Stimulant use disorder: Difference between revisions
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{{SK}} Stimulant intoxication; stimulant withdrawal | {{SK}} Stimulant intoxication; stimulant withdrawal | ||
==Overview== | ==Overview== | ||
Stimulant use disorder is a substance use disease characterized by | Stimulant use disorder is a substance use disease characterized by stimulant drug misuse leading to tolerance, dependence, and abuse. Acute stimulant intoxication is associated with euphoria with affective blunting, hypervigilance, anxiety, and impaired judgment with somatic symptoms characteristic of stimulant drugs such as tachycardia, hypertension, perspiration, and psychomotor agitation. Abrupt discontinuation of stimulants is associated with a withdrawal syndrome characterized by a dysphoric mood with [[fatigue]], vivid, unpleasant dreams, increased appetite, and sleep disturbances.<ref name=DSMV>{{cite book | title = Diagnostic and statistical manual of mental disorders : DSM-5 | publisher = American Psychiatric Association | location = Washington, D.C | year = 2013 | isbn = 0890425558 }}</ref> | ||
==Stimulant Use Disorder== | ==Stimulant Use Disorder== | ||
| Line 114: | Line 114: | ||
*Impaired social or occupational functioning<ref name=DSMV>{{cite book | title = Diagnostic and statistical manual of mental disorders : DSM-5 | publisher = American Psychiatric Association | location = Washington, D.C | year = 2013 | isbn = 0890425558}}</ref> | *Impaired social or occupational functioning<ref name=DSMV>{{cite book | title = Diagnostic and statistical manual of mental disorders : DSM-5 | publisher = American Psychiatric Association | location = Washington, D.C | year = 2013 | isbn = 0890425558}}</ref> | ||
===DSM-V Diagnostic for Stimulant Intoxication<ref name=DSMV>{{cite book | title = Diagnostic and statistical manual of mental disorders : DSM-5 | publisher = American Psychiatric Association | location = Washington, D.C | year = 2013 | isbn = 0890425558 }}</ref>=== | ===DSM-V Diagnostic Criteria for Stimulant Intoxication<ref name=DSMV>{{cite book | title = Diagnostic and statistical manual of mental disorders : DSM-5 | publisher = American Psychiatric Association | location = Washington, D.C | year = 2013 | isbn = 0890425558 }}</ref>=== | ||
{{cquote| | {{cquote| | ||
A. Recent use of an amphetamine-type substance, cocaine, or other stimulant. | A. Recent use of an amphetamine-type substance, cocaine, or other stimulant. | ||
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*Impairment in a functional area (social, work, school)<ref name=DSMV>{{cite book | title = Diagnostic and statistical manual of mental disorders : DSM-5 | publisher = American Psychiatric Association | location = Washington, D.C | year = 2013 | isbn = 0890425558}}</ref> | *Impairment in a functional area (social, work, school)<ref name=DSMV>{{cite book | title = Diagnostic and statistical manual of mental disorders : DSM-5 | publisher = American Psychiatric Association | location = Washington, D.C | year = 2013 | isbn = 0890425558}}</ref> | ||
===Diagnostic Criteria=== | ===DSM-V Diagnostic Criteria for Stimulant Withdrawal=== | ||
{{cquote| | |||
* A. Cessation of (or reduction in) prolonged amphetamine-type substance, cocaine, or other stimulant use. | * A. Cessation of (or reduction in) prolonged amphetamine-type substance, cocaine, or other stimulant use. | ||
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Specify the specific substance that causes the withdrawal syndrome (i.e., [[amphetamine]]-type substance, [[cocaine]], or other stimulant). | Specify the specific substance that causes the withdrawal syndrome (i.e., [[amphetamine]]-type substance, [[cocaine]], or other stimulant). | ||
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==References== | ==References== | ||
Latest revision as of 22:34, 13 November 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jesus Rosario Hernandez, M.D. [2]
Synonyms and keywords: Stimulant intoxication; stimulant withdrawal
Overview
Stimulant use disorder is a substance use disease characterized by stimulant drug misuse leading to tolerance, dependence, and abuse. Acute stimulant intoxication is associated with euphoria with affective blunting, hypervigilance, anxiety, and impaired judgment with somatic symptoms characteristic of stimulant drugs such as tachycardia, hypertension, perspiration, and psychomotor agitation. Abrupt discontinuation of stimulants is associated with a withdrawal syndrome characterized by a dysphoric mood with fatigue, vivid, unpleasant dreams, increased appetite, and sleep disturbances.[1]
Stimulant Use Disorder
Differential Diagnosis
- Depressive and bipolar disorder
- Generalized anxiety disorder
- Schizophrenia
- Stimulant intoxication
- Stimulant withdrawal
- Panic disorder
- Phencyclidine intoxication[1]
Epidemiology and Demographics
The prevalence of stimulant use disorder is 2,000 per 100,000 (0.2%) of the overall population.[1]
Risk Factors
- Adult antisocial personality disorder
- Antisocial personality disorder
- Bipolar disorder
- Childhood conduct disorder
- Exposure to community violence during childhood
- Schizophrenia
- Substance use disorder
- Impulsivity
- Prenatal cocaine exposure,
- Postnatal cocaine use by parents
- Unstable home environment, having a psychiatric condition[1]
Prognosis
Poor prognostic factors include:
- Antisocial personality
- Impulsivity
- Substance use disorders
- Living in an unstable home environment[1]
DSM-V Diagnostic Criteria for Stimulant Use Disorder[1]
| “ |
A. A pattern of amphetamine-type substance, cocaine, or other stimulant use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:
This criterion is not considered to be met for those taking stimulant medications solely under appropriate medical supervision, such as medications for attention-deficit hyperactivity disorder or narcolepsy. Specify if:
Specify if:
Specify current severity:
|
” |
Stimulant Intoxication
Differential Diagnosis
- Anxiety disorder
- Bipolar disorder
- Depressive disorder
- Psychotic disorder
- Stimulant intoxication delirium
- Schizophrenia
- Stimulant-induced depressive disorder
- Generalized anxiety disorder
- Panic disorder[1]
Risk Factors
- High chronicity of use
- Low tolerance
- High rate of absortion[1]
Prognosis
Poor prognostic factors include:
- Convulsions
- Cardiac arrhythmia
- Hyperpyrexia
- Impaired social or occupational functioning[1]
DSM-V Diagnostic Criteria for Stimulant Intoxication[1]
| “ |
A. Recent use of an amphetamine-type substance, cocaine, or other stimulant. AND B. Clinically significant problematic behavioral or psychological changes (e.g., euphoria or affective blunting: changes in sociability; hypervigilance; interpersonal sensitivity; anxiety, tension, or anger; stereotyped behaviors; impaired judgment) that developed during, or shortly after, use of a stimulant. AND C. Two (or more) of the following signs or symptoms, developing during, or shortly after, stimulant use:
AND D. The signs or symptoms are not attributable to another medical condition and are not better explained by another mental disorder, including intoxication with another substance. Specify the specific intoxicant (i.e., amphetamine-type substance, cocaine, or other stimulant). Specify if:
|
” |
Stimulant Withdrawal
Differential Diagnosis
- Anxiety disorder
- Bipolar disorder
- Depressive disorder
- Psychotic disorder
- Sexual dysfunction
- Sleep disorder
- Stimulant-induced intoxication delirium[1]
Risk Factors
Repetitive high-dose use[1]
Natural History, Complications and Prognosis
Poor prognostic factors include:
DSM-V Diagnostic Criteria for Stimulant Withdrawal
| “ |
AND
AND
AND
Specify the specific substance that causes the withdrawal syndrome (i.e., amphetamine-type substance, cocaine, or other stimulant). |
” |