Methamphetamine Use and Psychosis

Clinical Features and Diagnosis

Methamphetamine is a sympathomimetic agent that produces massive efflux of dopamine in the central nervous system, which can lead to psychotic symptoms, according to the American Academy of Pediatrics 1
Psychotic symptoms from methamphetamine use typically include delusions, hallucinations, and disorganized thoughts/speech, as noted by the American College of Radiology 2
Unlike other forms of altered mental status, patients with psychosis frequently maintain intact awareness and level of consciousness, as observed by the American College of Radiology 2
Medical conditions that can mimic psychosis must be ruled out, including central nervous system lesions, metabolic disorders, other toxic encephalopathies from substances of abuse, and infections affecting the brain, as recommended by the American Academy of Child and Adolescent Psychiatry 3

Stimulants are contraindicated in patients with existing psychosis, as they can worsen symptoms in individuals with schizophrenia or other psychotic disorders, according to the American Academy of Child and Adolescent Psychiatry 4
Families should be included in the treatment plan and provided with emotional support and practical advice, as suggested by medical insights 5