Psychiatria pre prax 2/2009

Psychotic symptoms in methamphetamine dependent subjects

This is a review article on methamphetamine-induced psychosis. About 20 000 subjects in the Czech Republic abuse methamphetamine (MAMP). The prevalence of psychotic states in this subpopulation is eleven times more frequent as compared to general population. Genetic factors, premorbid personality and methamphetamine itself with its neurotoxic and neuropathophysiological effects are important in etiopathogenesis of MAMP psychosis. The clinical picture with paranoid-hallucinatory symptoms resembles an acute episode of schizophrenia, negative or affective signs may also be present. Most of the MAMP-induced psychotic states subsides within one week, however up to 40 % of the patients may develop a psychosis persisting for several months. Antipsychotics are the first choice treatment in MAMP psychosis, the second generation should be preferred to the first one. The patient´s abstinence and avoidance of stress are necessary for a successful treatment.

Keywords: methamphetamine, psychosis, causes, symptoms, treatment