Transcript
8/18/2019 Mental Disorders and Comorbidity
1/24
Mental – Behavioural
disorders and Comorbiditydue to stimulants uses
Frida Neila Rahmatika2014.2040.1011.082
8/18/2019 Mental Disorders and Comorbidity
2/24
STIMULANT USES
Chapter one
8/18/2019 Mental Disorders and Comorbidity
3/24
Overview
• Substance misuse or abuse is frequently classied :
• Eperimental
• !ecreational
• "ependant
• that may result in adverse physical and#or psycholo$icale%ects
8/18/2019 Mental Disorders and Comorbidity
4/24
&E!MS – "SM ' C!(&E!()
• maladaptive pattern of substance use leadin$ tosi$nicant adverse consequences
• must recur durin$ a *+,month period-)buse
• maladaptive pattern of substance use leadin$ toclinically si$nicant impairment or distress. as
manifested of the followin$ within a *+ month period:• tolerance.• withdrawl symptom.• /ersistent desire or unsuccessful e%orts to cut down or
control use• Social impairment
"ependence
8/18/2019 Mental Disorders and Comorbidity
5/24
• a syndrome due to cessation of. orreduction in. heavy and prolon$edsubstance use
• clinically si$nicant impairment or
distress• lasts several days to + wee0s-
1ithdraw
l
• reversible substance,specic
syndrome with maladaptivebehavioral or psycholo$ical chan$esdevelopin$ durin$ or shortly afterusin$ the substance
(ntoication
8/18/2019 Mental Disorders and Comorbidity
6/24
Stimulants 2• are dru$s that are purported to enhance
sociability. condence and alertness while reducin$inhibition-
• &he sensation : euphoria and wellbein$ thesee%ects are usually only short lastin$-
8/18/2019 Mental Disorders and Comorbidity
7/24
(ncludes
• Cocaine,
• dexamphetamine,
• methamphetamine (including crystal and
ice,• ecstasy (!," #
Methylenedioxymethamphetamine, M$MA,
• methylphenidate,
•
ephedrine,• %seudoephedrine
• Ca&eine
8/18/2019 Mental Disorders and Comorbidity
8/24
• Ori$inally found in plants : Cocca and Ephedra
• Legally uses '• amphetamine 3"eedrine. )dderall4.
methylphenidate 3!italin45 : Both are uses aspsycotrophic a$ents
• Epehdrine – /seudoephedrine : use widely
• Ilegal uses '• Cocaine
8/18/2019 Mental Disorders and Comorbidity
9/24
/hysiolo$ical E%ects
(ncreased heart rates
(ncreased blood pressure
(ncreased temperature
)mphetamine : reduce coordination
increase ris0 ta0in$
8/18/2019 Mental Disorders and Comorbidity
10/24
E%ect Sou$ht by 6ser
Euphoria
Empathy
Enhanced sociability
(ncreased ener$y level and stamina
)ppetite suppression-
8/18/2019 Mental Disorders and Comorbidity
11/24
Associated harms%hysiological '• &achycardia.
• hypertension.
• sei7ures.
• arrhythmias.
• tremor.
• mydriasis.
• dehydration.
•
diaphoresis.• nausea.
• muscle crampin$.
• 8aw clenchin$.
• 8itteriness
Increased ris taing• fear reduction : dan$erous
drivin$. ris0 of suicide
%sychological '• )niety
• /aranoia
•
/sychosis• "epresion
In)ecting drugs associatedris
Long term *rain structure changes
8/18/2019 Mental Disorders and Comorbidity
12/24
(C",*9 Classication
• *;- – Mental and behavioural disorders due to use ofcocaine
• *
8/18/2019 Mental Disorders and Comorbidity
13/24
Stimulant Overdose
=ow to medium ris0 of overdose for oral use-
hi$h ris0 of overdose associated with smo0in$ orin8ectin$ use
Si$n include :• 'ery fast breathin$ and heartbeat• 6nconsciousness• Chest pains• Midriasis• Sei7ures or >itterin$• Muscle Crampin$• "i77iness• 6rinatin$ /roblem -
8/18/2019 Mental Disorders and Comorbidity
14/24
Stimulant +ithdraal
• )cute . lastin$ up to two wee0s :
– "epression. dysphoria. fati$ue.ehaustion and somnolence and loss of
appetite• ollowin$ prolon$ed use. last several
wee0s or months-
–
insomnia. persistent cravin$. intensedreamin$ and irritability
8/18/2019 Mental Disorders and Comorbidity
15/24
&reatments for )buse and
"ependency
• "etoication
• Symptomatic
• rehabilitation centers or supportive
housin$
8/18/2019 Mental Disorders and Comorbidity
16/24
MENTAL AN$ -E.A/I0U1AL $IS01$E1$UE T0 STIMULANTS USES
Chapter &wo
8/18/2019 Mental Disorders and Comorbidity
17/24
"epression and Stimulantsuses
• "epression is common amon$st stimulant users.both in the days followin$ heavy use and durin$withdrawal-
• !ebound phenomen due to monamine depletion
• Stimulant e%ects on sleep may worsen sleep,wa0e cycle disturbances associated withdepression
8/18/2019 Mental Disorders and Comorbidity
18/24
• !eductions in stimulant use improve symptoms ofdepression-
• (f depression persists despite adequate withdrawal from
stimulants. then treat as for primary depression
• &here is little consistent evidence that antidepressants arebenecial in mana$ement of stimulant withdrawal
• CB& may address stimulant use and is e%ective
8/18/2019 Mental Disorders and Comorbidity
19/24
)niety and Stimulants 6ses
• 6sualy present with withdrawl symptom
• ?i$her stimulant use predictin$ $reater severityof aniety
• Mana$ement : reduce stimulant uses
• can be treated with ben7odia7epines. even CB& isalso e%ective in reducin$ $eneral symptoms ofaniety-
8/18/2019 Mental Disorders and Comorbidity
20/24
%sychosis and stimulants use
• characterised by a loss of connectedness withreality
• Stimulants are amon$st the most commonly usedsubstances in individuals with psychosis
• Stimulant,induced psychosis involves bothpositive and ne$ative symptoms includin$paranoid hallucinatory states. bi7arre ideas aswell as volitional disturbances and can often be
indistin$uishable from acute or chronicschi7ophrenia
8/18/2019 Mental Disorders and Comorbidity
21/24
)cute psychotic
• treatment should involve e%orts to encoura$e abstinencefrom stimulants which should result in the resolution ofpsychotic symptoms
•
)ntipsychotics may be added
8/18/2019 Mental Disorders and Comorbidity
22/24
=on$er term psychotic
• (n those who have eperienced more thanone episode of psychosis. re$ular lowdose use of antipsychotics may be
necessary• Clo7apine is e%ective in individuals with
psychosis and comorbid stimulant use-
8/18/2019 Mental Disorders and Comorbidity
23/24
/ersonality "isorder
• 6se of stimulants may eacerbate impulsivity.mood disturbance and an$er in people withCluster B type personality disorders
8/18/2019 Mental Disorders and Comorbidity
24/24
T.AN2 30U
top related