Acute exacerbation of paranoid psychotic state after long-term abstinence in patients with previous methamphetamine psychosis.
From a population of 111 patients with chronic methamphetamine (MAP) psychosis, who were treated at ten mental hospitals during the past 3 years, 21 patients were selected for study. Sixteen patients who experienced MAP psychosis again used MAP one or more times after long-term abstinence and experienced acute exacerbation of a paranoid psychotic state which was almost identical to the initial psychotic episode. Four of these patients relapsed following a single MAP reuse of an amount less than that initially used, and one relapsed without evidence of MAP reuse. In eight patients, small doses of neuroleptics, e.g., 3 mg per day of haloperidol, prevented the acute provocation of a psychotic state by MPA reuse. Subsequently, three of these relapsed into a psychotic state following MAP reuse without concurrent haloperidol medication. The clinical data were compared with animal experiments which indicate that chronic MAP use can induce a long-term susceptibility to sensitization to MAP. The positive prophylactic effect of small doses of haloperidol on the acute exacerbation may suggest the participation of dopaminergic supersensitivity as a mechanism for the paranoid psychotic state.
D000328:Adult; D003702:Delusions / Q000139:chemically induced; D006212:Hallucinations / Q000139:chemically induced; D006220:Haloperidol / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008694:Methamphetamine / Q000009:adverse effects*; D010259:Paranoid Disorders / Q000139:chemically induced* / Q000523:psychology; D011605:Psychoses, Substance-Induced / Q000523:psychology*; D012008:Recurrence; D012563:Schizophrenia, Paranoid / Q000139:chemically induced; D012565:Schizophrenic Psychology; D013375:Substance Withdrawal Syndrome / Q000523:psychology*; D014273:Triflupromazine / Q000627:therapeutic use
D008694:Methamphetamine; D006220:Haloperidol; D014273:Triflupromazine