People who use stimulants who have binged for 2 to 3 days are dysphoric and exhausted, and they sleep excessively for 24 to 48 hours. To reduce irritability and induce sleep, people may commonly use alcohol, cannabis, benzodiazepines, or opioids with cocaine or MA (often called “landing gear”). Following more chronic and regular stimulant use, severe withdrawal symptoms last several days, with less severe symptoms (e.g., fatigue, depressed mood, anxiety, drug craving, concentration difficulties) lasting 1 to 3 weeks (UNODC, 2019b). The incidence and severity of stimulant-induced side effects and overdose potential are also dose related.
Antipsychotic drugs
Prior psychiatric studies have found that GABAergic cortical dysfunction seems to relate to schizophrenia. To diagnose amphetamine toxicity, other toxicities need to be explored, including toxicities to cocaine, methylxanthine, phencyclidine, and other sympathomimetics. Schizophrenia, mania, alcohol withdrawal, and meningitis should also be considered. However, some patients may require antihypertensive treatment to combat hypertensive urgency or emergency.
Treatment Options
Schizophrenia is a disease of slow progression, often with years between the first subclinical symptoms and the full-blown psychosis. As a consequence, substance use and psychosis may mutually exacerbate each other over a long period of time, making it difficult to conclude that one condition caused the other. In high doses, illicit and prescription amphetamines can produce cardiovascular collapse, myocardial infarction, stroke, seizures, renal failure, ischemic colitis, and hepatotoxicity. Heart attacks, seizures, subarachnoid, intracranial hemorrhage, and strokes may also result in death. The rate of suicide and accidents can increase during periods of toxicity and withdrawal. Route of administration of drugs in animal (typically intraperitoneal injection) in comparison with human (typically oral) pharmacology research tends to vary greatly (see Kuczenski and Segal, 2005 for an in-depth discussion of these issues as they relate to ADHD pharmacotherapy research).
Review Questions
Each medication carries unique side effects (e.g., metabolic syndrome caused by second-generation atypical antipsychotics, extrapyramidal symptoms [medication-induced movement disorders] caused by haloperidol). Prescribing decisions should be based on each patient’s how long do amphetamines stay in urine risk–benefit profile and reevaluated throughout the course of treatment (Fluyau et al., 2019). During acute withdrawal, the “crash” results in patients who sleep several days at a time, depending on the dose and duration of the binge (Nishino, 2009).
- These intense dreams, which may sometimes contain vignettes in which the person loses or drops a supply or refuses to smoke, can be used therapeutically to educate patients on their progress and identify potential triggers to recurrent use (Yee et al., 2004).
- In many studies, a single amount of caffeine is administered to all participants, regardless of weight.
- Interestingly, another study in mice found that doses of 10, 30, and 100 mg/kg administered 30 minutes before training impaired learning, whereas doses of 1, 3, 10, and 30 mg/kg i.p., administered immediately following training enhanced learning (Angelucci et al., 1999).
- Collaborative arrangements between hospitals and local treatment facilities can allow for door-to-door SUD treatment.
- The principal routes for cocaine and MA use are oral ingestion, nasal insufflation (snorting), intravenous injection, and inhalation of smoke vapors (smoking/inhalation).
- Moreover, the greater the amount of self-administered cocaine per week leading up to the 23 days of enforced abstinence, the lower the activity in the rostral ACC and the right lateral prefrontal cortex.
Myocardial infarction can occur with both low-dose and high-dose cocaine use (Kim & Park, 2019). Studies on the association between cocaine use and cardiovascular mortality have produced conflicting results (Kim & Park, 2019). This may be due to variations in populations, as well as to study design issues, such as how studies control for other risk factors known to affect cardiovascular mortality, like cigarette smoking and depression. Some https://ecosoberhouse.com/article/6-successfull-and-motivational-sobriety-stories/ research suggests that individual factors may play a strong role in whether a person using cocaine experiences cardiovascular consequences (Kim & Park, 2019). People who use stimulants and present with life-threatening medical conditions (e.g., arrhythmias, compromised airways, seizure) and lethal drug levels should be treated with standard life-saving techniques that respond to the presenting symptoms (NIDA, 2018b; Vasan & Olango, 2020).
In addition, a double-blind, placebo-controlled, crossover study examined the effects of mixed d,l-amphetamine (0.15 and 0.3 mg/kg) in 154 children ranging in age from 5 to 16 years (Ahmann et al., 2001). Mixed d,l-amphetamine was shown to have an efficacy rate of 59%, when examined with the criteria that parents and teachers agreed on during their evaluation of the child’s behavior. Mixed d,l-amphetamine had an efficacy rate of 81%, when based on parental feedback alone.
IV. Methylphenidate
Psychiatric Disorders
- Variability in stimulant purity and an unpredictable and unknown relationship to body weight means overdose cannot always be predictable based on the substance used.
- The binge is characterized by frequent mood swings as plasma concentration levels of the stimulant fluctuate.
- Educate patients and their families about these risks, proper storage of the drug, and proper disposal of any unused drug.
- Physical exertion and an overheated room can increase the likelihood of adverse effects because stimulants affect the body’s heat-regulating mechanism at the same time that blood vessel constriction conserves heat.
- A review of the literature reveals that, in addition to the established knowledge that amphetamines can cause acute psychotic symptoms, more evidence has emerged that amphetamines may play a role also in the pathogenesis of schizophrenia.
- These studies indicate that frontal areas involved in attention and executive functioning are particularly affected by extended cocaine use, although, with no corresponding behavioral impairments, the functional implications of these findings remain opaque.
