How do you formulate and diagnose patients with chronic psychosis that developed after methamphetamine use but persists after cessation of use?

It may ultimately become schizophrenia that’s been unmasked by the stimulant use. I believe you need six months or maybe three months for a schizophreniform diagnosis, and then after that, it becomes schizophrenia if it meets all the other criteria. I have to check the DSM on the timeline.

I have found older antipsychotics (Haldol, trifluoperazine) to be more effective for these patients than the newer agents.

If psychosis remains after a year sober, stimulant-induced psychosis seems appropriate. I would consider schizophrenia with a family history of schizophrenia.

I saw this several times in the Psych Emergency, where a lot of the patients would be psychotic on meth, but sometimes they would end up in jail for many months, and were then sent back to the hospital upon release from jail with a negative drug test, but still psychotic, so then they were treated a...

This is a conundrum for me in an urban outpatient private practice. I have a number of patients (mostly men in their 30s, 40s, and 50s) who became paranoid after crystal meth use. Those symptoms are quite resistant to neuroleptic medications, even at high doses, even when the CM use has stopped. I h...

Article on this: Glasner-Edwards et al., PMID 25373627.

It's a sad situation. Meth has been flooding our country, and some patients, due to this, develop persistent symptoms. The meth our patients are taking is a cooked-up drug cartel neurotoxic substance. Scary.

Good article on it in the Atlantic in...

I have seen this in the Iowa prison system, where I worked for 15 years. As you can imagine, it is a mixed bag of results over time. If symptoms do resolve or decrease significantly, it takes much more time than expected, over a year. If they have been on IV meth for years, it is a different story—r...

I originally posted the question with patients in mind who have chart diagnoses of schizophrenia or schizoaffective disorder often but developed chronic positive symptoms of psychosis (like AH and paranoid delusions) later in life after significant stimulant abuse. Often, after a month or more of so...