Therapy of substance-induced psychosis associated with the use of psychostimulants in patients with schizophrenia and schizophrenia spectrum disorders: results of an observational noninterventional study

Therapy of substance-induced psychosis associated with the use of psychostimulants in patients with schizophrenia and schizophrenia spectrum disorders: results of an observational noninterventional study

 

Authors

 

A.A. Budanova

Federal State Budgetary Educational Institution of Higher Education “Kuban State Medical University” of the Ministry of Health of the Russian Federation, Krasnodar, Russian Federation

E.O. Boiko

Federal State Budgetary Educational Institution of Higher Education “Kuban State Medical University” of the Ministry of Health of the Russian Federation, Krasnodar, Russian Federation

O.G. Zaitseva

Federal State Budgetary Educational Institution of Higher Education “Kuban State Medical University” of the Ministry of Health of the Russian Federation, Krasnodar, Russian Federation

 

https://doi.org/10.26617/1810-3111-2024-3(124)-64-70

 

Journal: Siberian Herald of Psychiatry and Addiction Psychiatry. 2024; 3 (124):  64-70.

 

Abstract

Introduction. Despite the close association between mental disorders and substance use, there is little research on therapeutic approaches and prevention of adverse outcomes with the assessment of treatment options. The most effective modern drugs that relieve both the symptoms of schizophrenia and substance-induced psychosis caused by psychostimulants are antipsychotics. It is assumed that in the case of psychoactive substance-induced psychoses, antipsychotic therapy continues for a short period, while with abstinence from psychoactive substance use, there is a high probability of remission formation. Objective. A comparative study of two tactics for treating substance-induced psychosis caused by psychostimulants in patients with schizophrenia and schizophrenia spectrum disorders. Material.An observational noninterventional study of the treatment of psychostimulant-related psychoses was conducted on a sample of male patients (n=43) with schizophrenia and schizophrenia spectrum disorders. Two groups of patients were formed from the total sample in accordance with therapeutic protocols: group 1 (n=22) ‒ with the use of anti-psychotics, group 2 (n=21) ‒ with the use of antipsychotics and infusion therapy. Methods: clinical and psychopathological (taking into account the data of the Brief Psychiatric Rating Scale ‒ BPRS, and the Positive and Negative Syndrome Scale ‒ PANSS), laboratory (chemical and toxicological examination of biological fluids, general blood and urine tests, biochemical blood test, RW, HIV, hepatitis B and C blood tests), instrumental (electrocardiography, chest radiography), statistical (in the StatTech v. 3.1.6 program using the Kolmogorov-Smirnov and Shapiro-Wilk criteria). Results. The high scores on the BPRS scale revealed during the first day of hospital stay indicated a severe course of psychosis and pronounced psychomotor agitation. Statistically significant (p<0.001) intergroup differences were recorded by day 4: the total score in group 2 was lower than in group 1, the differences were leveled by day 8. According to the PANSS positive syndrome subscale, statistically significant (p<0.001) intergroup differences were documented by day 4 of the therapy, the average score in group 2 was lower; by day 10, the average scores in the groups did not differ statistically significantly. In group 1, the development of adverse events was detected more frequently (n=11, 50%) than in group 2 (n=6, 28.6%). At baseline, BP indices exceeded the normative ones: in group 1 ‒ 142.3±15.1, 88.7±7.8, in group 2 ‒ 141.8±9.3, 88.5±4.3. Normalization of BP occurred by day 2 of the therapy, the intergroup statistical significance of differences was documented from day 2 till day 10. Conclusion. The inclusion of infusion therapy for the relief of psychoses caused by the use of psychoactive substances in patients with schizophrenia and schizophrenia spectrum disorders increases the overall effectiveness of the therapeutic process: psychomotor agitation and other positive symptoms are reduced on average by 4 days earlier, and stabilization of the somatic condition of patients is achieved earlier, side effects are minimized when prescribing antipsychotics.

 

Keywords: substance-induced psychosis, psychostimulants, psychoactive substances, schizophrenia, schizophrenia spectrum disorders, antipsychotic therapy, infusion therapy.

 

Article (pdf)

 

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Materials 

For citation: Budanova A.A., Boiko E.O., Zaitseva O.G. Therapy of substance-induced psychosis associated with the use of psychostimulants in patients with schizophrenia and schizophrenia spectrum disorders: results of an observational noninterventional study. Siberian Herald of Psychiatry and Addiction Psychiatry.2024; 3 (124): 64-70. https://doi.org/10.26617/1810-3111-2024-3(124)-64-70

 

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