Drug Abuse and Psychosis: New Insights into Drug-induced Psychosis

Aims:Drug-induced psychosis and drug abuse/dependence in schizophrenia are new clinical problems due to the increasing prevalence of drug consumption in this population. the objective is to know if the abuse/dependence of illegal drugs may influence the duration of acute hospitalization in schizophrenia.Method:It was conducted a retrospective cohort study on a sample of 256 acute hospitalizations of patients with schizophrenia and related disorders in Valladolid (Spain) between 2004 and 2006. at the moment of admission 82 patients had active drug abuse/dependence and 174 did not. A Cox proportional-hazards regression model was constructed considering drug abuse/dependence as predicting factor and length of stay as result variable.Results:The mean length of stay was 12.2 days (SD= 7.5) in the group without drug abuse/dependence and 7.7 days (SD= 29.0) in the drug group (means difference p=0.05). When abuse/dependence of drugs is present, the risk of discharge at any moment during the hospitalization increases in 34% (p=0.04). When Global Assessment of Functioning at the moment of admission is included in the regression model, the results remain significant (risk 35%, p=0.047). Clinical status at discharge was significantly better for the drug users group. Drug users were more frequently at his/her first hospitalization (58.2% versus 35.2%; p=0.001).Conclusion:In schizophrenia, abuse/dependence of drugs is associated with a 34% lower duration of acute hospitalization. This fact might be due to a relevant proportion of drug-induced psychosis who recovers earlier than idiopathic schizophrenia episodes.

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Neuropsychology in the Differential Diagnosis of Dual Pathology: Schizophrenia and Drugs Abuse/Dependence

European Psychiatry ◽

10.1016/s0924-9338(09)70701-1 ◽

2009 ◽

Vol 24 (S1) ◽

pp. 1-1 ◽

Cited By ~ 1

Author(s):

M.L. Vargas ◽

S. Lopez ◽

A.M. del Brio ◽

M.L. Fernandez ◽

M.A. Franco

Keyword(s):

Differential Diagnosis ◽

Drug Abuse ◽

Drug Users ◽

Verbal Learning ◽

Diagnostic Tools ◽

Control Group ◽

Drug Induced ◽

Dual Pathology ◽

Visual Spatial ◽

Drug Induced Psychosis

Aims:Dual diagnosis of schizophrenic disorders and drug abuse/dependence are increasing due to more frequent use of cannabis and cocaine. It is important to differentiate between primary schizophrenia with associate drug abuse/dependence and drug-induced psychosis. The objective is to detect neuropsychological differences between drug users and non-users in schizophrenia patients, which could be used as diagnostic tools.Method:We conduct one case-control study on 12 schizophrenia out-patients (10 male) with vital history of drug abuse/dependence (mainly cannabis and cocaine) and one control group of 18 schizophrenia out-patients (12 male) who never used illegal drugs (global age mean: 32.8 years; SD:7.2). It was applied one neuropsychological battery sensitive to the neuropsychological deficit frequent in schizophrenia: WAIS-III, BADS, WCST, Colour Trails, Trail Making A and B, BVRT, California Verbal Learning Test (spanish version: TAVEC). Variables was summarized determining Z values and principal components. It was constructed one Logistic Regression Model to determinate the better predicting model of drug use state.Results:The resultant model included two predictors: WAIS Perceptive Organization Index and Trails Component. The prediction formula for Ln Odd Ratio of drug abuse/dependence group is: -13.83 + 1.09 (Trails Z score) + 0.16 (WAIS Perceptive Organization Index). It explains for 63% of the variance (p = 0.001). The ROC curve for using in diagnose was constructed.Conclusion:Neuropsychological diagnosis can contribute to the differential diagnosis of schizophrenia in dual pathology. The better functioning in visual-spatial tasks increases the probability of psychosis related with drugs use.

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First-episode primary psychosis with comorbid drug abuse and drug-induced psychosis: diagnostic stability and clinical evolution at long-term follow up

European Neuropsychopharmacology ◽

10.1016/s0924-977x(16)31544-9 ◽

2016 ◽

Vol 26 ◽

pp. S517

Author(s):

C. Di Pace ◽

S. Paletta ◽

A. Reggiori ◽

M.C. Mauri ◽

A.C. Altamura

Keyword(s):

Drug Abuse ◽

First Episode ◽

Drug Induced ◽

Diagnostic Stability ◽

Clinical Evolution ◽

Long Term Follow Up ◽

Drug Induced Psychosis

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Primary psychosis with comorbid drug abuse and drug-induced psychosis: Diagnostic and clinical evolution at follow up

Asian Journal of Psychiatry ◽

10.1016/j.ajp.2017.04.014 ◽

2017 ◽

Vol 29 ◽

pp. 117-122 ◽

Cited By ~ 6

Author(s):

M.C. Mauri ◽

C. Di Pace ◽

A. Reggiori ◽

S. Paletta ◽

A. Colasanti

Keyword(s):

Drug Abuse ◽

Drug Induced ◽

Clinical Evolution ◽

Drug Induced Psychosis

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Treatment of Drug-Induced Psychosis with Diphenylhydantoin†

Canadian Psychiatric Association Journal ◽

10.1177/070674377602100811 ◽

1976 ◽

Vol 21 (8) ◽

pp. 565-569

Author(s):

O. I. Ifabumuyi ◽

J. J. Jeffries

Keyword(s):

Drug Abuse ◽

Antiepileptic Drugs ◽

Epileptiform Activity ◽

Multiple Drug ◽

Drug Induced ◽

Hallucinogenic Drugs ◽

Eeg Recordings ◽

Drug Induced Psychosis

Summary This paper introduces an alternative to the major tranquilizers in the treatment of acute psychotic breakdown following multiple drug abuse. All the patients described had been taking hallucinogenic drugs for over five years. Only three of several successfully treated cases are described. Two of these cases were followed by EEG recordings, which did not show any localized epileptiform activity. The response to diphenylhydantoin is described both clinically and as recorded by EEG. An initial two-week period is necessary in order that the effects of the drugs can be demonstrated clinically or on EEG tracing. It cannot be concluded from this that the antiepileptic drugs are the drugs of choice in drug-induced psychosis; but, diphenylhydantoin has shown dramatic effectiveness in these previously refractory cases. In view of the response, some abnormal cerebral discharge from an as yet undiscovered locus may be involved in the pathogenesis of drug-induced hallucinations.

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Drug-induced psychosis

Reactions ◽

10.1007/bf03264415 ◽

1980 ◽

Vol 15 (1) ◽

pp. 11-12

Keyword(s):

Drug Induced ◽

Drug Induced Psychosis

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Peripheral Autonomic Potentials in Primary Headache and Drug-Induced Headache

Cephalalgia ◽

10.1046/j.1468-2982.1998.1804216.x ◽

1998 ◽

Vol 18 (4) ◽

pp. 216-221 ◽

Cited By ~ 12

Author(s):

S Evers ◽

H Voss ◽

B Bauer ◽

P Sörös ◽

I-W Husstedt

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Drug Abuse ◽

Healthy Subjects ◽

Primary Headache ◽

Tension Type Headache ◽

Low Back ◽

Drug Induced ◽

Type Headache ◽

Drug Induced Headache

Autonomic functions of different primary headache types have been investigated in several studies, most of them analyzing cardiovascular reflex mechanisms or biochemical changes. The results are contradictory; only in tension-type headache and in cluster headache has a sympathetic hypofunction been shown in a preponderance of studies. We analyzed the peripheral autonomous potentials (PAPs) in different primary headache types and in drug-induced headache and compared the results with those of healthy subjects and of patients with low back pain. Latencies of PAPs were significantly increased in all headache types but not in low back pain; amplitudes of PAPs did not show significant differences compared to healthy subjects. Patients with a long duration of drug abuse had increased PAP latencies, whereas patients with a high number of migraine attacks per year had decreased latencies. Our data suggest that sympathetic hypo-function as measured by PAP latencies is a general phenomenon in headache but not in all pain syndromes. Drug abuse leads to an increase of this hypofunction. While measuring PAPs is not an appropriate method by which to differentiate between headache disorders, it allows assessment of autonomic disturbances in primary and drug-induced headache.

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Re: Drug-Induced Psychosis with Levetiracetam

The Canadian Journal of Psychiatry ◽

10.1177/070674370505001413 ◽

2005 ◽

Vol 50 (14) ◽

pp. 948-948

Author(s):

Marco Mula ◽

Michael R Trimble

Keyword(s):

Drug Induced ◽

Drug Induced Psychosis

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Kaleidoscope

The British Journal of Psychiatry ◽

10.1192/bjp.205.2.166 ◽

2014 ◽

Vol 205 (2) ◽

pp. 166-167 ◽

Cited By ~ 2

Author(s):

Derek K. Tracy ◽

Dan W. Joyce ◽

Sukhwinder S. Shergill

Keyword(s):

Violent Crime ◽

Population Based ◽

The Novel ◽

Drug Induced ◽

Persecutory Delusions ◽

Appropriate Treatment ◽

Cannabis Extract ◽

Drug Induced Psychosis ◽

The Uk

Drugs and violence are often observed as bedfellows; both have been associated with psychosis but the nature and timing of their relationships remains unclear. As part of the UK Prisoner Cohort Study, Keers et al prospectively followed up 967 prisoners convicted of sexual or violent offences (about a quarter of whom had a psychotic illness) in the community after release. Schizophrenia was associated with greater rates of violence, but the risk was mediated by untreated psychosis or when presenting with persecutory delusions – and no other definable psychopathology. Interestingly, drug-induced psychosis did not increase the risk of violence per se, once the substance misuse itself was accounted for. Does treatment have an impact on risk of violence in a population-based sample of patients with psychosis? Fazel et al demonstrated reductions in violent crime in patients during the time they were prescribed antipsychotics. Interestingly, the rates of violent crime were also reduced in patients with bipolar disorder who received mood stabilisers. Therefore, in addition to the effects of antipsychotics and mood stabilisers on relapse rates, their potential effects on violence and crime could be used to make decisions about management for these groups of patients. There is a clearer need for the appropriate treatment of prisoners with psychotic illnesses if their risk of violence is to be moderated. Cannabis is one of the most commonly used social drugs worldwide; it increases risk of psychosis, but there has been little to offer pharmacologically to those dependent upon this most prevalent illicit drug, and various trials of mood stabilisers, antidepressants and α2 adrenergic agonists have generally been disappointing. Allsop et al evaluated the novel cannabis extract nabiximols, containing cannabidiol – which has been shown to attenuate paranoia and euphoria – and tetrahydrocannabinol, delivered as a buccal spray. The active drug group showed statistically significant benefits in reduced withdrawal irritability, depression and cravings and remained longer in treatment. However, both placebo and drug groups showed reduced cannabis use at follow-up, with placebo being as effective as nabiximols in promoting longer-term cessation.

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