Mental Behavioural

disorders and Comorbidity

due to stimulants uses
Frida Neila Rahmatika
2014.2040.1011.082

Chapter one

STIMULANT USES

Overview

Substance misuse or abuse is frequently classified :

Experimental
Recreational
Dependant

that may result in adverse physical and/or psychological

effects

TERMS DSM V CRITERIA

Abuse

maladaptive pattern of substance use leading to

significant adverse consequences
must recur during a 12-month period.

maladaptive pattern of substance use leading to

clinically significant impairment or distress, as
manifested of the following within a 12 month period:
Dependen tolerance,
withdrawl symptom,
ce
Persistent desire or unsuccessful efforts to cut down or
control use
Social impairment

Withdraw
l

a syndrome due to cessation of, or

reduction in, heavy and prolonged
substance use
clinically significant impairment or
distress
lasts several days to 2 weeks.

Intoxicati
on

reversible substance-specific
syndrome with maladaptive
behavioral or psychological changes
developing during or shortly after
using the substance

Stimulants ?

are drugs that are purported to enhance

sociability, confidence and alertness while reducing
inhibition.

The sensation : euphoria and wellbeing these

effects are usually only short lasting.

Includes
Cocaine,
dexamphetamine,
methamphetamine (including crystal and
ice),
ecstasy (3,4
Methylenedioxymethamphetamine, MDMA),
methylphenidate,
ephedrine,
Pseudoephedrine
Caffeine

 Originally found in plants : Cocca and Ephedra

Legally uses :
amphetamine [Dexedrine, Adderall],
methylphenidate [Ritalin]) : Both are uses as
psycotrophic agents
Epehdrine Pseudoephedrine : use widely

Ilegal uses :
Cocaine

Physiological Effects
Increased heart rates

Increased blood pressure

Increased temperature

Amphetamine : reduce coordination

increase risk taking

Effect Sought by User

Euphoria
Empathy
Enhanced sociability
Increased energy level and stamina
Appetite suppression.

Associated harms

Tachycardia,
Physiological
hypertension,
seizures,
arrhythmias,
tremor,
mydriasis,
dehydration,
diaphoresis,
nausea,
muscle cramping,
jaw clenching,
jitteriness

Psychological :

Anxiety
Paranoia
Psychosis
Depresion

Increased risk taking

fear reduction : dangerous
driving, risk of suicide
Injecting drugs associated
risk

Long term brain structure changes

ICD-10 Classification

F14. Mental and behavioural disorders due to use of

cocaine
F15. Mental and behavioural disorders due to use of other
stimulants, including caffeine

Stimulant Overdose
Low to medium risk of overdose for oral use.
high risk of overdose associated with smoking or
injecting use
Sign include :

Very fast breathing and heartbeat

Unconsciousness
Chest pains
Midriasis
Seizures or Jittering
Muscle Cramping
Dizziness
Urinating Problem .

Stimulant Withdrawal
Acute , lasting up to two weeks :
Depression, dysphoria, fatigue,
exhaustion and somnolence and loss of
appetite
Following prolonged use, last several
weeks or months.
insomnia, persistent craving, intense
dreaming and irritability

Treatments for Abuse and

Dependency
Detoxification
Symptomatic
rehabilitation centers or supportive
housing

Chapter Two

MENTAL AND BEHAVIOURAL DISORDER

DUE TO STIMULANTS USES

Depression and Stimulants

uses
Depression is common amongst stimulant users,
both in the days following heavy use and during
withdrawal.
Rebound phenomen due to monamine depletion
Stimulant effects on sleep may worsen sleepwake
cycle
disturbances
associated
with
depression

Reductions in
depression.

If depression persists despite adequate withdrawal from

stimulants, then treat as for primary depression

There is little consistent evidence that antidepressants are

beneficial in management of stimulant withdrawal

CBT may address stimulant use and is effective

stimulant

use

improve

symptoms

of

Anxiety and Stimulants Uses

Usualy present with withdrawl symptom
Higher stimulant use predicting greater severity
of anxiety
Management : reduce stimulant uses
can be treated with benzodiazepines, even CBT is
also effective in reducing general symptoms of
anxiety.

Psychosis and stimulants use

characterised by a loss of connectedness with
reality
Stimulants are amongst the most commonly used
substances in individuals with psychosis
Stimulant-induced
psychosis
involves
both
positive and negative symptoms including
paranoid hallucinatory states, bizarre ideas as
well as volitional disturbances and can often be
indistinguishable
from
acute
or
chronic
schizophrenia

Acute psychotic

treatment should involve efforts to encourage abstinence

from stimulants which should result in the resolution of
psychotic symptoms

Antipsychotics may be added

Longer term psychotic

In those who have experienced more than
one episode of psychosis, regular low
dose use of antipsychotics may be
necessary
Clozapine is effective in individuals with
psychosis and comorbid stimulant use.

Personality Disorder
Use of stimulants may exacerbate impulsivity,
mood disturbance and anger in people with
Cluster B type personality disorders

THANK YOU