Efficacy and dropout rates of antipsychotic medications for methamphetamine psychosis: A systematic review and network meta-analysis

Srisurapanont, Manit; Likhitsathian, Surinporn; Suttajit, Sirijit; Maneeton, Narong; Maneeton, Benchalak; Oon-arom, Awirut; Suradom, Chawisa

doi:10.1016/j.drugalcdep.2020.108467

Cited by 14 publications

(22 citation statements)

References 30 publications

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“…One RCT 23 found aripiprazole was more efficacious than placebo but no medication was clinically superior to the others. In a network metaanalysis by Srisurapanont et al 16 comparing the treatment effects of risperidone, haloperidol, aripiprazole, paliperidone, quetiapine, and olanzapine for MAP, 6 RCTs [24][25][26][27][28][29] with 395 patients were included (Table 1). All of the trials were conducted outside of the United States, and 5 of the trials were conducted in an inpatient setting.…”

Section: Cases Case 1: Methamphetamine Intoxicationmentioning

confidence: 99%

“…Mean age ranged from 25.2 to 38.8 years and the majority of participants were male (range 54.6% to 100%). 16 Although the network meta-analysis 16 found low-quality evidence that olanzapine and quetiapine were superior to risperi- done and aripiprazole, the results of the individual trials found no significant difference between each pair of antipsychotics in reducing the main psychotic symptoms.…”

Section: Cases Case 1: Methamphetamine Intoxicationmentioning

confidence: 99%

“…The adverse reactions reported are consistent with the well-known profile associated with the antipsychotics, and no significant adverse reaction, such as neuroleptic malignant syndrome was reported. 16,[24][25][26][27][28][29] For example, higher rates of EPS were reported with haloperidol, increased incidence of akathisia with aripiprazole, weight gain with olanzapine, and sedation with olanzapine and quetiapine. 11,16,23 Given the limited data, SGAs are preferred over first-generation antipsychotics due to the lower risk of EPS, but no specific SGA is recommended for the treatment of MAP.…”

Section: Cases Case 1: Methamphetamine Intoxicationmentioning

confidence: 99%

“…16,[24][25][26][27][28][29] For example, higher rates of EPS were reported with haloperidol, increased incidence of akathisia with aripiprazole, weight gain with olanzapine, and sedation with olanzapine and quetiapine. 11,16,23 Given the limited data, SGAs are preferred over first-generation antipsychotics due to the lower risk of EPS, but no specific SGA is recommended for the treatment of MAP. 11,23 The choice of antipsychotic should be based on the risks and benefits of the medication for the individual patient.…”

Section: Cases Case 1: Methamphetamine Intoxicationmentioning

confidence: 99%

“…11,23,[30][31][32] The optimal antipsychotic treatment duration for MAP is unclear. 4,11,16 MAP is a selflimiting disorder for most patients, and some authors suggest that antipsychotics should be tapered off after the resolution of psychotic symptoms and discontinued after 4 weeks of methamphetamine abstinence. 16 The guideline for the pharmacologic management of methamphetamine-related disorders by Wodarz et al 11 recommends maintaining patients on the antipsychotic for approximately 6 months because residual symptoms may persist in some patients.…”

Section: Cases Case 1: Methamphetamine Intoxicationmentioning

confidence: 99%

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Pharmacotherapy treatment of stimulant use disorder

Liu¹

2021

Mental Health Clinician

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Stimulant use disorder (SUD) is a public health problem in the United States that is associated with increased morbidity and mortality. Psychosocial interventions, such as cognitive behavioral therapy and contingency management, are the main treatment modality for SUDs and no pharmacotherapy is currently FDA approved for this indication. Although some medications show promising data for the treatment of SUD, the evidence remains inconsistent, and the clinical application is limited due to the heterogenicity of the population and the lack of studies in patients with various comorbidities. Selection of pharmacotherapy treatment for methamphetamine intoxication, persistent methamphetamine-associated psychosis with methamphetamine use disorder, and cocaine use disorder in patients with co-occurring OUD are discussed in 3 patient cases.

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Section: Cases Case 1: Methamphetamine Intoxicationmentioning

confidence: 99%

Section: Cases Case 1: Methamphetamine Intoxicationmentioning

confidence: 99%

Section: Cases Case 1: Methamphetamine Intoxicationmentioning

confidence: 99%

Section: Cases Case 1: Methamphetamine Intoxicationmentioning

confidence: 99%

Section: Cases Case 1: Methamphetamine Intoxicationmentioning

confidence: 99%

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Pharmacotherapy treatment of stimulant use disorder

Liu¹

2021

Mental Health Clinician

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Differenzialdiagnostische Unterscheidung zwischen substanzinduzierten und primären Psychosen:

et al. 2021

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ZusammenfassungSubstanzinduzierte psychotische Störungen (SIPS) sind häufig und für ca. 25 % der ersten Einweisungen in eine psychiatrische Klinik verantwortlich. Aus klinischer Sicht ist aufgrund ähnlicher psychopathologischer Phänomene die diagnostische Unterscheidung zwischen SIPS und primären (genuinen oder kryptogenen) psychotischen Störungen oft eine Herausforderung. Dieser Umstand wird dadurch erschwert, dass SIPS im Zusammenhang mit Cannabis, Halluzinogenen und Amphetaminen ein erhebliches Risiko des Übergangs in eine primäre psychotische Störung (z. B. Schizophrenie) haben. Im ersten Abschnitt dieser Arbeit werden zunächst zwei exemplarische Fallvignetten aus der allgemeinpsychiatrischen und forensischen Praxis vorgestellt. Danach wird im Sinne einer selektiven Literaturübersicht die Relevanz der differenzialdiagnostischen Unterscheidung beider Störungsbilder aus der Sicht der allgemeinen und forensischen Psychiatrie in Bezug auf Therapie, Prognose und richterliche Entscheidung bezüglich der Unterbringung im Maßregelvollzug (§ 63 vs. § 64 StGB) beleuchtet. Der letzte Abschnitt hat das Ziel, ein strukturiertes Vorgehen zur differenzialdiagnostischen Unterscheidung zwischen SIPS und primären psychotischen Störungen zu erarbeiten. Die in dieser Arbeit dargestellten und diskutierten Konzepte und Befunde sollen klinisch tätigen Psychiatern und Psychologen die Diagnosestellung im allgemeinen und forensischen Kontext erleichtern.

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A Narrative Review of the Pathophysiology and Treatment of Methamphetamine-Associated Psychosis

Stacy,

Frantz,

Miller

et al. 2024

Int J Ment Health Addiction

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The evaluation and management of methamphetamine-associated psychosis (MAP) is an area of study with a paucity of large-scale, longitudinal data. Methamphetamine use has soared in popularity worldwide in the past decade, leading to a surge in individuals experiencing its neurotoxic effects. Current evidence suggests that methamphetamine causes neurodegeneration and psychosis through VMAT2 inhibition which raises dopamine and GABA levels in the brain’s dopaminergic pathways, leading to oxidative stress and inflammation. Differentiating MAP from primary psychotic disorders is challenging; high rates of persistent psychosis leading to a diagnosis of primary psychotic disorder and an absence of an etiologic differentiation amongst the DSM-5 diagnostic criteria further complicate the diagnostic process. Once a diagnosis of methamphetamine-associated psychosis is made, benzodiazepines have been shown to provide temporary relief; in addition, depending on the severity and impact of psychotic symptoms, antipsychotics may be indicated both short and long terms for ongoing symptom management. Robust data for these treatments is limited and primarily draws on animal studies or case reports. Further research is needed to codify MAP treatment standards of care.

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Efficacy and dropout rates of antipsychotic medications for methamphetamine psychosis: A systematic review and network meta-analysis

Cited by 14 publications

References 30 publications

Pharmacotherapy treatment of stimulant use disorder

Pharmacotherapy treatment of stimulant use disorder

Differenzialdiagnostische Unterscheidung zwischen substanzinduzierten und primären Psychosen:

A Narrative Review of the Pathophysiology and Treatment of Methamphetamine-Associated Psychosis

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