Spout Cervical Oesophagostomy

BRITMattribute to an " abstinence syndrome."In all of the literature which I have been able to survey, and in personal clinical experience, hallucinations have not been seen as a symp- tom of psychostimulant withdrawal.The most generally described symptoms are lethargy, depression, and suicide attempt.I would suspect that these symptoms in the case presented represent the psychologic response of a schizophrenic woman to the withdrawal of a drug on which she is psychic- ally dependent, or a psychic response to hospitalization.Studies have demonstrated the considerable correspondence between very large doses of stimulants over a period of a few days and the development of a paranoid psychosis.'The aetiology of a psychosis which has existed for one and a half years at first observation, developing four and a half years after beginning to take excessive quantities of phenmetrazine, is problematic.This is so especially when that dosage, while excessive, is less than that which may be necessary to cause the acute, drug-induced psychosis.If we may roughly equate 25 mg.phenmetrazine with 5 mg.dexamphetamine, then their patient took the equivalent of 30-40 mg.dex- amphetamine, daily.This is, in my experi- ence, insufficient to cause an acute drug (or sleep deprivation) psychosis.That chronic, moderately high doses of amphetamines can cause a psychosis independent of personality variables has been suggested,2 but not estab- lished.-Iam, etc.,