What is amphetamine psychosis?
Psychosis is a state in which a person experiences a temporary disconnect from reality and loses the ability to distinguish internal psychological processes from external events. Psychosis can be experienced on its own or as a symptom of a mental health condition. Certain substances can also trigger psychosis symptoms.
One of the most common types of substance-induced psychosis is amphetamine psychosis. Like other types of substance-induced psychosis, amphetamine psychosis is relatively short-lived and typically subsides once the individual stops using amphetamines. However, some cases may persist after amphetamines are out of a person’s system. Amphetamine psychosis typically arises in one of two forms: amphetamine-induced psychosis and amphetamine withdrawal psychosis.
What Stimulants Cause Psychosis?
There are different kinds of street amphetamines. Common ones and some of their slang terms are:
- Amphetamine: goey, louee, speed, uppers, whiz
- Dextroamphetamine (ADHD medicine used illegally): dexies, kiddie-speed, pep pills, uppers; black beauty (when combined with amphetamine)
- Methamphetamine (crystal solid form): base, crystal, d-meth, fast, glass, ice, meth, speed, whiz, pure, wax
- Methamphetamine (liquid form): leopard’s blood, liquid red, ox blood, red speed
Illegal amphetamines come in different forms:
- Pills and capsules
- Powder and paste
They can be used in different ways:
- Dabbed onto the gums
- Inhaled through the nose (snorted)
- Injected into a vein (shooting up)
Symptoms of Amphetamine Psychosis
Amphetamine psychosis may manifest in different ways based on individual differences, the presence of other psychiatric conditions, or the effects of combining amphetamines with other drugs. However, amphetamine psychosis usually produces the following symptoms:
- Disorganized thinking
- Difficulty concentrating
- Rapid, often illogical speech
- Increased or erratic motor activity
- Poor insight into causes of symptoms
- Extreme agitation
- Paranoid delusions
- Grandiose delusions
- Visual hallucinations
- Auditory hallucinations
Only about 18 percent of people who use amphetamines ever experience amphetamine psychosis symptoms. However, given that 16 million adults in the United States are prescribed stimulants and half a million Americans use methamphetamines every week, this still represents a significant number of people.
Like all classes of stimulants, amphetamines work by activating the sympathetic nervous system and promoting the release of natural stimulant chemicals into the brain, including dopamine, norepinephrine, and adrenaline. These chemical messengers elevate heart rate and increase blood pressure, improving focus, alertness, and attention.
While these effects can be helpful for individuals with conditions like attention hyperactivity disorder, they may also cause stress or anxiety. These adverse reactions can aggravate or induce a wide range of psychological disorders and symptoms, including paranoia or panic. The chances of adverse amphetamine side effects are particularly high when using large amounts of amphetamines. When combined with other changes caused by amphetamine addiction and abuse, panic and paranoia can progress to psychosis.
The symptoms of amphetamine psychosis resemble symptoms of chronic psychotic disorders like schizophrenia, which makes it hard for physicians to immediately tell the two conditions apart. Minor differences in symptom profiles can sometimes help clinicians determine if an episode of psychosis is substance-induced. For example, visual hallucinations are relatively rare in schizophrenia but are more common in substance-induced psychosis. Conversely, symptoms of disorganized speech and avolition that are common in schizophrenia are less likely to occur in amphetamine psychosis.
However, these subtle differences aren’t always apparent. People who exhibit symptoms of amphetamine psychosis may initially be misdiagnosed with schizophrenia or other chronic psychotic disorders. In some cases, they may even be sent to inpatient psychiatric treatment with the wrong referral diagnosis. When these individuals are given antipsychotic drugs to treat their symptoms, it can take clinicians even longer to realize that their psychotic symptoms were substance-induced. Improvement may be associated with the effects of the antipsychotic medication rather than the one factor consistently associated with recovery from amphetamine psychosis: time.
Amphetamines are eliminated from a person’s system within 12–15 hours of stopping use, and symptoms typically subside shortly afterward. However, once induced, it is not unusual for amphetamine psychosis to persist as brain chemistry gradually returns to normal. These symptoms rarely last longer than ten days, though some people may require one to two months for dopamine levels to recover. Extendedamphetamine psychosis is more likely to occur in people who have used amphetamines for long periods.
Risk Factors and Acute vs. Chronic Psychosis
The use of amphetamines is common among patients with psychiatric disorders, especially in the United States. In animal models, there is sensitization to the rewarding effects of amphetamines. Sensitization is also seen in human subjects. There is reason to believe that an earlier psychosis involves a risk of future psychotic episodes due to this sensitization, or possibly to the development of dopaminergic supersensitivity.
Psychosis may be precipitated acutely by amphetamine due to its effects on dopaminergic activity in the CNS. In the longer term, the neurotoxic effects of the drugs on serotonin and dopamine neurons and dopamine transporters may play a role. Amphetamine sensitization seems to cause dysregulation of dopamine by the ventral subiculum. There is an over-expression of the dopamine receptor, subtype 2 (DRD2), and a higher sensitivity of DRD2 to the effects of amphetamines in vulnerable individuals.
In addition to the increased risk of psychosis following the use of amphetamines in people who have experienced amphetamine-induced psychosis previously, patients with schizophrenia and schizotypal personality traits may more readily become psychotic after the use of amphetamines. Other risk factors for psychosis may include amphetamine use disorders (abuse and dependence), the presence of other psychiatric disorders (primarily attenuated psychosis syndrome, personality disorders, and affective disorders), early cognitive dysfunction (such as those found in the prodromal states of schizophrenia), family history of mental disorder and the use of other drugs like opiates, benzodiazepines, cannabis, and alcoholism.
Amphetamine psychosis may be purely related to high drug usage, or high drug usage may trigger an underlying vulnerability to schizophrenia. There is some evidence that vulnerability to amphetamine psychosis and schizophrenia may be genetically related.
The similarities between acute schizophrenic psychosis and psychosis following the use of amphetamines are so pronounced that the latter has been suggested as a model for schizophrenia. However, it remains unresolved whether the relationship between amphetamines and psychosis is explained by drug exposure (amphetamine-induced psychosis), amphetamines use triggering a primary psychotic disorder, or both. Although psychosis may be induced by amphetamine in healthy individuals, not all subjects become psychotic by the doses of amphetamines allowed in the experiments.
Some, but not all, individuals using amphetamines have experienced psychotic episodes, and a few have experienced psychosis as an adverse event during stimulant treatment. Is this a result of differences in amphetamine exposure or differences in vulnerability? Furthermore, psychosis is precipitated by a lower dose of amphetamines in individuals with primary psychosis and may be blocked by the use of anti-psychotics. Finally, there seem to be many genetic and physiological similarities between amphetamine-induced psychosis and acute schizophrenic psychosis, suggesting that vulnerability may play a significant role in the occurrence of amphetamines-induced psychosis.
Amphetamine Psychosis Treatment
Amphetamine psychosis treatment is usually pretty simple. In most cases, the symptoms of amphetamine psychosis subside on their own over time. The most severe symptoms of amphetamine-induced or amphetamine withdrawal psychosis tend to dissipate within one to three days of discontinuing amphetamine use. Prolonged symptoms are usually milder and can often be managed safely at home.
However, many people need inpatient treatment during the acute phase of amphetamine psychosis, as severe psychotic symptoms can be dangerous. Many inpatient interventions focus on preventing people from acting on delusional thoughts. People experiencing acute stimulant intoxication or withdrawal may also require additional medical care to address other withdrawal symptoms, including hyperthermia, dehydration, or high blood pressure.
Research shows that antipsychotic drugs used to treat schizophrenia and other chronic and organic psychotic disorders, such as haloperidol (Haldol) and olanzapine (Zyprexa), can reduce symptoms of amphetamine psychosis. Benzodiazepines may also be administered to reduce agitation and treat or reduce the risk of seizures. However, because these drugs also carry potentially dangerous side effects, many clinicians resist using them unless necessary.
Often, the most crucial component of the treatment plan for amphetamine psychosis is a referral to a substance abuse treatment program. Many people whose amphetamine use has progressed to the point of psychosis live with a substance use disorder and require intervention to begin recovery.
Amphetamine Addiction Recovery
Treatments for amphetamine use disorder may include a combination of the following:
If you experience strong drug cravings, you may find it easier to go through amphetamine withdrawal in a hospital setting. Hospitalization may also help if you have negative mood changes, including aggression and suicidal behavior.
Individual counseling, family therapy, and group therapy can help you:
- Identify the feelings associated with amphetamine use
- Develop different coping mechanisms
- Repair relationships with your family
- Develop strategies to avoid amphetamine use
- Discover activities you enjoy in place of amphetamine use
- Get support from others with use disorder as they understand what you’re going through, sometimes in a 12-step treatment program.
Your doctor may prescribe medication to ease severe symptoms of withdrawal. Some doctors may prescribe naltrexone to help with your cravings. Your doctor may also prescribe other medications to help relieve symptoms of anxiety, depression, and aggression.
Reclaim Your Life From Amphetamine Psychosis
Many people need inpatient treatment during the acute phase of amphetamine psychosis, as severe psychotic symptoms can be dangerous. Amphetamine addiction is a chronic disease that can cause significant health, social, and economic problems that should not be taken lightly. We Level Up Washington Center can provide you, or someone you love, the tools to recover from this condition with a professional and primary mental health treatment to ease amphetamine withdrawal symptoms.
Feel free to call us to speak with one of our counselors. We can inform you about this condition by giving you relevant information. Our specialists know what you are going through. Please know that each call is private and confidential.
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At We Level Up Washington, our primary focus is providing comprehensive mental health treatment for individuals with conditions like cocaine addiction. While we do not directly provide detox services, we offer secondary treatment programs that address co-occurring addiction-related mental health disorders.
Our evidence-based approach to mental health treatments aims to improve your overall well-being and help you overcome the challenges of cocaine addiction. Contact us today for a complimentary mental health evaluation and take the first step towards a transformative recovery journey.
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 Bramness JG, Gundersen ØH, Guterstam J, Rognli EB, Konstenius M, Løberg EM, Medhus S, Tanum L, Franck J. Amphetamine-induced psychosis–a separate diagnostic entity or primary psychosis triggered in the vulnerable? BMC Psychiatry. 2012 Dec 5;12:221. doi: 10.1186/1471-244X-12-221. PMID: 23216941; PMCID: PMC3554477.