Methamphetamine Psychosis in Japan: a survey

Nakatani, Yoji; Yoshizawa, J.; Yamada, H.; Iwanami, Akira; Sakaguchi, M.; Katoh, Nobukatsu

doi:10.1111/j.1360-0443.1989.tb03941.x

Cited by 14 publications

(9 citation statements)

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“…In a review of studies relating to the first and second epidemics of MA abuse in Japan, Sato [59] reported that during the second epidemic, nearly 50% of those admitted to the hospital for MA psychosis had experienced this condition previously with the most extreme cases having been readmitted for treatment of MA psychosis more than 10 times. A number of studies have examined risk factors for recurrent MA-induced psychoses, with identified triggers including MA use or resumption of use [38], even in relatively small amounts following protracted abstinence [60], other substance use [61], including heavy alcohol use, even in the absence of MA use [54,59,62]; sleep deprivation [63], and psychosocial stressors [62,64]. When MA use triggers re-currence of psychosis, the symptom presentation tends to remain the same as in prior episodes [59].…”

Section: -Clinical Correlates Of Methamphetamine Psychosismentioning

confidence: 99%

Methamphetamine Psychosis: Epidemiology and Management

Glasner‐Edwards¹,

Mooney²

2014

CNS Drugs

203

161

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Psychotic symptoms and syndromes are frequently experienced among individuals who use methamphetamine, with recent estimates of up to approximately 40% of users affected. Though transient in a large proportion of users, acute symptoms can include agitation, violence, and delusions, and may require management in an inpatient psychiatric or other crisis intervention setting. In a subset of individuals, psychosis can recur and persist and may be difficult to distinguish from a primary psychotic disorder such as schizophrenia. Differential diagnosis of primary versus substance-induced psychotic disorders among methamphetamine users is challenging; nevertheless, with careful assessment of the temporal relationship of symptoms to methamphetamine use, aided by state-of-the art psychodiagnostic assessment instruments and use of objective indicators of recent substance use (i.e., urine toxicology assays), coupled with collateral clinical data gathered from the family or others close to the individual, diagnostic accuracy can be optimized and the individual can be appropriately matched to a plan of treatment. The pharmacological treatment of acute methamphetamine-induced psychosis may include the use of antipsychotic medications as well as benzodiazepines, although symptoms may resolve without pharmacological treatment if the user is able to achieve a period of abstinence from methamphetamine. Importantly, psychosocial treatment for methamphetamine dependence has a strong evidence base and is the optimal first-line treatment approach to reducing rates of psychosis among individuals who use methamphetamines. Prevention of methamphetamine relapse is the most direct means of preventing recurrence of psychotic symptoms and syndromes. Long-term management of individuals who present with recurrent and persistent psychosis, even in the absence of methamphetamine use, may include both behavioral treatment to prevent resumption of methamphetamine use and pharmacological treatment targeting psychotic symptoms. In addition, treatment of co-occurring psychiatric disorders including depression and anxiety is important as a means of preventing relapse to methamphetamine use, which is often triggered by associated symptoms.

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Section: -Clinical Correlates Of Methamphetamine Psychosismentioning

confidence: 99%

Methamphetamine Psychosis: Epidemiology and Management

Glasner‐Edwards¹,

Mooney²

2014

CNS Drugs

203

161

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“…We recently showed that individuals with MAMP psychosis present many of the characteristic symptoms of schizophrenia: 85% had auditory hallucinations, 71% had delusions of persecution, 63% had delusions of reference, 47% had visual hallucinations, 41% delusions of thought reading, 28% delusions of thought insertion, 26% delusions of thought broadcasting, 23% delusions of being controlled, and 27% had odd speech [Chen et al, 2003]. Moreover, MAMP‐related psychotic symptoms can persist for months, or occasionally years, in the absence of ongoing MAMP use [Tatetsu et al, 1956; Nakatani et al, 1989; Iwanami et al, 1994].…”

Section: Introductionmentioning

confidence: 99%

Morbid risk for psychiatric disorder among the relatives of methamphetamine users with and without psychosis

et al. 2005

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It is not clear why some methamphetamine (MAMP) abusers develop psychotic symptoms, while others use MAMP regularly over long periods and remain unscathed. We tested the hypotheses that those users who develop MAMP-induced psychosis (MIP) have greater familial loading for psychotic disorders than users with no psychosis. Four hundred forty-five MAMP users were recruited from a psychiatric hospital and a detention center in Taipei, and were assessed with the Diagnostic Interview for genetic studies (DIGS-C) and the Family Interview for genetic study (FIGS-C). Morbid risk (MR) for psychiatric disorders in first-degree relatives was compared between those MAMP users with a lifetime diagnosis of MAMP psychosis and those without. The relatives of MAMP users with a lifetime diagnosis of MAMP psychosis had a significantly higher MR for schizophrenia (OR = 5.4, 95% CI: 2.0-14.7, P < 0.001) than the relatives of those probands who never became psychotic. Furthermore, the MR for schizophrenia in the relatives of the subjects with a prolonged MAMP psychosis (MIP-P) was higher than in the relatives of those users with a brief MAMP psychosis (MIP-B) (OR = 2.8, 95% CI: 1.0-8.0, P = 0.042). The greater his or her familial loading for schizophrenia, the more likely a MAMP user is to develop psychosis, and the longer that psychosis is likely to last.

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“…(Am J Psychiatry 2010; 167: [17][18][19][20][21][22][23] Warning Network, which monitors drug-related emergency department utilization statistics, indicate that among emergency department visits in 2006 for treatment involving illicit drug use, 11.2% involved amphetamines (7). In one Oregon hospital, methamphetamine use accounted for 2.4% of emergency room visits for any purpose in 2006 (8); at a San Diego trauma center, the number of individuals testing positive for methamphetamine rose by more than 70% from 2003 to 2005, causing methamphetamine to surpass marijuana as the most commonly detected drug of abuse (9).…”

Section: From Mclean Hospitalmentioning

confidence: 99%

“…He adopted a "sober lifestyle," did not drink or use drug s, and attended 1 2 -step g roups, althoug h he had decades (12,13). Few U.S. studies have described patients with prolonged methamphetamine psychosis, but a substantial literature on this topic has accumulated from other countries, especially Japan (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27); many of these studies are not in English, however. Although psychotic symptoms usually remit after acute intoxication, some patients exhibit prolonged psychosis for weeks or months after stopping methamphetamine (11,14).…”

Section: From Mclean Hospitalmentioning

confidence: 99%

“…In Japan, methamphetamine has been by far the most widely abused illicit drug for more than 50 years; until recently, Japanese substance abusers rarely consumed drugs other than methamphetamine, thus allowing investigators to assess the effects of methamphetamine without the confounding effects of other substances (29). A more recent study (19) described 132 consecutive patients with methamphetamine psychosis admitted to a Tokyo hospital from 1978 to 1987; about 28% required more than 61 days of hospitalization. About two-thirds remitted within 20 days after stopping methamphetamine, but about 10% displayed psychosis lasting more than 6 months and in some cases even a few years.…”

Section: Case Presentationmentioning

confidence: 99%

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Remission of Persistent Methamphetamine-Induced Psychosis After Electroconvulsive Therapy: Presentation of a Case and Review of the Literature

Grelotti

Kanayama²,

Pope³

2010

AJP

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Illicit methamphetamine abuse represents a major problem in many countries worldwide, including the United States. Prolonged regular smoking or injection of methamphetamine can cause a psychosis, typically characterized by paranoid delusions and auditory hallucinations and often associated with disturbances in mood. These symptoms may persist long after methamphetamine is discontinued and may prove refractory to antipsychotic medications. The authors describe a patient who developed a typical methamphetamine psychosis that persisted despite months of abstinence from methamphetamine and weeks of treatment with antipsychotic medication but that responded promptly to electroconvulsive therapy (ECT) on two separate occasions: on initial presentation and again a year later when the patient relapsed into methamphetamine abuse and developed psychosis again. The authors review the large international literature on methamphetamine psychosis, much of which is from Japan and has not previously been summarized in English. Persistent methamphetamine psychosis has been widely reported in Japan for more than 50 years but is rarely discussed in the American literature, possibly because some such cases are misdiagnosed in the United States as primary psychotic disorders. Given the growing public health problem of methamphetamine abuse in the United States, the distinction between persistent methamphetamine psychosis and a primary psychotic disorder has grown increasingly important. Thus, American clinicians should be alert to the possibility of methamphetamine psychosis and may wish to consider ECT in refractory cases.

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Methamphetamine Psychosis in Japan: a survey

Cited by 14 publications

References 1 publication

Methamphetamine Psychosis: Epidemiology and Management

Methamphetamine Psychosis: Epidemiology and Management

Morbid risk for psychiatric disorder among the relatives of methamphetamine users with and without psychosis

Remission of Persistent Methamphetamine-Induced Psychosis After Electroconvulsive Therapy: Presentation of a Case and Review of the Literature

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