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Treatment for amphetamine psychosis.
Steven J Shoptaw1, Uyen Kao, Walter W Ling
1Family Medicine, University of California, 10880 Wilshire Blvd Suite 540, Los Angeles, California 90024, USA. sshoptaw@mednet.ucla.edu
The Cochrane Database of Systematic Reviews
|October 10, 2008
Summary
Antipsychotic medications effectively treat amphetamine psychosis symptoms. Newer antipsychotics like olanzapine show better tolerability than older ones like haloperidol, despite higher costs.
Area of Science:
- Psychiatry
- Pharmacology
- Clinical Trials
Background:
- Chronic amphetamine use can lead to paranoia and hallucinations.
- Dopamine antagonists have been traditionally used for amphetamine psychosis.
Purpose of the Study:
- To evaluate treatments for amphetamine psychosis, assessing risks, benefits, and costs.
- To synthesize evidence from randomized controlled trials (RCTs) and clinical trials (CCTs).
Main Methods:
- Searched multiple databases (MEDLINE, EMBASE, CINAHL, PsychINFO, CENTRAL) from inception to 2008.
- Included RCTs and CCTs evaluating treatments for amphetamine psychosis.
- Extracted data independently, using intention-to-treat analysis and assessing outcomes with Relative Risk and Weighted Mean Difference.
Main Results:
- One RCT involving 58 participants met the inclusion criteria.
- Both olanzapine and haloperidol effectively reduced psychotic symptoms.
- Olanzapine demonstrated significantly better safety and tolerability, particularly regarding extrapyramidal symptoms, compared to haloperidol.
Conclusions:
- Antipsychotic medications are effective in reducing symptoms of amphetamine psychosis.
- Newer antipsychotics like olanzapine offer improved tolerability over older agents like haloperidol.
- Further research is needed on conventional antipsychotics, newer agents, benzodiazepines, and naturalistic studies to inform treatment strategies.
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