Psychosis associated with acute recreational drug toxicity: a European case series.

Authors:
Alison M Dines
Alison M Dines
Clinical Toxicology
David M Wood
David M Wood
University of London
United Kingdom
Christopher Yates
Christopher Yates
Royal Melbourne Hospital
Australia
Fridtjof Heyerdahl
Fridtjof Heyerdahl
Ullevaal University Hospital
Norway
Knut Erik Hovda
Knut Erik Hovda
Ullevaal University Hospital
Norway

BMC Psychiatry 2016 08 18;16:293. Epub 2016 Aug 18.

Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, London, UK.

Background: Psychosis can be associated with acute recreational drug and novel psychoactive substance (NPS) toxicity. However, there is limited data available on how common this is and which drugs are most frequently implicated. We describe a European case series of psychosis associated with acute recreational drug toxicity, and estimate the frequency of psychosis for different recreational drugs.

Methods: The European Drug Emergencies Network (Euro-DEN) collects data on presentations to Emergency Departments (EDs) with acute recreational drug and NPS toxicity at 16 centres in ten countries. Euro-DEN data from October 2013 through September 2014 was retrospectively searched, and cases with psychosis were included. The proportion of cases with psychosis per drug was calculated in the searched Euro-DEN dataset.

Results: Psychosis was present in 348 (6.3 %) of 5529 cases. The median (interquartile range) age was 29 (24-38) years, 276 (79.3 %) were male and 114 (32.8 %) were admitted to psychiatric ward. The drugs most commonly reported were cannabis in 90 (25.9 %) cases, amphetamine in 87 (25.0 %) and cocaine in 56 (16.1 %). More than one drug was taken in 189 (54.3 %) cases. Psychosis was frequent in those ED presentations involving tryptamines (4/7; 57.1 %), methylenedioxypyrovalerone (MDPV) (6/22; 27.3 %), methylphenidate (6/26; 23.1 %), lysergic acid diethylamide (LSD) (18/86; 20.9 %), psilocybe mushrooms (3/16; 18.8 %), synthetic cannabinoid receptor agonists (4/26; 15.4 %) and amphetamine (87/593; 14.7 %), but less common in those involving mephedrone (14/245; 5.7 %), methylenedioxymethamphetamine (MDMA) (20/461; 4.3 %) and methedrone (3/92; 3.3 %). Amphetamine was the most frequent drug associated with psychosis when only one agent was reported, with psychosis occurring in 32.4 % of these presentations.

Conclusion: The frequency of psychosis in acute recreational drug toxicity varies considerably between drugs, but is a major problem in amphetamine poisoning. In rapidly changing drug markets and patterns of use, the Euro-DEN sentinel network contributes to measuring the scale of drug-related harms in Europe beyond other more established indicators.

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12888-016-1002-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4990880PMC
August 2016
28 Reads

Article Mentions


Provided by Crossref Event Data
wikipedia
Wikipedia: 6-APB
August 21, 2017, 12:59 pm EST

Publication Analysis

Top Keywords

recreational drug
20
acute recreational
20
drug toxicity
12
associated acute
12
psychosis associated
12
cases psychosis
12
psychosis
11
drug
10
nps toxicity
8
case series
8
frequency psychosis
8
european case
8
recreational
6
toxicity
5
acute
5
mdpv 6/22
4
methylenedioxypyrovalerone mdpv
4
6/22 273
4
involving tryptamines
4
presentations involving
4

References

(Supplied by CrossRef)
Article in BMJ.
P Byrne et al.
BMJ. 2007
Article in BMC Psychiatry.
JG Bramness et al.
BMC Psychiatry. 2012
Article in Subst Abuse.
C Roncero et al.
Subst Abuse. 2014
Article in Comp Psychiatry.
MJ Smith et al.
Comp Psychiatry. 2009
Article in Am J Psychiatry.
T Brugha et al.
Am J Psychiatry. 2005
Article in Aust N Z J Psychiatry.
VA Morgan et al.
Aust N Z J Psychiatry. 2012
Article in J Forensic Sci.
Z Mehmedic et al.
J Forensic Sci. 2010

European monitoring centre for drugs and drug addiction (EMCDDA) et al.
2015

Europol and European monitoring centre for drugs and drug addiction (EMCDDA) et al.
2013
Article in The Lancet Psychiatry.
M Forti Di et al.
The Lancet Psychiatry. 2015
Article in Acta Psychiatr Scand
A Iwanami et al.
Acta Psychiatr Scand 1994

Similar Publications