This review provides a critical analysis of the central nervous system effects of acute and chronic methamphetamine (MA) use, which is linked to numerous adverse psychosocial, neuropsychiatric, and medical problems. A meta-analysis of the neuropsychological effects of MA abuse/dependence revealed broadly medium effect sizes, showing deficits in episodic memory, executive functions, information processing speed, motor skills, language, and visuoconstructional abilities. The neuropsychological deficits associated with MA abuse/dependence are interpreted with regard to their possible neural mechanisms, most notably MA-associated frontostriatal neurotoxicity. In addition, potential explanatory factors are considered, including demographics (e.g., gender), MA use characteristics (e.g., duration of abstinence), and the influence of common psychiatric (e.g., other substance-related disorders) and neuromedical (e.g., HIV infection) comorbidities. Finally, these findings are discussed with respect to their potential contribution to the clinical management of persons with MA abuse/dependence.

Neurocognitive Effects of Methamphetamine: A Critical Review and Meta-analysis

Aims To examine the literature regarding clinical pharmacokinetics, direct effects and adverse clinical outcomes associated with methamphetamine use.

Methods  Relevant literature was identified through a PubMed search. Additional literature was obtained from relevant books and monographs.

Findings and conclusions  The mean elimination half-life for methamphetamine is approximately 10 hours, with considerable inter-individual variability in pharmacokinetics. Direct effects at low-to-moderate methamphetamine doses (5–30 mg) include arousal, positive mood, cardiac stimulation and acute improvement in cognitive domains such as attention and psychomotor coordination. At higher doses used typically by illicit users (≥50 mg), methamphetamine can produce psychosis. Its hypertensive effect can produce a number of acute and chronic cardiovascular complications. Repeated use may induce neurotoxicity, associated with prolonged psychiatric symptoms, cognitive impairment and an increased risk of developing Parkinson's disease. Abrupt cessation of repeated methamphetamine use leads to a withdrawal syndrome consisting of depressed mood, anxiety and sleep disturbance. Acute withdrawal lasts typically for 7–10 days, and residual symptoms associated with neurotoxicity may persist for several months.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1360-0443.2009.02564.x

A review of the clinical pharmacology of methamphetamine.

Issues. The major physical and psychological health effects of methamphetamine use, and the factors associated with such harms. Approach. Comprehensive review. Key Findings. Physical harms reviewed...

Major physical and psychological harms of methamphetamine use

The Methamphetamine Treatment Project (MTP) offers the opportunity to examine co-occurring psychiatric conditions in a sample of 1016 methamphetamine users participating in a multisite outpatient treatment study between 1999-2001. Participants reported high levels of psychiatric symptoms, particularly depression and attempted suicide, but also anxiety and psychotic symptoms. They also reported high levels of problems controlling anger and violent behavior, with a correspondingly high frequency of assault and weapons charges. Findings continue to support the value of integrated treatment for co-occurring conditions, especially the importance of training counseling staff to handle psychotic symptoms when needed.

Psychiatric symptoms in methamphetamine users.

Methamphetamine (MA) abuse is increasing to epidemic proportions, both nationally and globally. Chronic MA use has been linked to significant impairments in different arenas of neuropsychological f...

Implications of chronic methamphetamine use: a literature review

We reviewed a series of deaths in which methamphetamine was detected in the decedent's blood Analysis of postmortem whole blood was performed by gas chromatography/mass spectrometry with a limit of quantitation of 005 mg/L Methamphetamine was detected in 146 cases; 52 were drug caused, ie, a death in which the direct toxic effects of the drug caused or contributed to the death, 92 were classified as drug related, ie, a death in which the drug was demonstrated in the blood, but did not directly cause death A large proportion of the deaths resulted from homicidal (27%) or suicidal (15%) violence An examination of methamphetamine concentrations in drug related deaths (n = 92), suggests that the range of concentrations in the recreational abusing population is substantial (005-930 mg/L) but with a median concentration of 042 mg/L, and with 90% of that population having concentrations less than 220 mg/L There was substantial overlap in methamphetamine concentration between drug related deaths and drug caused deaths, although the highest concentrations were seen in the unintentional (accidental or undetermined) drug caused deaths Methamphetamine related traffic deaths (n = 17) showed patterns of driving behavior consistent with reports elsewhere, and showed blood methamphetamine concentrations ranging from 005-260 mg/L (median 035 mg/L) The data show that most methamphetamine deaths occur with blood concentrations greater than 05 mg/L, but can occur with levels as low as 005 mg/L, though usually in conjunction with other drugs or significant natural disease Neither apparently toxic nor therapeutic concentrations should be used in isolation to establish conclusively whether a death was caused by methamphetamine; proper classification of deaths involving methamphetamine requires complete death investigation, including investigation of the scene and circumstances of death, and a complete autopsy

Terri Haddix

Papers

Cause and manner of death in fatalities involving methamphetamine