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Recovering From Methamphetamine-Induced Psychosis

Mar - 04 | | No comments. | Addiction Research

Methamphetamine-induced psychosis is a serious mental disorder that sometimes appears in longtime meth users who habitually take large doses of the drug. People with the disorder exhibit many of the symptoms commonly associated with paranoid schizophrenia, and in some cases, even experts in the field have problems telling the difference between the two conditions. Many people with methamphetamine-induced psychosis recover without specific treatment once they stop using meth, while others improve with the help of medications called atypical antipsychotics. However, some people with the disorder never fully recover, even if they receive antipsychotics and permanently discontinue meth use.

Basics of Methamphetamine-Induced Psychosis

Although meth-induced psychosis most typically appears in chronic consumers of high methamphetamine dosages, other factors may play a role in the onset of the disorder. For instance, people who inject or smoke meth generally have higher risks for psychiatric problems than people who dissolve the drug in alcohol or water, or snort it through their noses. Meth users who frequently experience sleep deprivation also may have higher risks for the condition’s onset, or develop stronger symptoms once psychosis begins. Additional at-risk populations include meth users who simultaneously abuse other drugs and meth users with pre-existing mental disorders.

Common symptoms found in someone with meth-induced psychosis include visual hallucinations; auditory (sound) hallucinations; a delusional belief that someone is “out to get” him or her; extreme suspiciousness regarding the actions of others; the belief that someone is “reading” his or her mind; attempts to explain or justify strange or delusional thinking; a profound lack of self-insight or self-awareness; and violent or aggressive behavior related to delusional beliefs. Many of these symptoms mirror or mimic the symptoms of paranoid schizophrenia. While schizophrenics tend to experience certain symptoms more frequently than people with meth-induced psychosis (and vice versa), doctors sometimes have significant problems telling the difference between the two conditions. In some cases, they only suspect the presence of drug-related problems if they know for certain their patient uses meth, or has used meth in the past.

Recovery Without Specific Treatment

A variety of studies conducted between the 1970s and the 2000s show that most cases of meth-induced psychosis fade within roughly a week to 10 days if the affected individual discontinues methamphetamine use and gives his or her body the chance to recuperate from any sleep deficits. In a smaller number of cases, recovery in these circumstances takes as long as two weeks to a month-in rare cases, recovery takes up to three months.

People who recover from the disorder are sometimes susceptible to a psychotic relapse. Potential factors involved in a relapse include resumption of methamphetamine use, separate or combined use of other drugs, alcohol use, and exposure to psychologically stressful social situations. In addition, some people experience a return of their meth-induced psychosis symptoms for no detectable reason. In previously recovering addicts who return to meth use, psychosis can appear much more quickly than it appeared the first time around.

Antipsychotic Treatment

As their name indicates, antipsychotics are classes of medications designed to reduce and control the symptoms of psychosis. Older forms of these drugs, called typical antipsychotics, were originally developed to combat the psychotic effects of schizophrenia. Specific types of typical antipsychotics include the medications haloperidol (Haldol), fluphenazine and chlorpromazine (Thorazine). Unfortunately, use of these drugs carries a significant risk for the onset of a secondary condition called tardive dyskinesia (TD), which produces uncontrollable muscle movements. Partly in response to the TD-related risks associated with typical antipsychotics, drug companies started developing atypical antipsychotics in the 1990s; members of this class of drugs-which do in fact produce smaller TD-related risks than typical antipsychotics-include olanzapine (Zyprexa), aripiprazole (Abilify), risperidone (Risperdal) and quetiapine (Seroquel).

Doctors and researchers don’t have a lot of long-term evidence regarding the effectiveness of either typical or atypical antipsychotics in people with methamphetamine-induced psychosis. This is due, in part, to the difficulty involved in distinguishing the condition from schizophrenia. Still, according to the results of an extensive review conducted in 2008 by researchers at UCLA, doctors treating meth-induced psychosis should strongly consider giving their patients low doses of atypical antipsychotics for a period of roughly two weeks, then stopping or tapering off use of these drugs. In most cases, this prescription pattern will reduce any severe initial symptoms of psychosis while minimizing the risks for any unwanted side effects.

A New Potential Treatment Option

As noted previously, some people with meth-induced psychosis don’t fully regain their mental faculties, even months or years after they quit using methamphetamines and undergo appropriate antipsychotic drug treatment. According to research published in 2010 in the “American Journal of Psychiatry,” people in this situation may benefit from electroconvulsive therapy (ECT), a form of treatment that uses controlled doses of electricity to trigger temporary seizures which, in turn, have the potential to produce helpful alterations in a patient’s brain chemistry. However, use of this technique is currently limited and no one knows for sure how many people with meth-related psychosis would benefit from its use.