The Clinical Symptomatology of Amphetamine Psychosis and its Relationship to Amphetamine Levels in Urine

Abstract
Twenty patients who experienced acute psychotic symptomatology in conjunction with amphetamine abuse were divided into two groups. One of these showed complete clearing while the other cleared of acute symptoms only to show residual pathology of thinking and affect as assessed by a separate rating team Symptomatology was rated on a 0—4 + scale and compared for the two groups as to type of symptom, intensity of symptomatology, rate of clearing, and the duration that symptomatology persisted. No qualitative differences in symptoms for the two groups was delineated. The only quantitative difference for the two groups’ presenting symptomatology to attain statistical significance was in the area of behavioral disturbance which was greater for the group that showed complete clearing, but which cleared significantly more rapidly in this group. Evaluation of duration of symptomatology without regard to symptom intensity showed a significantly longer time required for clearing of delusions and behavioral disturbance in the group whose final status showed residual pathology of thinking and affect. For one symptom, hallucinations (which was the first symptom to clear in both groups) both initial scores and duration of symptomatology were not significantly different for the two groups. This suggests that clearing of this symptom relates more to amphetamine excretion than to the presence or absence of residual mental status pathology. Evaluation of the relationship of symptoms to 24-hour urinary amphetamine excretion as determined by gas chromatography also showed rapid clearing of hallucinations and suggested a tendency for delusional symptoms to follow declining amphetamine levels.