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Remschmidt H. 
“Psychotische Zustandebilder bei jugendlichen Drogenkonsumenten”. 
Münch. med. Wschr.. 1973;115,(27):1225-29.
Psychotic conditions (PC) occurring in juvenile drug takers are discussed. The incidence of schizophreniform psychoses (SP) increased in American soldiers in Europe between 1967 and 1971. Both acute toxic psychoses (TP; intoxication psychoses) and SP are more common when combinations of drugs (e.g. as well as hashish other hallucinogens, amphetamine, alcohol, tranquilizers, sedatives) are used. TP was shown to disappear in a few days with antipsychotic medication (e.g. chlorpromazine) but SP required longer treatments and sometimes became chronic. Factors governing the occurrence of a PC in drug takers include the drug or drugs, personality, motivation, past experience and the setting. Drugs known to be determinant for the appearance of PCs include hashish, LSD, other hallucinogens and amphetamines and combination can potentiate or supplement the effect. A doseeffect relationship has been shown for hashish, but for LSD a minimum dose of 100-250 mcg was shown necessary to cause depersonalization experiences. The most important PCs seen are panic reactions, TPs, prolonged SPs (endogenous psychoses), flashback episodes (reappearance of symptoms after a symptom-free period) and pre-psychotic states. Panic reactions last only a short time and are controllable with sedatives. In many cases of TP, specific symptoms due to the drug used (e.g. stimulant amine, LSD) also appear. 4 Cases of TP are described in detail; all patients had used hashish and LSD, while 3 had also used stimulant amines, opiates and other hallucinogens. The TP disappeared in 1 case after treatment with psychopharmaceuticals, while a further patient required neuroleptic medication (haloperidol and neurocil). Therapy of PCs can be divided into 2 phases, acute and rehabilitation. In the acute stage the patient is treated with psychopharmaceuticals (neuroleptics); TPs disappear rapidly. Amongst 70 patients treated for drug addiction the Author saw 5 cases of acute or chronic psychoses, a further 8 had a history of PC, and 4 reported flash-back episodes.
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