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Stimulants: cocaine, amphetamines and party drugs
Published in Berry Beaumont, David Haslam, Care of Drug Users in General Practice, 2021
Increasing use and doses of stimulants can result in a number of psychological effects. Visual or tactile hallucinations may occur. Sometimes users pick at their skin (the ‘cocaine bug’) or crawl round the floor picking up imaginary insects. Some develop automated behaviour, for example repetitively taking a clock apart and putting it back together. Feelings of anxiety, irritability and restlessness may lead on to suspiciousness and paranoid behaviour. Stimulant psychosis is a toxic state characterised by persecutory delusions and hallucinations occurring in a state of high arousal. Reverse tolerance may occur to these effects, with increased sensitisation over time. However, for most chronic users euphoria becomes ever harder to achieve. The majority of chronic stimulant users eventually develop clinical depression in spite of continued use.
Signs and Symptoms in Psychiatry
Published in Mohamed Ahmed Abd El-Hay, Essentials of Psychiatric Assessment, 2018
Visual hallucination: false perception involving vision, consisting of both formed (complex) images, e.g., people, and ill-defined (elementary) images and colors, e.g., flashes of light. They may appear normal or abnormal in size; if the latter, they are more often smaller than the corresponding real percept (sometimes called Lilliputian). Visual hallucinations occur in many mental disorders, often in conjunction with auditory hallucinations. However, visual and tactile hallucinations are usually linked to organic conditions (Tombini et al., 2012); i.e., they occur more in cases of dementia, delirium, recently developed blindness, drug withdrawal states, drug intoxications (e.g., hallucinogenic, anticholinergic, or dopaminergic substances), temporal lobe epilepsy, migraine, and other organic mental disorders. Ill-defined visual experiences occur in ocular and neurologic diseases, e.g., flashing lights occur with retinal detachment, whereas scintillating lights, a series of undulating jagged lines, blurred areas, or dark spots occur in migraine (scotomas). Seeing a curtain of darkness over the lower visual field is a sign of transient ischemic attack. Small dark specks, called floaters, that drift across the visual field are a common and benign result of senescent changes in the eye.
Introduction
Published in Jack A. Jenner, Hallucination-focused Integrative Therapy, 2015
Most definitions agree that hallucinations require certain characteristics: Sensory perception. This discriminates hallucination from imagination, which is a kind of as-if perception lacking the sensory quality of hallucinations.A compelling sense of reality. This also distinguishes AVHs from imagination (Slade and Bentall, 1988).Uncontrollability. Slade and Bentall (1988) argue that hallucinations are beyond control. However, while it is true that many hallucinating subjects complain of having no control at all, some certainly have. For example, quite a few voice hearers, especially those with religious themes, are able to evoke their voices. Most voice hearers have at least some control, although this is insufficient in most patients (Jenner, 2012a, 2012b). Some patients have intuitive abilities to regulate their voices, and some therapies report increased mastery of voices following coping training, although patients may still perceive voices. It seems unrealistic not to call these perceptions hallucinations just because they are in some sense controllable.Absence of an external stimulus. No consensus exists on whether AVHs need to come from the outside world (true hallucination) or from inside the head (pseudohallucination). Voice hearers report variably (i.e. perceiving their voices as coming from outside, inside, and both outside and inside the head). Many tactile hallucinations are experienced within the body. Also, hallucinations may be triggered by external stimuli, such as background noise. These reports raise doubt about the mandatory absence of an external stimulus.
Adverse events associated with diphenhydramine in children, 2008–2015
Published in Clinical Toxicology, 2020
Robert B. Palmer, Kate M. Reynolds, William Banner, G. Randall Bond, Ralph E. Kauffman, Ian M. Paul, Jody L. Green, Richard C. Dart
Previous reports of massive DPH overdose describe severe toxicity, including status epilepticus, cardiac dysrhythmias, and death, in both adults and children [15,18–20]. Successful resuscitation of two severely DPH-poisoned toddlers with seizures and prolonged QRS have also been described [21,22]. In the present case series, and despite some reportedly large ingestions, the incidence of seizures was low, at only 5.5%. Although QTc prolongation and QRS changes were both reported, no cases of torsade de pointes or other significant dysrhythmia were observed. However, despite the reported severe neurologic symptoms, the visual and tactile hallucinations we observed seem underreported.
Treating hallucinations in Parkinson’s disease
Published in Expert Review of Neurotherapeutics, 2022
Alice Powell, Elie Matar, Simon J. G. Lewis
Auditory hallucinations are less frequent in PD (reported prevalence of 22% to 48%) [9] and may accompany hallucinations across other modalities [4,15]. They are rarely paranoid or imperative in nature [15], usually involving simple noises such as rustling, voices and music [9,11]. Olfactory hallucinations occur in around 10% of patients with PD with or without hyposmia or cognitive impairment and can precede the development of motor symptoms by one to five years [11,16]. Tactile hallucinations though uncommon, are reported in PD typically accompanying hallucinations in other modalities [11]. Finally, there are only a few case reports of gustatory hallucinations in PD [11].
Remission of persistent methamphetamine-induced psychosis after cariprazine therapy: presentation of a case report
Published in Journal of Addictive Diseases, 2022
Valerio Ricci, Gabriele Di Salvo, Giuseppe Maina
Visual and auditory hallucinations are the basic symptoms to establish the diagnosis of substance-induced psychosis currently based on DSM-5. Other subjective experiences concerning ‘body consistency’ include tactile hallucinations and delusions of bodily transformation.4 Crucial in the diagnosis of “substance-induced psychotic disorder" is that primary schizophrenic symptoms should not precede the substance use.