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Updated on April 7, 2022

Amphetamine Psychosis

What Is Amphetamine Psychosis?

Psychosis is when a person loses contact with reality. Different things can cause it — one of them being amphetamines. Both use of and withdrawal from amphetamines can cause psychosis. Symptoms are similar to schizophrenia and can occur even in healthy people.

Amphetamine psychosis doesn't subside until the substance leaves the body. This can take anywhere from a few hours to several days. Psychotic symptoms can include hallucinations and delusions (present in 13 to 45% of amphetamine users).7 

Not all amphetamine users will experience amphetamine psychosis. It depends on factors such as metabolism and mental health conditions.

What are Amphetamines?

Amphetamines stimulate the central nervous system. Some of their possible effects include:

  • Excitement
  • Faster thinking
  • Wakefulness
  • Focus
  • Energy
  • Euphoria
  • Weight loss.

Doctors prescribe amphetamines to treat several conditions. These include ADHD, Parkinson's Disease, and narcolepsy. 

Amphetamine use can cause different health issues, such as:

  • Anxiety
  • Hyperactivity
  • Extreme agitation
  • High blood pressure
  • Irregular or rapid heart rate
  • Headaches 
  • Paranoia
  • Pupil dilation

A person attempting to quit amphetamine use may experience withdrawal.

Amphetamine withdrawal side effects and symptoms can include:

  • Tiredness and an increased need for sleep
  • Increased appetite
  • Twitching
  • Vivid or unpleasant dreams
  • Slowed reaction and movement
  • Aches and pains
  • Agitation
  • Depression

Amphetamines can cause euphoria. Because of this, they have a high potential for abuse and addiction. When left untreated, amphetamine addiction can increase the risk of acute and chronic psychosis. 

Paranoia and Adderall

Adderall is a popular amphetamine brand. Research into Adderall shows psychosis occurs in 0.21% of users. Possible causes include:

  • Sleep deprivation — Adderall can interfere with normal sleep patterns. Chronic lack of sleep can lead to increased anxiety. This, in turn, could progress into psychosis.
  • History of mental illness — Those who have experienced mental illness in the past may be more vulnerable to psychosis.
  • High dosage — Many people abuse Adderall because of its euphoric effects. As they build up a tolerance, they make take higher doses. Taking higher doses could make psychosis more likely.

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Causes of Amphetamine Psychosis

Mental health experts have proposed various theories to explain the cause of amphetamine psychosis. One theory suggests the reason may be drug use alone. Although evidence is lacking, this model implies that everyone who takes amphetamines must be psychotic.  

Another hypothesis is the self-medication theory. This model suggests that people with psychiatric disorders may use drugs to reduce symptoms or side effects of other medications.

The third hypothesis model relates to primary addiction, suggesting a shared neural pathway between schizophrenia and addiction. These pathways highlight a dysregulation of an expansive neural network due to changes in the brain. Such alterations can raise the likelihood of psychosis.

Finally, the stress vulnerability model suggests that people have a pre-existing risk of psychosis triggered by amphetamine use.

Symptoms of Amphetamine Psychosis

People who experience amphetamine psychosis will have symptoms similar to schizophrenia.

The following list details the main symptoms of amphetamine psychosis:

  • Paranoid delusions
  • Visual and auditory hallucinations 
  • Scattered thoughts
  • Inattention
  • Agitation
  • Delusions of grandeur
  • Feelings of persecution
  • Lack of insight

People taking methamphetamine report feeling like insects are crawling on or biting them. Another term used to describe this symptom is METH mites

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How is Amphetamine-Induced Psychosis Diagnosed?

Amphetamine psychosis symptoms are similar to schizophrenia, making it hard to diagnose. Researchers are still debating whether amphetamine psychosis should be a separate category.

Some studies suggest that people with amphetamine psychosis will report more pronounced visual hallucinations. However, these symptoms do not make diagnosis easier. 

Disorganized thoughts are not common in amphetamine psychosis. This occurs more often in people with primary psychosis. Recovery from amphetamine psychosis is also faster.

Those with amphetamine psychosis may have masked symptoms due to taking other medications. This makes it hard to know if abstaining from amphetamines is improving their condition. That, in turn, further complicates diagnosis.

Extended psychosis tends to occur in people who have abused higher doses of amphetamine and for longer periods.

Treatment for Amphetamine Psychosis 

Treatment for amphetamine psychosis may include antipsychotic medications or benzodiazepines.

Some antipsychotic drugs that have demonstrated efficacy here include haloperidol and olanzapine. There are, however, no standard guidelines. Usually, no medication is necessary to resolve symptoms; abstinence is sufficient.

If someone is addicted to amphetamines, health care specialists may recommend other treatment options. This may include inpatient care and cognitive-behavioral therapy. Combining treatment for amphetamine use will help reduce consumption and address the root cause(s) behind the addiction.

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What Can Happen If Drug-Induced Psychosis Is Left Untreated?

Without treatment, there is a risk of continued use and worsening symptoms. Amphetamine psychosis can become chronic. 

If left untreated, amphetamine psychosis can be dangerous to oneself and others. It may also be a sign of substance addiction. Many drugs, including amphetamines, present a risk of severe health conditions like overdose and death.

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Resources

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  1. Bramness, J., Gundersen et al. "Amphetamine-induced psychosis--a separate diagnostic entity or primary psychosis triggered in the vulnerable?." BMC Psychiatry.
  2. Farnia, V., & Golshani, S. (2016, April 01). "Amphetamine-Induced Psychosis." Neuropathology of Drug Addiction and Substance Misuse, Science Direct.
  3. NIDA. "Part 1: The Connection Between Substance Use Disorders and Mental Illness." National Institute on Drug Abuse, 28 May. 2020.
  4. "COVID-19 Questions and Answers: For People Who Use Drugs or Have Substance Use Disorder." Centers for Disease Control and Prevention (CDC), February 2021,
  5. "Amphetamines." United States Drug Enforcement Administration.
  6. Moran, Lauren V et al. “Psychosis with Methylphenidate or Amphetamine in Patients with ADHD.” The New England journal of medicine vol. 380,12 : 1128-1138. doi:10.1056/NEJMoa1813751,
  7. Farnia, Vahid. “Amphetamine Psychosis: Clinical Features and Treatment.” Journal of Addiction Research & Therapy, 2016, https://doi.org/10.4172/2155-6105.C1.027.

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