Pharmacopsychiatry 2002; 35(2): 62-71
DOI: 10.1055/s-2002-25067
Original Paper
© Georg Thieme Verlag Stuttgart · New York

Spontaneous Recurrence of Methamphetamine-lnduced Paranoid-Hallucinatory States in Female Subjects: Susceptibility to Psychotic States and Implications for Relapse of Schizophrenia

K.  Yui1, 2 , S.  Ikemoto3, 4 , K.  Goto3 , K.  Nishijima3 , T.  Yoshino1, 5 , T.  Ishiguro1
  • 1Department of Psychiatry, Jichi Medical School, Tochigi, Japan
    Institute at which the work was carried out: Department of Legal Medicine and Human Genetics,
    Jichi Medical School, Tochigi, Japan, and Medical Care Section, Tochigi Prison, Ministry of Justice, Sozya,
    Tochigi, Japan
  • 2Honolulu V. A., National Center for PTSD, Honolulu, USA
  • 3Nippon Veterinary and Animal Science University, Tokyo, Japan
  • 4Department of Legal Medicine and Human Genetics, Jichi Medical School, Tochigi, Japan
  • 5Department of Pharmacy, Jichi Medical School, Tochigi, Japan
Weitere Informationen

Publikationsverlauf

20. 11. 2000

15. 6. 2001

Publikationsdatum:
12. April 2002 (online)

In this study, we examined the relationship between increased sensitivity to stress associated with noradrenergic hyperactivity and dopaminergic changes, and susceptibility to subsequent spontaneous recurrences of methamphetamine (MAP) psychosis (i.e., flashbacks). The subjects were 81 physically healthy females. Plasma monoamine metabolite levels were assayed in: 19 flashbackers, of whom 11 experienced a single flashback and 8 exhibited subsequent flashbacks; 20 non-flashbackers with a history of MAP psychosis; 8 subjects with persistent MAP psychosis; and 23 MAP users and 11 non-user controls. All 19 flashbackers had undergone frightening and stressful experiences during previous MAP use. Mild psychosocial stressors then triggered their flashbacks. During flashbacks, plasma norepinephrine levels increased, with a small increase in plasma levels of 3-methoxytyramine, which is an index of dopamine release. Among the 19 flashbackers, the 8 with subsequent episodes had increased NE levels and slightly increased 3-methoxytyramine levels, while the 11 with a single episode displayed small increases in norepinephrine and 3-methoxytyramine levels. Thus, noradrenergic hyperactivity and increased dopamine release in response to mild psychosocial stressors may be responsible for the development of flashbacks. Robust noradrenergic hyperactivity with slightly increased DA release in response to mild stress may induce susceptibility to subsequent flashbacks. Flashbacks and schizophrenia may share the pathophysiology of susceptibility to recurrence of paranoid-hallucinatory states such as stress sensitization, and also noradrenergic hyperactivity and enhanced DA release. Thus, flashbacks may provide an appropriate model of susceptibility to paranoid-hallucinatory states of schizophrenia. The model psychosis is a potential tool for validating basic neurobiological concepts thought to be related to the schizophrenia. A better understanding of the neurobiological mechanisms of susceptibility to recurrence could provide useful information in the development of strategies for preventing relapse.

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Kunio Yui

Department of Psychiatry, Jichi Medical School

Minamikawachi 3311-1

Tochigi 329-0498

Japan

Telefon: +81 (48) 862-7520

Fax: +81 (48) 836-1372

eMail: nibrin@jichi.ac.jp