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Methamphetamine use tied to psychosis

Methamphetamine use significantly increased the likelihood of experiencing psychotic symptoms, according to recent study results.

“Methamphetamine is used by an estimated 14 (million) to 53 million people worldwide,” researchers wrote. “A major public health consequence of the drug’s use is a transient psychotic reaction.”

Rebecca McKetin, PhD, of the Centre for Research on Ageing, Health and Well-being at Australian National University in Canberra, and colleagues examined the probability of psychotic symptoms occurring during periods of methamphetamine use in 278 participants aged at least 16 years who met DSM-IV criteria for methamphetamine dependence but who did not meet criteria for lifetime schizophrenia or mania.

Participants underwent four noncontiguous 1-month observation periods. The Brief Psychiatric Rating Scale was used to screen for suspiciousness, unusual thought content or hallucinations in the past month, and participants reported on the number of days of methamphetamine use in the past 4 weeks. Use of other narcotics, such as cannabis, heroin, cocaine, ecstasy, hallucinogens, alcohol and tobacco, was measured as well.

Results indicated that there was a fivefold increased risk for psychotic symptoms during periods of methamphetamine use vs. periods of no drug use (OR=5.3; 95% CI, 3.4-8.3). The increased likelihood of psychotic symptoms was strongly dose-dependent. For example, 1 to 15 days of methamphetamine use, compared with abstinence, was associated with a fourfold increased risk for psychosis (OR=4.0; 95% CI, 2.5-6.5), and 16 or more days of use was linked to more than 11 times the risk (OR=11.2; 95% CI, 5.9-21.1). Frequent cannabis use (OR=2.0; 95% CI, 1.1-3.5) and/or alcohol use also increased the risk for psychotic symptoms (OR=2.1; 95% CI, 1.1-4.2).

“The large increase in the risk of psychotic symptoms occurring during periods of methamphetamine use indicates a need to increase awareness of the drug’s potential effect on mental health,” the researchers wrote. “Clinicians need to be vigilant for signs of methamphetamine use among patients who present with psychosis and to appreciate the role that methamphetamine plays in the generation of psychotic symptoms.”

Disclosure: Study researcher Dan I. Lubman, PhD, reports financial relationships with AstraZeneca, Bristol-Myers Squibb, Janssen and Lundbeck. Study researcher Robert L. Ali, FAChAM, reports financial relationships with Reckitt Benckiser Pharmaceuticals.