Stress induced spontaneous recurrence of methamphetamine psychosis: the relation between stressful experiences and sensitivity to stress

We examined increased sensitivity to stress in relation to spontaneous recu rrences of methamphetamine (MAP) psychosis (i.e., flashbacks). Plasma monoa mine metabolite levels were assayed in: 26 flashbackers, of whom 11 were on neuroleptics before and during the study, and the other 15 received neurol eptics in the course of the study; 18 non-flashbackers with a history of MA P psychosis; eight subjects with persistent MAP psychosis; and 23 MAP user and 11 non-user controls. The 26 flashbackers had experienced stressful eve nts and/or MAP-induced fear-related psychotic symptoms during previous MAP use. Mild psychosocial stressors then triggered flashbacks. During flashbac ks plasma norepinephrine levels increased markedly; among the flashbackers, those with a history of stressful events, whether or not they had experien ced fear-related symptoms, showed a further increase in 3-methoxytyramine l evels. Stressful experiences, together with MAP use, may therefore induce s ensitization to stress associated with noradrenergic hyperactivity, involvi ng increased dopamine release, and so triggering flashbacks. (C) 2000 Elsev ier Science Ireland Ltd. All rights reserved.