Summary
Definition
Анамнез и осмотр
Ключевые диагностические факторы
- compulsive stimulant use despite negative consequences
- hypervigilance
- hyperarousal
- anxiety
- hallucinations
- chest pain
- paranoia
- increased BP
- dilated pupils
- tachycardia
- skin picking, skin lesions, excoriations
- dental decay, gum disease
- trismus, bruxism
- dyspnea
- hyperthermia
Другие диагностические факторы
- guarded/suspicious behavior
- euphoria
- alertness
- increased concentration
- headache
- irritability
- aggression
- nausea, vomiting
- depression
- anorexia
- increased motor activity
- anhedonia
- hemoptysis
- pacing
- cardiac arrhythmias
- vasculitis
- cerebral hemorrhage
Факторы риска
- Adverse childhood events
- history of previous stimulant use
- selling/producing drugs, or other criminal justice system involvement
- polysubstance use
- history of body packing, body stuffing, or "parachuting"
- history of illicit manufacturing or distribution
- history of a mental health disorder
Диагностические исследования
Исследования, которые показаны в первую очередь
- comprehensive blood panel
- cardiac blood markers
- serum creatine kinase
- hepatitis serology
- HIV serology
- urine toxicology testing
- gas chromatography/mass spectrometry of urine or blood
- ECG
- chest x-ray
Исследования, проведение которых нужно рассмотреть
- blood toxicology testing
- abdominal flat plate x-ray
- abdominal CT scan
- echocardiogram
Алгоритм лечения
acute intoxication or withdrawal
nonpregnant adults and adolescents
pregnant
sustained remission
continued use or relapse
treatment resistant
Составители
Авторы
Timothy E. Albertson, MD, MPH, PhD, FRCP

Distinguished Professor of Medicine
Anesthesiology, Pharmacology and Toxicology, and Emergency Medicine
Division of Pulmonary and Critical Care Medicine
University of California Davis School of Medicine
Sacramento
CA
Раскрытие информации
TEA declares that he has no competing interests.
Рецензенты
Alexis Ritvo, MD, MPH
Assistant Professor and Addiction Psychiatry Fellowship Director
University of Colorado School of Medicine
Aurora
CO
Раскрытие информации
AR declares that he is contracted as medical director for the Alliance for Benzodiazepines Best Practices, a nonprofit organization.
Maria Rahmandar, MD
Medical Director, Substance Use & Prevention Program
The Potocsnak Family Division of Adolescent and Young Adult Medicine
Ann & Robert H. Lurie Children's Hospital of Chicago
Assistant Professor
Northwestern University Feinberg School of Medicine
Chicago
IL
Раскрытие информации
MR declares that she has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Список литературы
Основные статьи
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th edition, text revision (DSM-5-TR). Washington, DC: American Psychiatric Publishing; 2022.
National Institute on Drug Abuse. Methamphetamine research report: what is methamphetamine? Oct 2019 [internet publication].Полный текст
Paulus MP, Stewart JL. Neurobiology, clinical presentation, and treatment of methamphetamine use disorder: a review. JAMA Psychiatry. 2020 Sep 1;77(9):959-66.Полный текст Аннотация
Substance Abuse and Mental Health Services Administration (SAMHSA). Treatment for stimulant use disorders: updated 2021. Treatment Improvement Protocol (TIP) series, no. 33. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 1999 (updated 2021).Полный текст Аннотация
World Health Organization. Guidelines for identification and management of substance use and substance use disorders in pregnancy. Nov 2014 [internet publication].Полный текст
Siefried KJ, Acheson LS, Lintzeris N, et al. Pharmacological treatment of methamphetamine/amphetamine dependence: a systematic review. CNS Drugs. 2020 Apr;34(4):337-65.Полный текст Аннотация
Soares E, Pereira FC. Pharmacotherapeutic strategies for methamphetamine use disorder: mind the subgroups. Expert Opin Pharmacother. 2019 Dec;20(18):2273-93. Аннотация
Статьи, указанные как источники
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Отличия
- Cocaine use disorder
- Malignant hypertension
- Anticholinergic drug exposure
Больше ОтличияРекомендации
- The ASAM/AAAP clinical practice guideline on the management of stimulant use disorder
- Engagement and Retention of Nonabstinent Patients in Substance Use Treatment
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