Symptoms and course of psychosis after methamphetamine abuse: one-year follow-up of a case.

To the Editor: The frequency of methamphetamine use has alarmingly increased in Iran, as in many other countries in recent years.1 The most recent survey on drug abuse in Iran, performed a couple of years ago, showed that only a minority of the Iranian substance abusers (3.6%) used methamphetamine.2 However, in the past 2 years and with the local production of methamphetamine, its price has dropped to less than onefifth its former price. Methamphetamine use has increased several-fold in that time, and current nonofficial estimates suggest that methamphetamine is currently the second or third most widely used illicit substance in Iran, which means its use is in a real epidemic state. Moreover, many of the patients who abstain from opioids, including the patient described in the present case, turn to methamphetamine as an assumed “non-addicting” substitute. As a result, methamphetamineinduced psychosis has substantially increased and an overwhelmingly increasing number of these individuals are admitted every day to psychiatric emergency settings.3 Contrary to the current notion of the text revision of the Fourth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), some studies have suggested that methamphetamine-induced psychosis might last for more than 1 month.4–6 However, little is known about the course and treatment of the patients with chronic methamphetamine-induced psychotic syndrome.7 Here, we report a case of methamphetamine-induced psychotic disorder with protracted symptoms and its clinical course during 1 year of treatment and follow-up. We suppose that this patient could support the still unproven claim of chronic methamphetamine-induced psychosis and also provide some new evidence regarding the course of these patients.