مصرف دوز بالای متامفتامین (شیشه) ریسک ابتلا به سایکوز (جنون ) را افزایش می دهد Dose-Related Psychotic Symptoms in Chronic Methamphetamine

مصرف دوز بالای  متامفتامین (شیشه) ریسک  ابتلا به سایکوز (جنون ) را افزایش می دهد
مصرف ماده مخدر شیشه (متامفتامین ) می تواند توهم  وهذیان وایجاد روانپریشی کند
هرچقدر مدت  اعتیاد به مخدر شیشه بیشتر و میزان دوز مصرفی بالاتر باشد ریسک ابتلا به جنون (سایکوز ) بالاتر می رود
ریسک جنون با مصرف ماده مخدر شیشه (متامفتامین ) بالا می رود
ریسک جنون با مصرف مخدر شیشه (متامفتامین )

استفاده از متامفتامین  به تنهایی  می تواند ریسک ابتلا به جنون  را تا 5.3 برابر بیشتر کند
در صورتی  که مصرف کننده گان  متامفتامین (شیشه)  از مواد مخدر دیگر همانند الکل و یا ماریجوانا استفاده کنند ریسک جنون دو برابر حالت عادی  خواهد شد

در مطالعاتی  که در استرالیا  بر روی 278 نفر مصرف کننده مخدر متامفتامین (شیشه )  که سن انها بالای 16 سال بود مشخص شد که ابتلا به سایکوز (جنون ) بر اثر مصرف ماده مخدر متامفتامین (شیشه ) وابسته با دوز است  و با مصرف دوز های بالای مخدر متامفتامین (شیشه ) ریسک ابتلا به جنون (سایکوز افزایش می یابد )
این مطالعات تحت سرپرستی خانم دکتر ربکا مک کیتن در سیدنی استرالیا به مدت 13 سال مطالعه بر روی 278 معتاد به متامفتامین انجام شده است
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     Strong Dose-Dependent Effect With Meth and Psychosis

    Dose-Related Psychotic Symptoms in Chronic Methamphetamine


    The risk of developing psychotic symptoms increases during periods of methamphetamine use among long-term users, new research suggests.
    Investigators from Australian National University in Canberra found that among long-term users, there was a 5-fold increased likelihood of psychotic symptoms during periods of meth use vs periods of abstinence.
    Such symptoms included suspiciousness (71%), delusions or unusual thought content (35%), and hallucinations (51%).
    This risk was strongly related with how often they used the drug, with the odds increasing from 4.0 (95% confidence interval [CI], 2.5 - 6.5) with 1 to 15 days' use in the past month to 11.2 (95% CI, 5.9 - 21.1) when people were using for 16 or more days in the past month.
    Dr. Rebecca McKetin
    "This translated into an increase of around 10% having psychotic symptoms in the past month when they were not using methamphetamine up to 48% when they were using it heavily, that is, for more than 16 days," lead author Rebecca McKetin, PhD, from Australian National University, told Medscape Medical News.
    The risk was compounded by heavy cannabis and alcohol use, which increased the risk for psychotic symptoms up to 69%.
    The study was published online January 9 in JAMA Psychiatry.
    Longitudinal Study
    According to Dr. McKetin, "methamphetamine is known to be associated with psychosis, but to what extent this relationship is due to preexisting psychosis among users of the drug is not clear."
    She noted that she had done a lot of previous research showing that methamphetamine users had higher rates of psychosis than the general population, "but people kept saying to me things like, 'those people who go crazy on the drug, well, they were crazy beforehand,' " Dr. McKetin said.
    "Despite the seemingly obvious link, which many people take for granted, I kept hearing from people who didn't think that the drug itself could cause psychotic symptoms, and they tended to yield to the view that it was merely exacerbating or precipitating some kind of underlying mental health condition," she said.
    "The bottom line is that we didn't know how much the drug was responsible for the high rates of psychosis among meth users and how much of this was because they are a high-risk group for psychotic symptoms."
    The study examined 278 methamphetamine users aged 16 years and older while they were, and were not, using the drug in order to assess any potential contribution of meth to psychotic symptoms.
    The mean age of the study participants was 31.7 years; 72% were male; 72% were single; and 78% were unemployed. Most were born in Australia (89%), with English as their preferred language; they had a median of 10 years of schooling.
    All participants met DSM-IV criteria for methamphetamine dependence in the year before entering the study and had used the drug for a mean of 13.1 years. The majority (83%) had injected it.
    The participants were followed during a period of several years and were interviewed several times. On each occasion, a comprehensive assessment of their drug use and their psychiatric status was performed.
    Need for Evidence-Based Interventions
    The researchers found that methamphetamine users were significantly more likely to experience psychotic symptoms when they were taking the drug compared with when they were not taking the drug (odds ratio [OR], 5.3; 95% CI, 3.4 - 8.3; P < .001).
    Dr. McKetin speculated that psychosis is related to the increase in dopamine levels produced by methamphetamine intoxication.
    "Dopamine plays a key role in the emergence of psychotic symptoms in people with psychotic disorders. Most antipsychotic drugs attenuate dopamine activity, and methamphetamine more generally affects monoamine regulation and can have neurotoxic effects both on dopamine and other neurotransmitter systems, and these changes may also play a role," she said.
    Dr. McKetin believes psychotic symptoms should be recognized as a serious and harmful side effect of methamphetamine use.
    "I would like people to stop saying that people who go crazy on meth were crazy to start with. We need to have a better public health response to methamphetamine use to combat this harm, and the thing I would like most to see is the broader implementation of evidence-based interventions to help people reduce their methamphetamine use," she said.
    Cannabis Adds to the Problem
    Dr. Shawn Cassady
    The authors are correct to caution that psychotic proneness may be increased in stimulant-abusing populations, commented Shawn Cassady, MD, an addiction psychiatrist at First Step, Cockeysville, Maryland, who called the study "interesting and informative."
    "The study presents an interesting statistical model, used in economics research, for individual on-off-on methamphetamine events, and each subject is essentially his or her own control, thus increasing the power to detect real changes," Dr. Cassady told Medscape Medical News.
    He also raised the possibility that cannabis may have a greater effect on symptoms of suspiciousness, hallucinations, and unusual thought.


    "The co-presence of cannabis further increases the risk of psychosis, which we would expect. In fact, cannabis use was more prevalent than methamphetamine use. The median cannabis use was 20 days per month vs 8 days per month for methamphetamine, which raises the question of which is more psychotogenic."
    Dr. Cassady also pointed out that cannabis is eliminated more slowly, and so it might be considered continuously present in the system of the methamphetamine abusers.
    "This study fairly confirms that cannabis use only increases the risk of psychoticlike symptoms," he added. "Further study is needed to identify individual risk factors for psychoticlike responses to methamphetamine and cannabis use."
    The study was funded by the National Health and Medical Research Council and the Australian Government Department of Health and Ageing. Dr. McKetin and Dr. Cassady have disclosed no relevant financial relationships.
    JAMA Psychiatry. Published online January 9, 2013. Abstract

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