AMPHETAMINE-INDUCED PSYCHOSIS LEADING TO HOMICIDE, SUICIDAL ATTEMPTS, AND DISORIENTATION: A CASE REPORT
DOI:
https://doi.org/10.55519/JAMC-04-14128Keywords:
Amphetamine abuse, psychosis, hallucinations, suicidal behavior, violent ideations, case report.Abstract
Amphetamine abuse leads to severe psychiatric and cardiovascular complications–psychosis, hallucinations and aggressive behavior. A 34-year-old male of five years noted history of amphetamine abuse and presented with amphetamine psychosis characterized by hallucinations, violent ideations and a recent suicide attempt is described in this case report. Previously under the influence of amphetamines, two years prior, the patient committed homicide. Patient had periods of very severe disorientation and agitation, history of suicidal ideation and violent thoughts toward others. Toxicology screenings were done, all were consistent with amphetamine presence. Diagnostic studies included cardiac biomarker elevations and abnormal electrolyte levels. Management was immediate and involved sedation, antipsychotic therapy and cardiovascular support, followed by long term psychiatric care and substance abuse rehabilitation. Here, chronic amphetamine abuse is shown to have profound psychiatric and behavioral effects and to require integrated treatment strategies to meet the complex needs of such patients.
References
1. Banks ML, Worst TJ, Rusyniak DE, Sprague JE. Synthetic cathinones ("bath salts"). J Emerg Med 2014;46(5):632–42.
2. Maxwell JC, Rutkowski BA. The prevalence of methamphet-amine and amphetamine abuse in North America: a review of the indicators, 1992–2007. Drug Alcohol Rev 2008;27(3):229–35.
3. Bramness JG, Gundersen ØH, Guterstam J, Rognli EB, Konstenius M, Løberg EM, et al. Amphetamine-induced psychosis—a separate diagnostic entity or primary psychosis triggered in the vulnerable? BMC Psychiatry 2012;12:221.
4. Tost H, Alam T, Meyer-Lindenberg A. Dopamine and psy-chosis: theory, pathomechanisms and intermediate pheno-types. Neurosci Biobehav Rev 2010;34(5):689–700.
5. McKetin R, Leung J, Stockings E, Huo Y, Foulds J, Lappin JM, et al. Mental health outcomes associated with ampheta-mine use: a systematic review and meta-analysis. EClini-calMedicine 2019;16:81–97.
6. Berman S, O’Neill J, Fears S, Bartzokis G, London ED. Abuse of amphetamines and structural abnormalities in the brain. Ann N Y Acad Sci 2008;1141:195–220.
7. Mullen JM, Richards JR, Crawford AT. Amphetamine-related psychiatric disorders [Internet]. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025 Jan– [updated 2023 Jun 8; cited 2025 Jan 24]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482368/
8. Degenhardt L, Roxburgh A, Black E, Bruno R, Campbell G, Kinner S, et al. The epidemiology of methamphetamine use and harm in Australia. Drug Alcohol Rev 2008;27(3):243–52.
9. Fusar-Poli P, Estradé A, Stanghellini G, Venables J, Onwumere J, Messas G, et al. The lived experience of psy-chosis: a bottom-up review co-written by experts by experi-ence and academics. World Psychiatry 2022;21(2):168–88.
10. Iqbal MN, Levin CJ, Levin FR. Treatment for substance use disorder with co-occurring mental illness. Focus (Am Psychi-atr Publ) 2019;17(2):88–97.
11. Ferrucci M, Limanaqi F, Ryskalin L, Biagioni F, Busceti CL, Fornai F. The effects of amphetamine and methamphetamine on the release of norepinephrine, dopamine, and acetylcho-line from the brainstem reticular formation. Front Neuroanat 2019;13:48.
12. McCutcheon RA, Krystal JH, Howes OD. Dopamine and glutamate in schizophrenia: biology, symptoms, and treat-ment. World Psychiatry 2020;19(1):15–33.
13. Glasner-Edwards S, Mooney LJ. Methamphetamine psycho-sis: epidemiology and management. CNS Drugs 2014;28(12):1115–26.
14. Ali MI, Rashad MM, Alzain NM, Al-Awad FA, Alzaharani MA, Alshamarani AS, et al. Impulsiveness, suicide, and ag-gression in a sample of patients with disorders of methyl am-phetamine use. J Family Community Med 2024;31(3):257–64.
15. Luo D, Tan L, Shen D, Gao Z, Yu L, Lai M, et al. Characteris-tics of depression, anxiety, impulsivity, and aggression among various types of drug users and factors for developing severe depression: a cross-sectional study. BMC Psychiatry 2022;22(1):274.
16. Kelly TM, Daley DC. Integrated treatment of substance use and psychiatric disorders. Soc Work Public Health 2013;28(3–4):388–406.
17. Quello SB, Brady KT, Sonne SC. Mood disorders and sub-stance use disorder: a complex comorbidity. Sci Pract Per-spect 2005;3(1):13–21.
18. Davis LL, Frazier E, Husain MM, Warden D, Trivedi M, Fava M, et al. Substance use disorder comorbidity in major de-pressive disorder: a confirmatory analysis of the STAR∗D cohort. Am J Addict 2006;15(4):278–85.
19. Zarrabi H, Khalkhali M, Hamidi A, Ahmadi R, Zavarmousavi M. Clinical features, course, and treatment of methampheta-mine-induced psychosis in psychiatric inpatients. BMC Psy-chiatry 2016;16:44.
20. Lecomte T, Mueser KT, MacEwan W, Thornton AE, Buchan-an T, Bouchard V, et al. Predictors of persistent psychotic symptoms in persons with methamphetamine abuse receiv-ing psychiatric treatment. J Nerv Ment Dis 2013;201(12):1085–9.
21. Fluyau D, Mitra P, Lorthe K. Antipsychotics for ampheta-mine psychosis: a systematic review. Front Psychiatry 2019;10:740.
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