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Methamphetamine–Related Psychosis: Symptoms, Epidemiology, Risk Factors and Intervention

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The increasing popularity of amphetamine-type stimulants (ATS), particularly methamphetamine (MA), has become a major concern for global health. A major health consequence of MA use is its association with the experience of psychotic symptoms. Individuals with MA-related psychosis are at risk of multiple ...

The increasing popularity of amphetamine-type stimulants (ATS), particularly methamphetamine (MA), has become a major concern for global health. A major health consequence of MA use is its association with the experience of psychotic symptoms. Individuals with MA-related psychosis are at risk of multiple short-term and possibly long-term sequelae. Especially the risk of later development of an enduring psychotic illness such as schizophrenia is debated. Other poor outcomes include high rates of mental problems, heavy health service utilization, and premature death due to accidents and suicidal behaviors. It is essential to examine the profiles of psychiatric damage in the population who use MA and to find factors influencing its occurrence and development, which can facilitate to better formulate prevention and control strategies and reduce the burden of disease.

Over the past decades, a lot of research has been done on MA-related psychosis, and the results showed that the prevalence of psychosis in MA users is much higher than that in the general population, particularly in dependent MA users. Violent behaviors were highly frequent in MA-related psychosis patients. Moreover, persecutory delusion and auditory hallucination were the most frequent persistent psychotic symptoms in these patients. Many factors are related to the development of MA-related psychosis. Studies showed that the risk of MA-related psychosis was significantly different among people with different characteristics. Male gender, low level of education, unemployment, and being single are risk factors of MA-related psychosis. Besides, form of MA, intensity of MA use including dose, frequency, and duration of use, and polydrug use are significantly correlated with the risk of MA-related psychosis. Other important factors contributing to MA-related psychosis include a history of mental disorders and adverse childhood events such as (ADHD). Additionally, research also suggests that there may be a correlation between genetic variation and MA-related psychosis. Some specific genes such as adenosine receptor [ADORA2A] gene, metabotropic glutamate receptor 2 [GRM2] gene, and 5-HTTLPR gene may be related to the susceptibility of MA-related psychosis. However, more studies are needed to replicate these findings and to figure out the interaction between genetic and environmental factors that contribute to the onset of MA-related psychosis.

Apart from the findings mentioned above, another question of concern is the persistence and treatment of MA-related psychosis. Although the symptoms are transient in a large proportion of MA users, who typically remit within 1 week of abstinence, MA-related psychosis can become prolonged and persistent in a subset of individuals despite drug abstinence. As for its treatment, a limited number of randomized clinical trials (RCT) showed that antipsychotic medications are useful for the treatment of MA-related psychosis. However, further large-scale RCTs with a focus on efficiency, safety, tolerability, and adverse effects of antipsychotic meditations are needed. And studies exploring molecular or imagine mechanism and other effective treatment paradigms for MA-related psychosis are still warranted.

We warmly welcome various articles relevant to MA-related psychosis. And studies with novel findings that demonstrate risk factors, molecular or imagine mechanism, early intervention and treatment of MA-related psychosis are of particular interest. The progress in the field of MA-related psychosis will definitely help to reduce the burden of this disease dramatically.


Keywords: Methamphetamine, drug-induced psychosis, risk factors, early intervention, treatment


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