MAMa FAQ's #15

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More information can be found in Crystal Meth: They Call it Ice.

What mental illnesses are caused by methamphetamine?

Bipolar – manic depression is characterized by wild mood swings and erratic behavior. Manic behavior is commonly seen when high, but mood swings often persist even in sobriety for many months. Mood swings may be associated with violence, suicide, motor vehicle crashes, and child abuse. Drug induced bipolar generally resolves when off drugs. If the person had Bipolar Disorder before they became addicted, they do not get better off of meth, but rather need continued psychiatric care.

Schizophrenia Hallucinations are almost universal among meth addicts (>90%). They usually ensue after a prolonged period (many days) without sleep. These hallucinations are not diagnostic of schizophrenia. The addict usually realizes they are not real (Man, I am seeing things!)

As the addict continues to use, however, real psychosis develops in some users. They develop fantastic delusions involving plots against their lives, conspiracies, people following them etc. These delusions are often accompanied by hallucinations that are often vivid and frightening.

Psychosis caused by methamphetamine is treatable with the same antipsychotic medications we use for schizophrenia, and a small number of meth addicts will need them for the rest of their lives. Most addicts recover from their psychosis with no residual mental illness.

Depression is universal as the addict goes into withdrawal. Typically it lasts 3-6 months and then slowly resolves, but some addicts continue to have severe depression for 2 or 3 years after getting off methamphetamine. This depression is related to depletion of neurotransmitters in the brain. It responds to anti-depressant medications called Serotonin Reuptake Inhibitors [example Prozac]. Patients also benefit from support group settings where they can express themselves and somebody understands what they are going through. Having a mentor or sponsor who has recovered from this depression gives them hope that they can recover too.

Anxiety is also very common in current users and those in withdrawal. They have severe unprovoked panic attacks with rapid pulse, breathlessness, and unexplained fear. Panic attacks and nightmares commonly fade away in the first 3-6 months off methamphetamine. When they are severe, they can be treated with anti-anxiety medications.

Dementia is a consequence of long term high dose meth use and is a function of cell death in the cortical parts of the brain, particularly the frontal lobe. Memory loss is the most frequent symptom and it can be severe. Halting speech is also common, as the addict has to think about what you say for a while before he can respond to it. Severe cases are treated with Aricept, the same medicine used for Alzheimer’s disease.

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