Psychostimulant use and the brain

Lappin, Julia; Sara, Grant

doi:10.1111/add.14708

Cited by 77 publications

(40 citation statements)

References 124 publications

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“…Therefore, the unadjusted estimates we have presented are likely to be inflated due to the multitude of risk factors for poor mental health that co-occur with the use of amphetamines. Possible aetiological factors contributing to high rates of mental disorders amongst people who use amphetamines include common risk factors for substance use problems and mental disorders (e.g., familial risk [82], early childhood trauma [84]), the pharmacological effects of amphetamines (e.g., mood enhancement, withdrawal symptoms), the lasting neurophysiological and potential neurocognitive sequelae of chronic heavy use [88], as well as the secondary consequences of substance dependence (e.g., social isolation related to unemployment, stigma) and co-occurring risk factors (e.g., high rates of polysubstance use and low socio-economic background [87]).…”

Section: Discussionmentioning

confidence: 99%

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Mental health outcomes associated with the use of amphetamines: A systematic review and meta-analysis

et al. 2019

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a b s t r a c tBackground: The use of amphetamines is a global public health concern. We summarise global data on use of amphetamines and mental health outcomes. Methods: A systematic review and meta-analysis (CRD 42017081893). We searched Medline, EMBASE, PsycInfo for methamphetamine or amphetamine combined with psychosis, violence, suicidality, depression or anxiety. Included studies were human empirical cross-sectional surveys, case-control studies, cohort studies and randomised controlled trials that assessed the association between methamphetamine and one of the mental health outcomes. Random effects meta-analysis was used to pool results for any use of amphetamines and amphetamine use disorders. Findings: 149 studies were eligible and 59 were included in meta-analyses. There was significant heterogeneity in effects. Evidence came mostly from cross-sectional studies. Any use of amphetamines was associated with higher odds of psychosis (odds ratio [OR] = 2.0, 95%CI 1.3-3.3), violence (OR = 2.2, 95%CI 1.2-4.1; adjusted OR [AOR] = 1.4, 95%CI 0.8-2.4), suicidality OR = 4.4, 95%CI 2.4-8.2; AOR = 1.7, 95%CI 1.0-2.9) and depression (OR = 1.6, 95%CI 1.1-2.2; AOR = 1.3, 95%CI 1.2-1.4). Having an amphetamine use disorder was associated with higher odds of psychosis (OR = 3.0, 95%CI 1.9-4.8; AOR = 2.4, 95%CI 1.6-3.5), violence (OR = 6.2, 95%CI 3.1-12.3), and suicidality (OR = 2.3, 95%CI 1.8-2.9; AOR = 1.5, 95%CI 1.3-1.8). Interpretation: Methamphetamine use is an important risk factor for poor mental health. High quality population-level studies are needed to more accurately quantify this risk. Clinical responses to methamphetamine use need to address mental health harms.

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Section: Discussionmentioning

confidence: 99%

“…We also recognise the potential significant impact of cardiovascular and neuropsychiatric sequelae, such as hypertension, stroke, neurocognitive impairment and Parkinson's disease, on mental health. These were beyond the scope of the current review but have been reviewed elsewhere [88].…”

Section: Discussionmentioning

confidence: 99%

Mental health outcomes associated with the use of amphetamines: A systematic review and meta-analysis

et al. 2019

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“…157 Finally, clinicians should assess the possibility of illicit drugs intoxication such as the psychostimulants methamphetamine/amphetamine, cocaine, and 3,4-methylenedioxymethamphetamine (MDMA). 158…”

Section: Drug-induced Seizuresmentioning

confidence: 99%

Principles of Pharmacotherapy of Seizures and Status Epilepticus

2020

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Status epilepticus is a neurological emergency with an outcome that is highly associated with the initial pharmacotherapy management that must be administered in a timely fashion. Beyond first-line therapy of status epilepticus, treatment is not guided by robust evidence. Optimal pharmacotherapy selection for individual patients is essential in the management of seizures and status epilepticus with careful evaluation of pharmacokinetic and pharmacodynamic factors. With the addition of newer antiseizure agents to the market, understanding their role in the management of status epilepticus is critical. Etiology-guided therapy should be considered in certain patients with drug-induced seizures, alcohol withdrawal, or autoimmune encephalitis. Some patient populations warrant special consideration, such as pediatric, pregnant, elderly, and the critically ill. Seizure prophylaxis is indicated in select patients with acute neurological injury and should be limited to the acute postinjury period.

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“…Methamphetamine users often present to emergency rooms with varied neurological and psychiatric manifestations resulting in significant morbidity and mortality. Recently, Lappin & Sara [18] published a detailed review emphasizing that severe long-term impairment is a neuropsychiatric deficit associated with Psychostimulant Use Disorder (PUD). These authors explored psychostimulant neurochemistry; the moderators, mechanisms producing pathology, clinical responses, and the prognosis.…”

Section: Introductionmentioning

confidence: 99%

Psychostimulant use disorder emphasizing methamphetamine and the opioid -dopamine connection: Digging out of a hypodopaminergic ditch

Blum

Cadet

Gold

2021

Journal of the Neurological Sciences

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Background: Approved food and drug administration (FDA) medications to treat Psychostimulant Use Disorder (PUD) are needed. Both acute and chronic neurological deficits related to the neurophysiological effects of these powerfully addictive drugs can cause stroke and alterations in mood and cognition. Objective: This article presents a brief review of the psychiatric and neurobiological sequelae of methamphetamine use disorder, some known neurogenetic associations impacted by psychostimulants, and explores treatment modalities and outcomes. Hypothesis: The authors propose that gentle D2 receptor stimulation accomplished via some treatment modalities can induce dopamine release, causing alteration of D2-directed mRNA and thus enhanced function of D2 receptors in the human. This proliferation of D2 receptors, in turn, will induce the attenuation of craving behavior, especially in genetically compromised high-risk populations. Discussion: A better understanding of the involvement of molecular neurogenetic opioid, mesolimbic dopamine, and psychostimulant connections in "wanting" supports this hypothesis. While both scientific and, clinical professionals search for an FDA approved treatment for PUD the induction of dopamine homeostasis, via activation of the brain reward circuitry, offers treatment for underlying neurotransmitter functional deficits, potential prophylaxis, and support for recovery efforts. Conclusion: Dopamine regulation may help people dig out of their hypodopaminergia ditch.

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Psychostimulant use and the brain

Cited by 77 publications

References 124 publications

Mental health outcomes associated with the use of amphetamines: A systematic review and meta-analysis

Mental health outcomes associated with the use of amphetamines: A systematic review and meta-analysis

Principles of Pharmacotherapy of Seizures and Status Epilepticus

Psychostimulant use disorder emphasizing methamphetamine and the opioid -dopamine connection: Digging out of a hypodopaminergic ditch

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