Begüm AYDIN TASLI, Sefanur KÖSE, Meltem PUŞUROĞLU, Cicek HOCAOGLU

Bir Kadın Olguda Metamfetamin Kullanımına Bağlı Gelişen Psikotik Bozukluk

Metamfetamin, Dünya çapında sıklıkla suistimal edilen ve güçlü bağımlılık yapıcı etkileri olan amfetamin türevi bir maddedir. Kronik metamfetamin kullanımı bir süre sonra dopaminerjik reseptör yoğunluğunda değişikliklere yol açar. Özellikle mezolimbik sistem ve striatumdaki dopaminerjik sistemler üzerinde etkilidir. Duyarlılık ve bağımlılıkla sonuçlanır. Dopaminerjik sistemdeki bu değişiklik psikotik belirtileri açıklayabilir. Bununla birlikte metamfetaminin neden olduğu psikoz mekanizması ve cinsiyete özgü özellikler tam olarak aydınlatılabilmiş değildir. Son yıllarda yapılan çalışmalarda metamfetamin ve benzeri uyarıcıların şizofreni ve ilişkili bozuklukların görülme sıklığında artışa neden olduğu ortaya konulmuştur. Metamfetamin psikozu şizofreni benzeri klinik özelliklere sahiptir. Hatta bazen birbirlerinden ayırt etmek oldukça güçtür. Bu olgu sunumunda tek seferlik ve düşük doz metamfetamin kullanımı sonrası psikotik bozukluk gelişen bir kadın olgu ele alınmıştır.

Anahtar Kelimeler:

metamfetamin, psikoz, kadın, Metamfetamin, madde kaynaklı psikozlar

Psychotic Disorder Due to Methamphetamine Use in a Female Case

Methamphetamine is an amphetamine-derived drug that is frequently abused worldwide and has strong addictive effects.Chronic methamphetamine use leads to changes in dopaminergic receptor density after a while.It acts on dopaminergic systems, particularly in the mesolimbic system and striatum, resulting in sensitization and addiction.This change in the dopaminergic system may explain the psychotic symptoms. However, the mechanism of psychosis caused by methamphetamine and sex-specific features have not been fully elucidated. Studies in recent years have shown that methamphetamine and similar stimulants cause an increase in the incidence of schizophrenia and related disorders. Methamphetamine psychosis has a clinical presentation very similar to schizophrenia. Sometimes it is very difficult to distinguish them from each other. In this case report, we discuss a female case who developed psychotic disorder after a single use of methamphetamine.

Keywords:

Metamfetamin, madde kaynaklı psikozlar, kadın,

PDF

___

1. Jayanthi S, Daiwile AP, Cadet JL. Neurotoxicity of methamphetamine: main effects and mechanisms. Experimental Neurology. 2021 Oct 1;344.
2. Meredith CW, Jaffe C, Ang-Lee K, Saxon AJ. Implications of chronic methamphetamine use: a literature review. Harvard Review of Psychiatry. 2005. Vol. 13. p. 141–54.
3. Elliott JM, Beveridge TJR. Psychostimulants and monoamine transporters: upsetting the balance. Current Opinion in Pharmacology. 2005. Vol. 5. p. 94–100.
4. Chiang M, Lombardi D, Du J, et al. Methamphetamine‐associated psychosis: clinical presentation, biological basis, and treatment options. Human Psychopharmacology: Clinical and Experimental. 2019 Sep 22;34(5).
5. Bramness JG, Rognli EB. Psychosis induced by amphetamines. Current Opinion in Psychiatry. Lippincott Williams and Wilkins; 2016. Vol. 29. p. 236–41.
6. Kluwe-Schiavon B, Viola TW, Sanvicente-Vieira B, et al. Substance related disorders are associated with impaired valuation of delayed gratification and feedback processing: a multilevel meta-analysis and meta-regression. Neuroscience and Biobehavioral Reviews. Elsevier Ltd; 2020. Vol. 108 p. 295–307.
7. Dankı D, Dilbaz N, Okay T, ve ark. Madde kullanımına bağlı gelişen psikotik bozuklukta atipik antipsikotik tedavisi: bir gözden geçirme. Bağımlılık Dergisi, 2005. Cilt:6 Sayı:3, s:136-141
8. Lappin JM, Sara GE, Farrell M. Methamphetamine-related psychosis: an opportunity for assertive intervention and prevention. Addiction. Blackwell Publishing Ltd; 2017. Vol. 112. p. 927–8.
9. Sekine Y, Minabe Y, Ouchi Y, et al. Association of dopamine transporter loss in the orbitofrontal and dorsolateral prefrontal cortices with methamphetamine-related psychiatric symptoms. Am J Psychiatry. 2003. Vol. 160.
10. Wearne TA, Cornish JL. A comparison of methamphetamine-induced psychosis and schizophrenia: a review of positive, negative, and cognitive symptomatology. Frontiers in Psychiatry. Frontiers Media S.A.; 2018. Vol. 9
11. Grant KM, LeVan TD, Wells SM, et al. Methamphetamine-associated psychosis. Journal of Neuroimmune Pharmacology. 2012. Vol. 7. p. 113–39.
12. Chiang M, Lombardi D, Du J, et al. Methamphetamine-associated psychosis: clinical presentation, biological basis, and treatment options. Human Psychopharmacology. John Wiley and Sons Ltd; 2019. Vol. 34.
13. Drug market trends: cocaine amphetamine-type stimulans. https://www.unodc.org/unodc/en/data-and-analysis/wdr2021.html (22 Mart 2022 de ulaşıldı)
14. Shelly J, Uhlmann A, Sinclair H, et al. First-Rank Symptoms in Methamphetamine Psychosis and Schizophrenia. Psychopathology. 2017 Jan 1;49(6):429–35.
15. Arunogiri S, Foulds JA, McKetin R, Lubman DI. A systematic review of risk factors for methamphetamine-associated psychosis. Australian and New Zealand Journal of Psychiatry. SAGE Publications Inc.; 2018. Vol. 52. p. 514–29.
16. Yang M, Yang C, Liu T, London ED. Methamphetamine-associated psychosis: links to drug use characteristics and similarity to primary psychosis. International Journal of Psychiatry in Clinical Practice. 2020 Jan 2;24(1):31–7.
17. Balhara YPS, Kuppili PP, Gupta R. Neurobiology of comorbid substance use disorders and psychiatric disorders: current state of evidence. Journal of Addictions Nursing. 2017 Jan 1;28(1):11–26.
18. Greenfield SF, Back SE, Lawson K, Brady KT. Substance abuse in women. Psychiatric Clinics of North America. 2010. Vol. 33. p. 339–55.