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Transtorno relacionado ao uso de anfetamina e metanfetamina

Last reviewed: 13 Sep 2025
Last updated: 14 May 2025

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • uso compulsivo de estimulantes apesar de consequências negativas
  • hipervigilância
  • hiperexcitação
  • ansiedade
  • alucinações
  • dor torácica
  • paranoia
  • pressão arterial (PA) elevada
  • pupilas dilatadas
  • taquicardia
  • coçar a pele, lesões cutâneas, escoriações
  • deterioração dos dentes, doenças da gengiva
  • trismo, bruxismo
  • dispneia
  • hipertermia
Full details

Other diagnostic factors

  • comportamento protegido/suspeito
  • euforia
  • estado de alerta
  • aumento da concentração
  • cefaleia
  • irritabilidade
  • agressividade
  • náuseas e vômitos
  • depressão
  • anorexia
  • atividade motora aumentada
  • anedonia
  • hemoptise
  • acatisia
  • arritmia cardíaca
  • vasculite
  • hemorragia cerebral
Full details

Risk factors

  • eventos adversos na infância
  • história de uso prévio de estimulantes
  • venda/produção de drogas ou outro envolvimento com o sistema de justiça criminal
  • uso de múltiplas substâncias
  • história de atuar como "mula de tráfico", fazer body stuffing ou paraquedismo
  • história de fabricação ou distribuição ilícita
  • história de um transtorno de saúde mental
Full details

Diagnostic tests

1st tests to order

  • perfil sanguíneo abrangente
  • marcadores cardíacos sanguíneos
  • creatina quinase sérica
  • sorologia para hepatite
  • sorologia do HIV
  • exames toxicológicos da urina
  • cromatografia gasosa acoplada à espectrometria de massa da urina ou do sangue
  • eletrocardiograma (ECG)
  • radiografia torácica
Full details

Tests to consider

  • exames toxicológicos do sangue
  • radiografia abdominal simples
  • tomografia computadorizada (TC) abdominal
  • ecocardiograma
Full details

Treatment algorithm

INITIAL

intoxicação aguda ou abstinência

ACUTE

adultos não gestantes e adolescentes

gestante

ONGOING

remissão sustentada

uso contínuo ou recaída

resistente a tratamento

Contributors

Authors

Timothy E. Albertson, MD, MPH, PhD, FRCP
Timothy E. Albertson

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

Disclosures

TEA declares that he has no competing interests.

Peer reviewers

Alexis Ritvo, MD, MPH

Assistant Professor and Addiction Psychiatry Fellowship Director

University of Colorado School of Medicine

Aurora

CO

Disclosures

AR declares that he is contracted as medical director for the Alliance for Benzodiazepines Best Practices, a non-profit organisation.

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

Disclosures

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.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

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].Full text

Paulus MP, Stewart JL. Neurobiology, clinical presentation, and treatment of methamphetamine use disorder: a review. JAMA Psychiatry. 2020 Sep 1;77(9):959-66.Full text  Abstract

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).Full text  Abstract

World Health Organization. Guidelines for identification and management of substance use and substance use disorders in pregnancy. Nov 2014 [internet publication].Full text

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.Full text  Abstract

Soares E, Pereira FC. Pharmacotherapeutic strategies for methamphetamine use disorder: mind the subgroups. Expert Opin Pharmacother. 2019 Dec;20(18):2273-93. Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
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