Amphetamine psychosis is a form of
psychosiswhich can result from amphetamineor methamphetamineuse. Typically it appears after large doses or chronic use, although in rare cases some people may become psychotic after relatively small doses (Including Amphetamine based ADD/ADHD drugs such as Adderall). Other chemicals or drugs which similarly increase dopaminefunction (such as cocaineand L-DOPA) can produce similar psychotic states. Because of this, the term stimulant psychosis is sometimes preferred.
Amphetamine psychosis can include
delusions, hallucinations and thought disorder. This is thought to be largely due to the increase in dopamine and perhaps serotoninactivity in the mesolimbic pathwayof the braincaused by amphetamine-like drugs, although other factors such as chronic sleep deprivationmay also play a part. The link between amphetamine and psychosis is one of the major sources of evidence for the dopamine hypothesis of psychosis.
The link between amphetamine and psychosis was first made by Young and Scoville in 1938Young, D. & Scoville, W.B. (1938) Paranoid psychosis in narcolepsy and the possible danger of benzedrine treatment. "The Medical clinics of North America", 22, 637-46.] and was originally considered to be a rare condition. As amphetamine use increased after
World War II, largely due to the widespread use of amphetamine compounds in nasal decongestant and dieting preparations, it became clear that chronic amphetamine use often led to psychotic symptoms.
Hallucinations are frequently reported in chronic amphetamine users, with over 80% of users reporting the presence of hallucinatory experiencesKalant, O.J. (1966) "The amphetamines: Toxicity and addiction" Springfield, Ill: Charles C Thomas Publishers.] , typically as visual or auditory experiences. Delusions, paranoia, fears about persecution, hyperactivity and panic are also reported as the most common featuresEllinwood, E.H, (1967) Amphetamine Psychosis. I. Description of the individuals and processes. "Journal of Nervous and Mental Disease", 144, 273-283.] .
Concurrent to having delusions and hallucinations, chronic amphetamine users may also display stereotyped, repetitive and seemingly purposeless movements, known as 'motor stereotypies' or more commonly as 'knick knacking', 'tweaking' or being 'hung-up'. These may include examining, sorting, disassembling, and cleaning. The article on
pundinggives a more complete description of this behavior. This behavior may appear similar to the symptoms of OCD.
One particular manifestation of psychosis associated with amphetamine use is
delusional parasitosisor " Ekbom's syndrome", where a person falsely believes themselves to be infested with parasites. However, related behaviour may occur in non-psychotic conditions, where users will realise they are not infested by parasites but will pick at their skin anyway. This more closely resembles obsessive-compulsive disorder.
However, it is important to note that in the above account, the behavior may be similar but the ideation is radically different. There is no ideational connection between compulsive self-grooming and a delusional belief that one is infested with parasites - the "coke horrors" as William S. Burroughs called it. ["One day you wake up and feel like you've got bugs crawling under your skin. It's the coke horrors. Just relax and shoot in plenty of that good pure G.I. M [translation: government-issue morphine] ." William S. Burroughs, "Letter From a Master Addict to Dangerous Drugs".]
Amphetamine psychosis in popular culture
There is a chapter in
Hunter S. Thompson's Fear and Loathing in Las Vegasentitled 'Aaawww, Mama, Can This Really Be the End?... Down and Out in Vegas, with Amphetamine Psychosis Again?', a reference to Bob Dylan's song " Stuck Inside of Mobile with the Memphis Blues Again".
In the film "
Requiem for a Dream", the character Sara Goldfarb suffers amphetamine psychosis after having been prescribed amphetamines as a weight loss drug; she imagines that her refrigerator is trying to devour her.
The anti-drug advertising of the
Montana Meth Projectoften focuses on the dangers of amphetamine psychosis.
In episode four of the television series
Breaking Badthe character Jesse Pinkman apparently suffers from a brief episode of Amphetamine psychosis.
Sherlock Holmes' nemesis Dr. Moriarity may have been a figment of Holmes' paranoid delusions which may have been brought on by his use of cocaine. "The man pervades London, and no one has heard of him. That's what puts him on a pinnacle in the records of crime." [Sir Arthur Conan Doyle, Memoirs of Sherlock Holmes]
Dopamine hypothesis of psychosis
* [http://www.acnp.org/g4/GN401000166/Default.htm Chronic amphetamine use and abuse] - Review published in 2000.
* Connell, P.H. (1961) "Amphetamine Psychosis". Oxford University Press.
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