ACUTE EXACERBATION OF PARANOID PSYCHOTIC STATE AFTER LONG-TERM ABSTINENCE IN PATIENTS WITH PREVIOUS METHAMPHETAMINE PSYCHOSIS

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  • 1 January 1983
    • journal article
    • research article
    • Vol. 18  (4) , 429-440
Abstract
From a population of 111 patients with chronic methamphetamine (MAP) psychosis, who were treated at 10 mental hospitals during the past 3 yr, 21 patients were selected for study. Patients (16) 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 8 patients, small doses of neuroleptics, e.g., 3 mg/day of haloperidol, prevented the acute provocation of a psychotic state by MPA reuse. 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.