Stimulant use disorder dsm 5 code

• 1 asymptoma
• 2 stimulants that cause psychosis
  • 2.1 amphetamine
    • 2. 1.1PSihesis with one -time use
    • 2.1.2 DEPARITION OF Psychosis
    • 2.1.0041
  • 2.2KOKain
  • 2.3metkatinon (Ephedron)
  • 2.4methylphenidate
  • 2.5 METUMPETUMETUMETUMIN
  • 2.6Kofoofin
  • 3 Objects in the ICD-10 900 3.
  • 3.3DSM-5
• 4Treatment
• 5See See also
• 6Notes
• 7Literature

The symptoms caused by different stimulants differ slightly, but have features in common with organic psychoses, such as: hallucinations, delusions, thought disturbances, and, in rare cases, catatonia. nine0010

Physical symptoms in long-term stimulant abuse or overdose often accompany stimulant psychoses (but not organic psychoses). These additional symptoms may include aggression, arrhythmia, pupillary dilation, diarrhea, arterial hypertension, hyperthermia, nausea, shortness of breath, anxiety, convulsions, sleep deprivation, tremors, and vomiting.

Amphetamine

Amphetamine and its derivatives (amphetamines) are known to cause psychosis when used chronically or at high doses ^{. The word "amphetamines" means both (±)-1-phenylpropan-2-amine itself and its substituted derivatives. Examples of amphetamine derivatives: cathinone, ephedron, methamphetamine, methcathinone, methylphenidate.}

Dexamphetamine is used medicinally in Western countries under the trade name Dexedrine, and Adderall is a mixture of amphetamine salts (amphetamine aspartate monohydrate, amphetamine sulfate, dextroamphetamine sulfate, and dextroamphetamine sucrose). In medicine, lisdexamfetamine is also used. All of these drugs can cause stimulant psychosis when abused. nine0010

Symptoms of amphetamine psychosis include auditory and visual hallucinations, delusions of persecution and delusions of attitude along with clear consciousness and extreme agitation ^{, sometimes there may be some signs of the Kandinsky-Clerambault syndrome . In this case, the person experiences tension and anxiety. The hallucinations are usually true, but pseudo-hallucinations may also occur .}

Microhallucinatory-paranoid syndrome sometimes occurs, as with cocaine use ^{. It manifests itself in hallucinatory sensations of small insects on the body, or worms, dots, threads.}

In rare cases, there is a catatonic stupor or catatonic excitation, a manic state, a state of ecstasy with fussiness and brightness of perceptions, a syndrome of obsessive-compulsive disorders on the background of a depressive-dysphoric mood ^.

The symptoms of acute amphetamine psychosis are very similar to the acute phase of schizophrenia ^{. Sometimes people in the state of amphetamine psychosis had a symptom of blocking thoughts (breaks in the associative process), insertion or withdrawal of thoughts, echo of thoughts (sounding of their own thoughts), reasoning, inadequacy of facial expressions .}

Only 50 mg of amphetamine have been reported to cause psychosis, but in some cases even 650 mg did not cause psychosis. This amount of the substance was administered 8 times to a healthy person, while he experienced only euphoria, increased libido, increased mental activity and productivity. Each time after the end of the action of the substance, depression, memory impairment and a decrease in sexual desire were observed, but psychoses did not occur ^.

With continued use of amphetamine, psychosis increases, therefore, treatment requires its immediate withdrawal ^.

Single use psychosis

One patient developed convulsive seizures and further "unclear consciousness" from a single use of 140 mg of amphetamine ^.

There is a case of delirium in a 7.5-year-old child who consumed 300 mg of amphetamine while recovering from pharyngitis. Delirium was accompanied by hallucinations, the child observed small crawling insects in the corners of the room, experienced horror and was disoriented. At the physical level, there was an increase in temperature, dilated pupils, impaired coordination. The duration of this psychosis was less than a day, and it ended in complete recovery ^.

Duration of psychosis

The duration of psychosis as a result of acute poisoning usually lasts 1-3 days, in extremely rare cases it can be extended for a maximum of 1 week with a large amount of the drug used.

Connell studied 30 amphetamine abusers. In 2 of them, the psychosis was gone in 5-7 weeks, in 5 people - in 2-4 weeks, in 1 - in 2 weeks, and in the majority - 15 people - the psychosis was gone in less than 1 week. The medical history of the remaining 7 is unknown ^.

In rare cases, psychosis can last 2-7 months ^{and even more than 3 years after stopping the use of amphetamine. Allier described a man who had been ill for 1.5 years with pseudo-hallucinations of a commentary nature ("voice") and a feeling of being controlled. In particular, he wrote that the patient believed that he (and the rest of the people) was being controlled using radar from the Vatican .}

According to a study by Sano and Nagasaka, of 599 amphetamine abusers, 62% developed psychoses that resulted in rapid recovery. In 10% of patients, psychosis did not go away after 6 months after discontinuation of the drug ^.

In Japan, at the time of the amphetamine injection epidemic, there were many cases of chronic, long-term stimulant psychoses ^.

Somatic and neurological symptoms

Acute amphetamine psychosis may be accompanied by the following somatic symptoms: tachycardia, mydriasis, tremor, revitalization of tendon reflexes, dry mouth ^{. However, with prolonged psychosis, these symptoms may be absent. nine0010}

Cocaine

Cocaine powder.

Cocaine has the same short-term psychotic potential as amphetamine ^{. More than half of cocaine abusers reported some psychotic symptoms . Typical symptoms include paranoid delusions: people feel they are being watched (specifically, they are being watched for their cocaine use) . Often there are hallucinations associated with delusional ideas . Dermatozoic delirium with goosebumps is also a fairly common reaction .}

According to a study by Brady, Lydiard et al., 90% of patients (26 of 29) with cocaine-related stimulant psychosis had paranoid delusions (related to cocaine use), 96% of patients (28 of 29) had hallucinations, 21% (6 of 29) had tactile hallucinations, 38% (11 of 29) had visual hallucinations ^.

Metcathinone (ephedrone)

Metcathinone psychosis usually develops against the background of severe insomnia and general exhaustion of the body. Occurs in the form of rudimentary or acute paranoid with delusions of persecution, delusions of special significance, visual or verbal hallucinations ^{. Rare are verbal hallucinosis and delusions of jealousy . The literature also describes cases of amental-like psychosis and twilight clouding of consciousness .}

Methcathinone psychosis usually lasts 3-4 hours (in some patients it may last up to 1 month) ^.

Methylphenidate

Pack of Ritalin (active ingredient: methylphenidate).

Methylphenidate, used medically in Western countries under the trade name Ritalin, methylin, metadate, concerta, deutran (in the form of a transdermal patch), is a central nervous system stimulant with a similar mechanism of action to cocaine ^{. This substance can also lead to psychosis if abused chronically .}

An overdose of methylphenidate results in symptoms similar to those of acute amphetamine intoxication ^{. They include euphoria, delusions, disorientation, hallucinations, delirium, confusion, intoxication psychosis . When taking high doses of methylphenidate, aggressiveness, delirium, hallucinations and a state of panic may be observed .}

The clinical picture of methylphenidate intoxication can include a wide range of symptoms, including schizophrenic symptoms, panic states (and panic attacks), manic-like states, anxiety states ^{. When canceled - depressive states .}

A case has been described of oral/intravenous administration of methylphenidate to patients with depression, in one of whom it caused severe depersonalization, in another - paranoid psychosis ^{. Another clinical case is paranoid psychosis in a 36-year-old man who used intravenous methylphenidate 100-200 mg daily .}

Methamphetamine

Crystal methamphetamine.

Methamphetamine is used medically in Western countries under the name "deoxin" and is available in 5 mg tablets, but illicit methamphetamine use is more commonly associated with stimulant psychosis and at much higher doses. nine0010

According to one Australian study in 2006, 18% of 309 active methamphetamine users experienced psychosis in the past year ^.

Symptoms of methamphetamine psychosis: auditory, visual, tactile and olfactory hallucinations, delusions of persecution and delusions of relations (erroneous assessment by the patient of the attitude of other people towards him), compulsive behavior, stereotypes, anhedonia, depression, flattened affect ^{. Most often, psychosis occurs in the form of a rudimentary or acute paranoid with delusions of persecution, special significance, with visual or verbal hallucinations . Like amphetamine psychosis, it is similar to that of schizophrenic patients . The literature also describes manic-delusional psychoses .}

A case of twilight clouding of consciousness in a patient who abused methamphetamine for about 2 years ^{is described. The condition lasted 8 days, while the patient experienced visual and auditory hallucinations, heard the voice of the planet Mars, and believed that in this way this planet tried to make contact with the Earth. Tachycardia up to 120 per minute, mydriasis and arterial hypertension were also observed. nine0010}

Methamphetamine psychosis usually occurs after many days of substance use, in doses of 6-11 ml intravenously per day ^{. The duration of the psychotic disorder is usually 8 to 10 hours, but can be up to 1 month .}

Caffeine

It has been suggested that caffeine in high doses or chronic abuse may induce psychosis in healthy people or exacerbate pre-existing psychosis in patients with schizophrenia ^.

Chronic use of caffeine, theobromine, theophylline in high doses can lead to debilitation of the nervous system, which can become the basis for subsequent psychosis ^.

The most commonly reported delirium is caused by an overdose of caffeine ^{. There is an influx of vivid visual hallucinations, sometimes auditory, a person loses orientation in the world around him. After removing caffeine from the body, the memory of the past is usually partially or completely preserved. Some patients lose the ability to judge distances correctly, and objects appear closer to them than they really are. Somatic disorders associated with delirium: mydriasis, hyperemia, ataxia, tachycardia, intense thirst, dry skin and mucous membranes, cyanosis of the skin, sometimes increased blood pressure and fever . Neurological and somatic symptoms are similar to those in atropine poisoning .}

In more severe cases, there may be a deeper clouding of consciousness, accompanied by senseless motor excitation ^{. In these cases, subsequent complete amnesia is frequent and the clinical picture is closer to twilight stupefaction .}

An elderly woman who consumed 300 grams of coffee daily (about 30 g of pure caffeine) for two years experienced a psychosis with disorientation in the surrounding space, episodic visual hallucinations, euphoria, agitation, which ended in death ^.

There are also cases of hallucinosis ^{. Protracted psychoses with visual and auditory hallucinations with prolonged abuse of tea are described by VP Polyakov and Wark .}

Affective psychoses in long-term caffeine abusers are quite rare, but a case has been described of a state resembling hypomanic ^.

Caffeine poisoning psychoses with impaired consciousness usually do not last more than a few days ^{. nine0010}

ICD-10

In the International Classification of Diseases, 10th Revision (ICD-10), psychotic disorders associated with the use of stimulants are designated by the following codes:

• F14.50 Schizophrenia-like disorder due to cocaine use cocaine use disorder
• F14.52 Cocaine use predominantly hallucinatory disorder
• F14.53 Cocaine use predominantly polymorphic psychotic disorder
• F14.54 Cocaine use disorder with predominantly depressive psychotic symptoms
• F14.55 Cocaine use disorder with predominantly manic psychotic symptoms
• F15. 50 Other stimulant use disorder (including caffeine) schizophrenia-like disorder (including caffeine)
Predominantly delusional disorder associated with the use of other stimulants (including caffeine)
• F15.52 Predominantly hallucinatory disorder associated with the use of other stimulants (including caffeine)
• F15.53 Predominantly polymorphic psychotic disorder associated with the use of other stimulants (including caffeine)
• F15.54 Use disorder associated with the use of other stimulants (including caffeine) with predominantly depressive psychotic symptoms
• F15.55 Use disorder other stimulants (including caffeine) with predominantly manic psychotic symptoms

ICD-11

Exists as a separate category in ICD-11 - "stimulant-induced psychotic disorder, including amphetamines, methamphetamine and methcathinone" (6C46.6) and "cocaine-induced psychotic disorder” (6C45.6) ^.

DSM-5

DSM-5 has a diagnosis of substance/medication-induced psychotic disorder.

ICD-9-CM code for amphetamine (or other stimulants) and cocaine: 292.9.

Amphetamine (or other stimulants). ICD-10-KM codes:

• F15.159 With substance use disorder, mild.
• F15.259 With a substance use disorder, moderate or severe.
• F15.959 No use disorder.

Cocaine. ICD-10-KM codes:

• F14.159 With substance use disorder, mild.
• F14.259 With a substance use disorder, moderate or severe.
• F14.959 No use disorder.

Treatment of overdose is to relieve symptoms during the acute phase of intoxication: maintaining normal body temperature, blood pressure and heart rate at an acceptable level until the substance is successfully metabolized and vital body functions return to baseline. nine0010

Short-term use of typical and atypical antipsychotics (neuroleptics) is indicated in the early stages of psychosis treatment ^{. In case of an overdose of psychostimulants, for example, haloperidol 5 mg 2 times a day can be prescribed . These drugs are effective in eliminating delirium and paranoid psychosis.}

In patients with overdose, with observed arterial hypertension, it is preferable to prescribe chlorpromazine (chlorpromazine), since, in addition to dopamine receptors (D₁, D₂, D₃ and D₄), it blocks α-adrenergic receptors ^{. The standard dosage is 50 mg 4 times a day, but may be increased to 100 mg . For more severe hypertension or tachyarrhythmias, beta-blockers such as propranolol (1 mg IV every 5 to 10 minutes until a dose of 8 mg is reached) are prescribed .}

Phenazepam, diazepam, lorazepam, or other benzodiazepines may be used to induce additional sedation that relieves stimulation of higher mental functions and arousal. ^.

• Long-term hallucinogen-induced perceptual disorder
• Hallucinatory paranoid syndrome
• Health effects of cocaine

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, stimulant psychosis, portal of doctors of the Chelyabinsk region and the city of Chelyabinsk

Stimulant psychosis , or Psychotical upset, pronounced by a stimulant of , a mental disorder with psychotic symptoms (for example, hallucinations, paranoid ideas, brading ideas and bred thinking and frantic thinking and frantic thinking and frantic thinking. behavior) that occurs in some people who use psychostimulants. Most often occurs in patients taking large doses (especially with chronic use), but, in rare cases, may occur in patients using therapeutic doses under the supervision of a physician. nine0010

Contents

• 1 Symptoms
• 2 Stimulants causing psychosis
  • 2.1 Amphetamine
    • 2.1.1 Single use psychoses
    • 2.1.2 Duration of psychosis
    • 2.1.3 Somatic and neurological symptoms
  • 2.2 Cocaine
  • 2.3 Metcathinone (ephedron)
  • 2.4 Methylphenidate
  • 2.5 Methamphetamine
  • 2.6 Caffeine
• 3 Designation in ICD-10 and DSM-5 nine0039
• 3.1 ICD-10
• 3.2 ICD-11
• 3.3 DSM-5

Symptoms

The symptoms caused by different stimulants differ slightly, but share features with organic psychoses, such as: hallucinations, delusions, thought disturbances, and, in rare cases, catatonia.

Physical symptoms in long-term stimulant abuse or overdose often accompany stimulant psychoses (but not organic psychoses). These additional symptoms may include aggression, arrhythmia, pupillary dilation, diarrhea, arterial hypertension, hyperthermia, nausea, shortness of breath, anxiety, convulsions, sleep deprivation, tremors, and vomiting. nine0010

Stimulants causing psychosis

Amphetamine

Amphetamine and its derivatives (amphetamines) are known to cause psychosis when used chronically or at high doses. The word "amphetamines" means both (±)-1-phenylpropan-2-amine itself and its substituted derivatives. Examples of amphetamine derivatives: cathinone, ephedron, methamphetamine, methcathinone, methylphenidate.

Dexamphetamine is used medicinally in Western countries under the trade name Dexedrine, and Adderall is a mixture of amphetamine salts (amphetamine aspartate monohydrate, amphetamine sulfate, dextroamphetamine sulfate, and dextroamphetamine sucrose). In medicine, lisdexamfetamine is also used. All of these drugs can cause stimulant psychosis when abused. nine0010

Symptoms of amphetamine psychosis include auditory and visual hallucinations, delusions of persecution and delusions of attitude along with clear consciousness and extreme agitation, sometimes there may be some signs of mental automatism syndrome (Kandinsky-Clerambault syndrome). In this case, the person experiences tension and anxiety. Hallucinations are usually true, but pseudohallucinations can also be observed.

Sometimes there is a microhallucinatory-paranoid syndrome, as with cocaine use. It manifests itself in hallucinatory sensations of small insects on the body, or worms, dots, threads. nine0010

In rare cases, there is a catatonic stupor or catatonic excitation, a manic state, a state of ecstasy with fussiness and brightness of perceptions, a syndrome of obsessive-compulsive disorders on the background of a depressive-dysphoric mood.

The symptoms of acute amphetamine psychosis are very similar to those of the acute phase of schizophrenia. Sometimes people in a state of amphetamine psychosis had a symptom of blocking thoughts (breaks in the associative process), insertion or withdrawal of thoughts, echo of thoughts (sounding of their own thoughts), reasoning, inadequacy of facial expressions. nine0010

Only 50 mg of amphetamine have been reported to cause psychosis, but in some cases even 650 mg did not cause psychosis. This amount of the substance was administered 8 times to a healthy person, while he experienced only euphoria, increased libido, increased mental activity and productivity. Each time after the end of the action of the substance, depression, memory impairment and a decrease in sexual desire were observed, but psychoses did not occur.

With continued use of amphetamine, psychosis increases, so treatment requires immediate withdrawal. nine0010

Psychosis with a single use

One patient developed convulsive seizures and further "unclear consciousness" from a single use of 140 mg of amphetamine.

A case of delirium was reported in a 7.5-year-old child who used 300 mg of amphetamine while recovering from pharyngitis. Delirium was accompanied by hallucinations, the child observed small crawling insects in the corners of the room, experienced horror and was disoriented. At the physical level, there was an increase in temperature, dilated pupils, impaired coordination. The duration of this psychosis was less than a day, and it ended in complete recovery. nine0010

Duration of psychosis

The duration of psychosis as a result of acute poisoning usually lasts 1-3 days, in extremely rare cases it is extended by 1 week maximum with a large amount of the drug used.

Connell studied 30 amphetamine abusers. In 2 of them, the psychosis was gone in 5-7 weeks, in 5 people - in 2-4 weeks, in 1 - in 2 weeks, and in the majority - 15 people - the psychosis was gone in less than 1 week. The medical history of the remaining 7 is unknown. nine0010

In rare cases, psychosis can last 2–7 months or even more than 3 years after amphetamine use has been stopped. Allier described a man who had been ill for 1.5 years with pseudo-hallucinations of a commentary nature ("voice") and a feeling of being controlled. In particular, he wrote that the patient believed that he (and the rest of the people) was controlled by radar from the Vatican.

According to a study by Sano and Nagasaka, of 599 amphetamine abusers, 62% developed psychoses that resulted in rapid recovery. In 10% of patients, psychosis did not go away after 6 months after discontinuation of the drug. nine0010

In Japan, at the time of the amphetamine injection epidemic, there were many cases of chronic, long-term stimulant psychoses.

Somatic and neurological symptoms

Acute amphetamine psychosis may be accompanied by the following somatic symptoms: tachycardia, mydriasis, tremor, revitalization of tendon reflexes, dry mouth. However, with prolonged psychosis, these symptoms may be absent.

Cocaine

Cocaine powder.

Cocaine has the same potential to cause short-term psychosis as amphetamine. More than half of cocaine abusers reported some psychotic symptoms. Typical symptoms include paranoid delusions: people feel they are being watched (specifically, they are being watched for their cocaine use). Often there are hallucinations associated with delusional ideas. Dermatozoic delirium with goosebumps is also a fairly common reaction. nine0010

According to Brady, Lydiard et al., 90% of patients (26 of 29) with cocaine-related stimulant psychosis had paranoid delusions (related to cocaine use), 96% of patients (28 of 29) had hallucinations, 21% (6 of 29) had tactile hallucinations, 38% (11 of 29) had visual hallucinations.

Metcathinone (ephedron)

Metcathinone psychosis usually develops against the background of severe insomnia and general exhaustion of the body. It proceeds in the form of a rudimentary or acute paranoid with delusions of persecution, delusions of special significance, visual or verbal hallucinations. Verbal hallucinosis and delusions of jealousy are rare. The literature also describes cases of amental-like psychosis and twilight clouding of consciousness. nine0010

Methcathinone psychosis usually lasts 3-4 hours (in some patients it can last up to 1 month).

Methylphenidate

Pack of Ritalin (active ingredient: methylphenidate).

Methylphenidate, used medically in Western countries under the trade name Ritalin, methylin, metadate, concerto, deutran (in the form of a transdermal patch), is a central nervous system stimulant with a similar mechanism of action to cocaine. This substance, when chronically abused, can also lead to psychosis. nine0010

An overdose of methylphenidate results in symptoms similar to those of acute amphetamine intoxication. They include euphoria, delusions, disorientation, hallucinations, delirium, confusion, intoxication psychosis. When taking high doses of methylphenidate, aggressiveness, delirium, hallucinations and a state of panic can be observed.

The clinical picture of methylphenidate intoxication can include a wide range of symptoms, including schizophrenic symptoms, panic states (and panic attacks), manic-like states, anxiety states. When canceled - depressive states. nine0010

A case has been described of oral/intravenous administration of methylphenidate to patients with depression, in one of whom it caused severe depersonalization, in another - paranoid psychosis. Another clinical case is paranoid psychosis in a 36-year-old man who used intravenously 100-200 mg of methylphenidate daily.

methamphetamine

Crystal methamphetamine.

Methamphetamine is used medically in Western countries under the name "deoxin" and comes in 5 mg tablets, but illicit methamphetamine use is more commonly associated with stimulant psychosis and at much higher doses. nine0010

According to one Australian study in 2006, 18% of 309 active methamphetamine users experienced psychosis in the past year.

Symptoms of methamphetamine psychosis: auditory, visual, tactile and olfactory hallucinations, delusions of persecution and delusions of relations (erroneous assessment by the patient of the attitude of other people towards him), compulsive behavior, stereotypes, anhedonia, depression, flattened affect. Most often, psychosis occurs in the form of a rudimentary or acute paranoid with delusions of persecution, special significance, with visual or verbal hallucinations. Like amphetamine psychosis, it is similar to the psychosis of schizophrenic patients. The literature also describes manic-delusional psychoses. nine0010

A case of twilight stupefaction in a patient who abused methamphetamine for about 2 years is described. The condition lasted 8 days, while the patient experienced visual and auditory hallucinations, heard the voice of the planet Mars, and believed that in this way this planet tried to make contact with the Earth. Tachycardia up to 120 per minute, mydriasis and arterial hypertension were also observed.

Methamphetamine psychosis usually occurs after many days of substance use, in doses of 6-11 ml intravenously per day. The duration of a psychotic disorder is usually from 8 to 10 hours, but sometimes up to 1 month. nine0010

Caffeine

It has been suggested that caffeine in high doses or chronic abuse may induce psychosis in healthy individuals or exacerbate pre-existing psychosis in schizophrenic patients.

Chronic use of caffeine, theobromine, theophylline in high doses can lead to exhaustion of the nervous system, which can become the basis for subsequent psychosis.

The most commonly reported delirium is caused by an overdose of caffeine. There is an influx of vivid visual hallucinations, sometimes auditory, a person loses orientation in the world around him. After removing caffeine from the body, the memory of the past is usually partially or completely preserved. Some patients lose the ability to judge distances correctly, and objects appear to them to be closer than they really are. Somatic disorders associated with delirium: mydriasis, hyperemia, ataxia, tachycardia, intense thirst, dry skin and mucous membranes, cyanosis of the skin, sometimes increased blood pressure and fever. Neurological and somatic symptoms in this case are similar to those in atropine poisoning. nine0010

In more severe cases, there may be a deeper clouding of consciousness, accompanied by senseless motor excitement. In these cases, subsequent complete amnesia is frequent and the clinical picture is closer to twilight stupefaction.

There is a case when an elderly woman, who consumed 300 grams of coffee daily (about 30 g of pure caffeine) for two years, experienced a psychosis with disorientation in the surrounding space, episodic visual hallucinations, euphoria, agitation, which ended in death. nine0010

There are also cases of hallucinosis. Protracted psychoses with visual and auditory hallucinations with prolonged abuse of tea are described by V.P. Polyakov and Wark.

Affective psychosis in long-term caffeine abusers is quite rare, but a case has been described of a state resembling hypomania.

Caffeine poisoning psychoses with impaired consciousness usually do not last more than a few days.

Designation in ICD-10 and DSM-5

ICD-10

In the International Classification of Diseases, Revision 10 (ICD-10), psychotic disorders associated with the use of stimulants are indicated by the following codes:

• F14.50 Schizophrenia-like disorder due to cocaine use
• F14.51 Predominantly delusional disorder due to cocaine use
• F14.52 Predominantly hallucinatory disorder due to cocaine use
• F14.53 Predominantly polymorphic psychotic disorder due to cocaine use
• F14.54 Cocaine use disorder with predominantly depressive psychotic symptoms
• F14.55 Cocaine use disorder with predominantly manic psychotic symptoms
• F15.50 Schizophrenia-like disorder associated with the use of other stimulants (including caffeine)
• F15.51 Predominantly delusional disorder associated with the use of other stimulants (including caffeine)
• F15. 52 Predominantly hallucinatory disorder associated with the use of other stimulants (including caffeine)
• F15.53 Predominantly polymorphic psychotic disorder associated with the use of other stimulants (including caffeine)
• F15.54 Other stimulant use disorder (including caffeine) with predominantly depressive psychotic symptoms
• F15.55 Other stimulant use disorder (including caffeine) with predominantly manic psychotic symptoms

ICD-11

In the ICD-11 exists as a separate category - "stimulant-induced psychotic disorder, including amphetamines, methamphetamine and methcathinone" (6C46.6) and "cocaine-induced psychotic disorder" (6C45.6). nine0010

DSM-5

DSM-5 has a diagnosis of substance/medication-induced psychotic disorder.

ICD-9-CM code for amphetamine (or other stimulants) and cocaine: 292.9.

Amphetamine (or other stimulants). ICD-10-KM codes:

• F15.159 Use disorder mild.
• F15. 259 With a substance use disorder, moderate or severe.
• F15.959 No use disorder.

Cocaine. ICD-10-KM codes:

• F14.159 Use disorder mild.
• F14.259 With a substance use disorder, moderate or severe.
• F14.959 No use disorder.

Treatment

Treatment of overdose is to relieve symptoms during the acute phase of intoxication: maintaining normal body temperature, blood pressure and heart rate at an acceptable level until the substance is successfully metabolized and the vital functions of the body do not return to baseline. nine0010

Short-term use of typical and atypical antipsychotics (neuroleptics) is indicated in the early stages of psychosis treatment. In case of an overdose of psychostimulants, for example, haloperidol 5 mg 2 times a day can be prescribed. These drugs are effective in eliminating delirium and paranoid psychosis.

Patients with overdose, with observed arterial hypertension, it is preferable to prescribe chlorpromazine (chlorpromazine), since, in addition to dopamine receptors (D₁, D₂, D₃ and D₄), it blocks α-adrenergic receptors.

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