Delayed psychosis due to L.S.D

What we have learned from the Methadone Maintenance Treatment of Dual Disorder Heroin Use Disorder patients

Mental Disorders and Heroin Use Disorder (HUD) often co-occur and constitute correlated risk factors that the authors believe are best considered from a unitary perspective. In this article we review and discuss data collected by the V.P. Dole Research Group in Dual Disorder (V.P. Dole DD-RG) patients according to the following six discussion points: (1) Treatment of personality disorders during Methadone Maintenance Treatment (MMT); (2) Treatment of Mood Disorders during MMT; (3) Treatment of Anxiety Disorders during MMT; (4) Treatment of Psychotic Disorders during MMT; (5) Treatment of violence during MMT; (6) Treatment of Alcohol Use Disorder (AUD) during MMT. In treating Mood Disorder in HUD patients, we must bear in mind the interactions (potentiation and side effects) between psychopharmacology, used substances and agonist opioid medications; the use of psychiatric medications as an anti-craving drug, and the possible use of agonist and antagonist opioid medications in treating the other mental disorders. In treating chronic psychosis in HUD patients, we must consider the potentiation and side effects of antipsychotic drugs consequent on HUD treatment, worsening addiction hypophoria and inducing a more severe reward deficiency syndrome (RDS) in hypophoric patients. Violence and AUD during MMT can benefit from adequate dosages of methadone and co-medication with Sodium gamma-hydroxybutyrate (GHB). The experience of our V.P. Dole DD-RG suggests the following: (a) DD is the new paradigm in neuroscience in deepening our understanding of mental health; (b) To successfully treat DD patients a double competence is needed; (c) In managing DD patients priority must be given to Substance Use Disorder (SUD) treatment (stabilizing patients); (d) Antidepressant use is ancillary to SUD treatment; antipsychotic use must be restricted to acute phases; mood stabilizers must be preferred; any use of Benzodiazepines (BDZs) must be avoided.

Catatonia LSD induced?

The case of a patient who developed catatonia one week following Lysergic Acid Diethylamide (LSD) ingestion is presented. The psychosis developed two days after the intake. The catatonic syndrome resolved dramatically following one treatment of electroconvulsive therapy (ECT). This is perhaps the first case report of catatonia following the use of LSD. The need for a diagnostic category of organic catatonia is highlighted.

Vulnerability to psychosis associated with hallucinogen use

Ninety-five patients hospitalized for acute psychosis were reviewed with respect to hallucinogen use and family history of mental illness. Sixty-three percent of admissions had used hallucinogens to some degree within 3 years of the index admission. Drug users were predominantly male, although no age or diagnostic differences with the nondrug group were found. The incidence of hospitalized first degree relatives was approximately 30% and equal for both drug and nondrug groups. Male drug users and female nondrug users were more likely to have had first degree relatives hospitalized. For male psychotics only, lower degrees of drug use were associated with a greater number of hospitalized first degree relatives. For female psychotics only, drug use was positively associated with full scale IQ. The findings suggest sex differences in vulnerability to psychoses associated with hallucinogen use.

Psychiatric sequelae of phencyclidine abuse

Phencyclidine use has been noted to produce a psychosis of several week's duration in a small fraction of users. Descriptions of the premorbid personalities of those who became psychotic resemble descriptions of LSD and marijuana users who experienced prolonged psychiatric difficulty. In addition, the psychosis produced can often be recognized as a "hallucinogen" psychosis. Certain features of the phencyclidine psychosis, namely the neurologic abnormalities, dose-related severity of symptoms, and regularity of the length of illness, are not noted with other psychedelic drugs, leading to the conclusion that PCP psychosis is a drug effect rather than a brief functional psychosis precipitated by the disintegrating PCP experience. However, the infrequent occurrence of psychosis in the (apparently) large exposed population still suggests that this is a combination of drug effect and vulnerable, pathologic personality.

Instances of treatment for opiate and nonopiate drugs in one urban community

Study was made to learn the extent of drug abuse coming to the attention of treatment personnel in private and public facilities within one urban community during a 1-month period. Reports from 105 facilities indicated alcohol was the major drug of abuse with heroin and nonopiate drugs running a distant second and third, respectively. Of 8,784 requests for treatment in which the use of drugs was seen as a factor, 83% involved alcohol, 9% opiates, 6% nonopiate, nonalcoholic drugs, and 2% unknown drugs.

Hallucinogenic drugs as precipitants of schizophrenia

The authors have examined the drug-taking histories of 46 schizophrenics and 46 matched controls. They have found that the schizophrenics on average used a wider variety of drugs, in greater amounts. Schizophrenics who had used drugs experienced the onset of symptoms on average four years earlier than non-users and were also admitted to hospital four years earlier, on average. Those schizophrenics who had used drugs had had better premorbid personalities than the non drug-users. These results are indicative of some precipitating role of drug abuse in the onset of schizophrenia.