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Dopaminergic mechanisms in idiopathic and drug-induced psychoses.

Stimulant drugs such as cocaine and amphetamine are among the most commonly abused substances by schizophrenic patients. This may be due in part to aspects of the illness and treatment side effects that impel patients to use dopamine agonist drugs. Dopaminergic neural systems have been shown to mediate both stimulant drug effects and schizophrenia. Because of the hypothesized overlap in the pathophysiology of schizophrenia and the neurobiological effects of chronic stimulant use, the potential for serious complication of the primary disease by substance abuse exists. This article reviews the neurobiological mechanisms of behavioral sensitization and neurotoxicity associated with chronic stimulant administration in the context of pathophysiological theories of schizophrenia. Discussion focuses on the potential impact of stimulant use on the disease process as well as the manifest phenomenology and course of schizophrenia.

Amphetamine↗

Psychoses associated with marijuana use in Thailand.

Marijuana use among the 45,000 Air Force troops stationed in Thailand during the period September 1971 to September 1972 was extensive. Nevertheless, only five cases of prolonged psychosis associated with marijuana use in this population were referred for psychiatric evaluation. These cases resembled several types of adverse reactions previously described in the literature: one case of a "marijuana psychosis"; one case of an "organic marijuana syndrome"; and three cases of "marijuana-mobilized functional psychosis." With the exception of the patient with the "marijuana psychosis," this small group of men had either borderline or schizoidal premorbid personalities. Other more transient psychotic episodes appear to go unreported by the troops because of the rapid clearing of symptoms and the punitive policy of the Air Force toward drug abuse.

Adult↗