※ 引述《bingogo (bingo)》之銘言:
: Amphetamine除了引起agitation,
: 也常造成psychosis,
: 是不是也可以用antipsychotics來治療?
在 pubmed 找到一篇文章,希望大家幫忙申覆
Treatment for amphetamine psychosis.Shoptaw SJ, Kao U, Ling W.
Department of Family Medicine, University of California, 10880
Wilshire Boulevard, Suite 540, Los Angeles, CA, USA, 90024.
BACKGROUND: Chronic amphetamine users may have experience of
paranoia and hallucination. It has long been believed that
dopamine antagonists, such as chlorpromazine, haloperidol,
and thioridazine, are effective for the treatment of amphetamine
psychosis. OBJECTIVES: To evaluate risks, benefits, costs of
treatments for amphetamine psychosis. SEARCH STRATEGY: MEDLINE
(1966-2007), EMBASE (1980-2007), CINAHL (1982-2007), PsychINFO
(1806-2007), CENTRAL (Cochrane Library 2008 issue 1), references
of obtained articles. SELECTION CRITERIA: All randomised
controlled and clinical trials (RCTs, CCTs) evaluating treatments
(alone or combined) for people with amphetamine psychosis DATA
COLLECTION AND ANALYSIS: Two authors evaluated and extracted the
data independently. Dichotomous data were extracted on an
intention-to-treat basis in which the dropouts were assigned as
participants with the worst outcomes. The Relative Risk (RR)
with the 95% confidence interval (95% CI) was used to assess
the dichotomous data. The Weighted Mean Difference (WMD) with
95% CI was used to assess the continuous data. MAIN RESULTS:
The comprehensive searches found one randomised controlled trial
of treatment for amphetamine psychosis meeting the criteria
for considering studies. The study involved 58 participants
and compared the efficacy and tolerability of two antipsychotic
drugs, olanzapine (a newer antipsychotic) and haloperidol (a
commonly used antipsychotic medication used as a control
condition), in treating amphetamine-induced psychosis. The
results show that both olanzapine and haloperidol at clinically
relevant doses were efficacious in resolving psychotic symptoms,
with the olanzapine condition showing significantly greater
safety and tolerability than the haloperidol control as measured
by frequency and severity of extrapyramidal symptoms. AUTHORS'
CONCLUSIONS: Only one RCT of treatment for amphetamine psychosis
has been published. Outcomes from this trial indicate that
antipsychotic medications effectively reduce symptoms of
amphetamine psychosis, the newer generation and more expensive
antipsychotic medication, olanzapine, demonstrates significantly
better tolerability than the more affordable and commonly used
medication, haloperidol.There are other two studies that did not
meet the inclusion criteria for this review. The results of these
two studies show that agitation and some psychotic symptoms may
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be abated within an hour after antipsychotic injection. Whether
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this limited evidence can be applied for amphetamine psychotic
patients is not yet known.The medications that should be further
investigate are conventional antipsychotics, newer antipsychotics
and benzodiazepines. However, naturalistic studies of amphetamine
psychotic symptoms and the prevalence of relapse to psychosis in
the presence of amphetamine, are also crucial for advising the
development of study designs appropriate for further treatment
studies of amphetamine psychosis.
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