD have lower dopamine levels in their brain, and these low levels mean their brain could seek stimulation. Adderall releases dopamine and other neurotransmitters, stimulating the central nervous system.
Amphetamines like Adderall can cause or be associated with the recurrence of psychiatric disorders. People who become dependent on amphetamines sometimes decrease their usage after experiencing side effects like paranoia and hallucinations. Some people may experience symptoms during withdrawal as well as during sustained use.
In addition to the behavioral problems that someone with psychosis and a substance use disorder experience, the person is often in poor physical health. People with psychosis are at a higher risk of cardiovascular diseases. Taking Adderall can cause heart problems to develop. Mortality rates are higher in people with psychosis because of their poor overall health and the increased risk of suicide.
Adderall psychosis occurs when someone uses a drug regularly for an extended period and begins experiencing psychotic symptoms. Psychosis induced by Adderall use can last days, months, and even years after someone stops taking the drug. The difference between a psychosis disorder and a substance-induced psychotic disorder is that the psychotic symptoms emerged after someone was using a drug.
The presentation of symptoms is slightly different in Adderall psychosis compared to primary psychosis. Researchers suggest that a primary psychotic disorder and a substance-induced psychosis disorder shouldn’t necessarily be considered two separate conditions but are recognized as two disorders that are closely associated. People who develop Adderall psychosis should be monitored closely. Further use of Adderall or any other type of stimulant is discouraged. Adderall psychosis can typically be resolved with abstinence from the substance.
Amphetamine Psychosis Recovery
Acute psychosis induced by amphetamines seems to have a faster recovery and appears to resolve with abstinence, although the recovery may be incomplete. Recent studies have found that although most symptoms of amphetamine psychosis will dissipate within a few weeks of the onset with abstinence, some symptoms can last several years. Psychotic relapse, also known as flashbacks, is common in those in recovery from an amphetamine addiction and who had suffered from a previous instance of amphetamine psychosis.
Recovery from amphetamine psychosis can take anywhere from a few weeks to a few years. This all depends on the individual characteristics of the person and an array of other (not yet fully known) factors. Those with a family history of dementia or psychosis are at an increased risk of a longer recovery period than those who are mentally stable and healthy.
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Amphetamine Psychosis and Addiction Treatment
Amphetamine psychosis and addiction treatment are most effective when it is tailored to a person’s specific condition. There is no “one size fits all” treatment. Some individuals may take a week or so to complete the detox process, while others may need longer amounts of time. Many people may need rehab during the initial phase of their treatment. This is because this is often the period when severe amphetamine withdrawal symptoms emerge.
These symptoms can be dangerous if not monitored properly. Many rehab centers even recommend interventions to prevent people from acting on their paranoia, delusions, or hallucinations. Aside from the difficult mental rehab process, medication-assisted treatment might also be necessary during this period. Conditions such as high blood pressure, hypertension, and severe headaches are common, and they can be dangerous to people with co-morbidities.
Gaining lasting recovery after amphetamine addiction proves difficult and has a long road to wellness. You can achieve this wellness with the right help. You need an array of therapies, programs, and services, such as:
- Medically assisted detox
- Inpatient addiction rehab
- Behavioral therapies, including cognitive behavioral therapy (CBT), and holistic treatment program
- Individual, family, and group counseling as help for family members of drug addicts
- Coping skills and life skills to prevent relapse
- Quality nutrition and medical care
Inpatient drug rehab provides a drug-free place away from obstacles that could trigger your cravings. The client typically stays in a treatment center for several weeks and participates in individual and group therapies. If you or a loved one is struggling with amphetamine psychosis and addiction. We Level Up NJ addiction specialists are standing by to help.
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