Susceptibility to episode recurrence in spontaneous recurrence of methamphetamine psychosis

Behavioral sensitization to methamphetamine induces specific interneuronal mRNA pathology across the prelimbic and orbitofrontal cortices

Schizophrenia is associated with significant pathophysiological changes to interneurons within the prefrontal cortex (PFC), with mRNA and protein changes associated with the GABA network localized to specific interneuron subtypes. Methamphetamine is a commonly abused psychostimulant that can induce chronic psychosis and symptoms that are similar to schizophrenia, suggesting that chronic METH induced psychosis may be associated with similar brain pathology to schizophrenia in the PFC. The aim of this study, therefore, was to examine mRNA expression of interneuron markers across two regions of the PFC (prelimbic (PRL) and orbitofrontal cortices (OFC)) following METH sensitization, an animal model of METH psychosis. We also studied the association between GABA mRNA expression and interneuronal mRNA expression to identify whether particular changes to the GABA network could be localized to a specific inhibitory cellular phenotype. METH sensitization increased the transcriptional expression of calbindin, calretinin, somatostatin, cholecyctokinin and vasoactive intestinal peptide in the PRL while parvalbumin, calbindin, cholectokinin and vasoactive intestinal peptide were upregulated in the OFC. Based on our previous findings, we also found significant correlations between GAD₆₇, GAT₁ and parvalbumin while GAD₆₇, GAD₆₅ and GAT₁ were positively correlated with cholecystokinin in the PRL of METH sensitized rats. Within the OFC, the expression of GABA_Aα1 was positively correlated with somatostatin while GABA_Aα5 was negatively associated with somatostatin and calbindin. These findings suggest that METH sensitization differentially changes the expression of mRNAs encoding for multiple peptides and calcium binding proteins across the PRL and the OFC. Furthermore, these findings support that changes to the GABA network may also occur within specific cell types. These results, therefore, provide the first evidence that METH sensitization mediates differential interneuronal pathology across the PRL and OFC and such changes could have profound consequences on behavior and cognitive output.

Methamphetamine Motivated Murder: Forensic Psychological/Psychiatric & Legal Applications in Criminal Contexts

This article examines the clinical and forensic (psycho-legal) aspects of methamphetamine use. The author will describe the clinical and psychiatric effects of the drug on an individual's functioning. Forensic psychological/psychiatric issues including substance-induced psychosis relevant to a not guilty by reason of insanity defense, diminished capacity, and mitigation at capital sentencing will be addressed. Case law pursuant to forensic aspects of methamphetamine use will also be thoroughly explored.

Amphetamine-induced psychosis--a separate diagnostic entity or primary psychosis triggered in the vulnerable?

Use of amphetamine and methamphetamine is widespread in the general population and common among patients with psychiatric disorders. Amphetamines may induce symptoms of psychosis very similar to those of acute schizophrenia spectrum psychosis. This has been an argument for using amphetamine-induced psychosis as a model for primary psychotic disorders. To distinguish the two types of psychosis on the basis of acute symptoms is difficult. However, acute psychosis induced by amphetamines seems to have a faster recovery and appears to resolve more completely compared to schizophrenic psychosis. The increased vulnerability for acute amphetamine induced psychosis seen among those with schizophrenia, schizotypal personality and, to a certain degree other psychiatric disorders, is also shared by non-psychiatric individuals who previously have experienced amphetamine-induced psychosis. Schizophrenia spectrum disorder and amphetamine-induced psychosis are further linked together by the finding of several susceptibility genes common to both conditions. These genes probably lower the threshold for becoming psychotic and increase the risk for a poorer clinical course of the disease.The complex relationship between amphetamine use and psychosis has received much attention but is still not adequately explored. Our paper reviews the literature in this field and proposes a stress-vulnerability model for understanding the relationship between amphetamine use and psychosis.

Pareidolias in obsessive-compulsive disorder: neglected symptoms that may respond to serotonin reuptake inhibitors

BACKGROUND

Obsessive-compulsive disorder (OCD) is a multifaceted and treatable condition. We describe a patient with OCD whose main complaint was the experience of pareidolias (i.e., 'images seen out of shapes'), a symptom that responded to treatment with a serotonin reuptake inhibitor.

METHOD

Single case report.

RESULTS

Mrs A, a 38-year-old married white woman with a history of OCD, reported visualizing faces of witches and gorillas out of floor tiles. She would see these figures without making any effort, and despite the intense discomfort associated with it, was unable to dismiss the images. Her symptoms responded to a therapeutic trial with clomipramine.

CONCLUSION

Patients presenting typical pareidolias need to be probed for underlying OCD. This approach may have material impact on treatment decisions, with good response of the aforementioned condition to serotonin reuptake inhibitors.