An Overview of Methamphetamine-induced Psychotic Syndromes

In the United States, methamphetamine use has recently increased significantly, reaching an epidemic proportion. Methamphetamine has a unique psychopharmacology, and it can be neurotoxic in both animal models and humans. Acute methamphetamine intoxication produces sympathetic nervous system activation and euphoria, whereas acute methamphetamine toxicity can lead to thought disorder, hallucinations, and paranoid psychosis. Methamphetamine-induced psychotic syndromes are likely to be increasingly prevalent given the increasing incidence of methamphetamine use in the United States, and are not well characterized as represented in current psychiatric literature. We present a review of the available literature regarding both acute and chronic methamphetamine psychosis, its clinical course, and the available treatment options. Most cases of methamphetamine-induced psychosis resolve spontaneously within 10 days of abstinence, but a minority of patients will continue to experience chronic symptoms of psychosis distinct from syndromes of primary psychotic disorders. We will also briefly discuss the relationship between methamphetamine uses, psychosis, and schizophrenia, and the complicated presentation and treatment of patients presenting with psychotic symptoms and methamphetamine abuse.