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Methamphetamine-Related Syndromes and Therapeutic Approaches

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The typical syndrome associated with MA intoxication that leads patients to seek or need medical attention is acute agitation, which may often best be handled by talking down the patient, assuring them that the condition will pass in time, while observing them and ensuring a calm environment. If recent MA administration indicates the possibility of toxicity, measures may be taken to promote clearance of the drug; emetics or lavage may be useful in removing amphetamine pills, but much more common is toxicity from intravenous or smoked MA. Currently, there are no medications that can quickly and safely reverse a life-threatening MA overdose. In severe cases, when potential for harm to self or others is manifest, either a benzodiazepine or an antipsychotic may be used. Although little formal research has established the efficacy of any pharmacotherapeutic regimen for MA overdose, the traditional approach is to provide 5 mg of haloperidol, frequently in combination with 1–2 mg of lorazepam, administered orally or parenterally in repeated doses. Other approaches include providing 1–2 mg of risperidone orally or parenterally, with 1–2 mg of lorazepam orally, administered in several doses over a 12-hour period, with the patient evaluated for 12 hours. Clinicians should observe for and treat possible dehydration and hyperthermia (Brown and Yamamoto 2003).

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Table Reference Number
TABLE 12–2. Early abstinence/withdrawal from methamphetamine: symptoms and clinical challenges (duration 2–10 days)
Table Reference Number
TABLE 12–3. Methamphetamine psychosis symptoms

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