Substance-induced schizophrenia: possible pathogenetic mechanisms

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Abstract

This brief report presents a narrative literature review describing potential pathogenetic mechanisms underlying the transformation of drug-induced psychoses into chronic psychotic disorders of the schizophrenic spectrum. The central role of hyperdopaminergia in the development of productive psychotic symptoms is discussed, along with the possibility of dopamine D2 receptor sensitization resulting from prolonged use of stimulant drugs. Attention is drawn to the previously described phenomenon of reverse tolerance, the study of which at genetic, molecular, neurotransmitter, and clinical levels may offer a promising approach for clinical assessment of prognosis and prevention of schizophrenia in individuals with a history of substance use.

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About the authors

Ilya A. Fedotov

Ryazan State Medical University

Author for correspondence.
Email: ilyafdtv@yandex.ru
ORCID iD: 0000-0002-2791-7180
SPIN-code: 4004-4132
ResearcherId: N-9456-2016

MD, Cand. Sci. (Medicine), Assistant Professor

Russian Federation, Ryazan

Dmitriy I. Shustov

Ryazan State Medical University

Email: dmitri_shustov@mail.ru
ORCID iD: 0000-0001-7803-3388
SPIN-code: 3887-5475

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Ryazan

References

  1. Shport SV, Klimenko TV. Contemporary addictions situation in the Russian Federation: achievements, current problems and ways of resolving them. Journal of Addiction Problems. 2023;35(3):8–26. EDN: HBISDZ
  2. United Nations Office on Drugs and Crime, World Drug Report 2023, The synthetic drug phenomenon. Vienna: United Nations, 2023.
  3. Kostyuk GP, editor. ICD-11. Chapter 06. Mental and behavioral disorders and neuropsychiatric developmental disorders. Statistical classification. Moscow: KDU, Universitetskaya kniga; 2021. doi: 10.31453/kdu.ru.91304.0143
  4. Psychoses, Substance-Induced. [cited 2024 Nov 12]. Available from: https://www.ncbi.nlm.nih.gov/mesh/68011605
  5. Fedotov IA, Volodin BYu, Novikov VV, Shustov DI. Peculiarities of clinical symptoms, somatic complications, approaches to therapy and outcomes of delirium induced by exposure to synthetic cannabinoids: systematic review. I.P. Pavlov Russian Medical Biological Herald. 2023;31(3):467–479. doi: 10.17816/PAVLOVJ259737 EDN: ZLOBGK
  6. Fedotov IA, Volodin BYu, Novikov VV, et al. Analysis of symptoms, approaches to therapy and outcomes of synthetic cathinone-induced delirium: systematic review. Science of the Young (Eruditio Juvenium). 2023;11(2):257–270. doi: 10.23888/HMJ2023112257-270 EDN: IVMQBJ
  7. Shytov EA, Kiselev DN, Shustov DI. Comorbidity of mental disorders with alcohol and drug abuse (Revue of the problem dual diagnose). I.P. Pavlov Russian Medical Biological Herald. 2009;17(2):100–105. doi: 10.17816/PAVLOVJ20092100-105 EDN: KZWUQL
  8. Mendelevich VD. Organic mental illnesses are outlawed: farewell to Karl Bonhoeffer. Neurology, neuropsychiatry, psychosomatics. 2024;16(5):4–8. doi: 10.14412/2074-2711-2024-5-4-8 EDN: SAMBHT
  9. Kirzhanova VV, Grigorova NI, Bobkov EN, et al. The state and activity of the narcological service in the Russian Federation in 2021: an analytical review. Moscow: V.P. Serbsky National Research Medical Center; 2022. (In Russ.)
  10. Vinnikova IN, Klembovskaya EV, Pechenkina OI, Oskolkova SN. Modern approaches to the problem of schizophrenic psychoses due to the use of stimulants. Mental Health. 2020;(10):54–64. doi: 10.25557/2074-014X.2020.10.54-64 EDN: UXCGMV
  11. Kinkulkina MA, Vinnikova MA, Severtsev VV. Psychotic disorders associated with the use of synthetic cathinones: a review of the literature. Narcologia. 2021;20(7):52–60. doi: 10.25557/1682-8313.2021.07.52-60 EDN: BXELVL
  12. Strelyukhin AK. Clinic of acute and chronic hashish poisoning [dissertation]. Ashgabat; 1942. 391 p. (In Russ.)
  13. Niemi-Pynttäri JA, Sund R, Putkonen H, et al. Substance-induced psychoses converting into schizophrenia: a register-based study of 18,478 Finnish inpatient cases. J Clin Psychiatry. 2013;74(1):e94–e99. doi: 10.4088/JCP.12m07822
  14. Rognli EB, Heiberg IH, Jacobsen BK, et al. Transition from substance-induced psychosis to schizophrenia spectrum disorder or bipolar disorder. Am J Psychiatry. 2023;180(6):437–444. doi: 10.1176/appi.ajp.22010076
  15. Starzer MSK, Nordentoft M, Hjorthøj C. Rates and predictors of conversion to schizophrenia or bipolar disorder following substance-induced psychosis. Am J Psychiatry. 2018;175(4):343–350. doi: 1 0.1176/appi.ajp.2017.17020223
  16. Kendler KS, Ohlsson H, Sundquist J, Sundquist K. Prediction of onset of substance-induced psychotic disorder and its progression to schizophrenia in a Swedish national sample. Am J Psychiatry. 2019;176(9):711–9. doi: 10.1176/appi.ajp.2019.18101217
  17. Murrie B, Lappin J, Large M, Sara G. Transition of substance-induced, brief, and atypical psychoses to schizophrenia: a systematic review and meta-analysis. Schizophr Bull. 2020;46(3):505–516. doi: 10.1093/schbul/sbz102
  18. Asadullin AR, Galeeva EKh, Lisovskaya SB, et al. Systematization to classification "designer" drugs and potentially hazardous chemicals, with a brief overview of the problem. Narcologia. 2017;16(3):94–100. EDN: YPSHZF
  19. Severtsev VV. Psychotic disorders associated with the use of synthetic cathinones: clinical features, treatment approaches, prognosis [dissertation]. Moscow; 2023. 148 p. (In Russ.) EDN: BYNZQT
  20. Rakitin SA. Clinical and dynamic features of psychoses that have developed against the background of the use of modern synthetic psychoactive substances [dissertation]. Tomsk; 2023. 207 р. (In Russ.) EDN: UUTTCA
  21. Markov AV. Mental disorders in consumers of synthetic cations at the stage of remission formation (clinical, psychopathological and rehabilitation aspects) [dissertation]. Saint Petersburg; 2024. 184 р. (In Russ.) EDN: LAYQXQ
  22. Mendelevich VD. Psychotic disorders due to drug use: current state of the problem. Narcologia. 2014;13(7):93–100. EDN: SJXQHB
  23. Carlsson A, Waters N, Waters S, Carlsson ML. Network interactions in schizophrenia — therapeutic implications. Brain Res Brain Res Rev. 2000;31(2-3):342–349. doi: 10.1016/S0165-0173(99)00050-8
  24. Kapur S. Psychosis as a state of aberrant salience: a framework linking biology, phenomenology, and pharmacology in schizophrenia. Am J Psychiatry. 2003;160(1):13–23. doi: 10.1176/appi.ajp.160.1.13
  25. Orsolini L, Chiappini S, Papanti D, et al. The bridge between classical and “synthetic”/chemical psychoses: towards a clinical, psychopathological, and therapeutic perspective. Front Psychiatry. 2019;10:851. doi: 10.3389/fpsyt.2019.00851
  26. Fiorentini A, Cantù F, Crisanti C, et al. Substance-induced psychoses: an updated literature review. Front Psychiatry. 2021;12:694863. doi: 10.3389/fpsyt.2021.694863
  27. McCutcheon RA, Krystal JH, Howes OD. Dopamine and glutamate in schizophrenia: biology, symptoms and treatment. World Psychiatry. 2020;19(1):15–33. doi: 10.1002/wps.20693
  28. Delage C, Morel A, de Witt P, et al. Behavioral sensitization to psychostimulants and opioids: What is known in rodents and what still needs to be explored in humans? Prog Neuropsychopharmacol Biol Psychiatry. 2023;127:110824. doi: 10.1016/j.pnpbp.2023.110824
  29. Ujike H. Stimulant-induced psychosis and schizophrenia: the role of sensitization. Curr Psychiatry Rep. 2002;4(3):177–84. doi: 10.1007/s11920-002-0024-7
  30. Richtand NM, Woods SC, Berger SP, Strakowski SM. D3 dopamine receptor, behavioral sensitization, and psychosis. Neurosci Biobehav Rev. 2001;25(5):427–43. doi: 10.1016/s0149-7634(01)00023-9
  31. Futamura T, Akiyama S, Sugino H, et al. Aripiprazole attenuates established behavioral sensitization induced by methamphetamine. Prog Neuropsychopharmacol Biol Psychiatry. 2010;34(6):1115–1119. doi: 10.1016/j.pnpbp.2010.06.006
  32. Weidenauer A, Bauer M, Sauerzopf U, et al. Making sense of: sensitization in schizophrenia. Int J Neuropsychopharmacol. 2017;20(1):1–10. doi: 10.1093/ijnp/pyw081
  33. Mosolov SN. Psychoses of dopamine hypersensitivity during the antipsychotic pharmacotherapy of schizophrenia: what clinician needs to know. Current Therapy of Mental Disorders. 2018;(4):41–49. doi: 10.21265/PSYPH.2018.47.21794 EDN: YRPFNR

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