Antipsychotic use for amphetamine-induced psychosis tied to longer hospital stay

Patients with amphetamine-induced psychosis (AIP) who have been treated with antipsychotics appear to have a longer length of stay (LOS) than those who did not receive such treatment, reports a study.

The researchers carried out a retrospective chart review at an academic medical centre and identified adult participants who were diagnosed with AIP, admitted to inpatient psychiatry service, and had a urine drug screen (UDS) positive for amphetamines.

Those who were already taking an antipsychotic, had active prescriptions for amphetamine salts, or were in the emergency department for >48 hours were excluded.

Descriptive statistics were used to assess the demographics. The researchers compared LOS (primary outcome) between treatment groups using Kruskal-Wallis. They also evaluated secondary outcomes (ie, antipsychotics prescribed, proportion of patients utilizing as needed doses, time to initiation, and readmissions) using chi-square, Mann-Whitney U, and Kruskal-Wallis.

Sixty-nine patients were included in the analysis, of whom 35 were treated with antipsychotics and 34 were untreated. Median LOS was longer for patients treated with antipsychotics than their untreated counterparts (5 vs 2.5 days; p=0.001).

The type of antipsychotic used and time to initiation of antipsychotic drug showed no impact on LOS. In addition, no significant between-group differences were noted in readmission rates and positive UDS on readmission.

“Future studies are needed to evaluate antipsychotic use in AIP,” the researchers said.

Use of amphetamine increases the risk of AIP, which is characterized by symptoms such as delusion, agitation, and hallucination.

“While AIP may resolve with abstinence from amphetamines, antipsychotics are commonly used despite not being FDA approved,” according to the researchers.