Academic Journal
A call for action: Closing the evidence gap in management of stimulant-induced psychosis.
| Τίτλος: | A call for action: Closing the evidence gap in management of stimulant-induced psychosis. |
|---|---|
| Συγγραφείς: | Bouthillier A; Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada.; Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada., Sharafi H; Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada., Bisaga A; Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA., Jutras-Aswad D; Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada.; Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada. |
| Πηγή: | Addiction (Abingdon, England) [Addiction] 2026 Sep; Vol. 121 (9), pp. 2275-2283. Date of Electronic Publication: 2026 Mar 15. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 9304118 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1360-0443 (Electronic) Linking ISSN: 09652140 NLM ISO Abbreviation: Addiction Subsets: MEDLINE |
| Imprint Name(s): | Publication: Oxford : Wiley-Blackwell Original Publication: Abingdon, Oxfordshire, UK : Carfax Pub. Co., c1993- |
| Ιατρικοί όροι (MeSH): | Central Nervous System Stimulants*/adverse effects , Psychoses, Substance-Induced*/therapy , Psychoses, Substance-Induced*/diagnosis, Antipsychotic Agents/therapeutic use ; Humans ; Evidence Gaps |
| Περίληψη: | Background: Stimulant-induced psychosis (StIP) is emerging as one of most pressing health challenges. Over the past two decades, stimulant-related harms and psychiatric care demands have risen sharply. Individuals with StIP often present with severe agitation and high suicide risk, and up to half progress to chronic psychotic illness within two years. Despite this burden, clinical recommendations remain sparse and largely based on consensus rather than evidence. This article aims to critically appraise current conceptual and therapeutic approaches to StIP, highlight evidence gaps, and outline priorities for research and clinical practice. Argument: We propose a re-evaluation of StIP nosology, shifting away from DSM-5 distinctions that require symptom presence beyond abstinence and often fail in real-world settings. Management might require stage-specific approaches- acute (safety and short-term antipsychotics), subacute (stabilization and relapse prevention), and long-term (management of recurrent or persistent psychosis)- yet no validated staging models exist. Antipsychotic prescribing remains guided by expert opinion, with unresolved questions around choice of agent, treatment duration, and relapse prevention strategies. Evidence for psychosocial and behavioral interventions is very limited. Individualized care, supported by predictive tools, biomarkers, and longitudinal risk stratification, is essential to identify individuals at highest risk of progression and chronicity while minimizing unnecessary long-term pharmacotherapy. Conclusions: Stimulant-induced psychosis (StIP) exemplifies a widening evidence-practice gap. Addressing this requires a coordinated research agenda to address nosology and phenomenology, validate diagnostic algorithms, develop stage-specific management models, and test integrated pharmacological and behavioral strategies. Without such efforts, outcomes will remain poor, and StIP will continue to represent one of psychiatry's most consequential yet neglected syndromes. (© 2026 The Author(s). Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.) |
| References: | Curr Neuropharmacol. 2013 Sep;11(5):484-90. (PMID: 24403872) J Psychiatry Neurosci. 2006 Sep;31(5):301-13. (PMID: 16951733) Pharmacopsychiatry. 2017 May;50(3):87-95. (PMID: 28297728) Psychiatr Serv. 2006 Feb;57(2):185-96. (PMID: 16452695) CNS Drugs. 2014 Dec;28(12):1115-26. (PMID: 25373627) Curr Neuropharmacol. 2025;23(4):404-411. (PMID: 39449332) JAMA Psychiatry. 2021 Dec 1;78(12):1329-1342. (PMID: 34550301) JAMA Netw Open. 2018 Oct 5;1(6):e183758. (PMID: 30646256) Drug Alcohol Depend. 2021 Feb 1;219:108467. (PMID: 33385693) Int J Epidemiol. 2014 Feb;43(1):235-48. (PMID: 24374889) Am J Drug Alcohol Abuse. 2007;33(5):675-86. (PMID: 17891660) Schizophr Bull. 2016 Sep;42(5):1262-9. (PMID: 26884547) Schizophr Bull. 2020 Apr 10;46(3):505-516. (PMID: 31618428) MMWR Morb Mortal Wkly Rep. 2012 Feb 17;61(6):101-5. (PMID: 22337174) J Clin Psychopharmacol. 2025 Jul-Aug 01;45(4):349-352. (PMID: 40179274) Drug Alcohol Rev. 2010 Jul;29(4):456-61. (PMID: 20636664) Epilepsia. 2011 Feb;52(2):401-4. (PMID: 21314677) Lancet. 2007 Jul 28;370(9584):319-28. (PMID: 17662880) Br J Psychiatry. 1970 Dec;117(541):661-5. (PMID: 5492176) Arch Gen Psychiatry. 1973 Jul;29(1):35-40. (PMID: 4711131) Am J Psychiatry. 2007 Jan;164(1):160-2. (PMID: 17202560) Psychiatry Res. 2017 Jan;247:113-119. (PMID: 27888680) Public Health Rev. 2014 Jan;35(2):. (PMID: 26568649) J Clin Psychiatry. 2013 Jan;74(1):e94-9. (PMID: 23419236) Jpn J Psychiatry Neurol. 1990 Sep;44(3):531-9. (PMID: 2074612) Drug Alcohol Depend. 2013 Jul 1;131(1-2):23-35. (PMID: 23490450) Focus (Am Psychiatr Publ). 2020 Oct;18(4):493-497. (PMID: 33343262) Am J Psychiatry. 2010 Jan;167(1):17-23. (PMID: 20068123) Drug Alcohol Depend. 2000 Feb 1;58(1-2):67-75. (PMID: 10669056) Psychiatry Res. 2023 Oct;328:115475. (PMID: 37713923) Front Psychiatry. 2018 Oct 10;9:491. (PMID: 30364176) Am J Addict. 2015 Oct;24(7):586-9. (PMID: 26332037) Am J Psychiatry. 2019 Sep 1;176(9):711-719. (PMID: 31055966) Drug Alcohol Depend. 2024 Sep 1;262:111409. (PMID: 39089187) Aust N Z J Psychiatry. 2018 Jun;52(6):514-529. (PMID: 29338289) J Clin Psychiatry. 1999;60 Suppl 19:47-51; discussion 52-3. (PMID: 10507280) Biol Psychiatry. 1970 Apr;2(2):95-107. (PMID: 5459137) BMC Psychiatry. 2012 Dec 05;12:221. (PMID: 23216941) Psychiatr Serv. 2001 Apr;52(4):501-7. (PMID: 11274497) Am J Addict. 2000 Winter;9(1):28-37. (PMID: 10914291) Mol Psychiatry. 1999 Nov;4(6):512-23. (PMID: 10578232) Br J Psychiatry. 2004 Sep;185:196-204. (PMID: 15339823) Early Interv Psychiatry. 2018 Oct;12(5):928-934. (PMID: 27991722) Int J Drug Policy. 2024 Jul;129:104480. (PMID: 38861841) Hum Psychopharmacol. 2019 Sep;34(5):e2710. (PMID: 31441135) Early Interv Psychiatry. 2024 Dec;18(12):1015-1021. (PMID: 38772874) J Addict Med. 2020 Mar/Apr;14(2S Suppl 1):1-91. (PMID: 32511106) Addict Behav. 2018 May;80:154-160. (PMID: 29407687) J Addict Med. 2024 May-Jun 01;18(1S Suppl 1):1-56. (PMID: 38669101) Addiction. 2025 Oct;120(10):2005-2019. (PMID: 40702596) Br J Addict. 1989 Dec;84(12):1548-9. (PMID: 2611442) Am J Prev Med. 2021 Nov;61(5):738-749. (PMID: 34218964) Ann N Y Acad Sci. 2004 Oct;1025:279-87. (PMID: 15542728) Addiction. 2026 Sep;121(9):2275-2283. (PMID: 41833512) J Subst Use Addict Treat. 2023 Aug;151:209033. (PMID: 37011880) Addiction. 2007 Aug;102(8):1204-11. (PMID: 17565561) MMWR Morb Mortal Wkly Rep. 2020 Aug 21;69(33):1117-1121. (PMID: 32817603) J Addict Med. 2019 Mar/Apr;13(2):159-165. (PMID: 30379780) Drug Alcohol Depend. 2014 Jun 1;139:18-25. (PMID: 24685563) Ann N Y Acad Sci. 2006 Aug;1074:125-34. (PMID: 17105910) JAMA Psychiatry. 2023 Nov 1;80(11):1169-1174. (PMID: 37755727) Schizophr Bull. 2000;26(2):441-9. (PMID: 10885642) J Neuroimmune Pharmacol. 2012 Mar;7(1):113-39. (PMID: 21728034) Can J Psychiatry. 2017 Sep;62(9):624-634. (PMID: 28886671) Psychopharmacol Bull. 1986;22(3):751-6. (PMID: 3797580) Arch Gen Psychiatry. 2006 Apr;63(4):426-32. (PMID: 16585472) |
| Grant Information: | CHUM Foundation |
| Contributed Indexing: | Keywords: concurrent disorders; evidence gaps; guideline; integrated therapy; methamphetamine; psychotic disorders |
| Substance Nomenclature: | 0 (Antipsychotic Agents) 0 (Central Nervous System Stimulants) |
| Entry Date(s): | Date Created: 20260315 Date Completed: 20260819 Latest Revision: 20260831 |
| Update Code: | 20260831 |
| PubMed Central ID: | PMC13486903 |
| DOI: | 10.1111/add.70393 |
| PMID: | 41833512 |
| Βάση Δεδομένων: | MEDLINE |
καταχωρήστε σχόλιο πρώτοι!